I got punched in the face the other day.

Don’t worry. The guy who hit me was wearing 16-0z boxing gloves, and so was I. I got hit because I was in a boxing seminar, and I’m not very good at boxing.

I learned some skills in that class (and in other martial arts and self-defense classes), but more than that, I learned that I’m not made of glass. I can be hit. I can hit back (or try to, at least). And I can learn where I left the opening.  I’m not saying getting hit is awesome, or super fun, or a good idea to do every day. But it’s instructive to get in that position, to get under the gun, and realize that you’re strong enough to handle it.

why how we pay for healthcare actually matters

I have a patient in my practice, Francisco, who showed up to the walk-in clinic one day looking awful. His wife had driven him— insisted, he told me.  Fransisco was an always-upbeat guy who I had treated over the years for the major and chronic (uncontrolled diabetes) to the minor and self-limited (smashed thumb). He’s an auto mechanic who supports a big extended family. He’s hard-working. He always says thank you. He’s downright jolly, even when life gives him lemons. But this day, he was struggling to remain cheerful. He had nearly fallen in the shower, he told me, and felt dizzy, weak and sweaty. He had a headache, or sometimes more of an upper back/shoulder pain. It wasn’t going away.

I had a sinking feeling as I asked the medical assistant to check his blood sugar and vital signs. Francisco’s medical history put him at high risk for a number of life-threatening problems— things like a heart attack, or a diabetic coma. His blood sugar was normal. Damn, I thought, that would have been relatively easy to fix. His heart rate was too high. His oxygen level was too low.

He needed an EKG. He needed some blood tests. A full-service primary care clinic would have those things. My free mobile clinic did not. Even if I had more resources at hand, though, he needed to go to the emergency room where there were nurses and cardiologists and resources and machines. They would evaluate him, stabilize him, and treat him. They have to— it’s the law. But then, I knew, they would bill him. He might quality for emergency Medicaid, but given his and his wife’s modest incomes and their family’s complicated immigration status, it wasn’t clear whether he would. But when you need medical care right now, you’ll figure out how to pay for it later. You want to live right now.

I looked at his chart the next day. The emergency physicians did the EKG, they did the lab work.  He didn’t seem to be having a heart attack.  They did a lot of other tests, too— that to my eye, were varying degrees of necessary and/or helpful, but all expensive. He got some fluids. He got some medications. He got better. He went home.

I was immediately relieved. But also. . . I felt guilty. He was going to get a ruinous bill from the hospital when he turned out to be OK after all. I wasn’t wrong to send him. He needed to go. He was like a textbook case for someone who needs a cardiac workup, STAT. If I had sent him home, I would have been risking his life. But still, it pulls at me: could I have somehow saved him from financial disaster without compromising his health? The answer is no, I couldn’t have done anything that day to fix the problem. But WE can, by changing the way we deliver and pay for healthcare in this country. I tell this story because it’s not abstract– it’s very real.

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The value of persisting

When I was a teenager, I was part of a dance class— there were six or seven of us who were a core group. We had started as beginners and developed together.

The teacher gave us a pep talk one day, saying that everyone had a distinct strength to offer— Allison had perfect feet and posture, Val was very precisce, and me. . . well, I was always there. I never missed class. I showed up. I’m not going to lie, I was disappointed that my “strength” was that I could manage to show up.

But all these years later, it’s still a strength of mine— and it’s both more unusual and more effective than I’d known as a teenager. There are many, many times in my life that I’ve talked myself into showing up for something I didn’t initially think was worth it only to find that my presence was integral to the sucess of whatever it was. I’ve made friends by being the one who answered the open invitation. I’ve won awards by being the one who applied.  And I’ve transformed myself by being consistent in lots of little ways. I go to yoga class without fail, even when I don’t really feel like it. I can’t do insane arm balances because I’m really talented, I can do them because I’ve practiced nearly every day for years and years. I didn’t finish my doctorate swiftly because I’m brilliant, but because I was persistent in working on it and going after the support I needed.

So, hell yeah, persistence is a strength, and it’s a great one— because it translates to anything I decide to do. These days, persistence can be a political act (Elizabeth Warren FTW!)— and it’s powerful because it’s personal, it demonstrates commitment, and you can’t argue with it. So persist humans!

Moving forward: Looking inward

2016 has been a rough year– this  doesn’t need to be said anymore. I personally feel like I was dragged behind a truck over a bumpy road for a while, sucker punched a few times, and spat on for good measure. There’s political strife, there’s personal heartbreak, there are pure WTF moments (e.g., the car that crashed through my font yard last week). Yet I survived 2016 (unlike so many icons of creativity and resistance). And as it draws to a close, I have to wonder what 2017 holds. Great challenges, without a doubt. We must prepare ourselves to meet them head-on or risk being a) destroyed, literally or metaphorically b) complicit in evil, or c) all of the above.

Lots of folks have helped spur us to action— call your senators, organize, donate to social safety net and civil liberties groups. This is needed. This is good. Do that. Plenty of others have counseled self-care— also good advice. But I think we also need to take a step back, and start with self-inquiry. What can we learn about ourselves from the relentless onslaught of minor irritation and major trauma of 2016? How can we authentically move forward with our lives without giving into despair or fear, or being ruled by anger alone? What has this mind-fuck of a year shown us about ourselves?

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How to turn healthy eating into quality time

People tell me a lot that they’d like to eat healthy, but it takes time that they want to spend doing other things– spending time with the family, seeing cool things in the city, relaxing after a hard day, working on personal projects, learning new things. Or, it just takes a lot of ideas and it’s hard to think of something to make at night when you get home and you’re beat.

For me and Max, our meals are part of all this. We have amassed a collection of recipes culled from food blogs, and gorgeous hardcover cookbooks with glossy pictures. We often sit around over press-pot coffee on a weekend morning, after a run or walking the dogs, and plan out a week’s worth of meals. Recipes we know and love, ones we haven’t tried, ones that use an ingredient we saw at the market last time, ones that come together fast if it’s a busy night. This planning is like a ritual in itself– we look at the pictures, we enjoy it. We think how good that meal will be. We think about the week ahead– what’s going on?– and get our feet on the ground. We make a plan for some lunches, some dinners, some breakfasts– not usually 7 days worth, but enough to give us great options for most days and night.

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Evernote recipe library, lovingly curated over years

Then we do a weekend trip to the farmer’s market and/or sprouts and stock in everything we need to do the plan. This can be kind of fun in and of itself– the farmer’s market with its music and dogs and food trucks and, well, farmers, and the grocery store with the clerks who know us and the aisles laid out just so, where we know where to find exactly what we need. We’re really efficient shoppers by now 🙂

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summer farmer’s market haul

Finally, we’ll spend a little time prepping food, usually on Sunday. The kitchen smells good and there are some tunes, maybe a little dancing. Maybe we’re cooking lentils or beans or bulgur or wheat berries. Maybe we’re soaking cashews and freezing bananas. Maybe we’re roasting some veggies and washing some greens. Maybe we’re feeling ambitious and we’re making homemade vegan sausage and raw sauces in the blender. It might take half an hour, if we kept it simple. It might take a few hours, if we went all in. This step is awesome– it’s quality time together, but it also makes the weeknight dinner or the midweek lunch for work come together in 10 or 15 minutes– faster than ordering pizza (which is still tempting sometimes!).

Will this work for everyone? Of course not! But it shows on a broad level how we’ve integrated meals into our lives as a centerpiece of time together and relaxing and creativity, rather than a drain on us and a chore that gets in the way of those things. It serves us well!