Saturday, November 26, 2011


This year we celebrated Thanksgiving with a family dinner at our home, bringing together family from both sides and various parts of the country.  This morning I woke up reflecting on families and how we think about them.

Most physicians majored in science as undergraduates in college.  I majored in anthropology.  A generalist even then, without even the hint of medical school on the horizon, I was drawn to the study of humans, especially within the social and cultural matrix. This gave me license to also take any courses that interested me, which I happily did, including literature, psychology, sociology, the arts, language, and a variety of student-initiated courses through a pioneering and activist program called the Center for Participant Education (CPE), where I was part of the student staff. 

In anthropology, we studied kinship, drawing elaborate diagrams of personal connection. It was important to understand that in different cultures, the meaning of family is also different, that the mother's brother might have a role in one culture which the father has in another.

I think that I have always perceived all humanity as connected in a vast web, ultimately kin, though the details at the edges vary in ways that can define separation and difference.

My family has its own definitions.  I’m the oldest of three, with a sister 2 years younger and a brother 7 years younger.  My parents divorced when I was young.  My mother Adele’s family was enormous and present in my life.  People traveled across the country to attend weddings, Bar/Bat Mitzvah celebrations, other important life events, and funerals.  My father Leonard’s family was distant; his parents were people from whom he escaped as soon as he could, and who, after the divorce, weren’t there at all.  Somehow we also lost touch with the rest of his family, though many years later, there was a marvelous reconnection with his brother’s family and his aunt and uncle and cousin. My mother remarried to Phillip when I was 15, and I suddenly had 2 stepbrothers, and there were five siblings instead of three.`  My father remarried once, giving me 2 stepsisters, then again, then again, finally giving me a wonderful “wicked stepmother” Judie, and turning me into a “wicked stepdaughter.”  My mother and Judie became close, supporting each other through each husband's last illness, and still calling each other "my wife-in-law."

When my mother remarried, she invented a new kinship category that described the relatives of her husband’s first wife, who had died.  They became “our third family relatives.”  She continued to use that descriptor, without explanation, into the present, as if everyone knows the meaning of this kinship term. My mother also fostered many teens, who came to her for respite and an accepting environment.  This included some nieces and nephews as well as friends of friends of her own teens.  These latter sometimes became permanent family members, especially Bayla, who we always considered to be another sister.

When I married Steven, not only did we now have each other’s family as our own, we also took on all the official and non-official family that each of us had accrued.  Thus, his brother, Charles, became mine, but also his brother-in-law Calvin from his first marriage, became my brother-in-law as well. 

There have always been different ways that we have the children that we raise. However they come to us, they are our children, the foundation of our families.  We give birth to them, we adopt them, we foster them, we are drawn to each other as adults and adopt each other.  Their children are our grandchildren.  We also foster, adopt, and choose each other as grandparents and grandchildren.

Often, we become such close friends, that the relationship transcends even friendship and becomes family.  This has happened to me, to my husband, to our children, and to so many others. 

What is really important, it seems to me, is to acknowledge and cherish our families; however they come to be our fathers, mothers, children, grandparents, sisters, brothers.  And then to do so for their fathers, mothers, children, grandparents, sisters, brothers.   And moving on and outward through every connection and every generation, until we know without a doubt that we are all indeed part of the same family, connected irrevocably, our fortunes and fates linked forever.

Wednesday, November 23, 2011

Giving Thanks – Opening to Hope - Making Peace

My teens remind me that this holiday of Thanksgiving has a checkered past.  Its origin reminds us of when the generosity of one people was met with oppression by the other.  Yet the tradition of giving thanks for a successful harvest, and later, gratitude for making it through a variety of difficult times, is a long one and is shared by many people of different cultures.

What keeps us going in difficult and challenging times?  We are certainly living in such a time now, with widespread economic hardship and disparity.  Is there something essential that we can access under any circumstances that gives us strength and brings us peace?

The practice of gratitude allows us to find the beauty in our lives, acknowledge the love we give and receive, and experience ourselves as grounded and balanced.  It is not the same thing as being in denial of adversity.  It does not preclude realistic analysis of the situation, or take away from tough decision-making and planning.  Rather, it helps us appreciate and understand what we have, which is necessary to illuminate our view of the path ahead.

So for me, Thanksgiving is an opportunity for gratitude practice within the context of the greater community.  It’s important to know its checkered past, to do everything in our power to transform a history of oppression into appreciation and gratitude for diverse cultures and peoples.  And, of course, we celebrate with a great feast of thanks for the delicious harvest.

Two years ago, my son was a junior in high school and studying in Israel for the fall semester.  He was about to travel with his group to Poland to study the Holocaust.  The parents were asked to write letters which would be given to the students while they were there, for support during a difficult time, while they visited the death camps.  I wanted to write something for him about hope, and started writing a poem, but it morphed itself into a poem about bread and peace.  I think the two are strongly related, for we must have hope to be able to envision a world in peace.

Recipe for Peace:  Bread of the Earth

Take a very large bowl
And put the world into it.
Stir carefully while adding:
-1 measure of pure warm rain
-a double measure of the milk of human kindness
-1 teaspoon of wildflower honey
Sprinkle with your hands full of the leavening of humor.

While it starts to rise
Go away and leave it alone.
Use the time to lie in the sun
With your ancient Labrador retriever,
Arm resting on her lumpy softness,
Her breath whistling in your ear.

After she gets too hot, check the bowl.
The bubbles are proof that it will all come together.

Time to add more ingredients, this time by feel:
-seeds of change – be sure to put in enough
-breezes of hope fanned by millions of wings
-a mixture of human endeavor soaked in spirits
-some squeaky wheels liberally greased
-a few salty tears to bring out the flavor

Knead it with compassionate hands,
All the hands around the table,
Each sliding off the others
As the dough is stretched and compressed,
Formed, shaped, irrevocably changed by every touch.

While you are kneading, sing –
Find the notes that bring
The work and the workers together into harmony.

Then – you will know when – rest the dough.
Cover with good intentions.
Use this time to learn someone else’s language,
Talk to a stranger,
Or wonder who lives in outer space.

The time has come.
Now the dough can be brought
Into alignment with the stars,
Shaped into the peace that will perfectly fit
The pan it was meant to inhabit.

Slipping the pan into a crucible
Of uncounted starfire, you wait.
The scent is tantalizing –
It is what you have always longed for,
Yet do not know.

Finally, it is here, in your own kitchen.
And you sit with all the others,
Feeling the purr of your warm cat
Extending her vibration from your lap
Out to the universe,
While inside is Peace.

Danielle Rosenman
c. November 11, 2009

Sunday, November 6, 2011

Occupy Hope

This week Occupy Oakland, in solidarity with the Occupy Wall Street movement, sponsored a General Strike, which culminated in a 2 mile march to the Port of Oakland.  I was not there.  All that I am, forged in the heat of the protest marches and demonstrations against the Vietnam war, in favor of ethnic studies classes at U.C. Berkeley, in support of the people’s right to the use of land, sent my heart and my husband out to march.  My body, constrained by chronic back pain and more recently chronic foot pain, was unable to be there.

Invisible disability is more common than anyone knows.  There are so many of us who look just like everyone else, but who live with limitations of physical, mental, emotional, or intellectual function. 

Our nation, and indeed the world, is impaired by dysfunction that has been increasing, under the surface of awareness, for a long time.  As a society, we have been living with invisible disability.  Just as the individual’s unseen disability is so difficult for others to recognize, most people simply have not noticed the magnitude of the dysfunction in social institutions, or its affect even on the people that they know.     

Now the dysfunction, the disability, in our nation has become so widespread that it has broken the surface, and everyone can see it.  No longer invisible, it affects 99% of the people, and it can be experienced personally with all the senses, and not just seen as affecting someone else.  We and our friends are burdened with financial difficulties, worried about caring for our aging parents and getting our youth through college without leaving them crippled with debt.  We and our acquaintances are struggling to keep our homes, or have lost them, or never had a chance of owning them.  We and our families have lost our savings, or lost our jobs, or can’t get a job.  We all know single parents who can’t afford childcare or someone who retired after a full work life who must now try to find a job to pay the bills.  Around us, schools and universities and libraries and community centers and services for the aged, ill, and disabled are being closed, unfunded, unstaffed.   And, as my disability is something I cannot ignore, that of our society also must be addressed by us all.

If we are to engage with these issues, it helps to understand more about ability and disability.  The World Health Organization International Classification of Functioning, Disability and Health (ICF) has updated the discussion of ability and disability.  It defines “disability” as “an umbrella term for impairments, activity limitations and participation restrictions.”  The ICF emphasizes that anyone can experience disability, which thus becomes a “universal human experience.” 

Even more important, the meaning of a disability depends on the context of a given environment.   The environment can make a difference between the “level of capacity” and the “level of performance.”   If my environment is my home or my office, where I can sit on my reclining chair, I have less back pain, and my “performance,” or what I can actually do, is close to my “capacity”, or what I can do under ideal conditions.  On the other hand, if my environment is marching in a demonstration in the streets, my “performance” is less than my “capacity,” and I will have to stop in just a few blocks and go home.

The importance of these definitions is the concept that changing the environment can completely change the meaning of the disability.  The word “ability” can be defined as “the power to act.”  The previous, or medical, model is to try to fix the disability.  As a physician myself, it is always very tempting to put energy and resources into fixing the problem.  However, as an experienced physician, I know that this is not enough, and that the results are often limited.  The new model is to bring the person with the disability into balance with the environment, by changing the environment.  

Now we are in the realm of healing.  As physicians, we support healing, which derives from the word for wholeness.  As such, we are obligated to attend to the whole person within the whole partnership/family, within the whole community.  It is attention to the wholeness of our community, in the broadest sense, which inspires the Occupy movement. 

What else does the Occupy movement have to do with healing?  I’m not referring to the fact that so many people in this country have limited or no access to medical care, that the chief cause of bankruptcy is medical bills, that people die because they do not have health insurance (I personally have 2 friends whose death certificates should have included the diagnosis “due to lack of health insurance”).  I’m not discussing the lack of preventive medical care, which drives up unnecessary health care costs on top of the enormous human costs of illness.  I’m not even talking about the differential between the 1% and the 99%, and how the worth of a life and of health is measured in money.

The Occupy movement, grassroots assemblies across the whole country, is composed of a true representation of the 99%, different ages, genders, races, ethnicity, religions, work histories, interests, and ideas.  These assemblies promote wholeness, coming together for group consensus decision-making, helping each other with the activities of daily living of a society (housing, food, etc.), and focusing on healing the dysfunction of society as a whole.  It is a movement that rejects special interests, has no leaders, and has a single issue:
people together making change, resisting greed, corruption, and the hoarding of resources by the 1%.  They are changing the environment in the process of trying to fix the problem.  

This movement is our hope.  Any physician can tell you that we must have hope to go on, even in the most desperate circumstances.  When we have hope, we can tolerate the most difficult treatments, smile despite the pain, and plan for the future, to make a better world for our children’s children’s children.