Becoming: A Book Review

obama bookThis is one of the best books I’ve read in a long time . . .  and I read a LOT of books.

At first, it reads like a long chat with a girlfriend.  No weighty four-syllable words or policy discussions.  A friend curled up at the other end of the couch, pausing occasionally to sip from her glass of wine, and sharing stories of growing up in a close-knit family and vibrant but struggling neighborhood, academic and job successes and challenges, the well-trod paths of career discernment, job changes, marriage, miscarriage and infertility, mothering, daughtering, dreams and losses — all conveyed in a relaxed tone of voice, mostly optimistic about possibilities, and occasionally shaken by tough realities.

Eventually, of course, the path begins to take direction and the focus sharpens.  A husband with political ambitions, gifts, and speed.  One minute Michelle Obama is objecting to a run for the statehouse; the next, she’s negotiating with a Secret Service detail over concerns for her daughters’ safety not compromising their freedom and flexibility as young girls, at least not too much.  (She relates with great humor a hilarious scene in which she and high-school aged Malia make a determined dash for a locked door so that they can escape the confines of the White House and celebrate the Supreme Court marriage equality decision outside, enjoyed the rainbow-hued lights playing across the mansion’s façade in at least some proximity to the crowd gathered to celebrate.)

Of course, it doesn’t all happen in an instant and, as often occurs with such books, many more details emerge with respect to the Obamas’ earlier life in politics than regarding the later, presidential years.  The first years, from the statehouse to the Senate to Iowa, are marked by resistance, mistakes, naivete’, and a developing political eye on her part, helped along by the growth of a dedicated and brilliant support team. But the latter years are fascinating as well, as Mrs. Obama develops the projects that will mark her tenure as first lady, focusing on children’s eating habits and health, a direct response to challenges in her own family; on military families, as she comes to know a world previously hidden from her view; and on girls’ education, a commitment founded in her conviction that the South Side of Chicago as well as the rest of the country are packed with young people as intelligent and gifted as she and her brother, with young people who lack neither brains nor determination, but need the opportunities and support system that paved the path for a young Michelle.

Her thoughtfulness about her choices, and her light but deft touch as she notes the particular challenges she faced as the first black First Lady and as a mother of youngsters and then teens in a political fishbowl, are likely to illumine the way for anyone seeking to clarify her goals for the next stage of life, whatever it might be.  As a 65-year-old white woman trying to sort through what I hope my next ten-to-fifteen years might look like, I find a lot of wisdom in these pages.

And finally — as Michelle Obama reflects on her last day as First Lady and the changes in our country since — well, she brought tears to my eyes.  As the good-byes are said peaceful transition of power occurs, she observes that the joyful diversity that marked her husband’s to inaugural celebrations has been replaced by a stolid, white, male “optic,” (a word that’s often been noted by her team in connection with her own efforts), and gives up on trying to smile.  And as she looks back at the atmosphere which has enveloped our country, she experiences the heartbreak that many of us share.  (On a related note, today’s news includes a report that the Trump administration is rolling back regulations regarding school lunches — legislation on which Michelle Obama quietly worked hard, part of her legacy in promoting healthy lifestyle choices for children.)

I don’t RE-read that many books, but I’m going to start over on this one as soon as I can.  Energy, commitment, determination, humor, and grace.  I am impressed, moved, and inspired.

 

 

 

 

End of Life 3/3

breath air

Earlier this week, as a way of remembering Howard Gray immediately after his death, I flipped through a few of the emails I’ve received from him.  One of the first that popped up, written a couple of years ago, suggested that I read When Breath Becomes Air by Paul Kalanithi, M.D.  It looks as if I didn’t respond to the email, but I think that I had already read the book at that point.

Lucy Kalanithi, M.D. was the other main speaker at the Dayton conference a  few weeks ago.  The book (which I am not going to review here) details her husband’s experience with lung cancer; Lucy finished it after he died.  Paul Kalanithi was a brilliant young neurosurgeon when his diagnosis disrupted his life, and forced him to shift from physician delivering bad news to patient on the receiving end of a devastating report.  It’s a must-read for anyone whose life has jolted from one of ordinary dailiness (not that Paul Kalanithi was ever ordinary in the sense of the word which most of us understand) to the high drama of end-stage cancer.

Lucy spoke about the challenges she and Paul faced after his diagnosis, including

  • facing one’s own mortality
  • questions of identity ~ who am I now?
  • facing death and uncertainty
  • and the tension between living and dying.

That last one I remember so well from my stepmother’s stage 4 lung cancer diagnosis.  How do you deal with in-your-face issues of serious illness and likely imminent death and simultaneously forge a life among your family and friends?

Lucy left us with two poignant reflections, the latter emerging from the Q-and-A period and much discussed at out table.

The first had to do with Paul’s statement of desire: “I want everyone else to take care of Lucy so that she can take care of me.”  What a powerful recognition of, on the one hand, the needs of the primary caregiver, and on the other, the need of the patient for someone who can focus her life entirely on his need for care and support, to which everyone else can contribute by providing for the caregiver.

The second had to do with their conscious decision to have a child whose father would probably not live to see her grow up, whose father might not live to see her at all.  For the Kalanithis, their daughter was, and is, a life-giving source of joy and, while some shuddered at the thought of the courage required of her mother, most at our table could appreciate the powerful desire for love to break forth in the form of the birth of a child, even, or perhaps especially, in the heart of a sojourn toward death.

Please read this important book.  It illuminates an all-too-common experience, and may be the trigger you need to start a much-needed conversation with a loved one.

 

End of Life 2/3

Steve Pantilat, M.D. was the keynote speaker for the conference entitled Soul Work on Living and Dying that friends and I attended a few weeks ago.  Dr. Pantilat is a renowned expert on palliative care — care which he describes as “focused on improving the quality of life for people with serious medical illness.”

I’m going to offer a few highlights of his presentation (any errors are mine, straight from my notes), and suggest that you read his book, Life After the Diagnosis.

life after cover

One: We tend to think that we must choose between quality and quantity of life: we must choose either every treatment offered us to prolong life, or refuse treatment and die. This is a false and damaging dichotomy, as much care is available to make life in the face of illness more palatable — and often longer.  Dr. Pantilat advocates for everyone receiving palliative care from a team of caregivers within six weeks of a diagnosis of metastatic cancer.

Two: A terrible question: “Would you like us to do everything possible?”  Of course; who is going to sat “no” to  question like that?  I have been with both parishoners and family when that question has been asked, and it has been very difficult to walk the conversation back with what is always my next question: “Could you please explain the likely consequences of a ‘yes’ answer?”

A good question: “How are you hoping we might help?”  People may have very specific goals related to pain management, surviving until a family event takes place, travel plans, where they want to be when they die — but an open-ended question is needed for those hopes to surface.  My own commentary: People are often too intimidated by the presence of a physician at a hospital beside, or too frightened by the death they have not discussed with anyone, to say, “I know I’m going to die soon, so I think I’ll skip the clinical trial, and go home to be with my family instead.”  We have to ask, not assume, what someone’s priorities are.

Three: People are fearful that talking about these issues will destroy hope.  In fact, talking about the questions increases hope.  Other good questions include, “What are you hoping for in your future?” “What worries you most about what lies ahead?”

Four: A most unfortunate statement: “There’s nothing more we can do.”  In fact, there is always something that we can do in terms of helping someone address their concerns, companioning them, and alleviating their feelings of abandonment.

Five: It’s a myth that the goal is to have a “good death.” I would take issue with his statement that “grief is not mitigated by age and a ‘good death,” but his overall point is a good one:  The goal is to live a good life.

Next post: Another of our speakers.

End of Life 1/3

I suppose that I’ve always been intrigued by end-of-life issues.  So many early deaths in my family.  I volunteered for hospice decades ago, as a follow-up bereavement counselor — something that I thought was important for post-loss health, and something that I could do on my own schedule, on my phone, when my children were small.

I became much more interested in the realm of end-of-life care when my step-mother Jewel was dying of lung cancer.  It was a brutal experience for everyone involved.  If there was something that an oncologist could do wrong in treating someone with cancer far advanced at diagnosis, hers did — and refused to discuss other options with me.  My niece had also been a hospice volunteer and drove around for those four months with a box of materials in her car, my brother reached out to a social services agency, and I visited every few week-ends.  All of our efforts to provide my father with help and to offer both of them with a more humane experience were for naught.  Jewel was convinced that to decline aggressive treatment would be “to give up.”

A few years later, when I was a chaplain intern over the summer as part of my training for ministry, I saw much of the same on the medical intensive care unit of the hospital in which I trained.  So many tubes and machines, so many aggressive efforts, so many patients and family members unwilling to let go.  Of course, none of us can predict our reaction in similar circumstances — but I used to come home at night (or early in the morning), collapse, and say, “If anyone ever utters my name in the same sentence as the a phrase which includes that particular floor, being me home immediately!”

As a pastor, I have seen many people seek hospice care only a day or two before death is likely to come, and skip any form whatsoever of palliative care.    While there is much assistance available to ease the passage from this life to the next, physically and emotionally and spiritually and mentally, few people are aware of the options, and many share Jewel’s view: “Can’t give up!”

A few weeks ago, I was privileged to attend an outstanding conference on end-of-life care, and to share it with good friends: one a trained chaplain and two of them nurses — one of them now caring for her 90+ year-old father at home.  In the next few days, I’ll share some of what we learned.

Healthy Aging

boots desert

It seems to have happened quickly, but my children pointed out last week that I have probably been making minor adjustments for a long time.  Sadly, they are correct.

I have been walking downstairs (unless the stairs are very short ones!) sideways ever since recovering from the ankle I broke four years ago, and it’s apparent that that particular style has nothing to do with my ankle and everything to do with my knees.

An inveterate walker, I have blithely taken off days and weeks with increasing frequency in the last year.

We took a family vacation to the California desert last week, and I abandoned two of our hikes altogether when they  involved steep ascents without any shade in sight, moved slowly on others, and fell asleep most nights before 9:00.

Some weird thing has happened to one of my knees, and they both hurt all the time.

Yikes!  I have become an old woman.

I have no plans to give up walking and hiking, so this is going to have to be the Year of Healthy Aging.  Better food, more exercise, lower weight, less stress.

 

Photo: Valley of Fire NV

 

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