Saturday, April 15, 2017


Remember that scene from the original Rocky when emotionally stunted Sylvester Stallone invites his equally stunted potential gal Adrienne up the aged steps of his South Philly row home?  She’s down on the sidewalk, kind of toeing at the ground trying to decide whether to ascend to this crazy man’s place (where he will eventually introduce her to his turtles, Cuff and Link).  He gets angry with her reluctance, slams the wall and says something like, Whatsa matter?  Does my house STINK?
            I worry about the same damn thing as Rocky.  How do you know if your own house stinks if no one else lives there?  When I was raising three boys I KNEW my house stunk, they knew it – hell, they were the reason for it – but it was all our own sweat and pizza stench so it was fine.  Probably others were bowled over when they walked in the door; we didn’t know, didn’t care.  But have you ever walked into the old-lady-with-the-newspapers-and-cat-house and just thought, Holy mother of God!.  That’s probably what Adrienne was worried about, and I’m sort of concerned for myself as well.
            Listen, I love my solitude. LOVE IT.  Growing up in a huge loud Italian household, peace and quiet was not optional and then I raised three boys which was akin to being a zookeeper.  Little boys, aside from being reckless and loud, are vaguely odiferous all the time.  I mean, you can scrub them in a bath and towel dry them and within seconds something’s marinating right away.  Also, I’ve been married a few times to grown-up men who also, well, were guys. At this point I treasure being alone in bed because sleeping with another human is tough, folks, at least for me.  Sex, snoring, sweat, hot flashes, restless legs, bad dreams – Geezus! I don’t think I had a full night’s sleep for decades, but I’m starting to worry that I spend too much time by myself and might start babbling in public or not washing my hair. I called a dear friend who has lived alone for a decade, to ask her whether too much solitude can be a bad thing.
            “Shut up a minute,” she said, which is a Jersey greeting for, Hey, how’s the family?, “I’m watching this giraffe in the Denver zoo have a baby.”
            And, there’s my answer.
            “No kidding, there’s like 75,000 people watching right now!” she was so happy, “But many are getting pretty pissed off that every time they sign on there’s no little giraffe feet coming out the mama’s hoo-ha.”
            She went on to tell me how people were fighting about this in the comments section.  Virtual fighting about a giraffe birth.  Is this being social? Or crazy?  Who’s crazy – me who sings really loud by myself all the time or “social” people who are angry at a pregnant giraffe?
I was sweating when I hung up the phone, but had no way to gauge how sweaty.  Was I smelly sweaty? Another friend of mine is a brilliant woman in the financial industry who’s an expert in all things olfactory because she was born with an acute sense of smell.  We went hiking once and she stopped dead at one point, shook her head and said,
            “Hey, did you smell that guy’s deodorant?”
            I didn’t of course but I was suddenly afraid that she had always been so kind to me because she pitied me.  There’s a rule among backpackers when they’re out in the wilderness together for long periods of time:  nobody gets clean, period.  If just one person “freshens up” it ruins everything for the rest of us, so the protocol on the trail is just stay smelly.  I did 17 days in the wilderness with Outward Bound and trust me, no one was clean but that’s a good thing.  It’s kind of like the really smart kid who ruins it for the lazy ones.
Aside from group rules around dirt, nobody thinks their own shit stinks and let’s face it we all must live with our own stench.  But if you live alone, how do you even know?  I guess Nature is crafty, protecting us from ourselves so that we turn a blind nose to our own odors. How could you stand being with yourself otherwise? The same is true for our own faults and character defects – you just don’t grasp them, especially when you live alone.  Will I become that old lady with the hot house who screams at the kids git off my grass!!!  Will I be Adrienne – Rocky’s mentally challenged girlfriend who works at a pet store for company?  Maybe I’ll be Rocky, the cranky fighter dude living alone with his turtles, Cuff and Link.
            Here’s the thing:  I am never lonely, not for a second.  Love surrounds me all the time and my cup overflows.  There’s nothing I lack and when I want to connect with a human I make a call or take a walk.  Meditation keeps me firmly grounded in the FACT that I’m not alone.  It’s a fact.  I don’t see boundaries between people (or animals, turtles, giraffes) and I know that I’m totally part of a big happy cosmic soup.  But honestly, I just wonder if too much solitude will make me weirder than I already am.
            Last week, driving back from Steamboat there was a freak spring storm and the pass was a nightmare.  I came upon this accident:

            A bunch of us stopped to help but I was the only person on scene who had a smidgen of medical training as an EMT.  There were some walking wounded, stumbling around in shock but I went right to the driver whose legs were completely entrapped.  He was conscious and breathing and someone had called 911;  I knew all I could do was hold his hand and talk to him until those fabulous EMS guys got there.  So, I did. He was hyperventilating, because he was terrified and in pain.  I was trying to slow his breathing down a bit and keep him calm.  I said,
            “There’s a bunch of good people here with you.  And we’re gonna stay with you.  We will not leave you alone.”
            And then the miracle happened, the thing I’ve seen hundreds of times when I worked in an ER as a tech.  His whole body relaxed.  I could feel it and see it.  He let out a big sigh and put his head back for a second, only a second.  He knew he was not alone and even in that terrible state this fact brought him great relief and comfort.  The pain and fear returned quickly but I’ve seen the same thing over and over; people relax in the worst circumstances when they know that they are not alone. We are all in this together and our human nature does not allow us to leave the wounded and the hurt.  We’re hard wired to love and help, despite everything you read or see.  Check your own feelings the next time you see someone struggle.  We help each other, especially the very young, the very old, and the sick. Do not believe what you read.

            So, I’m working out the difference between solitude and isolation, being a loner and being lonely, treasuring my privacy (unlike poor Alice, the mama giraffe in the Denver zoo) and building walls to keep other’s out.  Adrienne walked up those steps, remember, and went timidly into Rocky’s house, which apparently did NOT stink.  She met Cuff and Link and she and Rocky found love which is Hollywood adorable. But I know that love is everywhere, that like an aspen grove we are all connected at the root even though it looks like we live separately.  We don’t.  I think I’ll stay engaged enough in the world that I won’t spiral into isolation and bad hygiene. My house and my body will be fine, because Love is always in the air.  I can smell it.

Saturday, March 11, 2017

How Lawyers Can Screw Up The Way You Die

When I was a practicing attorney, my colleagues and I would often sit around at lunch, arguing about whose sandwich was better. As a beleaguered single soccer mom, I sometimes welcomed the opportunity to fight about anything. It was habitual, and sort of a stress reliever like a good gym workout. Alone in our world of books and “right and wrong,” (as in “I’m right and you’re wrong”), we spent hours creating problems to solve so we could make money. Lawyers – like many professionals – form their own little bubble, but unlike say, IT guys or architects, our bubble is filled with righteousness. And our bubble’s better than your bubble.

I was a litigation attorney for 15 years and the very qualities that made me a really good lawyer made me kind of a lousy human. Arrogance, aggression, a niggling persnickety obsession with every little thing…. these are highly valued in the legal profession. Of course, when you’re a girl lawyer and you act like a guy lawyer you’re considered a “real bitch” which is a badge of honor in my former profession. But I’m digressing from the point. I sometimes did this in Court, to direct the judge’s attention away from my client’s crummy case, for instance. It worked pretty well, but there’s only so much smoke you can blow up a judge’s robe before you run out of hot air. Litigation wore me out, grated my soul up like cheese. I billed my last hour in 2004, gave away all my stuff, and left the East coast to be a cowgirl in Colorado.
Turns out lawyers, the human equivalent of gnats on a summer’s eve in Jersey, are everywhere, even out here in the Wild West. Like the old horror movie, Night of the Living Dead, you can’t escape them. I hung up my chaps and headed back into civilization to make a living which I do now as a healthcare consultant in an area called Advance Care Planning. This is the process of having individuals, families, and their healthcare tribe talk about what they want their lives to look like as they get sick or old. Lo and behold, who shows up to weigh in on this? Yep. The lawyers, laying claim to the reams of fussy paperwork around “estate planning” (which is about Dead You, not Living You) and not even understanding that humans – while alive and making decisions about future medical care – actually need space to talk to each other and their doctors. What they don’t need is check boxes and legalese.

In the 90s there was a series of very sad cases, three 20-something year-old women who ended up in chronic vegetative states due to accidents or overdoses. Parents and spouses argued in court while their poor corpses stayed alive on machines. These cases (Karen Ann Quinlan, Nancy Cruzan and Terry Schiavo) led to the passage of the Patient Self-Determination Act, a law that allows folks to determine their future on life support (or not) via the “Living Will.” Will? Did someone say ‘will’? Cha-ching! Another document we can create, own, and scare people about. And this is how lawyers stepped in to own your dying process. Without a heart for the work or an understanding of the doctor-patient-family triad, the suits jumped in and decided they would own the process of documenting death.

Lord, they are such a pain in my ass.
Lawyers have no business in the field of Advance Care Planning. None. Zero. You don’t need a lawyer to appoint a healthcare agent (through a Medical Durable Power of Attorney) and Living Wills are no longer worth the paper they are very expensively printed on. Lawyers don’t get this because they don’t get healthcare in the trenches. Understand that I’m committing heresy here and as we speak some very tight sphincter somewhere is preparing to sue me for the unauthorized practice of law or something. Whatever. I’m on a mission to wrest the dying process from the lawyers and give it back to the people and their healthcare team. It’s noteworthy that lawyers actually can kill us in many ways – death by a thousand subpoenas – but still, this is none of their business.
Here’s what happens when a lawyer gets involved in Advance Care Planning: they tell you to appoint a healthcare agent, but don’t stress that you must talk to that person and all other loved ones about your values and range of decisions. They have you check the boxes on a living will (DNR, DNI etc.) but don’t disclose that it’s basically a useless document. Clients leave thinking they have a Do Not Resuscitate Order when in fact they have a document that will likely be lost in the system somewhere and no one will even invoke until the patient is (1) unconscious; and (2) declared brain dead or terminal by two physicians. Trust me, by the time that document comes into play you are already “machined up,” in the ICU, tubes and vents everywhere. Lawyers have no idea how ineffective this document is. Then, after having you sign forms prepared by their paralegals, in addition to charging you too much and not informing you enough, they often just have you pack the whole bunch of papers into some obscure place where no one knows about them. Totally useless, but worse, the whole scenario gives you a false sense of security, I’ve taken care of that now, when in fact you haven’t done it correctly or effectively. At all.
Lawyers are important if you’re in trouble or you have a lot of money. Death and dying are trouble, alright, but not the kind a lawyer can anticipate or avoid. It’s not a medical emergency either. Death is just a natural process that we have altered through technology. Unable to keep our minds on pace with medical progress, we tend to hide our heads in the sand and then act horrified at these awful endings created by medical aggression. This can all be avoided by some pretty simple steps – like talking to your loved ones, filling out your own Medical Durable Power of Attorney (here’s a guide to state documents), disseminating them to everyone involved from family to physicians. And then talking some more. My ER doc friends tell me there is no document that comes close to the help of a well-informed family at the bedside. And with the current chaos in electronic medical record systems, chances are no one will ever know of or see that $500 document you signed in some lawyer’s office.
You may not be able to keep lawyers out of your life, but you can surely keep them out of your dying process. You don’t need a lawyer to make a future healthcare plan. Just talk to regular people – your family, friends, and healthcare team. Talk early and often about what really matters to you. You’ll only be in a “to pull or not to pull the plug” scenario after a hundred smaller decisions made by doctors and family. If you want to end up tethered to a machine you certainly can be, but it doesn’t have to be that way. You can empower your people to make sure that you remain in control of your dying process even if you can’t make decisions at the time. Give others the power to do that. Just make sure they don’t have “esquire” after their names.

Monday, March 6, 2017

MEN ON PAUSE: Big Bellies, Big Wisdon

I can’t even tell you how fabulous it is to watch my sexual energy ebb. Glory be, I have time again – to think, to breathe, to drink my morning coffee unmolested.  All those years, worrying about looking good while being sweaty and pleasing somebody else – all gone, quietly and blissfully replaced by another force of nature:  the urge to live big and deep while we still have time.  And pawing around with another human between the sheets just seems, well, stupid.
While so much is written about the horrors of hot flashes and mood swings no one tells you the best news about menopause – you actually get to put the men on pause.  Truth is, they stop wanting to get laid as well but of course meds were invented to address this, by – wait for it – male scientists, no doubt in their sixties.
For the love of God, people, it is FABULOUS to not have that twitchy urge to merge any more.  Liberation beyond imagining.  When I think of the time and energy I spent on sex… dang, I could have run the world and made millions.  After 50, sex is annoying (often annoying well before then) and it’s supposed to be that way.  Nature is brilliant, right? She always gives us what we need, and takes away what we don’t.  There’s no point in using energy to be naked and bumping around when you can’t reproduce anymore and time’s a-wasting in your life.  We get to collect ourselves, reinvent who we are without all that sexual nonsense.  It’s a joyful time; kick off those damn high heels and get barefoot – you and your fat belly.
Don’t get me wrong, I had plenty of fun in my heyday and am very appreciative of it all.  I did not miss the Sex Bus on this trip and I’m pretty sure I used up my allotment and maybe some of yours as well.  It’s just that when nature readjusts your hormones and that paunchy guy doesn’t look so appealing, you should rejoice in your newfound freedom instead of trying to suck in your gut and get rid of laugh lines.  You know why we look like rectangles after 50, why this belly appears and the waist vanishes?  Because we’re not supposed to be attracting seeds to make babies.  Procreation would be dangerous and unnatural, because God knows you have to be young to raise kids, they so wear your ass out.  Becoming a true broad after 50, we should be grateful for elastic waistbands and saggy necks.  We’re fading into the background to support the next generation of women through the trying times of marriage and babies.  We’re the crones, girlfriends, and we can’t expend valuable resources trying to look sexy.  It’s plain dumb.
There are so many women who just don’t care about sex, even way before menopause, but we’re not allowed to talk about it.  It’s verboten for a woman of any age to say this is a stupid waste of my time and energy and good luck finding any man who would fess up to that. But I personally know plenty of women who would rather curl up with a book than a guy, or spend time thinking about love rather than trying to “make” it.  When you hit your fifties, you realize you don’t “make” love – love makes you, and it is everywhere.  The idea of connecting intimately with one other human is replaced by the notion of universal connection with everyone and everything.  Spirituality blooms, if you let it, while gravity lowers your belly, eyelids, and sexual appetite.  I’m telling you, it’s like being let out of jail.  Free at last from the compulsion to physically connect, we are wildly liberated to embrace everything else, and the world is big indeed.  Words almost fail me at how happy I am that I couldn’t care less about sex any more.
I had a husband who insisted we watch an AARP video about “Sex After Fifty.” It was gross.  Shoot, I don’t want to see wrinkly old people in a hot tub trying to get laid.  It was kinda pathetic, really.  And sex in any body of water is a pain in the ass because it doesn’t work all that well.  Why would AARP feel compelled to create a video to tell us how to do something that nature doesn’t really support any more?  Why can’t we just love the fact that it’s over, rejoice in watching younger people do their thing while we take our place on the wisdom dais, teaching eager young ‘uns what life is really about?  And it’s not about sex.
It’s about the deep gratitude of every single small thing, from a babbling baby to a babbling brook, all the wonders of every precious day rolled out in front of us without the veil of worry about who needs to get laid or when we’re going to fit it in (so to speak).  Intimacy, it seems, is all about the eyes and the heart.  Other organs – once thought so vital (and in fact necessary for survival of the species) – fade in importance as the spirit expands.  When I was deciding how to handle my breast cancer diagnosis my brother Tony, who is a surgeon, said to me: I always asked my women patients, where does your sexuality truly lie? And that helped them figure a course.
My sexuality still lies in my brains, in my intelligence, my ability to see clearly and deeply.  My breasts served me well and I had little problem parting with diseased tissue.  I even threw a party for my boobs – Ta Ta to My Ta Tas – and really don’t miss them at all. Ironically, after experiencing cancer my intimacy with the world increased a hundredfold.  Sex almost seems more like exclusivity, a way to build a barrier to other people and experiences.  Without that worry or limitation (yes, sex is limiting), I get to love everyone and everything and there is not a sexual experience that comes close to this reality. My heart and happiness are bigger than ever. My cup runneth over.
And so, my sweet sisters and brothers, don’t buy the bullshit around sex in old age.  When you feel your libido ebbing, don’t run to the drug store for lubricating cream or take hormones that hurt your body so someone else can continue to pretend that he or she wants sex too.  Just go with that flow (and be glad the “other” flow is over for good…) and watch how big your heart becomes.  Being honest about your sex drive, or lack of it, is crucial to allowing yourself every healing you need, every moment you want, every truth you know deep down about yourself. 

Hello Buddha belly, bye-bye libido.  Thanks for the memories.  Bring on the wisdom.