death

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August 3, 2017

Goodbye, Grandpa Bob

Posted by Nathen under aging, death, family, Grandpa Bob
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My grandfather, Robert Greyling Pike, died last night. He was 98 years old and one of the best people I’ve ever known. I’ve spent the day feeling sad and talking with my family.

I sat down tonight to write a tribute and remembered that I have written about him several times in this blog. I just went back and reread it all and there is not much to add, so I’ll link to those posts and paste in yesterday’s journal entry, written just after I’d said my last goodbye to him. He was in hospice with end-stage Parkinson’s and I was leaving for a two-week trip. I knew I’d never see him again.

*About the links below: if you just read two, read the asterisked two. The others are a bit more peripheral, especially “Violent Storm.” [And sorry about the missing photos in these posts. Photobucket is holding them ransom for $400.]

January 11, 2009: Grandpa Bob Walking Slow *

January 22, 2012: A Violent Storm on the Beaufort Scale

January 28, 2012: Happy Birthday, Grandpa Bob! *

September 7, 2013: Goodbye, Joyful

March 20, 2014: Goodbye, Rollie

Wednesday, August 2, 2017

I’m on a United Airlines flight to SFO, currently above the Antelope Valley, heading back to NBTSC for the 19th year. I said my final goodbye to Grandpa Bob this morning, after playing him the Moonlight Sonata for the last time. He didn’t respond, but I think he could hear me and understood. I told him I was sad that I wouldn’t see him again but felt completely fine about him dying whenever he’s ready. I told him that he’s been an inspiration for me to learn new things all my life, to do things my own way, to focus on how I can help others and be useful, to nurture family connections, and to have fun. I said I hoped he was comfortable and peaceful, and that I hoped he was having good dreams and got to see his brother and all the other people he missed. I told him I loved him and kissed him on the head. It seemed like maybe he wanted to say something as I was leaving, but that’s beyond him now.

I’m amazed that he’s still alive. He’s had no food or water for over a week now, and I’ve only seen him move to wave and say hi to Margo or to try and take his oxygen tube off, and not even that in several days. Such a strong man! And he bore the whole process of enfeeblement with such grace and good humor. I get grouchy when I get a cold. He never got grouchy even on his deathbed. It’s something to see and something to think about. The strength of his body makes me wonder if there was something we could have done differently, that if so maybe he could have lived for a few more years.

But he was ready to die and he made that very clear weeks ago. And I don’t feel sad for him at all–I feel sad for us. I feel sad about never seeing him again, his sweet glee when he sees Margo, his little jokes. I feel sad about all of his experiences and knowledge disappearing from the earth. I feel sad that Margo won’t remember him. I feel sad that his capacity for joy, from watching a good movie, or listening to me play piano, or eating one of Maya’s birthday cakes, is disappearing. And that loss makes the world a little less wise and loving, and joyful and interesting.

Grandpa Bob teaches me something, mid-1970s. Photo by Steve Lester.

March 20, 2014

Goodbye, Rollie

Posted by Nathen under age, death, friendship, Grandpa Bob, loneliness, Rollie Shreves
1 Comment

My friend Rollie has died. He had an amazing life and taught me a lot. I am not the right person to describe his life and I’d decided not to describe any of his adventures here, but a quick look shows that there is really nothing online about him. So here’s a very short version of one of his typical adventures: In his mid-70s, he climbed K2. The sherpa didn’t want to let him come because he was too old, “But I was not the one who held us up… Not once.” On that trip to Nepal, he caught amoebic dysentery, which he cured himself of with a gruesome regimen involving coffee, hydrogen peroxide, bifidus, and enemas. “That was not fun, let me tell you, but I got rid of that bug. I went back to the doctors and they said it was completely gone.”

Right now I’m thinking most about what he taught me about getting old. He was still on an intellectual and spiritual mission when I last saw him, a week before he died. (In fact, the moment I learned he’d died, I was on my way to his house with the King James Bible on an Excel file–something he’d asked me to find to help with a scheme he had for decoding the Bible.) His memory and his mind were still strong, though his body was failing. Almost a hundred years old and he would tell me to “google” stuff, like, “Oh, just google ‘swansons’–they’ve got good deals on B12.” You can continue to learn and grow for almost a hundred years. I’ve seen it in Rollie. And you can keep your body going, too, but it’s work. He would say, “Nature is basically on your side until your 70s. In your 70s, you’ve got to work at, get it down to a science. In your 80s, it’s full-time. It’s an art and a science to keep going. In your 90s, it’s between you and God.”

He’s got me thinking about isolation in old age. He had a lot of friends in the community, but he spent most of his time alone and he told me several times that the loneliness was hardest part of his life. He had no family left in the time of his life when he needed pretty constant companionship, someone to notice when he fell. I suppose there is only so much planning you can do to head yourself towards an old age full of care and companionship. There’s a lot of luck involved. But I am thinking about it. It makes a big difference

Rollie was also one of my grandfather’s best friends over the last 60-some years, and the most poignant part of a poignant funeral for me was seeing my grandfather cry. He doesn’t generally cry, and never like that, sobbing. I felt the power of that moment and realized I haven’t known anyone for 60-some years, and I don’t know what that’s like, the depth of a 60-year relationship, the kind of hole that would leave in your life. But that’s how you want it to be, right? You want to have good enough, long enough, deep enough friendships that leave you heartbroken when they die. But you also want to have a lot of other dear relationships around you to take up the slack. My grandfather has that, and I want that, too.

Thanks for everything, Rollie.

Rollie (left) with Grandpa Bob, mid-1980s

October 20, 2013

42nd Year Retrospective

Posted by Nathen under Abandon Ship, aging, Benjamin Lester, Camp Latgawa, Candy Crush, Christina, Couples and Family Therapy, Damian Lester, Darlene Lester, death, desert living, Ely Lester, Ethan Mitchell, family, food, Gabriel, goals/intentions, heart rate training, Joshua Tree, learning curves, marriage, Maya, Morongo Basin Mental Health, NBTSC advisee groups, neurosequential therapeutics, Not Back to School Camp, Oliver Lee, Pacific Clinics, paleo diet, photography, Reanna, San Bernardino County, self-care, Steve Lester, therapy, Tilke Elkins, Transition Joshua Tree, work
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This is a long post, so first the short version. In the last year: I started working full time and am adjusting to that. I’m glad to be working towards my MFT licensure, but uncomfortable about how it pushes my relationships and other projects onto the back burner. My marriage gets better and better, despite this. The company I work for goes out of business so I get part of the summer off, and I get the exact same job (family therapist for US Marines & their families) with a new company.

And for the year ahead: I plan to continue this work, taking good care of myself, dance with Reanna every night, as promised to my friend, Tilke, in her “How to be a Real Artist” workshop, get in best shape in 5 years, and learn how to treat myself and Reanna really really well while working full time.

October: I started my year out at Farm & Wilderness, VT, staffing and teaching a really fun psychology project at Not Back to School Camp. As is traditional, I got really sick, but this time it was from a waitress in Rutland, not someone at NBTSC. I recuperated while visiting Ethan & Susannah, also in Vermont. Back in Joshua Tree, I started working out again (SERIOUS style), planted my first winter garden, fixed some electrical and plumbing problems in my trailer, and started setting up a private practice. In the process of hiring a supervisor, I found out that in California, unlike in Oregon, I cannot do my internship in a private practice. So I started looking for work in a local clinic.

Looking out over Woodward Reservoir from my cabin at Farm & Wilderness

Ethan, cataloging NBTSC lost & found in his library

The famous Quodlibetarian tub

Reanna

Reanna at Playa Del Rey

Ollie, a year ago

Ollie & Pap

Gabe, Damian & Maya on the Hwy 62 Art Tour

Trailer at sunset, looking south

November: I move into a new computer, archive my years of audio journal entries, and learn Sketchup while applying for and getting a job at Morongo Basin Mental Health: providing free, confidential therapy for US Marines, veterans, and their families. In what would become a series of small-town coincidences, a high school friend I hadn’t seen in decades worked there, saw my name on the interview list and sat in on my interview, interjecting stuff like, “Oh, yeah, good answer!” Nice way to interview. The manager of the military program assured me that the our contract was solid for at least two years. That’s about how long I need to get my hours for licensure, so the job sounded good–no chance of having to ditch my clients like I had to in grad school! I spent the rest of the month getting in as much time with Reanna and my family before starting full time work.

Rainbow over the Bartlet Mts

Maya & Ollie in hammock

Ollie helps Nana Honey cook

Me & Reanna

December: My 93 year old Grandpa Bob gets really sick, and I get really sick taking care of him. I was pretty sure he was going to die. He had pneumonia and had to go on antibiotics for the first time in his life. It took me weeks to fully recover. He eventually recovered, too, but I’m not sure he’ll ever fully recover. He’s been on antibiotics off and on ever since and is progressively less mobile. It’s got me thinking a lot about dying–how I can support the people I love when they start having a hard time taking care of themselves, and how I want to die when my time comes.

I start at MBMH, reading 40 hours a week of protocols. I have Christmas with family in Joshua Tree. My brother Damian starts a weekly evening with family, listening to an integral Christianity lecture and meditation that turns out to be a presentation of integral theory to Christians, rather than Christianity to integral thinkers, but valuable nonetheless.

Reanna & Christina, Xmas

Reanna & Maya, Xmas

Ely, Christina, Pap, Ben, Rebeca, Xmas

Gabe, Ely, Ollie, Christina, Xmas

Reanna, ukulele, heater

Ollie, bundled up

January: I get my first paid vacation ever–one week off, fully paid by MBMH. Weird, pretty nice. I write my first attempt at a comprehensive political statement. Reanna and I start a three-month experiment with a strict “paleo” diet, which mostly means we cut out sugar and grains from our diet. The theory is that human adaptation to grains and refined anything is shallow at best. I also start cooking Mexican food (the paleo-friendly recipes) from Rick Bayless’ Authentic Mexican. I love it. And Reanna loves eating it. I start learning to play Reanna’s ukulele. I play and sing “Amazing Grace” most nights for a month. Fun!

I’m working full time, which I’ve never done. It’s not my favorite schedule. I had to let go of most of my projects. I started building a solar batch water heater in the fall, for example, that is still not finished. The schedule has simplified my life quite a bit. Work all day, spend the evening with Reanna. I gained more respect for my friends who’ve been working full time for decades and still manage to write some music or read books. I’m ramping into a caseload, though, and am seeing seven clients a week by the end of the month.

My endurance training is going great by this point. Mid month I got my heart rate up to 179 bpm without hurting myself. Very exciting.

Smiley and Gallant visit

Reanna in our clean, cold kitchen

Dinner’s almost ready. (Photo by Reanna.)

Grandpa Bob turns 94

Me in therapist costume, with Ollie. (Photo by Reanna.)

February: Full time work continues. I get trained in the Trauma Resiliency Model, which I find very cool and useful. I re-up the trademark on Abandon Ship. I feel sad that I can’t write music with my brothers right now, but have plenty of optimistic plans to do so… Reanna starts designing our future house, another exciting project that I have to watch from the sidelines. I love watching her get super deep into a topic like this, though. She is now the resident expert in passive-solar-optimized-very-small-house design. We start car shopping, too. We need to be independently mobile in Joshua Tree.

Trench. Hose feeding trailer finally to be buried.

Reanna & treehouse near the Mexican border

Ollie, Damian

March: I’m up to 16 clients at MBMH and I’m fighting for mastery of the intense paperwork load. The clinical work is going great. My supervisor is good, I am fully engaged by my clients, and I get to see a good variety of folks–kids, adults, families, couples. The paperwork is fairly unpleasant, though. Mental health providers that get government funding spend a huge amount of time and energy creating and maintaining a paper trail for their work. These clinics get paid based on the work they claim to have done and then various agencies can audit their files and take that money back if a box wasn’t checked or a T wasn’t crossed. I spend my first very late day at work in March, trying to catch up on paperwork. Reanna is not happy.

Highlights: A great lecture by Bruce Perry, planting my first spring/summer garden, endurance training going great (I work out during my lunches at MBMH), meeting the Transition Joshua Tree folks. And Reanna. Reanna is wonderful.

Lowlights: My truck fails smog and I begin what becomes an expensive debacle trying to get it to pass. I start having sync problems with my Mac that I am still dealing with as I write. I start working on our taxes on weekends. Reanna is Canadian and that makes our taxes super complicated and somehow even though we hired a professional we ended up owing big fines.

Abandon Ship cover art, for the TM folks. Art by Tilke.

Damian & Ollie in old billy goat pen, future garden

Me, just having sunk the garden beds. (Photo by Reanna)

Reanna planting pepper starts

Ollie

Ollie & Reanna take the trash out

Ollie & Reanna rest in the hammock

April: I find out that Morongo Basin Mental Health has decided to go out of business after more than 40 years, at the end of June. That’s quite a shock and less for me than for the many decade-plus employees I work with. At home, our three months of paleo is up and I feel fine, as I have on just about every diet I’ve tried, but it clearly had not solved any of the problems we’d been tracking for the experiment. And I am sick in bed for a week for a third time this year. Reanna’s parents arrive for a month long visit. I don’t get to see them as much as I’d like, but we get in some fun events (like the Morongo Basin Conservation Association’s “Desertwise Landscape Tour” and Transition Joshua Tree’s Water Catchment Workshop), good talks, good swimming. I get trained in sand-tray therapy by my supervisor, Richard Gray, which I find quite useful.

Reanna preps cholla buds for dinner

Family dinner at Damian & Maya’s (Damian with Bugzooka)

Doug & Kathryn up San Jacinto

May: We get a great little car, a gift from Reanna’s parents. It gets 38 mpg unless we use the AC. At work, emotions are high and rumors are flying around. I try to avoid it as much as possible. My coworkers are mostly looking for work with great intensity. I decide that I will chill instead, concentrate on my clients, and do what I can to get my job back with whatever company picks up the military contract in the summer. Meanwhile, something is eating my garden. My weekends and after work time is often spent critter-proofing.

The highlight of the month by far is meeting my new nephew, Julian.

Julian in sling

Ollie in work gloves

First scorpion of a scorpion-rich year

June: I’m at 21 clients at the beginning of my last month at MBMH. The management has had me continue taking new clients but I’m starting to get nervous about it. It’s starting to look like my clients will have a significant lapse in services, and it pisses me off. I write people in charge at the county and local journalists but no-one can say how long it will take to get the military program back up and running. I know I’m fine. I can look forward to a full season working at NBTSC if things go badly. It sucks, though, that my clients are just getting dumped. It’s screwed up. I just have to set them up as best I can for the lapse and do the tons of paperwork to close their charts. Meanwhile, my co-worker, Jackie, introduces me to Candy Crush, which starts sucking up the cracks in my schedule.

Highlights: Jonathan & Ayako’s wedding in Idaho. Motorcycle safety class with Reanna. And being married to Reanna, of course.

Living room pano: Ely, Christina, Julian, Ben, Rebeca visit

Ben & Julian

North end pano from on top of Reanna’s sewing RV

Ayako & Jonathan, getting married

July: I’m unemployed again, but within two weeks I get interviewed by Pacific Clinics, the company who got the military contract that I’d been working for at MBMH. It looks like I’ll get the job based on the reputation I’d made for myself in that position. That feels good! It means I’ll miss most of NBTSC this year, too, for the first time in 14 years.

Reanna leaves for OR to do prep work for NBTSC and I delete Candy Crush from my phone so I can get some things done: install AC in our trailer, create an outside pantry, build a greywater cistern, make a front step for the trailer, get my motorcycle license, and a few other things. Satisfying. Then I fly up to OR to work the Camp Latgawa session of NBTSC.

Reanna hangs our laundry while I goof off with the camera

Cistern in progress

Julian & me

August: Finish at NBTSC (wonderful, as usual), and spend a few short days in Eugene at an NBTSC leadership summit, then back to Joshua Tree for my last week of unemployment. I completed some last-minute landscaping and plumbing projects, built a dry toilet and installed a weather station, then started training at Pacific Clinics in Arcadia.

At the end of August, Reanna got back from her travels, and we started shutting down all lights and electronics at 8pm and just hanging out until going to bed. This was lovely. We usually laid in the hammock outside, talking and looking at stars. The desert summer evenings are really, really nice. Especially with Reanna.

My advisee group, NBTSC Camp Latgawa

Ely & Julian before dinner

Reanna & Ollie, downtown Joshua Tree

September: I start making contact with clients and by the end of the month I’m back up to 7 clients. This is exciting, and it’s nice to be working with some of my old co-workers from MBMH, and the new crew at Pacific Clinics is an entertaining bunch. Working full time again limits what I can do in terms of projects, but I manage to put a new roof on the old goat pen/the new outside pantry, go visit Quail Springs permaculture farm, and start building a new composter with my 2-year-old nephew, Ollie.

At the end of the month, I have my first birthday at home in many years. Usually I’m at camp. It’s nice. My family threw me a little party and I’m glad to be here, even though I miss my people at Farm & Wilderness.

Yes, Ollie wants to help build the composter!

Rain Event, 29 Palms

With Reanna & ocotillo, on my 42nd birthday.

January 4, 2012

Goodbye, Ev

Posted by Nathen under 2011, death, family, photography
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A family member and friend of mine died just before Christmas, and I’m still reeling from the loss. Ev was one of my favorite people in the world. He was kind, generous, thoughtful, and strong. He was smart, funny, and interested, always fun to talk to. He was a great model for me of a good way to be a man and have a family, and to live with integrity. When I think about how good and uncomplicated our relationship was, I can’t help imagine that he was like that with everyone. I imagine that everyone who came into contact with him benefited like I did. Losing him seems straightforwardly a loss for us all.

Something else I keep thinking is that I am lucky to have known Ev well enough to feel this much grief. It didn’t have to be that way. He lived in very-northern California, far enough away that I might easily have seen him only at occasional Thanksgiving dinners. He also lived near a part of the I-5 that I drove by several times a year, most years. He and his family made it abundantly clear that I was wanted there, any time I was passing through. I always had a place to stay, a meal, and good conversation waiting. So I saw him several times a year and was able to connect with him that often. Lucky for me.

There is a way that you are born and marry into family, but in another very real way, you make your family. Who do you spend time with? Who do you keep up with? Who do you care about and for? That is your family.

I am so glad that Ev and I made each other family.

Ev, in flannel, goofing around with family, at home, after a ferocious snowball fight and enthusiastic snowman-building, 2010.

July 22, 2011

Goodbye, Minnie Lee

Posted by Nathen under death, family
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My grandmother died in April, and I miss her. I didn’t get to see her often, but I miss her being out there. She was one of a kind. She would have been 91 years old today.

I am still surprised that she died, even at 90. Its hard to imagine anything happening to her that she had not decided on. She may have had the strongest will I have ever encountered.

An example: One evening, in her mid-80s, I asked her how to successfully quit smoking. Several people I cared about were addicted to cigarettes and having trouble quitting. She said, “Oh, quitting smoking is easy. You just decide never to smoke another cigarette again, and then you never do.” She told me how, in her mid-70s, after smoking heavily since she was thirteen years old, and after only one day of reflection, quit cold-turkey with a carton of cigarettes still in her pantry, never to smoke again.

Who does that? I got the sense that it actually was easy for her. The difficulty of self-discipline was like a speck of dust in the way of her ambition. She was born to a subsistence farmer in 1920, in a town in Tennessee which still has no more than a few hundred people. She died the most respected woman in her wealthy retirement city in Florida, and don’t think that’s hyperbole. She mastered that game, and many others. She was a state-ranked tennis player, competitive golfer, and all-round athlete. She had been a successful fashion model and produced fashion shows late into her life.

Not everything went her way, of course. She had her share of disappointment and, I think, a good deal more than her share of tragedy. By the time I knew her, though, she was in control. She had what she wanted, said what she wanted, and got what she wanted. I really appreciated how frank she was with her opinions, and how she expected the same from me. “The problem with your hairstyle,” she said once, “is that you don’t have a hairstyle. It’s just all tousled, like a little girl.” I thought that was hilarious and asked her to show me the “right” way to part my hair. It turned out that she knew the right way to handle every detail of everyone’s life, which the anthropologist in me had a ball with.

I appreciated how well she loved the fine things in life, fancy food, elegant clothes and jewelry, dancing to a good swing band, just-so etiquette, her town, her friends, watching the sun set. I feel sad that I will never watch the sun set over the Caribbean with her again. “We’re lucky here,” she would say. “This is the most beautiful place in the world. Sometime when the sun sets you can see a green flash. Watch for it!” I appreciated how she would crow over me when I danced with her, or “how handsome” I looked, dressed up, hair parted just right.

Sadly, I have lost the only photo that exists of myself as an adult with her. I also do not have a copy of the one photo of myself as a child with her. This is all I have, but it is appropriate. I think she would like to be remembered this way:

My Grandmother, 1950s

January 21, 2011

The Definition of Disease

Posted by Nathen under ADHD, alcohol abuse, American Medical Association, Anorexia Nervosa, Attention-Deficit/Hyperactivity Disorder, Conduct Disorder, death, diagnostic criteria, disease, DSM-IV-TR, lists, mental disorders, suicidality
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I attended a lecture today about addiction where the lecturer claimed that the American Medical Association requires that a phenomenon meet the following criteria to be considered a disease:

1) It must be progressive

2) It must manifest identifiable symptoms

3) It must occur chronically in affected individuals

4) It must be fatal if left untreated

That makes some things obvious diseases. Cancers, for example. There are many things that we consider diseases that do not fit these criteria, though. I believe that obesity, for example, is not officially considered a disease because it is not fatal. It’s correlated with many fatal conditions but isn’t fatal on its own. Most mental disorders fail to meet this criteria too. Anorexia is fatal if untreated, but anxiety disorders, dissociative disorders, ADHD, learning disorders, conduct disorders, psychotic disorders, and dissociative disorders and many others are not. There is a pretty good case to make for alcoholism and some other addictions meeting these criteria. Disorders that are associated with suicidality, too, might qualify, like severe depression, and possibly “gender identity disorder,” though GID may not be progressive and so fail the first criteria.

November 6, 2010

I’m Growing a Mustache For Prostate Cancer Awareness

Posted by Nathen under aesthetics, death, disease, Freddy Mercury, homophobia, men, Movember, prostate cancer, statistics
[8] Comments

I’ve been working with the University of Oregon Men’s Center since last spring, helping out with their research projects. During one of our last meetings, a couple MBA students pitched us the idea of growing mustaches for “Movember” (Mustache + November) as a way to increase awareness of prostate cancer. We went for it, so I’m six days into a mustache. (If you want to see the final product, read at least the last paragraph in this post.)

Here are the “Rules for Participants” from the Movember website:

1) On Shadowe’en (October 31st), the complete moustache region, including the entire upper lip and the handlebar zones, must be completely shaved.

2) For the entire duration of Movember (Movember 1st – 35th inclusive), no hair shall be allowed to grow in the goatee zone – being any facial area below the bottom lip.

3) There is to be no joining of the moustache to sideburns.

4) Failure to conform to all of these rules may, at the discretion of the official Movember Committee, result in instant blacklisting and may void invitation to the end of MOnth festivities (this year lip-marked for Movember 35th!)

5) Movember Committee accepts no responsibility for lost jobs, rashes, food/beer encrustments or any other such mishaps caused to the wearer (or his partner) of a Movember Moustache. You grew it yourself.

So I’m growing a mustache and it’s a little terrifying. I think I look silly. I wonder if my clients will be able to take me seriously. And this is the first time that I’ve resented my therapist costume. In my street clothes I can (maybe) pass as a moderately hip guy who’s growing a mustache because it’s silly. In my therapist costume–khakis, button-up shirt–I look like nothing but an overly earnest businessman who is clueless about the fashion implications of a mustache. I squirm about it.

It’s also poking me in the homophobia, much like taking ballet did last year. My mustache reminds me a lot more of Freddy Mercury than one of the Beatles. I’m getting over that, though, by watching footage of Queen on Youtube. Freddy Mercury was an incredible rocker.

And anyways I like to push myself in these ways, bust my ego a little, uncover and deal with lingering homophobia, and support a good cause.

Prostate cancer has an amazingly low profile, considering that it’s more common in men than breast cancer is in women. One in six men in the US get it and it kills 30,000 of us a year–more than every other kind except lung cancer. The prostate cancer rates are so high in the elderly that it looks like pretty much every man would get it if they lived long enough. It doesn’t tend to produce symptoms for a long time after it starts growing, so it’s important to get checked after you hit 40. Yes, unfortunately this involves a “digital rectal examination”–a finger in the butt that could save your life. I’ve had one and it’s no fun but it’s not that bad.

Here are the major symptoms according to the Google Health:

Urinary hesitancy (delayed or slowed start of urinary stream)
Urinary dribbling, especially immediately after urinating
Urinary retention
Pain with urination
Pain with ejaculation
Lower back pain
Pain with bowel movement

I’m also registered with Movember, so you can donate a few dollars to the cause in my name. The proceeds go to the Prostate Cancer Foundation and LIVESTRONG Young Adult Alliance. Just click here and follow the directions. If my donations add up to $100 or more, I’ll post a photo of the final result in December.

September 6, 2010

Oliver, Rilke

Posted by Nathen under age, death, disease, Mary Oliver, poetry, quotes, Rainer Maria Rilke, Uncategorized
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Last term I took a class called Wellness and Spirituality Through the Life Cycle. It was a good class. I learned a lot about how people in different spiritual traditions think about and cope with illness, death and dying. It was also depressing. Maybe it was that it came on the heels of Medical Family Therapy, which is another relentless 10-week focus on illness, death and dying. Ten weeks got me down, but 20 weeks had me hitting some pretty strong existential angst: My parents are getting older and are going to die one day. So am I. My grandfather is 91 and doing great but was recently diagnosed with Parkinson’s. Man, am I going to miss him one of these days.

One day in Wellness and Spirituality we had a guest lecturer–Jonathan Stemer, a transpersonal therapist from Looking Glass, the clinic where I now have an internship. He read us a poem from Mary Oliver and a quote from Rilke. Both of them hit home. It’s hard to describe exactly how, but something about the brutality of death and the possibility of an open mind and heart in the face of it. I try to live an open life, but I think that a stance of openness can be an illusion if not in sight of hardships like illness and death. It can be a game of frivolity or superiority – charming but weightless.

“When Death Comes” by Mary Oliver:

When death comes
like the hungry bear in autumn;
when death comes and takes all the bright coins from his purse to buy me, and snaps the purse shut;
when death comes
like the measles-pox;

when death comes
like an iceberg between the shoulder blades,

I want to step through the door full of curiosity, wondering:
what is it going to be like, that cottage of darkness?

And therefore I look upon everything
as a brotherhood and a sisterhood,
and I look upon time as no more than an idea,
and I consider eternity as another possibility,

and I think of each life as a flower, as common
as a field daisy, and as singular,

and each name a comfortable music in the mouth
tending as all music does, toward silence,

and each body a lion of courage, and something
precious to the earth.

When it’s over, I want to say: all my life
I was a bride married to amazement.
I was the bridegroom, taking the world into my arms.

When it is over, I don’t want to wonder
if I have made of my life something particular, and real.
I don’t want to find myself sighing and frightened,
or full of argument.

And here’s the Rilke quote:

“Have patience with everything that remains unsolved in your heart. Try to love the questions themselves, like locked rooms and like books written in a foreign language. Do not now look for the answers. They cannot now be given to you because you could not live them. It is a question of experiencing everything. At present you need to live the question. Perhaps you will gradually, without even noticing it, find yourself experiencing the answer, some distant day.”

May 9, 2010

The Adverse Childhood Experiences Study

Posted by Nathen under alcohol abuse, battering, children, death, depression, disease, divorce, drug abuse, family assessment, lists, mental illness, neglect, parenting, physical abuse, predicting the future, rape, sexual assault, sexually transmitted disease, smoking, suicidality, unintended pregnancy
[4] Comments

I’m learning about child abuse and neglect in my Child and Family Assessment class. Today I read about the ACE study, by the US Center for Disease Control. It is a huge study, with over 17,000 participants, where they gathered information about childhood abuse, neglect, and household dysfunction, and then proceeded to see what health outcomes and behaviors they could predict with that information. It turns out they can predict a lot. They’ve published 50 articles on the study and the research is ongoing–they are continuing to collect health information as the participants in the study age. I’ll present a few of their findings below. For more, see the ACE Study.

Here are some of their findings. I’ll paste in the definitions of the categories of adverse childhood experiences below. Strong correlations were found with the following:

alcoholism and alcohol abuse (4 or more categories of ACE meant 4-12 times increase)
chronic obstructive pulmonary disease (that is, lung disease)
depression (4 or more categories of ACE meant 4-12 times increase)
fetal death
health-related quality of life (way more inactivity, severe obesity, bone fractures)
illicit drug use
ischemic heart disease (IHD)
liver disease
risk for intimate partner violence
multiple sexual partners (4 or more categories of ACE correlated with 50 or more sexual partners)
sexually transmitted diseases (STDs) (4 or more categories of ACE meant 4-12 times increase)
smoking
suicide attempts (4 or more categories of ACE meant 4-12 times increase)
unintended pregnancies

Here are the kinds of abuse, neglect, and dysfunction they asked about, quoted from the site:

Abuse

Emotional Abuse:
Often or very often a parent or other adult in the household swore at you, insulted you, or put you down and/or sometimes, often or very often acted in a way that made you think that you might be physically hurt.

Physical Abuse:
Sometimes, often, or very often pushed, grabbed, slapped, or had something thrown at you and/or ever hit so hard that you had marks or were injured.

Sexual Abuse:
An adult or person at least 5 years older ever touched or fondled you in a sexual way, and/or had you touch their body in a sexual way, and/or attempted oral, anal, or vaginal intercourse with you and/or actually had oral, anal, or vaginal intercourse with you.

Neglect

Emotional Neglect¹

Respondents were asked whether their family made them feel special, loved, and if their family was a source of strength, support, and protection. Emotional neglect was defined using scale scores that represent moderate to extreme exposure on the Emotional Neglect subscale of the Childhood Trauma Questionnaire (CTQ) short form.

Physical Neglect¹

Respondents were asked whether there was enough to eat, if their parents drinking interfered with their care, if they ever wore dirty clothes, and if there was someone to take them to the doctor. Physical neglect was defined using scale scores that represent moderate to extreme exposure on the Physical Neglect subscale of the Childhood Trauma Questionnaire (CTQ) short form constituted physical neglect.

Household Dysfunction

Mother Treated Violently:
Your mother or stepmother was sometimes, often, or very often pushed, grabbed, slapped, or had something thrown at her and/or sometimes often, or very often kicked, bitten, hit with a fist, or hit with something hard, and/or ever repeatedly hit over at least a few minutes and/or ever threatened or hurt by a knife or gun.

Household Substance Abuse:
Lived with anyone who was a problem drinker or alcoholic and/or lived with anyone who used street drugs.

Household Mental Illness:
A household member was depressed or mentally ill and/or a household member attempted suicide.

Parental Separation or Divorce:
Parents were ever separated or divorced.

Incarcerated Household Member:
A household member went to prison.

March 17, 2010

DSM-IV-TR Diagnostic Criteria for Eating Disorders

Posted by Nathen under abstinence, bodies, bulemia, death, diagnostic criteria, DSM-IV-TR, eating disorders, exercise, food, mental disorders, psychopathology
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There are two official DSM diagnoses for eating disorders, with two variations each. This gives us four options: Anorexia Nervosa, Restricting Type; Anorexia Nervosa, Binge Eating/Purging Type; Bulimia Nervosa, Purging Type; Bulimia Nervosa, Nonpurging Type.

This is are direct direct quotes from the DSM-IV-TR. “Postmenarcheal” means after the onset of the menstrual cycle. In addition to Anorexia Nervosa and Bulimia Nervosa, there is a category with no diagnostic criteria called Eating Disorder Not Otherwise Specified that clinician can give to someone “for disorders of eating that do not meet the criteria for any specific Eating Disorder.” People diagnosed with EDNOS are even more likely to die from their conditions than those in AN or BN.

Diagnostic criteria for 307.1 Anorexia Nervosa

A. Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during a period of growth, leading to body weight less than 85% of that expected).

B. Intense fear of gaining weight or becoming fat, even though underweight.

C. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.

D. In postmenarcheal females, amenorrhea, i.e., the absence of at least three consecutive menstrual cycles. (A woman is considered to have amenorrhea if her periods occur only following hormone, e.g., estrogen, administration.)

Specify type:

Restricting Type: during the current episode of Anorexia Nervosa, the person has not regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)

Binge-Eating/Purging Type: during the current episode of Anorexia Nervosa, the person has regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)

Diagnostic criteria for 307.51 Bulimia Nervosa

A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

(1) eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances

(2) a sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)

B. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxative, diuretics, enemas, or other medications; fasting; or excessive exercise.

C. The binge eating and inappropriate compensatory behavior both occur, on average, at least twice a week for 3 months.

D. Self-evaluation is unduly influenced by body shape and weight.

E. The disturbance does not occur exclusively during episodes of Anorexia Nervosa.

Specify type:

Purging Type: during the current episode of Bulimia Nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas

Nonpurging Type: during the current episode of Bulimia Nervosa, the person has used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas

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