The Illness of Our Mental Health Care System

As the mother sat in the waiting room, she watched a parade of patients shuffle in and out of the back rooms. No one was back there for very long; and all of them, as they left the psychiatric office, carried one or two or more prescriptions in their hands. No one was particularly happy and no one was particularly odd; but there was a peculiar air to the place that flirted with despair. Her son sat near, not talking, staring ahead with hostility and hatred. And the mother sat, toying with her hands and soaking up the despair – shell shocked by all that had recently transpired, and wondering, “What has happened to my son? And what will happen now?”

It hadn't been easy, this journey to this office. The long and rapid descent. Watching, helplessly and hopelessly. And there was no where and no one to which she could turn. Her son, mislead and misdiagnosed and mistreated by the family doctor. Unable to easily procure an appointment with a psychiatrist. Enduring the mental and physical brunt of her son's illness – weeks of mental decomposition. And now, finally, here, sitting with a flicker of hope and relief and a fantasy. Now they would get answers. They'll work as a team, a united front, this doctor, herself, her husband, her son. And they would find the path toward sanity together. She sighed and weaved her fingers together and then apart. She glanced at her son's rigid profile. Yes. Together, they would find a way.

Then her son's name was called and he disappeared behind closed doors. It was his choice to go alone, he was over eighteen. And the mother waited, alone. Months, maybe years, of uncertainty and there they were – so close to an answer. Anxious and giddy with anticipation, her despair eased away. They will talk; and then they'll call her back. They'll all discuss the options. Lay out the course to recovery . . . She placed her bottom lip between her teeth and nodded with determination.

It wasn't terribly long – less than fifteen minutes and the door opened. Her son did not glance her way, clutching papers in his hands, he stomped past the mother and out the door. She followed her son's departure with her eyes, watched as the door to the outside closed; and than turned her eyes back toward the the psychiatric nurse practitioner. There must have been a question and a haggardness to her look; and the man mouthed words her way. She stood, stepping closer. What was he telling her? What answer was she being given? He mouthed the words again and this time the mother understood. This time she understood how truly alone and lost they were. For what this man had mouthed was nothing more and nothing less than the words, “Good luck!” And then he closed that door and disappeared.

Anyone who has ever been part of the mental health care system can relate to the previous story. Patient privacy, HIPAA laws, the inability or unwillingness of the loved ones to communicate with their families or their doctors, result in family members (and, yes, even the patients) being left out of the recovery process. There is something very wrong with a system that excludes those who can help the most. It's the family members who are generally the primary caregivers. It's often the family members who have the best insight into their loved one's illness. They do, after all, live with it everyday. But all too often, they are ignored. Family members must advocate for their loved ones, for themselves, and for a better mental health care system. If you have a loved one with a serious mental illness (or any illness for that matter), demand to talk to the doctor – you can always talk to them. They don't need to disclose any information. Let them know how your loved one is doing, let them know your concerns. If they refuse to talk to you, encourage your loved one to find a new doctor. Educate yourself and others. Advocate. Join groups such as NAMI (National Alliance on Mental Illness) and BringChange2Mind and let our voices be heard!
http://www.nami.org/
http://www.bringchange2mind.org/

May is Mental Health Month

Mrs. Jane Doe turned the shopping cart into the next aisle and almost ran smack into Frances Neighbor. They smiled and began to talk. After awhile, Frances said, “Did you hear about poor Marty Finch? You know, Margo's son.” Jane shook her head. “He had this awful epileptic seizure at the high school – right in the hallway between classes. He's in the hospital now, trying to get his medication right.”

“Oh! How awful! The poor kid! And poor Margo!” said Jane.

“Yes. I saw Margo last night, brought her over some dinner. She's worried sick.”

Jane shook her head with sympathy and concern. “You know, I'm making a chicken casserole tonight. I'll bring her some.”

Okay. Now that you've read this rather poorly written grocery store scene, let's re-write it and change it up a bit:

Mrs. Jane Doe turned the shopping cart into the next aisle and almost ran smack into Frances Neighbor. They smiled and began to talk. After awhile, Frances said, “Did you hear about Marty Finch? You know, Margo's son.” Jane shook her head. “He had this awful fit at the high school. He went totally berserk. Scared the other kids to death!” She made a face and shook her head. “I guess he's over in St. Mary's Psych ward.”

Jane pursed her lips and whispered, “You know, I heard they were having trouble with him.”

“Schizophrenia!” Francis whispered. “That's what I heard!”

Jane shuddered. “That's so scary. Right in our own school.”

Maybe I've exaggerated this a bit, but I think you get my point. In both scenes, Marty Finch is very ill. He needs hospitalization and medication management. In both scenes he's depicted as having a serious neurological brain disease. The difference is in the attitude and understanding of the women. When Margo Finch's son is ill with epilepsy(an understood accepted disease), she gets casseroles. When he is sick with a mental illness, Margo and her son receive no empathy, little compassion; and Margo is forced to prepare her own dinner.

This is what May is Mental Health Month is all about. There is still an archaic belief that mental illness is not organically based, that it is something that can be fixed, if only the individual were a better, stronger human being – if he'd been raised better or tried harder or just didn't get so freaked out about everything.

“You know Uncle George wouldn't have that diabetes if he just tried a little harder. It's all those cookies Aunt Martha was always feeding him!”

Well maybe those cookies weren't so good for him, but they didn't cause his diabetes. Diabetes is a complicated, genetic, organically based disease that Uncle George did not cause and can not wish away. He can only control it with medication, diet and lifestyle.

It's time to understand mental illness as we understand epilepsy, diabetes, glaucoma, multiple sclerosis and countless other diseases. Accepting that we don't really know what causes them and that we can't, at this time, cure them, but we can treat individuals unlucky enough to have developed these conditions. We can treat them with the medications and medical resources that are available; and also, and foremost, we can treat them, and their loved ones, with the respect, empathy and compassion they deserve.

Where are the Cocoa Puffs?

Finally! The much anticipated pub date for my novel has been set. June 22, 2010! And in celebration of this small step toward holding my book in my hand I will post an excerpt from Where are the Cocoa Puffs?

A little background is needed to understand this scene. I will call this excerpt: Meet the 'Rents. (There’s a fair amount of texting in the novel, thus ‘Rents’ is short for parents. Okay… Pretty lame.) The scene: Dr. Jerry Benson, psychiatrist, has just found out that morning that Amanda, his eighteen-year-old daughter, has not only dyed her hair the reddest of red, but was also out all night with Ryan, the unknown boyfriend. Jerry has coerced Ryan into coming over for Sunday dinner to meet the rest of the family, knowing that the best tactic in this sort of thing is to: Keep your friends close and your enemies closer.

Excerpt: Where are the Cocoa Puffs? Section from Chapter Four

Ryan took a long time trying to decide what to wear. He was glad that the weather was cool, and that long sleeves were appropriate; no tattoos would be scrutinized. He finally settled on simple jeans and the light blue shirt his mother had sent him last Christmas that still sported the tags. He threw the tags vaguely towards the trash can, and ran his fingers through his straight dark hair. Would a little mousse make it less punkish? He fluffed it up a bit and out of his eyes. It fell back, straight and uneven across his forehead. Well, whatever, the doctor had already seen his hair. He could still bag the whole thing. Why did he care what this man thought of him? Was it a need to prove himself worthy? He was screwing his eighteen-year-old daughter after all . . . Show his respect for Mandy? Masochism? That was the most likely explanation, he thought as he pulled on his soft leather coat and searched for his car keys. Maybe the good doc could help him with that . . .

~~

Jerry set the table in the formal dining room. If they were going to do this thing, they should do it fully. Carol had chosen the fine china and crystal water goblets, usually reserved for holidays, which may have been a bit too much . . . But, what the hell. Although, really not a snob, he placed the various silver spoons and forks on the table, satisfied in his knowledge that this young man would be clueless on how to use the utensils. This man -- surely the reason for his daughter’s metamorphoses -- needed to understand the way things were . . .

Carol was just taking the roast out of the oven, when Amanda came into the kitchen. Carol felt the tension in the air before she even turned her eyes to her daughter. Amanda had showered; and her hair, although just as red, had bounced back to its natural curls, somehow softening the shock. Carol wondered how long it would take before the surprise she felt each time she looked at Amanda would fade. Amanda’s eyes were big and glassy with excitement, her nervous, jumpy energy, tangible.

“Can I help?”

Carol looked at her, even more surprised. “Sure! You can finish the salad,” pointing to the tomatoes that needed to be cut and the cucumber nearby. As Amanda began to chop with such enthusiasm that Carol worried for her fingers, Carol asked casually, “So how did you and Ryan meet? It is Ryan, right?”

Amanda nodded her head as she jabbed at the tomato as if to kill it. “At a party.”

“When?”

“A few weeks ago.”

Carol nodded her head, and thought about this piece of information. After a long moment she asked, “What’s he do?”

Amanda shrugged her shoulders. “Don’t know.”

“Is he in school?” Amanda shrugged. Did she ever talk to this boy . . . this man? If not talking, what then?

"I guess he works somewhere . . . Maybe takes classes at Albany, sometimes . . .” Amanda finally offered, distracted by the death of the tomato.

“How old is he?” Carol ventured, knowing she was asking just one question too many.

Amanda chopped hard at the cucumber, slicing it meanly in half. “I don’t know!”

Carol jumped involuntarily. Amanda swung her way, the knife point suspended between them momentarily before she let it drop loudly to the counter.

“I can’t do this! I hate cucumbers!”

“Okay . . . okay,” said Carol, trying to make her voice calm. “Why don’t you take that vase of flowers and put it on the dining room table.”

I can do that. I can do that, thought Amanda as she picked up the vase, and carried it carefully to the dining room, breathing deeply, wishing she’d smoked just a little more weed. She just could not seem to slow her mind . . . the jumpiness of her body . . . It wasn’t like she wanted to scream at her mother. She really didn’t hate cucumbers at all. And her mother, really, she didn’t hate her. She stepped into the dining room. Her father was just putting the water goblets above and to the right of the plates as she walked in. The table looked lovely, and was even made lovelier by the flowers she gently placed on the center of the table. He looked up at her and smiled, and Amanda felt her eyes fill with tears.

It hadn’t been all that long ago that they’d celebrated her eighteenth birthday in this very room, used these very same plates. She’d wanted a fancy dinner party, with all her best friends, donned in their best summer attire -- no jeans allowed was specifically printed on the invitations. She’d worn her pretty sleeveless green dress, her hair pulled and twisted into a fancy up-do, her mother’s pearls around her neck. Her mother had made all the food, served them courses as if they were in a fancy restaurant. She’d invited eleven people -- twelve being the perfect number when the table was at its longest, with all the leafs in place. It had been so difficult to decide which eleven people to invite (five girls and six boys), but in the end she felt she’d chosen wisely. All the girls looked beautiful in their slinky summer dresses. And she really wasn’t all that bothered by the boys, all of them respecting the no jeans request, but wearing instead, nasty cut offs, gym shorts or sweats. Kenny Frank was the only boy to wear a tie, but he’d failed to wear a shirt . . . which was okay, because the bright floral print looked good against his buff, muscular chest.

Her best friend, Ally, had sat to her left in a beautiful slinky yellow dress, and Jonathan was to her right, wearing one of those stupid tee shirts with a tux painted on it, and tugging at her hair, messing up her do and laughing. Everyone was laughing -- sticking their pinky fingers out as they drank the sparkling cider from her mother’s crystal goblets and saying, “To the birthday princess!” (It was pretty obvious that most everyone had smoked a little something, or drank something a little stronger than sparkling cider before ringing her doorbell.)

Amanda felt like a princess, sitting at the head of the table, smiling as her friends toasted her, pushing Jonathan’s hand playfully from her do . . . proud of the wonderful food her mother had prepared . . .

“I just can’t wait for the birthday spanking!” exclaimed Jonathan, and everyone had laughed, even her mother, as she slipped out of the room, carrying away the dirty dinner plates.

Jonathan’s hand was back on her head and Amanda felt a strand of hair fall free of its constraints. Again, she removed the hand. “Do I get to pick who spanks me?” asked Amanda, making the laughter increase and eliciting hopeful looks from some of the boys.

“Oh! Oh! Me! Pick Me!” cried Alex Simmons, from across the table, shooting his hand up and jumping up from his chair.

Chad Finch was suddenly up and grabbing Alex in a good-natured headlock, smashing Alex’s dark moussed-up spikes back into his head, as he exclaimed, “Sit down motherfucker. She doesn’t want your hands anywhere near her ass!” sparking a brief, but rowdy wrestling match, which shook the table, spilling goblets, teetering the candles, and causing general pandemonium. Kenny Frank jumped up like a bull, two baby carrots he’d stolen from the relish tray stuffed up his nose, and snorted them out and onto the table, which made Jennifer Wiley laugh so hard that she’d fallen off her chair. But Amanda -- she hadn’t laughed at all.

She stood up, more hair falling from her do, and screamed hysterically above the chaos, “Stop it! Stop it! You’re breaking my mother’s things! You’re spoiling everything!” Then she’d looked at the stunned faces of her friends and burst into tears. She’d run from the room, and it was Ally who’d followed her, fixed her hair, cleaned up her makeup . . .

They’d managed to finish dinner, cut the cake, even had ice cream, but somehow, something had been lost that was yet to be found. It was no wonder none of them called her anymore, even Ally -- barely spoke to her at school, avoided her as if she were contagious . . .

“Amanda?” her father asked.

She looked up from the table, waved away his concern, and said softly, “It looks like Christmas . . .” And then she was thinking of her childhood and the pure, uncomplicated joy of being a child, the love her parents had always shown her . . . Her father, taking this as some sort of apology, came to her, and when he put is arm around her and agreed about the table, she fought hard not to cringe and shove him away.

~~

Ryan chose the front door this time. He’d thought about bringing a bottle of wine, but quickly discarded that foolish idea and instead came empty handed, deciding flowers were too gay and he was hard pressed to come up with anything else. He stood there a moment, the large wooden door, a solid barrier before him. He adjusted his coat and felt his hair, making sure it wasn’t doing something really strange, before tapping the bell gently with his right hand. He tensed to the movement behind the door and adjusted his face in pleasant salutation.

Mercifully, Mandy opened the door. The red hair, still astounding, was now in cascading curls and he could not help but lean forward and kiss her lightly, his hand in her hair, hoping that her father wasn’t frowning from beyond the door. “Hey, babe,” he whispered.

“Hey.” She let him into the house, which was even more impressive through the front door. Two large white urns sprouting leafy green ferns adorned the formal entranceway. Off to the right, a dark mahogany spiral staircase led gracefully to the upstairs. To the left, an archway to the formal dining room. He could just make out that it was set, and waiting for him. Straight ahead, another larger arched entrance showed a different, but no less spectacular view of the massive living room and the windows beyond. The view of the valley, the focus the house was created around, was impossible to overlook even as it was dwarfed by the archway. The kitchen, off to the left of the living room, was not visible from where they stood.

“They’re in the kitchen,” she said, so he kissed her again, this time harder but not so hard as to be forced to hide or wait out an unwelcome hard-on. He moved away from her and pulled at the imaginary noose around his neck, his tongue lolling out with his death. Mandy laughed merrily, and they headed for the kitchen.

Carol was pulling out the rolls from the oven as Amanda and Ryan walked into the room. She turned around, her face flushed from the heat of the oven, which helped hide any other flush that might have erupted on her face from the pure sexuality of this young man (definitely man, not boy) that walked beside her daughter. Dark hair, dark soulful eyes, beautiful, but not too beautiful cheek bones . . . a young Johnny Depp, Jim Morrison perhaps . . .

Christy felt it too and her fifteen-year-old body did not quite know what to do with itself, and much to her horror she giggled and had to turn her face in shame.

Jerry made the introductions, seemingly oblivious of the static in the air.

Carol, who normally would have offered her guest a drink, (non-alcoholic in this case) and chit-chatted before dinner, felt the need to sit down, so that she rushed to get the food on the table, handing various bowls and platters to her family to take to the dining room. Once seated, Carol smiled at Ryan, feeling safer with the hard, firm wood of the large table to lean on and half her body hidden from view. “I’m so glad you could join us for Sunday dinner,” she said, as if they ate like this every Sunday. Ryan smiled a slightly crooked, and damned if it wasn’t sexy, smile her way, and thanked her for allowing him to be there. His teeth were the sort of perfect that only braces could endow. His shirt was of a fine linen cloth, Italian most likely. His hair, a curious black, flopped forward in uneven points, slipping down his forehead and threatening his eyes. Shorter in the back; random tuffs of hair stood erect and disorganized. Carol had the distinct, and incredibly inappropriate, urge to run her fingers through that hair.

Ryan picked up his linen napkin and placed it across his lap, and said, “Wow! This looks great.” He appreciated the goblets, the softly lit candles, the delicate china, knowing it was for him, and not in the way a guest would hope to be honored, but an intimidation, a challenge. He was up for it. Hadn’t just walking in the door been the biggest obstacle?

There was little talk, other than culinary chatter, as they began to pass the food around. Once the plates were full, Ryan waited until Jerry had picked up his fork, not sure if there was to be some sort of blessing, before reaching for his own. Amanda sat to his left and sizzled with excitement. He turned her way, his soft eyes shining with admiration and squeezed her thigh surreptitiously under the table.

Christy sat across from them, her mouth slightly agape. She seemed to suddenly realize this and forced it shut. She reached for the butter and gave her full concentration to buttering her bread.

Jerry missed the thigh squeeze, but had noted the napkin, now neatly on Ryan’s lap. He was further disappointed when Ryan reached for the salad fork without hesitation. He began to eat the leafy greens, and then set the fork carefully on the salad plate as he took a drink of water. Jerry sighed a bit. Then there was Carol’s behavior, acting as if she’d never seen a man before, which did nothing to improve Jerry’s disposition. He sighed again softly, and narrowed his eyes at Ryan, waiting for just the right moment before he said, “So tell us about your self.”

Jerry watched with satisfaction as Ryan, who had just put an unwieldy piece of lettuce in his mouth, looked momentarily perplexed on how to tackle such a broad based almost hostile question, and damn!, if Carol didn’t come to his rescue and say pleasantly, “Are you working? Going to school?”

Ryan swallowed with relief, and smiled at Carol as he said, “Well, both really. I work at UPS. A package handler.” He looked apologetic as he continued, “I took this semester off from Albany. I had to save some money, you know, to get through --”

“And what are you studying? Your major?” Jerry interrupted, with his subtle assault.

Ryan turned to him and met his eye as he said, “Architecture, sir. I have one semester left.”

Amanda looked at him in surprise. She didn’t know that. She hadn’t even known where he worked. Of course, she’d never asked. Had she even cared?

The room was duly impressed, and Jerry paused with a soft sigh to consider his next maneuver.

“Where are you from?” asked Carol. “Did you grow up around here?”

Ryan gently dabbed at his mouth then placed the napkin back on his lap. “No ma’am. Atlanta.”

Well, thought Jerry, that would explain the natural use of sir and ma’am, but he was hard pressed to pick up an accent. “Is that where your parents are now? Atlanta?” he tested.

Ryan shook his head. There was a hint of sadness in his movement. “No, sir. My father’s dead. A long time now. My mom’s remarried, living in Charlotte.”

Jerry felt himself running out of steam. He knew all about the dead parent thing. He was finding it difficult to find fault, so was forced to change tactics. “How old are you?” he asked bluntly.

There was a down beat of silence, Ryan’s eyes meeting Jerry’s, and then flickering away. “Twenty-one,” Ryan lied, the lie so obvious that Christy laughed out loud. Ryan flushed and smiled sheepishly, adding quickly, “Three years ago.”

“Excuse me?” asked Jerry, a twinkle in his eye.

Ryan’s grin was boyish with embarrassment as he said, “Three years ago, I was twenty-one, sir.” They all laughed then, even Jerry, and something in the way Ryan said it reminded him of his brother, Tom, and he softened, just a bit, to this new friend of his daughter’s.

Ryan felt the air shift, and knew that he had survived the initial inquisition, albeit shoddily. The focus moved slightly away from him, and he was able to gather his own information about this family; this life that Mandy was part of; these people who loved her. He covertly studied Dr. Benson as he looked down to cut his meat. He was a decent enough looking man, for his age. Not the least bit intimidating, although he’d tried hard to be. Still in good shape, a pleasant, calming face. Ryan imagined he was quite good at his job.

It was obvious that Carol had never quite had Mandy’s incredible looks, but Mandy’s hair, her eyes, her hot little body came from her mother. Carol was striking in a sexy older woman sort of way . . . He had not missed, nor did he ever, the affect he had on most women, including Carol. It had been part of his daily life, since he was fourteen, and although he never lost appreciation of it and used it to his advantage, he certainly did not dwell on it.

Christy was cute, would probably be pretty in a couple years. She was a perfect combination in body and face of her mother and father. It amused him that she couldn’t even look him in the eye. Each time he looked her way, her blue eyes were on him, but then shifted away and down, getting lost in the blush of her face. The contrast in the personalities of the sisters was remarkable. Amanda, the nucleus in a crowd, even in this tiny family; and isn’t that what took his breath away? Even now he could feel it, the excitement in her voice as she talked (was doing all the talking), her joy of being alive, as if she felt life more intensely than most . . .

Mandy grew more animated, chattering excitedly about her plans to study biomedical engineering, and that after she got her PhD, she was sure she would develop an artificial eye that could actually see, transmitting the images directly to the brain, an electronic pathway similar, but better than the optic nerve. Once that was done, the next thing she would tackle was the auditory system, a cure for deafness, something much better than cochlear implants . . . Her parents watched her with amazement, a slight knit to Jerry’s brow. Christy was bored and feeling less self conscious -- now that she’d realized that Ryan was only human and not some god Amanda had acquired -- wanted to talk about herself, but could not get a word in edgewise. Ryan sat back, a pleasant smile on his face, and thought about the last time he’d seen Mandy naked.

Speaking of Taxi Drivers

Speaking of taxi drivers, (see previous post) our taxi driver from the cruise ship to the Miami airport was Haitian.

That’s right. Cruise ship. I just returned from a four day cruise. My last trip for awhile. My father turns 80 next week and wanted to get us all together. He paid for all our flights and the cruise. It was a very nice thing (even if it did involve family). I told him for his 90th, we’d pay.

But, back to the cab ride. We asked the cab driver if his family was affected by the earthquake. He told us, thankfully, none of his family were hurt. He has three sisters. Their home was undamaged. Three blocks in one direction there was devastation. Many people died. Three blocks in the other direction, there was devastation. Many people died. But near his family home there sits a Christian radio station. He believes that the presence of this Christian radio station protected his family from devastation. I listen and nod and offer a few words of amazement. But, as we drive from this cruise ship towards the airport, I wonder about such a god. I am unable to resist turning to Paul and whispering, “It’s really too bad; the protective waves of God having only a three block radius . . .”

The Best Health Care Money Can Buy

So there I was, holding up my own IV bag, sitting in an ER in a strange place, surrounded by ailing Texans and looking to kill someone. If this is how they treat someone brought in with chest pains by ambulance, then how do they treat someone with a broken toe? Might you wait a week for someone to look at that toe? There was no bed for me, no wheelchair, no IV pole, no one the least bit interested in the fact that I was there. The EMT had poked me with probes and needles and then left me to my own devices.

My mind turned to Esmin Green, the woman who’d died while waiting to be seen in the Kings County Hospital ER. It took over an hour before anyone noticed, or apparently cared, that she was dead. I fantasized about that TV show. You know, ER, where three or four doctors run out into the pouring down rain to meet the ambulance. I looked at all the full chairs in the waiting room. No one had been called since we’d arrived. I turned to my husband, Paul, and said, “I’m going to rip this f-ing IV out of my arm and get the hell out of here!” Because, I knew, even then, that allowing them to bring me to this hospital from the airport in Houston, Texas, was a mistake. At this point, Paul felt it necessary to go up to the desk and ask again how long it might be.

And thus the first leg of our journey home from Belize was interrupted. I’d had severe chest/shoulder/stomach pains in Belize a few days prior to our trip home and had survived, but when the pain hit me again as we rushed from one terminal to the next, we stupidly thought someone should check me out. And that’s how I ended up in this overcrowded Texan ER.

Paul came back and told me that all the woman at the desk could tell him was that the longest anyone had waited that day was six hours. I started pulling on the tape holding the IV onto my arm and Paul said, “Really, Karen, I don’t think you should do that . . .” Then, quite suddenly and unexpectedly, they called my name. And that’s when it happened. I was sucked into the vortex of modern medical care and barely escaped with my life!

Every test they did was normal: the blood tests, the urinalysis, the x-rays, the electrocardiograms, more blood tests . . . yet they wouldn’t let me leave. I was 24 hours into my hospital stay and I still hadn’t seen the cardiologist or been told why (when it was pretty darn obvious that I wasn’t having a heart attack) I couldn’t just go home. I told Paul that I bet if we were uninsured the door would be hitting me in the ass as they shoved me out of the hospital; but as it is, we have very good insurance.

Finally, the evening of day two, they promised me that if my echocardiogram and the radioactive cat scan of my lungs were normal that I could leave the next morning in time to make our 10:15 flight home (we’d rescheduled it twice already). So, night two: I in the hospital bed, Paul in the lazy boy chair. I am abused every few hours by nurses: more blood needed to be drawn from my poor bruised arms, heart monitor batteries replaced, temperature checked, blood pressure taken . . . Then finally the cardiologist shows up at seven a.m. and tells me that my last two tests were normal. “I’m going home!” I feel like Dorothy!

Then in walks a phlebotomist, steps right between the doctor and I, and throws three empty blood vials on the bed and stretches that rubber armband thing at me. “What are you doing?” I ask in my best pre-murderous voice. “Oh!” she chirps. “I’m drawing some blood for your blah blah levels!” “Oh no you’re not,” I say. “I’m going home!” The doctor throws in, “No. She doesn’t need that.” The phlebotomist perhaps notices the doctor for the first time; and I go in for the kill. “Besides,” I say, “if you get another needle anywhere near me, I will be forced to kill you.” She gathers up her torture equipment and hightails it out of there. I’m pretty sure I ruined her day. Really, I was kidding -- sort of.

Then, on top of everything else, Paul gets into a big fight about the rotten state of medical care in the US with the Texan taxi driver who drove us from the hospital back to the airport. The Texan, of course, is going on about what an idiot Obama is for wanting to have the government control our health care; and Paul arguing that our system is very broken; and the Texan saying that Canadians all come to the US for their health care ’cause they die waiting in Canada (I have a good friend from Canada. She assures me that Canadians do not wish to come to the US for medical care and that their system works quite well, thank you!); and Paul trying to convince this guy that something needs to change; and I just wanting them both to shut up! Did Paul really think he could change this idiot’s entire Texan mindset during a $7.00 cab ride?

So I am home, finally. And fine. It was probably that conch ceviche, which was delicious, but perhaps too much for my sensitive stomach. Was I over tested, over poked, over insured, and over treated? Absolutely! If they’d found something truly wrong with me would I feel differently? Maybe . . . But let’s face it, what’s really sick is our health care system. Let’s keep our fingers crossed that this tiny first step that our government has taken towards a healthier health care system is just that -- a first step.

The People of Hopkins

We sit outside, under the overhang, at our table facing the life of the Garifuna village of Hopkins, Belize. We order our food and sip our drinks and watch as a world we only think we can imagine passes by. Bikes, toting entire families -- dad peddling, mom on the handle bars, baby on her lap, sister somewhere in between; round women walk by with floral dresses, their large breasts swinging towards the ground; laughter and the friendly call of goodnight; Garifuna children, their hair in pretty little braids, their simple white dresses dulled with road dust, play baseball with a piece of driftwood and a small coconut. A base hit! -- the child screeches with glee and runs towards second. A Rasta man strolls by, his braids swaying to the tunes from the restaurant; more bikes, bare feet pumping lazily; and dogs, always dogs, looking plaintively our way, tails wagging a slow wag -- have we received our food yet? Would we feed them? Our restaurant mates yell sharply from another table. The dog slinks away and I am saddened. I might have slipped her a little food. Two young chickens cross the road; flip flopped feet stroll by; a quick and noisy flock of parrots wing overhead; the soft Caribbean breeze kisses my neck as I swat at a sand fly; and I am disinclined to ever go home.


The Garifuna are just one of the many cultures that define Belize. This culture, descendents of Carib, Arawak and African peoples, created by man’s inhumanity to man, by greed and circumstances, have survived all that time has thrown their way. Beginning with a shipwreck on the island of Saint Vincent, would-be African slaves, never reaching American soil, blended their genes, their knowledge, their tenacity, with the already intermingled Venezuelan Caribs and island Arawaks -- and the Garifuna were born. They lived in relative peace with the French colonists for years until the British came, sparking death and war. The victorious British forcibly removed what was left of the Garifuna people to Roatan, one of the Bay Islands off Honduras, where they eventually migrated to the mainland and colonized along the Caribbean coast forming small peaceful fishing villages. And they brought with them their drumming and their cassava; their stories and their love of the sea; their warmth and their hardships. Now, two hundred years later, they are still struggling to keep their language, their history, their traditions and their place in the world.


And this small restaurant, owned by German expats, called Thongs, sits in the center of this Garifuna village; and it is charming. Often, we eat at one of the many Garifuna restaurants which are attached to the owner’s home, but tonight we chose to eat something different than fish or stew chicken or rice and beans. Thongs is a place that looks safe to a tourist -- foreign, yet not too foreign, painted a pretty orange, welcoming front porch, cute little tables -- so that we are not surprised, as we eavesdrop on their conversations, that the other patrons are all first time tourists.


The young waiter comes to one of the other tables to take their order and I chuckle to myself in an arrogant sort of way as these Americans answer him in clumsy Spanish. Do they not realize they’re speaking Spanish to a German in an English speaking country? But I know I am very wrong to think this way. No matter that I’ve been to Belize a dozen times and I own a house here -- I too am a tourist. And even when we move here fully and I can raise my status to expat -- even if I obtain my residency as so many of our friends in Belize have done -- I will never truly be part of this village, full of culture and rich history; and I will never know the conflict of walking the dusty pot holed streets of my ancestors -- now mingled with foreign investment, Chinese grocery stores, ‘fancy’ restaurants, condos and change -- and watch as the tourists and expats and foreigners eat their dinner while watching me back.

Strutting His Stuff!

In my opinion, this photo, which my husband snapped, deserves its own post.