Asombrado

Asombrado is a word in spanish that means amazed.   I often feel amazed, almost overwhelmed at the fullness of life energy in children .   Just today one of my patients came in, a girl of 9, spirited and comfortable in herself, direct with me, full of plans--truly something beautiful to see.  It reminded me of  a book I read years ago called The Girl Within, and the notion was this: that girls are especially free and full of ideals around 9-12 year old--and when women face difficulties in their adult years, they draw on the strengths of this period to carry on.   Ever since I read this book, I've have a special appreciation for girls of this age--girls who are free to feel their strengths, before they get hit with becoming sexualized and concerned with looks.

Oakland General Strike

   I went to Downtown Oakland before work on November 4th.  It was the day of the general strike, and the sight of all the people clamoring for the human rights brought tears to my eyes.  People have awakened and are connecting with their anger and feeling their strength.  The big media, despite themselves, seem to be giving a lot of attention, because deep down, they, too, know that something is deeply wrong.

   I'm going to quote the some stanzas of a poem written by Langston Hughes:

 Let America be America Again:

Let America be America again.

Let it be the dream it used to be.

Let it be the pioneer on the plain

Seeking a home where he is free.

(America was never free to me).

***

I am the poor white, fooled and pushed apart,

I am the negro bearing slavery's scars.

I am the red man driven from the land,

I am the immigrant clutching the hope I seek--And finding only the same old plan

Of dog eat dog, of might crush the weak.  

***

O, let America be America again--
The land that never has been yet--
And yet must be--
The land where every man is free.
The land that's mine--
The poor man's, Indian's, Negro's ME--
who made America,
Whose seet and blood, whose faith and pain,
Whose hand at the foundry, whose plow in the rain,
Must bring back our mighty dream again.
Sure, call me any ugly name you choose--
The steel of freedom does not stain.
From theose who live like leeches on the people's lives,
We must take back our land again, America!

O, yes, I say it plain,

America never was America to me,

and yet I swear this oath--

America will be!
An ever-living seed,
Its dream
Lies deep in the heart of me.

We the people, must redeem
Our land, the mines, the plants, the rivers,
the mountains and the endless plain--
All, all the stretch of these great green states--
And make America again.

I want her to have what I didn't have

     Back in February I spoke about walking into exam rooms and intuiting that some children had special family support, from both parents or weved siblings who had love to share.  Just last week I entered a room to see a 1 year old girl who was with her father that day.  Many young persons of this age are upset at being in a doctors office given all the shots they have had already, but this little girl was pretty relaxed and it made examining her a lot easier.   After a while it occurred to me that this father was giving his daughter a lot of special attention.  I told him so and added that fathers play such an especially important role in the lives of their daughters. Asked him how it was that was so involved.  Then his story came out.
     His childhood was rough.  His mother left when he was three, and he hung out with his father, and then had a stepmother who was abusive.  Then he said to me: "I want her to have what I didn't have."   I told him he was doing very well and wished him a good day.   It's true: every parent at heart wants their children to have it better than they did.

Credit cards and economic justice

      My girlfriend has an eye for economic justice.  She was buyng some some supplies at a green builder's store in Berkeley, and learned this about credit cards.  For VISA and Mastercard, the merchant pays around 0.5% of each transaction to the acquirer, the bank that forwards the transaction to the cardholder's bank and routes the money back to them from the cardholder's bank.  The cardholder's bank also charges a fee to the acquirer which is passed on the merchant.  Fees can be 2% or more.  If the card is a rewards card, the merchant fees are even higher.  BUT!   If you use a debit card and enter the PIN on a keypad, the charge is much less, because the card-issuing bank is out of the loop.
     So, if you're dealing with a local merchant, a small business for example, use your debit card.  Not only will you lower their expenses, less money will be headed to those nasty banks back east.  And consider where you buy things, too, although Big Box and on-line discounts are tempting: buy local and the taxes stay local.

Immigrant Life Number 19

     It was 5 AM when a group of  heavily armed,  uniformed men broke down the front door to raid a house.  A ten year old boy who was sleeping on the couch awoke to see 15 men with guns drawn.  The men searched and ransacked the house and then handcuffed  the boy's father and 15 year old brother.   The paramilitaries did not speak the language spanish, so they made the boy and his sister translate.  The girl began to have an asthma attack but they wouldn't let her use her medicine.    
     This wasn't Iraq or Afghanistan and these weren't US soldiers.  They were a SWAT team in Oakland, California,  looking for a drug dealer, but unfortunately for this family, they broke in to the wrong apartment.   The suspect was actually in a neighboring apartment.  There was no apology by the SWAT team, nor was any compensation for the damage, nor any offer of emotional counseling.   There were given a form to ask for restitution of their broken door, but 4 months later they have not received anything. 

     I learned about this when the family came to my medical office 3 days later because the younger children of 10 and 12 years old were having anxiety attacks and insomnia.  Worst of all, the children had been afraid that their father would be deported.  A year ago a five year old boy was brought in for aggressive behavior.  His mother, a Salvadoran immigrant, said that the SWAT team that burst into their apartment were looking for her younger brother, perhaps a low level drug dealer, and in that raid the little boy's grandmother was pushed down.   I asked that mother a while later how things where, and her brother was back at home--I guess he was not such a dangerous figure after all.

     That morning in my office I felt  both sad and angry.  As a doctor and as a human being I care deeply for my families.   I've worked in East Oakland as a doctor for 35 years; the working class, immigrant families I know endure great hardships: poverty, violent crime, work accidents, deportation.  It's an outrage that these raids are added to their quota of suffering. 

     I've done some research about SWAT and what I learned is alarming.  Since the 1980s, when Congress mandated that the military make equipment available to civilian police as part of the War on Drugs,  as many of 70% of the police departments in cities of over 50,000 have formed  heavily armed SWAT units--and really, they are paramilitaries. 

     According to a report  by the Conservative CATO Institute, paramilitary units are essentially soldiers, and soldiers are supposed to use lethal force and initiate violence on command.  This contrasts with the police,  whose role is to apprehend suspected law breakers, with minimum force, and adhere to constitutional procedures.       

     Albuquerque  had to dismantle its SWAT unit after losing  several wrongful death lawsuits.  An outside evaluator said that, "They had an organizational culture that led them to escalate rather than de-escalate violence."   In 1997 a SWAT team in Dinuba California--population 15,000--killed an innocent man during a raid.  A jury awarded the family $12.5 million, and Dinuba, too, disbanded its SWAT unit.  Dallas and Seattle no longer send  SWAT teams on suicide calls or drug raids.  

     I made some calls to to the police review commission, the local city councilman's office, and a community organization dealing with police brutality.   The family, although they are un documented and risk deportation, decided to press their case with the police.  Maybe at least they'll get compensation for the damages to the apartment.   Meanwhile the children are anxious and have trouble sleeping.

  

It's not fair

     Today I saw an eight-year-old girl for her first visit to our clinic.  She was a bright, healthy girl, and her mother seemed very nicely attuned attuned to her.  The girl was a good student.  I asked her mother if the family ever got to eat together--amongst Pediatricians, this is felt to be a good thing for families: drugs and other risky behaviors occur a lot less when families are able to have dinner and other kinds of quality time together.  I assumed that this must be the case because the girl seemed so together.
      I learned that in fact, dad spends a lot of time in Mexico helping his family, and this mother cares for her three children AND works two jobs--one from 8:30 to 4:00 and the 5:00 to 10:30PM.  She kind of joked that her chldren are raising themselves--but clearly she is doing a great job because this girl just shined--and wanted to be a teacher when she grew up--but there has to be some cost.  
      Mom had four siblings, and felt she was so short because they had been malnourished.  Like many immigrant parents, she had left school and gone to work at an early age, eleven, in her case, taking care of other children.  I can only picture her own mother being a skilled manager of scarce resources, and who taught this mother well.  
     I would give anything for her to have a chance to finish high school someday and have a chance to go back to school and  enjoy learning, run a day care or become a teacher--to have a chance to do something for herself.   It's unfair that it is so hard for working people, that immigrants are scapegoated.  And I know a many more immigrant parents as worthy as she is.   We need a better world for that to happen.

Diagnosis

     Diagnosis is an essential and challenging part of medicine.  I feel satisfied when I get it right--unless I've confirmed a new case of leukemia or something else with a possibly bad outcome. 
     When I fail to make a diagnosis, I feel bad.  Twenty five years ago I was working a Saturday drop in clinic and a boy of around 18 months was brought in.  He was in and out of being alert and the rest of the time moaning and falling asleep.   I immediately thought that he ingested some one's medicine or something toxic--that he was poisoned.  He reminded me of a boy with an ingestion from my internship--that boy was in and out of consciousness like this one and who got an invasive test for possible brain tumour.  It turned out he had taken a relative's medicine.  I barely examined this boy I was so convinced and asked a lot of questions and had the family search their house for an empty container.  Nothing was found.   I knew something was up, maybe that I hadn't thought of,  and asked a colleague to look at him.  He did something I hadn't--felt the boy's abdomen--and determined that he had an intussception, when the small bowel gets telescoped into the colon, a kind of surgical emergency.   Some babies have cyclical vomiting and obvious pain, and others get lethargic with their pain, like this one.   I had begun to narrow my thinking too soon.  Learning to keep one's mind open is essential
    Sometimes a missed diagnosis occurs because an illness just had not revealed itself yet.  A lot depends on when a disease is ready to 'declare itself':  to have developed to the point that a specific diagnosis can be made.   Once I saw a 3 year old boy with vomiting who otherwise seemed well, I figured he had mild gastroenteritis.   The next day I found out that he had gone to the ER with seizures, and when they scanned his brain, he had a tumor.   I felt terrible, but several colleagues with similar experiences said that this is typical of brain tumors,  that they are are often well advanced by the time they cause enough symptoms to be diagnosed.    Another time I saw an infant as a well baby check and his mother mentioned something about decreased appetite.  There was nothing at all obvious, but something didn't seem right, so I had her come back earlier rather than later.  Two or three days later the baby was diagnosed in the ER with leukemia. 
    Years ago I saw a girl  of six with fever and purple spots on her skin.  She had been seen by several colleagues for other visits during the previous month for fever and vague complaints.  By the time I saw her,  her leukemia had 'declared itself.'   What I'll always remember is her mother's reaction to hearing the diagnosis.  I told her that there was bad and good news:  the bad that she had leukemia and the good that nowadays we had excellent treatment with very high hope for her survival.   Rather than being shattered like almost all parents, she expressed some relief:  She had already figured out that her daughter had leukemia and expected the worst, so the possibility of cure gave her hope.
    Appendicitis in small children is notoriously difficult to diagnosis, and most children less than 4 or 5 progress to rupture before diagnosis.   This week I saw a 4 year old with vomiting and abdominal pain for 6 hours.   She looked like many children I had seen in the previous week with viral gastroenteritis.  I did ask some questions relative to appendicitis, but in the end sent her home on pedialyte, always with the instruction to come back if she didn't improve.  Two days later I learned that she had been admitted for appendicitis.  For days after,  I went over and over in my mind how she she had looked and what I should have done differently--even though I know most people would have done the same thing.   
     Just as one can miss a diagnosis by going down the wrong track, the opposite can happen.  Quite a few years ago I was seeing patients at work when four siblings with vomiting and diarrhea came in.  I was about ready to send all of them out with the same instructions for clear liquids when I began to notice something different about the oldest girl of 14.  As they started to walk out, I saw that she walked a bit stooped over. A doubt began to form and I tried to put my finger on it. I asked them not to leave and reconsidered.  She looked a little more in distress than the others, and she had more pain.  I examined her again and she had pain in her lower right abdomen.  When I put it all together, I thought it was quite likely that she had appendicitis, and I sent her off to the ER, where this was confirmed.  It would have been so easy to miss this one girl out of four who had something different.
     A few years ago I saw a 6 year old girl a few times and noticed that her abdomen seemed to be full of air all the time, and that her torso seemed elongated.  It nagged at me and I spoke to one of the radiologists who said maybe she had a connection between her esophagus and trachea which allowed air to leak into her GI tract.  Sure enough, that is what she had.  She had had one or two episodes of pneumonia as children with this problem do.  Her mother recalled that her abdomen had filled up with air just after birth.   Sometimes subtle problems can slip by for a long time until someone gets curious.
      

A few Good Books

     I love reading history, and presently at my bedside is Reconstruction, America's Unfinished Revolution, by Eric Foner.  We may have heard a lot about the civil war:  Abraham Lincoln freed the slaves, then some stuff happened .....  But we are terribly ignorant about Reconstruction, the period after emancipation.  Foner emphasizes, for one thing, that slaves were very much protagonists:  as the Union Army moved through the South, slaves fled their masters and plantations well in advance, and many slaves joined the union army.  People organized to demand land and services.  Some abolitionists and government officials supported the slaves, others pressured them to return to their former masters as wage laborers and sharecroppers.   Large amounts of confiscated land was given to the freedman, only to be taken back, as the North tried to win back some of the Southern gentry.  The right to vote was not passed by the US Congress, after much resistance North and South, until 1967.
     Both freedman (ex-slaves) and poor white farmers pressed to get land--land to be taken from the wealthy secessionists, the plantation masters.  In one instance in Georgia, freedman and poor whites found common cause.  This quote is from a petition by poor white farmers demanding land:

     Appropriate out of the vast amount of the surplus lands of the wealthy, a comfortable home for the helpless and dependent black man whose arduous labor for the last two hundred years justly entitles him to such inheritance...  We believe the freedman is just entitled to a home out of the lands of the secession party who tried to dissolve the Union in order to perpetuate slavery as the children of Israel were to the promised land.

    While the wealthy schemed to perpetuate the plantation system by different means including convict leasing, freedman pressed for the right to be individual contractors, and have the law protect them when landlords failed to pay them.  In South Carolina--which had the highest percentage of black people in a state--one freedman proposed a bill to regulate the profits of merchants and allow laborers to "meet and fix by ballot the rate of wages which their employer shall pay them."   Hmmm ... sounds like an idea whose time has come.
    
  

Racism Number 73

     I picked up some ironing today from my former housekeeper B., a black woman who grew up in the south.  She hated ironing but liked me enough to do it for me, and now that she's retired and scraping by, it's a way for us to have a visit and for her to make a little extra cash. 
     I've hear a lot of tales of woe from her.  Just now Social Security cut her off for two months because they overpaid her some, and she's worried about paying the rent.  I'll never forget the story she told about one of her wealthy clients who gave her a ride down to some poor part of town, and parked to drop B. off.   The woman  noticed that she was in a red zone and said she should move, but B. said to her, "It''s okay, they don't give white people tickets."   B. Said I should have seen the look on the woman;'s face--we had a good chuckle over that.
     Lately I've been hearing that two of her great grand children were sleeping over at her house sometimes. I had thought that it was to keep B. from being alone too much, but today the real story came out.  Their mother lives about an hour east towards Sacramento, and she gets up at 3:00 AM to drive them to B.'s place, arriving around 4:30.  They sleep a couple of hours and then go off to school, while the mom drives over to San Francisco to work.   The town where they come from is pretty redneck, and one of the boys was being beat up by the white boys, and the schools were poor.   Now they go to schools in Berkeley and the boy who was being bullied has improved his grades quite a lot.

Public Transportation

     Nothing like getting on public transportation to reaffirm my faith in people.  That's not always easy for someone who grew up a a shy, small, lonely, and not the least bit tough little boy.   For instance, today I had to take BART to San Francisco to see a specialist.   I've been bed all week with bronchitis, and wasn't really sure if I could tolerate standing up for the 25 minute ride in my weakened state.  With that anxiety in mind, the train I got on was fully packed and  I steeled myself for a long, hard trip.   The shy part of me thought, "No one will give me a seat, I'll just have to suffer."   At the first stop, someone got off right in front of me and a woman and I both started to move, and I said, "Do you mind, I'm really feeling sick today," and she said sure, no problem.   At the end of the ride, when we both got off in downtown San Francisco, I thanked her and she in turn said, "I hope you feel better, and I have to sit all day anyway."   Of course: show people some basic respect and courtesy, and they will return it.  It took me from feeling worried and alone to feeling safe and belonging.   Isn't that what community is about?
     About ten years ago I was in Paris in December--really cold--is there a translation for The Hawk?   (when I lived in Chicago, that was what people called the cold wind that blew off of Lake Michigan.)  I decided to go see the Bastille--there is a Metro stop there, so I was sure it was close by. I didn't know it had been demolished in 1789.  So I'm riding along on the Metro, and I slide over to make room for a burly, taciturn man, and across from us across from us was a man with a small bundled child in a backpack carrier.

     When he got ready to get off, preparing to exit,  he balanced the carrier on the back of his seat while he awkwardly pivoted around and tried to get it on his back.  I was watching, thinking I would help if need be.  Suddenly the backpack tottered just a little and started to slip--maybe one millimeter--and instantly the taciturn man and two other men sprang forward to help.  I wish I could have thanked them in their language.

    

Exploration

     I never know where curiosity will take me.  For instance, last September I was up at Pyramid Lake, a large lake in the high Nevada desert, on a Paiute Indian reservation.  Conditions are dry at the end of the summer, there wasn't much to see.  But I found a small canyon I hadn't explored before, and started going deeper.  There's a shrub called rabbit brush that for some reason blooms in the fall, a rich orange-yellow, and there was lots of it.

But mostly, the canyon was dry and barren and I walked along a long ways with nothing much to see.  Then, around a bend, out of nowhere, a  bush of showy penstemon, a brilliant blue as blue as the sky above the canyon walls,  the first wildflower I'd seen.  Spectacular, this burst of life in the midst of a parched canyon.  Something inspiring wonder:  THIS flower in THIS dry place.

   I kept going and never saw another one.  I kept going past meanders and narrows where the canyon cut through harder strata, and some dry waterfalls I scrambled over until I got to a dry waterfall 12 feet high, impossible to climb over.   So I turned back to a fork in the canyon and proceeded up that, and came to the remains of a deer that had fallen into the canyon.  It had been pretty well cleaned off except for tough skin, and a little ways further I found a skull--clearly carnivore--with criss-crossing fangs, mostly likely a coyote.   I never did find a spring like I have in several of the canyons, but I found things I never expected.  And on the way back, from time to time I could see the blue of the lake and the distant mountains.  I can't wait to get back there.

I can walk into the exam room and tell who has older siblings.

     I have a lovely picture of one of my families:   a one year old boy is held by his mom with his 12 year old sister on one, side and a 10 year old sister, herself  holding a six year old sister, on the other side.  A little child, or a young person as I like to say, surrounded by love and attention.  It's like having another set of parents, almost, except they're a lot younger and have just learned all this stuff about living not so long ago.
     I've gotten to where I can walk into an exam room and tell that an infant has caring older siblings, or sometimes a father who is very involved with his children.  I can tell because these infants are relaxed, curious, and much less wary of me, compared to others.  I can tell with the older children because they are more articulate and mature and have ideas about their future. 
     There is a wonderful book called Cider with Rosie by Laurie Lee, a story of growing up in rural England in the 1920s, and the opening scene of the book captures the spirit of what I'm talking about.  While moving to a new house, Laurie gets lost in a thicket of tall weeds, and he is rescued by his sisters:

      From this daylight nightmare I was awakened, as from many another, by the appearance of my sisters.   They came scrambling and calling up the steep rough bank, and parting the long grass found me.  Faces of rose, familiar, living; huge shining faces hung up like shields  between me and the sky; faces with grins and white teeth (some broken) to be conjured like genii with a howl, brushing off terror with their broad scoldings  and affection.  They leaned over me -one, two, three- their mouths smeared with red currants and their hands dripping with juice.

Thanks to Penguin Press  1959

When Racism Masquerades as Something Else

    This was forwarded to me by an old friend:  one of the first black students at Duke University in 1967. 

     Don't let the virulent hatred of Obama's presidency - veiled in "policy differences" - fool you.  Just ask someone raised around bigotry. 
   Carlos Dews is an author, a professor of English literature, and chairman of the Department of English Language and Literature at John Cabot University in Rome.

‘'The nigger show."
     I first heard this expression used to describe the Obama administration during a visit to my hometown in East Texas during the early summer of 2009.  I understood what the epithet meant: Our minds are made up, the president lacks legitimacy, and there is nothing he can do that we will support. I was not surprised to hear such a phrase.
     I grew up in the 1960s during the ragged end of the Jim Crow era, where many of the books in my school library were stamped Colored School, meaning they had been brought to the white school when the town was forced to integrate the public school system. I recall my parents had instructed me, before my first day of elementary school, not to sit in a chair where a black child had sat. And I remember my sister joked that her yearbook, when it appeared at the end of her first year of integrated high school, was in "black and white."
     The outward signs of racism of my home state have now disappeared, but racial hatred remains. My father and his friends still use the word nigger to refer to all black people, and the people of my hometown don't hesitate to spout their racist rhetoric to my face, assuming I agree with them. I hold my tongue for the sake of having continued access to this kind of truth I learned long ago how not to accept the hatred I was being taught and how to survive not having done so. More recently, I realized that I also learned another lesson: how to recognize racism when it masquerades as something else.
     More than 40 years after my first experiences with racism, I am thousands of miles away in Rome, but surrounded by ghosts. Last year, I received a grant from the National Endowment for the Arts for a community program called the  Big Read, which sponsors activities to encourage communities to come together to read and discuss a single book. I chose Harper Lee's To Kill a Mockingbird, in part because I thought that some of the most salient issues in the novel - racism, classism, xenophobia, the Jim Crow era - were perhaps relevant to an increasingly diverse, contemporary Italy.
     That there is racism in Italy is obvious to anyone who pays attention to current affairs. In fact, during the first week of the Big Read Rome, a story in one of Italy's national newspapers detailed the experience of a  Nigerian woman being called sporca nera (essentially, dirty nigger) by two women she asked to stop smoking on a Roman bus.
     But I never imagined that consideration of the novel would prove so relevant to a country that had just elected its first black president. Ironically, until the election of Barack Obama, my discussions of racism in the United States seemed historical. I felt that with the passage of the civil rights legislation of the mid-1960s, the country had turned a corner,  that the slow evaporation of overt racism was perhaps inevitable. Now, my personal experience of Southern racism feels current and all too familiar. A  news story about the Big Read that appeared in La Repubblica on Sept. 20 (unaware that my grant was awarded during the Bush  administration),  presciently brought Rome, Obama, To Kill a Mockingbird, and racism together in its headline: "Obama brings antiracist book to Rome." 
     Jimmy Carter was lambasted for having recently explained that the vehemence with which many Americans resist Obama's presidency is an expression of racism. Carter was accused of fanning the flames of racial misunderstanding  by labeling as "racist" what on the surface could be perceived as legitimate policy differences. Like Carter, as a white Southern man, I can see beyond the seemingly legitimate rhetoric to discern what is festering behind much of the opposition to Obama and to his administration's policy initiatives. I also have access, via the racist world from which I came, direct confirmation of the racial hatred toward Obama.
     The veiled racism I sense in the United States today is couched, in public discourse at least, in terms that allow for plausible deniability of racist intent. And those who resist any policy initiative from the Obama administration engage in a scorched-earth policy that reminds me of the self-centered white flight, the abandonment of public schools, and the  proliferation of private schools, that followed the 1954 Brown v. Board of  Education decision to desegregate public schools. The very people, like my own rural, working-class family back in East Texas, who stand to gain from  the efforts of the Obama administration and the Democratic Congress are,  because of their racism, willing to oppose policies that would benefit them  the most. Their racism outweighs their own self-interest.
     Unfortunately, racists in the United States have learned one valuable lesson since the 1960s: They cannot express their racism directly. In public, they must veil their racial hatred behind policy differences. This obfuscation  makes direct confrontation difficult. Anyone pointing out their racist motivations runs the risk of unfairly playing "the race card." But I know what members of my family mean when they say - as so many said during the town hall meetings in August - that they "want their country back." They want it back, safely, in the hands of someone like them, a white person.  They feel that a black man has no right to be the president of their country.
    During a phone conversation a few weeks after Obama's election, my father lamented that he and my mother might have to stop visiting the casinos in Shreveport, La.: Given Obama's election, "the niggers are already walking  around like they own the place. They won't even give up their seats for white women anymore. I don't know what we're going to do with 'em."     
      My students often ask me how I managed to avoid accepting the lesson in racism offered by my family. From the time I was 4 or 5 years old - roughly the same age as Scout Finch, the narrator of To Kill a Mockingbird - I  recall knowing that I didn't agree with racism More important, my paternal grandmother provided me with the encouragement that I could ignore what I  was being taught. She provided me with the courage to resist.
 My grandmother hoped that my father and his father represented the last  generations of the type of Southern man that had shaped her life - virulently racist, prone to violence, proud of their ignorance, and self-defeatingly stubborn. It was a type of Southern man that she hoped and prayed I could avoid becoming.
     However, my father and his father were not the last of their kind; their racial hatred has been passed on. My grandmother, if she were alive, would recognize the same tendencies among many of the people who shout down politicians and bring guns to public rallies. She would also see how the only change they have made is to replace overt racist epithets with more euphemistic language.
     Rather than seeing my home state and its racist attitudes, slowly, over time, pulled in the direction of more acceptance, the country as a whole has become more like the South, the racial or cultural equivalent of what is called the Walmartization of American retail.
     It might be easy to see literature as impotent in the face of the persistence and adaptability of racism. But I continue to believe in the transformative potential of literature and its ability to provide an alternative view of the world. And for children who are not lucky enough to have grandmothers like mine, I believe that books like To Kill a Mockingbird can provide inoculation against the virus that is racism.

Gratitude and Generosity

Nature's beauty is generous

    A few years ago I was in a checkout line at the local Safeway.  There was an older fellow in front of me.  He was buying just a few things and some cookies.  He wanted to get a second box of cookies but I could tell he didn't have enough money, because he put some money down, counted his coins, and shook his head and looked downcast.   He wasn't exactly disheveled, but he wasn't wearing designer jeans either.  After a quick moment of realizing he was a retiree on a fixed income, I stepped up, put a few dollars down and  told him to enjoy both boxes or something like that.  He gave a surprised look, then pleased, and went on his way.  Many's the time over the years has some stranger been generous or helpful to me, so here was a chance to pay back a little.

     I've had this idea for years of doing a book called "50 Ways to be Generous."   We're born with it, but we also need to be shown how to do it.  My parents were good providers but we didn't have a home with emotional generosity.  They didn't draw me out so I could give to others.  Most of what I know about being generous I've learned from watching other people.   I remember when a dear friend of mine was diagnosed with leukemia her friends rallied around her and organized blood donations, rides to the hospital, food for the icebox, baby sitting ....  It was beautiful to see.  Generosity is  also something as simple as someone letting me cut into a long line of traffic or holding the door open.

     I've been lucky to work for years with Latino culture.  I don't think a week goes by without a potluck or baby shower.  People are always looking for a chance to share and celebrate.  So I try to remember, when I'm feeling  hassled and worried about something, I try to rise above myself, and do something generous for someone else, even if it's small.   Any comments about generosity are very welcome.

Labyrinths

    Yesterday I was hiking up in the Oakland Hills and took a photo of a labyrinth constructed by anonymous folks over the years.  It reminded me of our so called health care 'system' that Tea Party folks say they don't want taken away.   What system?   The one that tens of millions don't have?   The one that's like a labyrinth with obstacles at every turn?

   Let me tell you a sad story, one that should never have happened.   I'm going to disguise a few details for confidentiality reasons.   A few years ago a young adult in his mid 20s--we'll call him W--a very ethical person, eking out a living as meditation teacher, someone who ate thoughtfully, and who like many his age had no health insurance, began to have intermittent fevers and some transitory, mysterious symptoms and joint pains.  He also had some chronic dental problems.  After a couple of months and some more testing, one day he received a call from his clinic saying that he had a positive blood culture, that it could be dangerous,  and that he should go to the hospital immediately.  As it happened an MD friend was there and W played the message for him.  The MD reinforced that he should go to the hospital urgently, that the infection could spread to different places.  W said he would think about it, try to get things together, and maybe go the next day.  He wasn't seen again for two or three days, and people assumed that he had was in the hospital.  Then a friend from work came over saying that the hadn't been around.  The friend and a roommate went back to his room and found him semiconscious on the floor and paralyzed on one side.  The bacteria had formed a small clot on a heart valve which broke loose and blocked an artery in the brain, and he had a stroke.   I'm sure that had he not been worried about the expenses of the hospital and and about losing his meagre wages, he would have gone to the hospital and likely have avoided the stroke.  

     Think of all those people with jobs that don't have benefits: the waitress at your favorite restaurant, the guy at the 7-11 or the gas station, the clerk at the photo shop.  Regular people who deserve better.  I've worked 35 years in the current so called 'system' and it doesn't work that well for a lot of people with insurance, let alone those without.  I'm sure you all know someone with a 'preexisting condition' who can't get health insurance because of it--or who has to pay exorbitant rates.   We need a single payer system and universal coverage.  All of the industrialized countries have some version of it, and none is perfect; but none of them has the disgrace of millions of citizens without insurance.  Checkout Physicians for a National Health Plan--a lot of good information there, and you can find out ways to get involved.