Welcome. Bienvenido. 欢迎. 환영. добро пожаловать.

Eleven hundred newly naturalized citizens and their loved ones streamed out of the Paramount Theater in Oakland last Thursday, and we were there to greet them:

“Welcome!”

“Congratulations!”

“We’re so glad you’re here!”

Also, “Would you like to register to vote?”

After all, that’s why I and dozens of compatriots were there: to empower our newest fellow Americans to speak out at the ballot box. A woman who heads up an activist group I phone bank with had told us that if we ever had a chance to participate in these registration drives, it was a really inspiring thing to do—especially in these dark days when immigrants face such hostility from the President himself. So I was on the lookout for the next opportunity, which happened to coincide with a long break in my work schedule on the one day of the week I’m in that neck of the woods.

I personally registered three of the nearly 300 who signed up that day: a man born in Mexico, another originally from South Korea, and a young woman whose parents brought her from Guatemala when she was two. By sheer coincidence, this last person happened to be the partner of my friends’ son—their whole family, as well as hers, were there to celebrate this last leg of her 28-year journey; it was wonderful to share in their joy.

I spoke with another woman who had been in this country for 30 years, since the age of 5, when her parents brought her from Mexico. One of the other volunteers had already registered her, but she was happy to chat while waiting in line to complete her passport application. She was excited to have finally become a citizen of the only country she had ever known. She was also excited to have a few hours away from work without any of her three young American-born kids clinging to her. We swapped stories about what a great treat it was to go to exotic places such as CVS and the grocery store unencumbered by little ones.

A friend of mine now in her 60s tells me she still vividly remembers the day decades before when she and her sister and their parents were sworn in as naturalized citizens at the Paramount Theater. They had come from Israel when my friend was eight. She can recall the excitement of the day, the outfit she wore (down to her shoes!). This friend, once s stranger in a strange land, has contributed so much to her family, her community, our country, and to me. She’s an inspiration.

I salute those who have just gone through their own journeys to this country, their own ceremonies at the Paramount, and know that they, too, will be an inspiration.

Congratulations! Welcome! And thanks. You are part of what makes America great.

Life and Death Matters

California’s End of Life Options Act, which allows doctors to write life-ending prescriptions for terminally ill adults who meet strict eligibility requirements, went into effect two years ago. In May, a judge halted the law on a technicality; an appeals court recently reversed that decision. As complicated and lengthy court processes continue to unfold, emotional and legal limbo remains.

“It is an American habit to turn complex moral problems into technical legal reasons,” writes Andrew Solomon in A Death of One’s Own (1995), about his mother’s decision to end her life rather than endure the final excruciating stages of ovarian cancer. Solomon weaves his personal story with an in-depth history of the euthanasia movement before aid-in-dying was legal anywhere in the United States. With unfailing empathy and candor, he explores every nuance of the issue, including how relegating it to the shadows compounds the difficulty. He describes the coded euphemisms his mother used with her doctors to secure what she needed. Solomon, his brother, and their father all whole-if-broken-heartedly supported her choice to die on her own terms at home, surrounded by loved ones. The necessity of secrecy heightened their intense isolation and sadness.

An unequivocal supporter of the right to choose, Solomon is also an unblinking chronicler of the ambivalence, sorrow, and potential risk such choice entails. “There is no question that if euthanasia is legalized it will be abused . . . The question is whether these abuses represent a greater crime against life than does keeping alive people who want to die.”

In the 23 years since A Death of One’s Own was published, much has changed. Seven states (including California) and the District of Columbia now allow some sort of physician-assisted dying. The terminology has also changed: “Death with Dignity” and similar monikers have largely replaced “assisted suicide” or “euthanasia.” Although there are still those who prefer the term “murder,” there is a growing consensus among proponents that existing laws are too narrow, excluding those with conditions such as Alzheimer’s and ALS from seeking legal relief.

What of those who suffer from unremitting psychic distress? Why are people with terminal cancer deemed to have good reason to end their suffering, but people afflicted with chronic depression are not? Here the slippery slope steepens.

Rachel Aviv delves deeply into this disquieting territory in The Death Treatment (2015), about Belgium’s law permitting euthanasia for those suffering from severe and unrelenting psychological distress.

Both Solomon and Aviv are beautiful and compelling writers. Each account illuminates the shadows we must explore to grapple with the awesome complexities of life and death decisions. As California’s End of Life Options Act continues on its topsy-turvy legal course, the imperative to bring into the light what it means to be alive and to die—and who gets to decide–continues.

*

What are your thoughts and experiences about this topic? What would you want for yourself?

*

(Originally published in the Northern California Society for Psychoanalytic Psychotherapy’s “Impulse”

Pre-existing Condition

I was in Kaiser’s waiting room, scrolling through my phone while listening for my name to be called. Out jumped the news that the Trump Administration was going after the Affordable Care Act again: The Justice Department declared that protecting people with pre-existing conditions from discrimination was unconstitutional.

I am one of the 52 million Americans at risk of losing my health coverage due to this latest assault; I’ve had cancer. I’m fine now, but my trip to Kaiser was for the CT scan I get every year to make sure I stay that way. I will need such follow-up care for the foreseeable future. It’s a similar story for anyone with heart disease, diabetes, depression, and a million other ailments, both major and minor. Before the ACA, my friend’s premature twins could never have gotten health insurance on their own as adults because of their early months in the neonatal intensive care unit. Another friend’s 20-something son was denied health insurance because he had been treated for mild acne as a teenager! Sooner or later, everybody ends up with a pre-existing condition. It’s called life.

Life is what I’ve continued to enjoy thanks to my excellent doctors and post-cancer scans. Normally I’m not anxious as I glide through the CT machine. I feel relieved and grateful to make sure I’m still cancer-free, or if not, to catch and treat it early. As I lie on my back, a soothing voice instructs me when to hold my breath, when to breathe. Normally my intake and release are as relaxed as they are at the end of a yoga class. But not today. After the news, I am hyperventilating. I don’t fear cancer nearly as much as I fear the determination of this President and his Republican enablers to take away my health care.

Since their several dozen failed attempts at repealing the Affordable Care Act, Republicans in Congress and the White House have waged a relentless sabotage campaign. In a cruel and cynical ploy, Republican legislators repealed the mandate–the least popular aspect of the ACA–in last year’s hastily passed tax bill. The mandate’s undoing is now the rationale for eliminating the highly popular provision that prohibits excluding or jacking up the rates of people with pre-existing conditions.

The DOJ’s move will take a while to reverberate through the courts, but the uncertainty it creates will drive up premiums even more, furthering Trump’s goal of imploding the law he hates largely because it’s his predecessor’s signature domestic achievement.

Will this risky gambit work for the Republicans? Maybe not. It turns out people like having access to treatment if it’s not called “Obamacare.” Protecting healthcare has been the #1 issue on voters’ minds across the country, and this has translated into Democratic victories.

So rather than hyperventilating, I’m going to work hard to elect people who want to make America well again. I’m voting as if my life depends on it. Because it does.

Starbucks: Teachable Moment

Many years ago, back when the corporate coffee giants started to swallow up neighborhood cafes, I saw a bumper sticker that said, “Friends Don’t Let Friends Drink Starbucks.” A similar sentiment was resurrected recently with #BoycottStarbucks. The hashtag went viral after a Philadelphia Starbucks manager called the police when two black men in the store asked to use the restroom without buying anything.  The call led to the men’s arrest, which led to national outrage.

I don’t usually go to Starbucks, because I sip my daily café au lait while reading the paper at my local café. But I’ve always had a soft spot for Starbucks, preferring their milky brew over the stronger stuff my friends like. I made one such friend blanch when I told her my favorite nightcap is a mix of 1% milk, water, and a spoonful of instant decaf thrown into the microwave. When it comes to coffee, I am more Philistine than aficionado.

But my affection for Starbucks runs deeper than taste, or lack thereof. As I’ve written before, I like that the company offers a decent wage, healthcare, and some education benefits to its employees. I even liked their widely mocked initiative a few years back to start conversations about race by having baristas scrawl “Race Together” on their cups. Better a clumsy attempt to engage on difficult terrain rather than no engagement at all. As a white woman, I know just how easy it is to steer clear of the topic altogether.

Nonetheless, I ventured into this avoided territory a few days ago. Coming back from my morning walk, I passed a black man who was standing on the side of the road, shaking his head at a super-sized SUV blocking a driveway and extending into the street.

“Man, who would park like this?” he said. “They’re gonna get a ticket, particularly in this neighborhood.”

We were in perhaps the most exclusive town in one of California’s most affluent counties. The blocked driveway led to a leafy estate behind a stone wall.

“Oh, is this your neighborhood?” the man added. “Do you like it here?”

I assured him it wasn’t my neighborhood,  that I was only walking through. (I failed to mention that I live in the next town over, where the houses go for a mere $1-5 million.) I hastened to add that although it was pretty here, I didn’t like how the residents walled themselves off from everyone else while using all the other towns’ services.

The man continued to speculate about how long it would take before somebody called the police and the SUV was ticketed.

“Actually,” I began, and this is where I ventured more deeply into my own clumsy conversation about race. “I bet you have more chance of being ticketed as a black man than this car does.”

He threw back his head in laughter. Then he asked my opinion about the Starbucks incident, saying he thought the company’s response and pledge of training was a good thing.

“I don’t like that Starbucks has been scapegoated,” I said. “This is not a Starbucks thing, That lets white people like me off the hook. It’s a societal problem that happens everywhere.”

“Happens to me all the time,” the man said. “Remember Rodney King? Same thing happened to me long before, only there were no video cameras back then.” He was stopped in Tennessee for driving while black by police, who shot him when he reached for something.

I said something about how terrible that was, how it was a good thing all these police abuses were being captured on smartphones now.

“Yeah, but we sued that police department and won because of course there was no gun!”

I expressed surprise that he was old enough to drive long before Rodney King; he looked so young.

“How old do you think I am?” he had me guess. I was way under.

“I’m fifty!” the man exulted. “You’ve heard that expression, ‘Blacks don’t crack?” Except for President Obama, he cracked, they put him through so much.”

We commiserated over how much we missed Obama.

“I’m JT,” he stuck out his hand. “I’m the foreman on the work crew here.”

I introduced myself, we shook hands, and said maybe we’d see each other again. I looked for him today on my walk. No JT. No blocked driveways. A lot of wealthy white people living in mansions where black and brown people labor. A lot of wealthy white women walking by. Still, JT and I both enjoyed our conversation.

I’ve had more conversations since, with white friends. How we are never questioned when using the restroom, at Starbucks or anywhere else. How we are emerging from the oblivion our privilege provides, horrified to see the extent of racial injustice.  How Starbucks isn’t the problem: we are.

It’s not much. But it’s something.

*

Thoughts on what happened at Starbucks?

 

 

 

Here We Are Again: Guns and Mental Illness

It’s an ordinary school day. Kids and teachers go in and out of the office, phones ring. Then a young man with an assault weapon walks in.

That’s how “DeKalb Elementary,” an Oscar nominee based on a 2013 Georgia incident, begins. As I watched, I thought what a wonderful counselor the office worker would make at the crisis hotline where I consult. Remaining calm and empathetic to the gunman throughout, she defuses a dangerous situation without anyone being harmed.

The day after I saw the film, a young man with an AR-15 walked into a Florida high school and killed 17 people.

We cannot rely on words to stop guns any more than we can rely on armed “good guys.” I juxtapose the two events and my work with at-risk people not to apportion credit or blame, but to illustrate different facets of the debate about mental illness that invariably arises whenever these tragedies occur.

We absolutely need more funding for mental health. Yet what’s often proposed after mass shootings is counterproductive. Donald Trump suggests bringing back institutions to contain the threat. Less inflammatory mental health “solutions” aim to identify and remove “monstrous” people—not their guns–from circulation. Mental health professionals already must report those at imminent risk of hurting themselves or others. Stigmatizing mental illness and enlisting clinicians as wide-net detainers makes people less, not more, likely to seek treatment. Blaming gun violence on the mentally ill overlooks the fact that they account for a tiny fraction of gun homicides and are far more likely to be the victims rather than the perpetrators of violence. It also ignores the biggest threat: guns.

Two days after seeing “DeKalb Elementary,” and the day after the Parkland massacre, I consulted at the crisis hotline. I told the staff how much the film reminded me of them and the unsung, heroic work they do. Counselors listen, assess for risk, and, like the office worker in the film, connect calmly and empathetically to enlist that aspect of the person’s ambivalence that leans toward safety rather than destruction. Outside resources are utilized when there is imminent danger, but usually the internal resources of human connection and compassion are enough to defuse a volatile situation.

Mass shootings and the fear they evoke can cloud assessment and intervention.  Callers are often hostile, distraught, vaguely menacing. Violence is notoriously difficult to predict; thoughts, feelings, and fantasies are not the same as action. Parkland illustrates not only the importance of being vigilant about danger, but the vigilance of making sure we are not overreacting from anxiety to enact ineffectual preventive detention.

Mental health interventions are most effective early on. Guns in the picture indicate that the window for optimal engagement has already closed. A culture that promotes more guns as the solution, not the problem, suggests collective, not individual, pathology.

*

This piece originally appeared in “Impulse,” an online publication of the Northern California Society for Psychoanalytic Psychotherapy

 

Enough

It’s surprising how affecting a pair of shoes can be. Particularly when they’re empty, and when they’re one of 17 pairs representing the students and faculty killed at Marjory Stoneman Douglas High School in Parkland, Florida, on Valentine’s Day.

These empty shoes, bereft of those who normally wore them, were on the steps of my town’s high school as part of a student-led nationwide walkout to protest Congress’s failure to do anything to stop gun violence.

There have been 17 shootings on school grounds in the United States so far in 2018, 208 since Columbine. Including that initial 1999 rampage, which shocked the nation and defined the country today’s teenagers know, more than 200 have been killed. This does not count the additional 29 assailants who died, all but two of whom turned their guns on themselves. Far more have been injured and traumatized.

A dispassionate account of these incidents, most of which never rise to the level of national attention, makes for sobering reading. Most of the victims are young, but so are most of the attackers—too young to even be called gunmen (almost all are male). One six-year-old boy fatally shot his six-year-old classmate. So many of the incidents arise out of arguments, and have nothing to do with the usual false narratives of lone nuts, terrorists, and other bad guys. It’s easily accessible guns—not mental illness or monsters–that turn mundane hot-headedness deadly.

School shootings account for a tiny fraction of the 33,000+ (and rising) annual gun deaths in the United States, and schools remain among the safest places to be. Too many kids have more to fear in dangerous neighborhoods and volatile homes or, if they’re young men of color, from police. All mass shootings, including highly publicized tragedies in nightclubs, workplaces, churches, concerts, and Congressional ballgames and meet-and-greets, account for only two percent of firearm fatalities. Almost two-thirds of all gun deaths are suicides. Research by the Harvard School of Public Health and Everytown for Gun Safety consistently shows that guns in the home are far more likely to increase the risk of injury, especially but not exclusively when domestic abuse occurs. States that have more guns (and less restrictive gun laws) tend to have more gun injuries and deaths than states that don’t. Whether we’re talking about suicide, homicide, or accident, limiting access to guns saves lives,

When we widen the scope of gun violence beyond the school shootings that understandably horrify us, we see, if we care to, the grotesque number of casualties—38,658 gun deaths in 2016, the last year for which CDC data are available. That’s a lot of pairs of empty shoes.

But it is those kids in schools—the post-Columbine generation—whose grief and rage now galvanize a nation. They are not activists for arming teachers, turning schools into prisons, or rounding up the mentally ill. They want politicians to stop cowering before the NRA and commonsense gun safety regulations, and they won’t stop until they get them.

“We are only 24 percent of the population, but we are 100 percent of the future!” The girl leading the walkout I attended exclaimed through her tears.

Her fellow classmate urged everyone to vote. The students paid tribute to the lives that would never be lived, the contributions that will never be made by students just like them. Too many empty shoes. But the kids still here are stepping in and stepping up. It is our sacred duty to step, walk, march, run, speak out—and vote—alongside them.

Does Love Trump Hate?

Love trumps hate. It’s a nice sentiment, but is it true? Arguably, fear and anger are stronger motivators, and bipartisan to boot: Trump capitalized on those passions to propel himself to electoral college victory, and fear and anger are also fueling the strong opposition that’s emerged since his election.

So what’s love got to do with it? Listening, connecting, empathy—the small and steady force that goes to work on hearts and minds like water on rock. That’s the spirit behind the canvassing I’m doing each month with Swing Left. We travel outside our deep blue bubble to engage with people in the nearest swing district to try to turn a red House seat blue. Door-to-door canvassing is like phone banking with exercise—moving down the list of people who mostly don’t answer. But when they do, something small and miraculous happens: listening, connecting, caring about the other person.

We ask people about their local concerns, how they’re feeling about the direction of the country. Talking to people helps me curb my own tendencies toward writing off those with different viewpoints. Of course we are trying to identify votes for Democrats in the mid-terms. But we also seek to understand what matters to people. I can assure you, it is not the Russians, or Trump’s tweets, or shutting down the government (a move that generally generates disgust, not kudos).  Mostly, people are concerned with traffic, healthcare costs, jobs. Danica Roem, the Democrat who unseated a long-term Republican in Virginia’s House of Delegates last fall, understood this. She may have won a place in history by being an out transwoman, but she won her campaign by focusing on fixing the congestion on Route 28.

She also won because of voter turnout: the highest statewide in 20 years for an off-year race, with the youth vote doubling in less than a decade.

Which brings us back to love and hate. Love’s opposite is not hate but indifference. We hear it all the time: “It doesn’t matter.” “Both parties are the same.” “My vote doesn’t count.” “Nothing will change.” Political demoralization is rampant across party lines, and it’s easy to understand why people who feel that politicians are indifferent to them are indifferent to voting.

The silver lining to the 2016 election is that many people who have never before participated in politics now see that elections have consequences, the outcomes are not the same, and that their involvement matters very much.

A sign I saw at this year’s San Francisco Women’s March sums it up:

This past election was not determined by Trump voters.

It was not determined by Democrats.

It was determined by non-voters.

Love won’t trump Trump and his GOP enablers. Voting will.

 

 

 

Crumbs

A recent AP story about how people are starting to see a bit more money in their paychecks reveals the scam at the heart of the GOP tax overhaul. One woman notes that she is now earning an extra $1.50 per pay period. I assumed that must be a typo, until the article explained that this amounted to $78 more per year.  A man whose paycheck boost covers two-thirds of his increased healthcare cost enthuses, “I have heard time and again that the middle class is getting crumbs, but I’ll take it!”

Actually, the middle class is getting screwed.

Unstated in the article, or in the massive GOP snow job touting this “reform,” is that the wealthiest individuals and corporations will pocket the lion’s share—not just in dollars, but in percentages. According to NPR and the Tax Policy Center, households making $1 million or more per year will get an average tax cut of $69, 660, or a 3.3 percent increase in income. Those making under $100,000 will average a tax cut of just under $1,000, a paltry 0.1-1.8 percent increase. The trivial amounts with which the Republicans are attempting to buy off ordinary Americans end in a few years, whereas slashed corporate tax rates on wealthy companies are permanent. There’s also no mention that tax cuts for the super-rich are funded by targeting blue states, healthcare, and many other programs Americans depend on. These include Social Security and Medicare, which House Speaker Paul Ryan has already vowed to go after next. His rationale? To curb the deficit, which he and his cronies have just enthusiastically exploded by massively cutting taxes for millionaires and billionaires.

Speaking of Paul Ryan, he evidently saw the same AP story I did. He didn’t think $1.50 was a typo, though, or cause for horror. Instead, he saw it as something to celebrate, tweeting about it as a success story. Ryan deleted the tweet after being roundly attacked for it.

He may try to cover his tracks, but Republicans can’t erase the truth. Their motto is, “Let them eat crumbs.”

We shouldn’t swallow it.

March On!

Yesterday I marched in the San Francisco Women’s March to secure our future with the future: my 20-something daughter and her friends. Last year my husband and I went to the march in Oakland, but this year he was at a climate conference all day. So I asked Ally if I could join her group as an unobtrusive mom.

“Sure,” she texted. “Just don’t wear like five fanny packs.” (Apparently, Valley-Girl-Speak is still an essential feature of women’s empowerment.)

I promised to wear only four, so I was in. Such delicate mother-daughter negotiations must have been rampant: Not only were there many two-generation duos at the march, but this sign:

(Hmm. I assumed my daughter’s sign referred to Trump, but perhaps she meant her mother?) Other signs read:

TODO LIST:

1. Smash the Patriarchy

2. Brunch

Ally and her friends had their priorities straight, though, and began with brunch. I huddled in the kitchen with another unobtrusive mom while the millennials spilled all over the living room, munching on fruit and making their signs. Finally, we were ready to go. The sole young man in attendance took the obligatory photos on the doorstep to mark the beginning of our march:

Then we headed for the Civic Center, the younger generation dancing and singing to the music on a portable sound system.

It was a gorgeous day in San Francisco, and the crowd was exuberant. Ally and her friends took selfies and pictures for their Facebook feeds (“You can tell it’s a millennial march,” she remarked to me):

I squeezed through the throngs checking out the signs. There were a jillion references to body parts—ovaries, uteruses, dicks, and two certain nether-regions made famous by the President himself: one to describe what he felt entitled to grab and one he used to demean places mostly inhabited by brown-skinned people. Here are some of my G-rated favorites:

A couple of enterprising men had set up a table on the fringe of the plaza, and were inviting everyone to sign their petitions. I recognized the sponsors and the cause (anti-tax) as Republican-based, but the pussy-hatted women adding their names apparently did not. I approached a couple to ask them if they knew what they had signed. They were shocked when I told them; one went and scratched out her name and told me she would alert her friends. Score one for the Resistance.  Score one also for Mom Lesson #1 (an extension of everything we told you about Stranger-Danger!!): Don’t assume that everyone hanging around a friendly gathering is friendly—some of them are out to hurt you, and will take advantage of your trust and goodwill.

After the rally, we marched down Market Street to the Embarcadero. It was fantastic to see not only so many of us marching, but so many lining the sidewalks cheering us on. It has been an exhausting and destructive year, but we’re still here, stronger and more determined than ever. Not only will we march, we will organize and vote all over the country to stop this administration and its enablers.

As my favorite sign put it:

Year-End Report from the Resistance

The arc of a year is often depicted as a joyous, energetic baby who ends up as a hunched-over old man, bruised and battered by the passage of time. 2017 didn’t exactly start out on such an optimistic note–how could it with Donald Trump set to move into the oval office? But along with millions more, I marched the day after the Inauguration, with high spirits and firm resolve to resist. (That’s my husband and me at the Oakland Women’s March in the picture above.)

I’ve spent the year plummeting between impotent rage and despair, punctuated by a few marches, calls to representatives, some phone banking, a little local affordable housing advocacy, some op-eds and letters to the editor, and check-writing to organizations fighting the fight more effectively than my demoralized self could muster. Mostly, though, I’m ending the year with a different kind of resistance: resisting the urge to crawl under a rock until it’s safe to emerge:

(Here we are again–has the “All clear” sounded?)

We knew this administration would be awful, but except for Trump’s own incompetence and self-destructive tendencies, it’s been far worse than imagined. The assaults are constant and brutal, effective and exhausting. The saving grace has been the strong opposition that’s been aroused. People took to the airports to protest Trump’s travel ban; they took to their representatives’ offices to thwart the repeal of Obamacare; they took to the streets to protest.white supremacists and neo-Nazis in Charlottesville.

Most important, people have taken to the ballot box. Democratic victories in Virginia and Alabama, as well as less splashy ones throughout the country, speak to the importance of electoral politics. After I crawl out from under my rock, that’s where I’ll be putting my energies in the new year, traveling with Swing Left to my nearest swing district to try to turn a red House seat blue.

So like the decrepit figure of Father Time who ushers out the old year, I’m ending 2017 battered and bruised, but with  determination for the new year. Onto 2018! Onto the mid-terms!

*

How have you survived this first year of Trump’s presidency?