Kaiser Pissed Me Off

I have been singing Kaiser’s praises as a HMO for the past nearly 2 years that I have been a member. It is delightful and refreshing how easy it is to get care there, in a variety of ways. I have had video visits, phone visits, email interactions and a flu shot in a walk-in clinic. The pharmacy was amazing; I’d request a refill on my app and my drugs would be in the mail to my house the next day, free shipping. This was also one of the first encounters with a provider in a long time (and few and far between throughout my life, truth be told) where I felt honestly cared for and listened to as a real, individual person. . Everything so organized and helpfully connected.  I was kind of reveling in feeling so good about my health care provider for once, that I was shocked when it all abruptly went to shit.

See I have a minor medical condition that wreaks havoc on my body and mind on a monthly basis. To add more fun to the situation, I am approaching menopause with all of the wacky symptoms that entails. I’ve been offered medications and treatments, even a hysterectomy to treat these things. Some of those things I have tried with variable success and some I have declined (cutting out my womb for anything less than raging cancer seems extreme to me, no thanks). I was thrilled to see that my beloved Kaiser offers yearly visits with a contracted naturopath. Hooray! How progressive! And much more in line with my own personal belief system about wellness. I immediately requested a referral from my primary care doctor and my request went to the review board for a blessing.

It was denied.

The reason? I am allowed care from the naturopath only after I have failed all traditional, “accepted” treatment. Since my employment has changed and this is America, my health insurance (and therefore, my healthcare providers) has also changed. Frequently. Don’t get me started on how messed up that whole scene is. However, as a result, records do not always follow in an orderly or timely fashion (I love our HC system), so the Kaiser reviewer was unable to see what I have already been through. For a hot minute I was all fired up and ready to collect all of my records to prove to them that I deserve these visits with a naturopath, I have earned them. But then it dawned on me how utterly fucked up and ass backwards this is. Why is this type of care reserved for “failed” cases? What if I want to reserve traditional care for the scenario where naturopathy has failed? Why am I not allowed to choose the primary modality that suits my needs and values? Kaiser: you have let me down; the honeymoon is over and now I can see you are just like all the rest.

Have Knife, Will Travel

I love travelling and staying in rental places with a kitchen. I know, I’m weird. Most people think of vacation as including a break from cooking, but this is how I relax. And I usually bring my own knives. I’m not trying to be all pretentious, but it really does affect my whole experience if I have to work with shitty tools, so I bring my own because the knives in rental homes invariably suck. Too much baggage you say? I think not. Cooking is one of my biggest creative outlets, and I enjoy doing it every day, home or away.  It is legitimately my hobby, and just like other people might bring their golf clubs or tennis racket on a trip, I bring my favorite knife.

Cooking with shitty knives makes cooking feel like a chore instead of a joy. When I cook I most love that feeling of being “in the flow”, creating, planning, timing, moving with ease about my kitchen and a cheap, dull knife blocks that flow. I’ve got to work harder to make things happen and that’s not fun. But with my trusty steel in my hand, I can navigate a rental kitchen with all of its crappy, mismatched cookware, dreaded induction cooktop and weird smelling utensil drawers. And that is part of the adventure – making delicious food in unfamiliar and less than ideal circumstances. But my knife, my most useful and beloved tool, that I won’t compromise and travel without anymore, lest cooking become a bummer and a burden.

Knives don’t have to be intimidating. Find one that fits in your hand comfortably, feels sturdy but not too heavy and has a sharp blade. You won’t feel like you have to work hard to cut stuff when you are using the right knife. I have had the same set of Global knives for almost 20 years and I still love them and use them everyday. My favorite is a big badass cleaver-kinda situation. Great for chopping veg, which I do a lot, and the wide flat blade is perfect for whacking garlic. I also have a serrated knife for slicing bread and stuff that is softer like tomatoes. My small paring knife is perfect for smaller jobs like taking the tops off of strawberries, opening packages (I know, it dulls the blade) and peeling potatoes. Not sure why, but I prefer to peel potatoes in my hand with a small knife. It just feels right, but as previously mentioned, I’m weird.

And I get it why rentals don’t stock good knives. People don’t know how or don’t take the time to care for them properly. They throw them in the dishwasher (shudder), instead of washing and drying them lovingly by hand. They use them for all variety of non-cooking related jobs such as opening bags, boxes and beers.  Or as a substitute for other tools like screwdrivers. They leave them out in the sun, sand and surf. So why bother? Those of us who care enough can and will just bring our own.

 

 

 

Perfectionism is Endemic in Healthcare

Healthcare (HC) is the perfect profession for enabling perfectionists. Ask me, I know! Where else is perfectionism not just desirable, but actually deemed essential? That’s like crack for perfectionists. In this context, we are expected to be perfect not just for our own internal satisfaction, but for matters of life and death. HC is a comfortable spot for perfectionists because it fosters this illusion that perfection is a desirable and attainable goal. As perfectionists, we are comfortable with feeling like everything we do or say or produce is up for judgment. Fear of being or appearing imperfect is real and feels untenable, like we won’t survive if we aren’t perfect. HC just feeds our belief that perfection is not only possible, but necessary. Because the real-world stakes are too high if we mess up, or even just appear to mess up  – people may be hurt or die or sue us. We could lose everything – money, profession, reputation.

There’s the rub though – perfectionists may strive for perfection = an absence of errors, but we won’t make it. In HC or anywhere else. Why? We are human. Understandably, patients have bought into this illusion that perfection is possible in HC. Their expectation is that medicine can cure all and providers won’t make any mistakes. And they are not shy about taking legal action or threatening to, if things don’t turn out the way they think they should. No matter how unrealistic. This has led to a dilemma in HC where even if you don’t know something or you make a mistake, it may be tempting to keep quiet and at least continue to appear perfect in order to avoid retribution for being human. HC and patients demand the maintenance of this illusion. I guess a similar situation might be with airline pilots. I know intellectually that they are human and thus will make mistakes sometimes. But I don’t want to think about that possibility too much or have it happen when I am on their plane!

What makes it all the worse is that the culture of HC does not allow us to talk to each other about this. I suspect all HC providers feel the onus of perfection to some extent, but we cover it up with bravado. We talk “shop”, many of us enjoy the sound of our own voices and like nothing more than to ask questions that will stump the presenter and showcase our own superior intelligence on whatever matter is being discussed. But can we make ourselves vulnerable and talk to each other about our mistakes, the times we didn’t get it right or our fears about shouldering this ridiculous amount of responsibility everyday? I’ve been in 23 years and I have yet to have a real, open, honest, meaningful conversation with a colleague about this stuff. We just don’t go there. Is it the type of deal where we don’t want to speak about even the possibility of failure for fear it will be invited into our lives? All I know is it is pretty fucking lonely.

I picked the greyest area of HC in which to practice on purpose because I find rigid, garden variety black and white decision-making kinda boring. I like variety and challenge and using my brain, but even here in hospice I struggle with my own perfectionist tendencies. As a HC provider, I make oodles of decisions on a daily basis. Some big, some little, but all involve the care and well-being of humans. That’s some pretty heavy shit. I can’t afford to have bad days, I’ve got to be on at all times collecting, analyzing, synthesizing what information I have and putting together a plan to hopefully help and not hurt someone who is counting on me to care for them. There are days where I wear that responsibility lightly; I’m in the flow and enjoying my work as a combination of pleasant puzzle/problem solving, education and advocacy. And then there are the other days. The days when I am second guessing every decision I make, where I feel at a loss about what is the best thing to do, when I over research and overanalyze in an attempt to bring myself some measure of peace about what I’ve done or am about to do. That sucks. And then sometimes, I continue this pattern in my sleep and either dream about it or wake up at 3 am thinking about it, going over everything again, did I do the right thing? Is that patient going to be ok? Do I look like a complete idiotic buffoon to my peers? How would a lawyer demonstrate my culpability in this situation if things go wrong? It can be exhausting. And I’m not going to tie it all up with a neat bow and tell you that is it hard work but worth it because I get to help people. None of that martyr-y bullshit. I am altruistic at my core and I do enjoy helping people, but sometimes it does not feel worth it. At least not to me. Sometimes it feels like a much too heavy burden to have all of those people (including myself) counting on me and expecting me to be able to make 10,000 decisions without a single error. The recovering perfectionist in me is tired out and ready to hand it all over to somebody else.

Sheet Pan Fried Rice? Yes!

I had a weird idea, tried it out and it worked! Yay! No more yucky wok to clean. No more prying stray grains of rice and veg remnants off of my stove. No cooking oil facial. Why? Because a sheet pan in the oven works for making fried rice!

Fried rice is one of my favorite vehicles for basically whatever is left in the fridge. Leftover meats, veg, grains. Yep, I’ve even made fried “rice” with leftover couscous! It makes a great meal for breakfast, lunch or dinner and travels well. A pile of this rice in my lunch container makes the work day better. Or at least tolerable; let’s be realistic.

Cut vegetables of choice into smallish bits (fresh, frozen or even leftovers) and toss with oil and soy sauce in a bowl. Spread out on a sheet pan and roast in a hot oven until soft and/or crunchy in spots (I like burnt edges personally). Spread leftover rice (or another dry-ish grain) on top of roasted veggies and roast again until rice is getting crunchy in places. Remove from oven and toss the lot together, adding more soy sauce (and/or Worcestershire – trust me, try it!) to taste. You can scramble up an egg or chop up some leftover meat to mix in too. I cooked up some sausage because it is what I had and it sounded good. And it was good! A little sesame oil and some chopped green onions to finish would also be fun, but unnecessary if you don’t have them or are just lazy.

If you line the sheet pan with foil, clean-up will be a snap. This is lazy cooking 101 and there is no shame in that!

Fantastic Farro

farro salad
fantastic farro

Ok, so I’m a word nerd who loves alliteration, don’t judge! Farro is a chewy grain that kinda looks like barley (another beloved grain). Healthy AF, but don’t hold that against it, it really is fabulous. And satisfying.  I haven’t cooked with it a lot, but plan to start. Especially after this salad I made last weekend. I know, you’re thinking “salad, big deal; I don’t get excited about salad, salad is punishment; salad is penance I do for other poor diet choices” -or maybe that’s just what I say to MYSELF!

I had a dear friend coming over for dinner, a friend who is very much open to my kitchen experiments with new flavors and ingredients. Planning a menu for guests is one of my favorite daydreaming topics. I sometimes begin with a theme, like maybe “Fall” or “Hawaiian luau”, one time it was even spam. Don’t ask. Next step, I mentally (sometimes physically) review what is in the larder, with special attention to what needs to be used now or lost to rot. This time, I had a slightly tatty bunch of kale, some previously roasted and gently pickled beets, a hunk of blue cheese calling out for attention. It pleases me to no end if I can avoid an extra trip to the grocery store and just use what I have.

So then I looked through cookbooks and googled different combinations of these ingredients for ideas. I briefly considered some sort of savory tart (knowing I had a slab of puff pastry stashed somewhere in the freezer), that could be good. Kale is yummy in soup, maybe a bean and kale soup with beet and blue cheese salad on the side? Could be tasty on a cold winter day. I know kale salad is a thing, so maybe go in that direction, but it is winter so must be hardy…that’s when I saw a recipe combining kale and farro. Wait! I have an unopened and unloved box of farro in my pantry! No time like the present to use it up. Their version used pomegranate arils and hazelnuts, but I had neither, so I went with my beets and some of the half bag of roasted pepitas I had way in the back instead. Here’s my version:

Farro Salad

 

Kale salad with beets, farro and ginger vinaigrette. Cook the farro in a pot of salted water until tender, this took about 30 minutes for me. It plumps up pretty big, so I only used about ½ cup dry. Drained that and let it cool. Made the dressing in my mini blender with a chunk of fresh ginger chopped up, apple cider vinegar, grapeseed oil (I wanted a neutral flavoured oil), salt, pepper and a little bit of honey. Maple syrup or sugar would also work for a hint of sweetness. Chopped up the kale, minus the stems, and massaged it in a bowl with part of the dressing. Then added the farro, the beets, peppers, the pepitas and blue cheese to the bowl and mixed it all together with most of the dressing (I kept some aside to add later, if needed). Let it all marinate in the fridge for a few hours and it came out delicious and everything became a delightful shade of pink! The rest of the menu? Acorn squash soup with seedy bread croutons; Puff pastry tartlets with ricotta, apple sausage, caramelized onions and Mama Lil’s peppers; Banana cocoa n’ice cream sandwiches with Effie’s cocoa biscuits. And, no trip to the grocery required!

 

Angst-O-Rama

I’m not sure why I’m feeling such angst this morning – a feeling of emotional and physical restlessness. Like I should and want to be doing something, but I’m not sure what. It is uncomfortable because I am an old hand at self-reflection and looking deep inside myself is typically a comfortable excursion. I know I’ve got that down to a science. I know where to look for answers in my psyche and history and deep corners of my mind and heart. I know myself. But this, this feeling is just puzzling.

Maybe I’m trying to find meaning where there isn’t any. Maybe this feeling is in response to a global pandemic and 10+ months of avoiding people and places like the plague, literally. Or maybe it is the anti-climax of the holiday season to cap off such a shitty year. Could it be that it is year-end reflection time and I’m unsatisfied with where I am in my progress toward living a full-time creative life? Do I need more exercise? Or is it just that this is a dreary, rainy, cold Sunday in December, my kids are complaining about being bored and I have to be on-call for a job that pays the bills but doesn’t light my fire?

And why do I always have to have a reason for feeling bad? Why do I need to justify my feelings to myself? Can’t I just accept that sometimes emotions blow through that are unpleasant but blessedly temporary? I tell other people that and give them permission to wallow and allow it to wash over and through them, but can’t seem to take my own advice. Why is my love, compassion and understanding greater for others than for myself?

Ooooh! That right there is a dark, unexplored corner of myself that needs some illumination. Not a bad endeavor for an angsty day…

The Cup Is Already Broken

‘The cup is already broken’. Ever hear that saying? In my mind, it is a mental nudge away from getting too attached to stuff, because at some point the stuff will break or otherwise be lost. There is an impermanence in the world that it is best to make peace with sooner than later.

This saying flashed in neon in my brain this morning when I dropped my brother’s coffee cup that he got on our trip to the Big Island when my teenager was just a baby boy. It is one of the few personal things of his I still have since he died unexpectedly in 2013. It has served as a cherished though melancholy reminder of him and our fantastic trips to Hawaii together and I had just broken the handle clean off. Damn.

I guess I could have just kept the cup on a shelf over the years, safe and protected from potential harm, but I didn’t. The risk of it breaking was acceptable to me and I kept using it and enjoying it in my daily life. Every time I made my tea in it or saw it sitting in the cupboard, it was an opportunity to remember Mike.

I thought I might freak out when it eventually broke, because I knew it couldn’t last forever. My brother didn’t. Nothing does. But I didn’t freak out and I didn’t whip out the super glue and desperately try to fix it either. I was surprisingly calm.  Briefly wistful maybe, but totally ok. Those memories are still there and those will never break. Even though the cup is no longer suitable for daily use, I’m still going to keep it because I like all of the things it symbolizes: Mike, Hawaii, impermanence, and treasuring memories over stuff. Like many things, it is still beautiful even broken.

New life grows out of my broken cup now

Writer’s Woes

What’s the difference between being in a funk which prevents creativity and experiencing the phenomenon of failing to engage with your medium that is sometimes called resistance, obstruction or perhaps disconnect, maybe simply failing to TCB (Take Care of Business, to quote the King)?

I think being in a funk, at least for me, is when I’m feeling kind of down and emotionally drained. The cause could be a whole variety of things (work or family stress, world events, raging hormones, too much peopling and going) but the thought of opening my computer to write at these times feels like a mountain too high to climb. Plus, my creative energy feels all stopped up and trying to “work through it” leads to lots of frustration, no flow and ultimately, more funk. Or maybe a deeper or longer funk. And then I start to feel bad about that! I’m not writing, my creative energy has left me for good, I have no talent or good ideas, I’m never going to make it as a writer…horrible thought spiral. Thankfully, these episodes do seem to pass with time, sort of like a storm blowing through.

The more difficult situation for me is when I have ideas and I want to write, but I just…don’t. Not for any good reason either. On most days I wake up at the crack of dawn before the rest of the family, so time and a quiet place to write really aren’t issues. I replaced my clunky old laptop with a sleek, beautiful machine with the apropos model name of “yoga” to keep me fit and flexible as a writer. I’ve got notebooks full of ideas ready to be fleshed out on paper. So why don’t I just sit down and do it? Inherent laziness? Fear of failure/success? Depression? A time-consuming habit/pseudoaddiction to pimple popping videos and endless hours of scrolling social media to see what the drones I went to high school with are doing?

Though the situations are different, the outcome (not writing) is the same. And I also think the cure is very likely the same. I suspect, even though I’d prefer to remain ignorant on this score, that at least part of the reason I am having both these frequent funks and periods of creative inertia is because I’m not taking care of myself as well as I could. As a living, breathing organism. I don’t mean this in a self-shaming, should-ing kind of way, but more in a practical, handle your shit kind of way. I think these uncomfortable situations may have increased in frequency lately because I need more real, nourishing food and fewer Cheez-its and martinis. More walks, more books and less phone, maybe a rest, maybe some journaling and yoga. Yep, that’s right, I’ve got my new age-y side (so sue me)! And though I’m far from perfect at recognizing and dealing with my funks and faults when they show up, I am more aware of them and moving in the right direction to be kind to myself when they do occur. I am nurturing self-compassion and committing to investing more in myself and my own well-being. Even if these measures don’t cure all of my writer’s woes, it is not a bad place to start. There’s no downside. Except to Cheez-it sales.

 

Cryin’ Over Wine

My sweet brother John sent me some fantastic wine in the mail and what do I do when it arrives? I burst into tears.

Not happy tears either. Deep, soul-level sad tears.

Not an expected reaction to a nice gift, you say? Well, let me tell you a little about grief:

It is sneaky. My older brother Mike died over 7 years ago, but the arrival of this particular wine that we had shared many times over the years to celebrate a variety of special times brought a big wave of grief crashing back on me. It caught me unawares, such a visceral reaction so long after losing him. But that’s another thing about grief – it eases up over time, but never completely goes away. And another weird thing about grief? Even though it is an uncomfortable feeling, I also sort of welcome it when it shows up because it reminds me of some important things: I was lucky to have such a great brother in my life and that we took time to make some really great memories together. I am grateful for the great brother I still have and that we can continue to make great memories, and share old ones. It also reminds me that life is pretty unpredictable so remember to focus on the things that really matter and bring you joy on a daily basis. I’m so grateful for all of it.

Morning Madness

Why do I leave my house in the early morning to get to my workplace  long before it opens? Why do I then sit in my car outside my office typing on my computer in the dark? Because to me, this simple act symbolizes that my personal work, the work of writing and creating, comes first. So on my way to my paying job, I make time for this concrete reminder of who I am and what is important to me.

Its important and that’s why I leave my house an hour earlier than I need to in order to get to work on time. Just like I make time to cook and feed myself and my family real food. Its all about priorities. What do your priorities say about you?

What I am trying to say with mine is: my creative life is more important than my money-making job and I will always strive to put it first. My brain also works best in the morning (sometimes VERY early mornings) so this arrangement works well for me. My creative work gets my best brain power. This makes me feel good, or at least better, about spending time at my job that pays the bills because I’ve already taken time to feed my soul and further my creative dreams.

It’s a tangible way I can express my priorities in life while still taking care of business (earning a living). It’s a Jedi mind trick, that prevents me from feeling like I’m selling out my dreams to make a buck.