A benefit of aging

At a recent party, a friend challenged the group to name one good thing about getting older. Most people mentioned longterm relationships: children, grandchildren, partners, friends. But I think there is also an intellectual benefit which I had difficulty articulating, until I ran across this passage in the book Go, Went, Gone by Jenny Erpenbeck, translated from the German by Susan Bernofsky. The main character, Richard, is a retired Classics professor.

“Much of what Richard reads on this November day several weeks after his retirement are things he’s known most of his life, but today, thanks to this bit of additional knowledge he’s acquired, it all seems to come together in new, different ways. How many times, he wonders, must a person relearn everything he knows, rediscovering it over and over, and how many coverings must be torn away before he’s finally able to truly grasp things, to understand them to the bone? Is a human life long enough? His lifetime or anyone else’s?”

It is exhilarating to finally have time to read more widely and synthesize new information with prior knowledge. When I practiced medicine, even at Social Security, I felt constrained to use my continuing education for practical purposes, to learn about conditions I was was likely to encounter. Now I read more widely, and discover unexpected connections.

Remembering a Dedicated Doctor

My medical school classmate, a member of the study group I profiled in When the Personal was Political, died last weekend after a long illness. She was the oldest and probably the gutsiest of the five of us, starting medical school at age 33. She had chosen to study nutrition first, when she was discouraged from medicine, but after Title IX passed in 1972, mandating that medical schools take the same proportion of women applicants as men applicants, she stepped right up. (From 1969-1970 to 1973-1974, the number of women applicants to medical school tripled.)

Judith (the pseudonym I used in the book) will be remembered as a beloved general internist and for the creative way she combined her nutrition and medical skills. But I remember her grit, her example of grace under pressure and her great sense of humor. She gave all of us in the study group a copy of Doctor Nellie by Helen Macknight Doyle, the autobiography of a pioneering woman doctor in California who practiced in Bishop, CA in the 1890s. It was her way of saying: it’s never been easy for women doctors, let’s just get on with it. She was soft-spoken and gracious but her commitment to excellent care for everyone was fierce. How lucky we were to be her classmates and colleagues.

Inspired by Japanese films

The spring 2019 issue of ZYZZYVA, a literary magazine based in San Francisco, includes my short story “Directors Cut”, which was inspired by years of watching Japanese movies. (Sorry, it’s not online.) The story is set in SF but I tried to imagine how a Japanese director would choose to film it.

The first subtitled films I saw, at an old art house theatre in Washington, D.C., were European. I hadn’t realized that a movie camera could show people who seemed real, not Hollywood-perfect. Fast forward to college, where my boyfriend, now husband, ran a film club and took a course on Japanese film. I attended several of the screenings with him and found that there was a world beyond Samurai films. My favorite Akira Kurosawa film is “Redbeard” (1965), his 3 hour epic about a country doctor. The story is set in Japan in the 19th century, but it is one of the best treatments of the intersection of social justice and medicine I have ever found. I saw it by myself at the Pacific Film Archive at UC Berkeley one rainy afternoon with a few other lucky souls. When the lights came on at intermission, a stranger asked me, “Did you imagine that it would be this good?” No, I hadn’t.

Yasujirō Ozu is one of my favorite directors, partly because he featured the actor Chisū Ryū, is in all but two of 54 films, often playing a father. Ryū was a gifted character actor— humorous, tender. Ozu’s films feel like a glimpse of family life in a completely different culture. The movies were contemporary when they were made, but now, more than half a century later, they document the years before and after WWII . Hirokazu Kore-eda, a younger director, whose film “Shoplifters” was released in the U.S. last year, is also known for family dramas, somewhat darker. Yesterday evening, PFA screened his first film, “Maborosi” (1995) which was stunning, despite the well-worn print. Japanese directors don’t limit themselves to one generation—this was a film about a young mother but it also featured a tough old lady fisherwoman, grandparents and children. Much of the film is set in a remote seaside village and the cinematography in the rural area is especially gorgeous.

Illusion or Maboroshi no Hikari (幻の光) is a 1995 Japanese film by director Hirokazu Koreeda starring Makiko Esumi, Tadanobu Asano and Takashi Naitō. It is based on a novel by Teru Miyamoto.This video montage is a tribute to Hirokazu Koreeda's direction.

Feminism in fiction

Finished reading Meg Wolitzer’s novel, The Female Persuasion. She does a good job of describing some recent generations of feminism: the Gloria Steinem generation, the generation that came of age when Steinem was already the grande dame of feminism and even, at the end, a very young woman now. That character sums up her feelings:

“ We should all definitely assert ourselves more in the world, that’s totally true. But I look at everything that women did and said in recent history, and somehow we still get to a caveman moment. And our responses to it just aren’t enough, because the structures are still in place, right?”

Pretty accurate, I have to admit. Yet at least the young woman has a sense of women’s history, which my generation didn’t growing up. The contributions of women were not simply “overlooked” but often suppressed, to the greater glory of the men in their lives, or because the achievements did not fit someone’s vision of a woman’s role. Just last week, I learned that Helen Keller was a co-founder of the ACLU and supported the NAACP. She was not only a victim of a disability but an activist—not as neat a story. But people are complicated, even and maybe especially women. That’s part of Wolitzer’s message, too.

Amateur musician

My most recent publication is a short piece about taking up the accordion, published in the The Threepenny Review. (Winter 2019). Years ago, I also wrote several pieces about playing the piano. Even people who enjoy listening to music often find my hobby baffling. It’s a lot of work and I’ll never make any money playing. Yet there is something about the physical activity of making music that is very gratifying. The scanned article about my piano lessons attached to this post helps explain why.

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The Best Thanksgiving Ever

My husband and my sons (my daughter couldn’t get away to come home) teamed up to make Thanksgiving dinner this year. I wasn’t allowed to help. So I started the day with a benefit yoga class, where the teacher donated the fee to the Alameda County Food Bank. It was a clear day here, after the rain, after a week of poor air quality due to the fire in Butte County up north. We were all newly grateful for clean air. I came home to a kitchen buzzing with activity. They managed to get an ambitious menu of turkey, stuffing, mashed potatoes, green beans, brussel sprouts and macaroni and cheese on the table, supplemented by marinated cauliflower from a friend and candied sweet potatoes from my nephew.

Not having to help was amazingly therapeutic for me. Growing up, Thanksgiving was the apotheosis of sexism in our house, before I knew what apotheosis or sexism meant. My father never stepped foot in the kitchen at any time but he was not a sports fan, either. When we combined forces with relatives, that’s when the truly toxic dynamic of all the guys, including male cousins and male nephews younger than me, watching the football game, eating snacks while the women slaved away in the kitchen held sway. And the guys didn’t do the dishes, either.

My husband started making the turkey in our house years ago when I was on call and has done it ever since. When my sisters are in town, they always contribute to the feast. One brother-in-law who doesn’t eat turkey created our mac and cheese tradition. Yet until this year, the anger I felt as a child and young woman always had a place at the table with me. It’s still not my favorite meal, or my favorite holiday but I’m hoping that I can retain the spirit of the gift my family gave me for the rest of my Thanksgivings.

10 year anniversary


It's been ten years since my book When the Personal was Political  was published.   It was a frantic summer, trying to put it together while the publisher, iUniverse, was merging with another online publisher.  To say that they were not focused on my book was an understatement.

Ten years on,  my central thesis, that the experience of a woman doctor is different from that of a man doctor, is hardly disputed.  People are familiar with the concept of implicit bias and women are fighting again for wage equality.  But at the time, there was a lot of push-back from men and women who felt that we women doctors should just be grateful to be in medicine at all.  It was unseemly to draw attention to our less-than-equal status.  I have always been susceptible to this argument, which in one sense is practical advice.  Assertive women are judged pushy and aggressive.   The "angry black woman" is an enduring stereotype.  On the other hand, nothing changes if we don't speak up.  There's a wonderful essay by C.L.R. James where he addresses the accusation that he is showing poor sportsmanship by pointing out the discrimination against black cricket players.  He says, "What do they know of cricket, who only cricket know?"

As I near retirement, I am proud of my years as a primary care doctor and my later years in the disability program of Social Security.  We were an altruistic generation and many of us shared the goal of treating every patient with dignity and fairness. We advocated for our patients because that felt comfortable in our doctor role.  It still does not feel comfortable to speak to our colleagues about fairness in the workplace.  

Reading discovery

Sometimes I come across a book that explains so much, answers so many questions that I never quite formulated much less asked, that I regret that I am reading it so late in life.   The book The Varieties of Religious Experience  by William James, lectures that the psychologist delivered "at Edinburgh  in 1901-1902" is such a book.  It's a synthetic work, which doesn't get bogged down in the details of individual beliefs but offers a grand overview of what we talk about when we talk about religion.  Here's a favorite quotation, from the chapter on mysticism:

 "Most of us can remember the strangely moving power of passages in certain poems read when we were young, irrational doorways as they were through which the mystery of fact, the wildness and the pang of life, stole into our hearts and thrilled them.  The words have now perhaps become mere polished surfaces for us; but lyric poetry and music are alive and significant only in proportion as they fetch these vague vistas of a life continuous with our own, beckoning and inviting, yet ever eluding our pursuit.  We are alive or dead to the eternal inner message of the arts according as we have kept or lost this mystical susceptibility."  

I think of my school hymn, "Lord, thy daughters pray thee, make us one and all, like the polished corners, of thy temple wall..."  and finally understand why I disliked it so much when I learned it in middle school.  I already recognized that those polished surfaces were not for me.


Everyone has feelings

Last weekend I attended the  Berkeley YWCA Women Authors Luncheon, which is a annual fundraiser.  As usual, there were four thought-provoking women authors, who spoke about their work.   One of them was Arlie Hochschild, a sociologist I greatly admired in the past, for books like The Second Shift and The Managed Heart.  Unfortunately, the best I can say about her current project, Strangers in their Own Land is that it is tone-deaf about race.  It's been hailed as "the book that explains the election" because she went to Louisiana to interview working class white people (the analogy would be going to South Africa and interviewing only the Afrikaners) and came away with the "Deep Story" that they feel that they have been waiting patiently in line for the American Dream and that "blacks, immigrants and ambitious women " have cut in line in front of them.  Never mind that educational attainment and income for blacks in Louisiana still lags far behind that of whites.  Ms Hochschild wants us to focus on feelings, not facts.   I asked her why she didn't ask her subjects about race directly, since they spent their formative years under segregation, a  lifelong Head Start for whites.   First she said that she knew that they were afraid that she would call them racist (now why would they be afraid of that? but good to know she realized that she was protecting them ) and then she referred me to the appendix of the new paperback edition.  I felt like I was back in my childhood, where no one ever talked about race and it was impolite to bring it up.  I wonder if Ms Hochschild ever anticipated how asking for empathy for white Southerners would feel to a black reader whose parents left the South to find opportunity? Especially when she does not ask them for empathy for us?

Here is a quotation from W.E.B. DuBois writing about reconstruction, that helps put the suffering of working class white people in the South  in perspective. "When a right and just cause loses, men suffer.  But men also suffer when a wrong cause loses.  Suffering thus in itself does not prove the justice or injustice of a cause.  It always, however, points a grave moral.  Certainly. after the war, no one could restrain his sorrow at the destruction and havoc brought upon the whites; least of all were the Negroes unsympathetic.  Perhaps never in the history of the world have victims given so much of help and sympathy to their former oppressors. Yet the most pitiable victims of the war were not the rich planters, but the poor workers; not the white race, but the black."   

Opioids in practice

For some time, I've wanted to write about the opioid epidemic from my point of view--the doc in practice, who doesn't understand what's happening at the time.   Here is that piece.   It is difficult to imagine how doctors trying to do the right thing can ever prevail against  the influence of  the drug companies, who put profits ahead of patients.  The coverage in the mainstream media, which has focused  on the doctors who were paid spokespeople for the pharmaceutical companies, has not emphasized enough how the companies influenced the rest of us through state medical boards, legislation and the FDA.