School's Back

"Today one of our spelling words was duo," my son began telling us over dinner (baked trout, zucchini soufflé, and Greek salad).

"Dual?" I asked.

"No - du-o.  So we tried to come up with some famous duos."

We chewed our salad expectantly, waiting to hear which duos he might mention.  Sherlock Holmes and Dr. Watson, perhaps?  

"People had a lot of ideas. Mary Kate and Ashley.  Mario and Luigi. Lewis and Clark."

We stopped munching for a second and looked at him.

"Oh, and of course Calvin and Hobbes," he finished, popping a lettuce leaf into his mouth.

Ah, fourth grade.  The halcyon days.  

***

These were my favorite passages from President Obama's back-to-school speech:

"Every single one of you has something you're good at.  Every single one of you has something to offer.  And you have a responsibility to yourself to discover what that is.  That's the opportunity an education can provide...What you make of your education will decide nothing less than the future of this country..."

"At the end of the day, the circumstances of your life - what you look like, where you come from, how much money you have, what you've got going on at home - that's no excuse for neglecting your homework or having a bad attitude.  That's no excuse for talking back to your teacher, or cutting class, or dropping out of school.  That's no excuse for not trying.  Where you are right now doesn't have to determine where you'll end up.  No one's written your destiny for you.  Here in America, you write your own destiny."

"That's why today, I'm calling on each of you to set your own goals for your education - and to do everything you can to meet them.  Your goal can be something as simple as doing all your homework, paying attention in class, or spending time each day reading a book...Maybe you'll decided to stand up for kids who are being teased or bullied because of who they are or how they look, because you believe, like I do, that all kids deserve a safe environment to study and learn."

and the part I loved most of all:

"You can't let your failures define you - you have to let them teach you...Don't be afraid to ask questions.  Don't be afraid to ask for help when you need it.  I do that every day.  Asking for help isn't a sign of weakness, it's a sign of strength...And even when you're struggling, even when you're discouraged, and you feel like other people have given up on you - don't ever give up on yourself."

Amen, Mr. President.  I hope our young people and their parents had the wisdom and respect to be open-minded enough to listen to this patently NON-ideological, NON-self-aggrandizing, very important, very worthwhile message delivered in a speech that, as advertised, and contrary to the paranoid predictions and vociferous preconceived notions of a frenzied, irrational, prejudiced, lie-fomenting right wing, stayed right on topic about the value of education.

My Favorite Word In Medicine

Sialolithiasis.

A surgeon reminded me of this word yesterday.  

"Isn't it almost like poetry?" He said.  "Sigh-yallow-lith-eye-a-sis."

It does fall trippingly from the tongue.  It means stone formation in the gland that produces spit.

Other favorites:

electroencephalogram

fulguration

chordae tendinae

echocardiography

adenopathy

fluoroscopy

gammaglobulin

but none of these has the same flow as

sialolithiasis.

You know you're an ex-English major when after being up for almost 36 hours straight, with maybe a half-hour snooze between obstetric calls, the one salient memory you have of your work day is a surgeon admiring the word sialolithiasis with you.

Caldereta: Filipino Comfort Food

Last night I made a dish I grew up with but have always been too intimidated to try: a stew called caldereta, derived from the Spanish word caldero (cooking pot). My family devoured it over sticky white rice and went back for seconds. It goes nicely with a Spanish Rioja - Ergo Tempranillo 2006 is delicious. Traditionally we're supposed to use goat meat for this but I stuck with beef. It would probably work with lamb or chicken too. There are recipes here and here for it. This was mine (concocted after reading Kulinarya by Barretto et al. and the wonderful little volume Filipino Homestyle Dishes by Norma Olizon-Chikiamco):

Caldereta (or, if you want to spell it the Tagalog way, Kaldereta)

Ingredients:

• 1.5 lbs stew meat cut into chunks
  
• 2 medium onions, chopped
  
• 5-6 cups of water
  
• 4 small linguiça sausages (about hot-dog size) or chorizos, sliced
  
• 12 large garlic cloves, chopped
  
• 1 4.25-oz can of liver paté (I was totally scared of this but it was fine)
  
• 1 15-oz can of tomato sauce (about 2 cups)
  
• 1/3 c vinegar
  
• 1 c grated mild cheddar cheese
  
• 2 Tb sugar
  
• 2 Tb soy sauce
  
• salt and pepper to taste
  
• 2 medium potatoes, peeled and cubed
  
• 4 sliced carrots
  
• 1 5.5-oz jar of pitted green olives (about 2 cups / 80 small olives)
  
• 1 bay leaf
  
• 1/2 of a red bell pepper, cored, seeded, and thinly sliced
  
• 1 c green peas (frozen = okay)
  
• optional: red pepper flakes to add a little heat
  

Directions:

• In a large casserole, brown the meat in oil over high heat with half of the onions.
  
• Add the water and bring to a boil, then reduce heat to low and simmer.
  
• In a separate pot, cook the linguiça/chorizo pieces, then set aside.
  
• In the same pot (the chorizo one), sauté the garlic for a minute or so, then add the liver pâte and stir together.
  
• Add the tomato sauce, vinegar, salt, pepper, and sugar. Stir to combine.
  
• Add the grated cheddar cheese and soy sauce and stir till smooth.
  
• Pour into simmering beef and continue to simmer for 20-30 min.
  
• Add potatoes, carrots, bay leaf, olives, and the rest of the onions and continue to simmer for about an hour. Add liquid if stew gets too thin.
  
• Stir in the cooked linguiça slices, red pepper, and peas toward the end. Serve over rice.
  

Some people use peppercorns, cinnamon sticks, pineapple juice...the variations are endless. It's a tasty dish that reminds me of childhood and home. As we say in the Philippines, "Sarap!" ("Yum!")

Movie Night and Pasta Provençale

On Monday my husband and I saw the Ridley Scott film "A Good Year," starring Russell Crowe and Marion Cotillard, with an appearance by Albert Finney.  What a lovely, charming, feel-good film.  It's about how a ruthless London stock trader (Crowe) finds his soul again when he has to return to his childhood home on a vineyard in Provence and reconnect with old friends and great memories. [N.B. - It was filmed in the villages of Bonnieux, Gordes, and Ménerbes (of A Year in Provence fame) in France, near the medieval-but-still-working Abbaye de Senanque, which is surrounded by lavender fields in bloom July and August...MUST VISIT!)]

It's not specifically a "food" movie but I couldn't help but want some Provence-inspired food after seeing footage of the golden sunlight of Southern France over the vineyards and villages, and scenes in which good meals were enjoyed in good company.  After harvesting some grape tomatoes and basil from our lback yard yesterday, with the sun warm on my back and the crickets' song vibrating loudly through the air all around me, I came up with this pasta dish, which, though not perfect, satisfied my

 craving well enough:  

3 1/2 - 4 cups orecchiette cooked al dente (a 1-lb box makes about 6 cups), tossed with a mixture of 

-breadcrumbs (about 2 Tb, sautéed in olive oil till golden), 

-chopped anchovies and capers (about half the contents of a tin of fillets rolled with capers), 

-garlic (1 large clove, minced and sautéed with above), 

-cured black olives (about a dozen, pitted and halved), 

-broiled small plum tomatoes (again, about a dozen, halved), 

-golden raisins (about 1/2 c), 

-toasted pine nuts (about 1/4 c), and 

-shredded fresh basil.  

I did use a tablespoon or two of dry white wine to deglaze the pan after sauté-ing the breadcrumbs, garlic, anchovies, and capers.  The cured olives were a tad salty, so maybe I'll use plain canned black ones next time, and I regret not picking more basil leaves and tomatoes to use, but overall it was just the kind of dish I wanted to eat after seeing this movie.  Not perfect, or not yet perfected, but workable.  Maybe I'll add some shaved fennel next time, and some kind of soft white cheese, and an herb or two...

No More Totes/Isotoner for Me

I am so, so, sooooooo angry.

I'm supposed to be working on peace and compassion and trying to let go of resentment.

But after I read THIS article yesterday I posted a very resentful, very non-peaceful update on my facebook page:  "T. is totally disgusted and thinks the Ohio Supreme Court shouldn't be allowed to take unauthorized pee breaks even if their painful bladders swell to the point of near-rupture."

So there.

I cannot possibly understand a) why any woman should be denied the opportunity to express breast milk if she needs to; b) how the need to express breast milk can be said to have nothing to do with a woman's "sex or condition;" and c) how firing someone because she needs to express breast milk can be considered anything other than patently discriminatory, especially when people with painfully full bladders have all the right in the world to get relief without permission.

Breast engorgement can be EXTREMELY painful.  Without relief, milk can spurt out at embarrassing moments and stain clothing, making the situation quite public.  Was the Isotoner company expecting this employee to go without relief ALL DAY?  I'm sure it would never impose such restrictions on their male employees who were doing a little peepee dance in the production line because their bladders were so full.

When I was nursing my son I had different reactions from different people.

When I went to the old-timer chief of surgery at my med school during my surgery rotation to ask for permission to drive home during my lunch break so I could nurse my son, to my great shock he said, "Of course!"

His young male chief residents, though - maybe because they hadn't had children of their own yet? - were less understanding.  I was begging to scrub out of surgery one time and one of them at first wouldn't allow it.  I was in so much pain that I was practically in tears.  Milk was starting to come out onto the front of my scrubs.  It was at that point, when it was a threat to the sterile field, that I was finally allowed to go.

The nurses in the OB/gyn department didn't want me pumping in the nurses' locker room.

The OB/gyn chief resident warned me not to use the back room of the residents' lounge.

The surgery residents were ok with my closing the door to the call room in the surgery residents' lounge but one of them jokingly called from outside, "Do it out here!  Do it out here!" When I opened the door one of my filled bottles was still on the night table waiting to get put away, and this resident or his buddy next to him said, "Oh my gosh, it looks just like real milk!'

I had to laugh.  "It IS real milk, man!" I said.  

I tried my best to keep up the nursing during those rotations, but after three months, my milk dried up, and on that day, I held my son and cried and cried.

Nursing is a deeply personal decision, and I think women who choose it should be supported in their efforts, not criticized or undermined, and certainly not persecuted or punished.  

A Mass to Remember

When the Son of Man comes in his glory, and all the angels with him, he will sit upon his glorious throne, and all the nations will be assembled before him.  And he will separate them one from another, as a shepherd separates the sheep from the goats.  He will place the sheep on his right and the goats on his left.

Then the king will say to those on his right, "Come, you who are blessed by my Father.  Inherit the kingdom prepared for you from the foundation of the world.

For I was hungry and you gave me food,

I was thirsty and you gave me drink,

a stranger and you welcomed me,

naked and you clothed me,

ill and you cared for me, in prison and you visited me.

Then the righteous will answer him and say, "Lord, when did we see you hungry and feed you, or thirsty and give you drink?  When did we see you a stranger and welcome you, or naked and clothe you?  When did we see you ill or in prison, and visit you?"

And the king will say to them in reply, "Amen, I say to you, whatever you did for one of these least brothers of mine, you did for me."

Then he will say to those on his left, "Depart from me, you accursed, into the eternal fire prepared for the devil and his angels.

For I was hungry and you gave me no food,

I was thirsty and you gave me no drink,

a stranger and you gave me no welcome,

naked and you gave me no clothing,

ill and in prison, and you did not care for me."

Then they will answer and say, "Lord, when did we see you hungry or thirsty or a stranger or naked or ill or in prison, and not minister to your needs?"

He will answer them, "Amen, I say to you, what you did not do for one of these least ones, you did not do for me."

-Matthew 25: 31-45

***

This scripture passage is the heart and soul of Catholic social teaching.  

I have heard and read it many times, but today I could not help but hear in it a lambasting of many Republican policies and attitudes toward the poor by Jesus himself.  There is no ambiguity here; all are called to help the unfortunate in concrete ways, to give willingly and without preconditions.  Period.

This dimension of Catholic faith, the emphasis on social justice, energized the life-changing legislative career of Senator Ted Kennedy.  Fr. Mark Hession of Our Lady of Victory Parish in Centerville, MA said during his homily, "These works of the Kingdom were daily concerns of the public life of Senator Kennedy."  I am so glad that reading was chosen as the liturgical centerpiece of his funeral Mass, which I "attended" from my living room via CNN's live coverage.  (Click here to see a pdf version of the Mass program.)

 I found Senator Kennedy's Choice of Mission Church - Our Lady of Perpetual Help on Mission Hill - less than half a mile from where I received my medical training - deeply moving and fitting.  It may have been a security nightmare for the Secret Service to prepare this place to receive four presidents and two thirds of the United States Senate, but it was the perfect place for Ted Kennedy's funeral Mass.  The basilica is at the heart of a community that embodies so many of the concerns of his career - civil rights, access to health care, social justice.  It had personal meaning for him, too:  he prayed for his sick child here.  Fr. Mark said it best during his well-written homily: "The senator's choice of this church for his funeral mass resonates with the meaning and the purpose of his life and work."

What a beautiful Mass it was.  I couldn't help noting the similarities between the Aquinos and the Kennedys, especially when Donald Monan, S.J., Chancellor of Boston College, opened the Mass with a description of the way private prayer was the secret strength behind Ted Kennedy's public life.  The readings chosen for the Liturgy of the Word  - Wisdom 3:1-9, Psalm 72, and one of my favorites, Romans 8:31-39 - conveyed perfectly the emphasis on justice and trust in God that has imbued the lives of the Kennedy family. Susan Graham sang Schubert's "Ave Maria" more exquisitely and expressively than I've ever heard it sung before, with perfect dynamics and consummate vocal control.  Literally pitch-perfect.

Most unforgettable and  moving, I think, have been Vicki Kennedy's extraordinary and exemplary grace and dignity throughout this week of public grieving, and Ted Jr.'s story of how his father encouraged him and helped him climb an icy hill shortly after he (Ted Jr.) lost his leg to bone cancer.  All the stories - moving, funny, striking, redemptive - put a human face on an iconic figure.  Ted Kennedy worked hard for the people, cared about individual suffering as well as global, and tried to be a good father to his children.  Instead of retreating from life because of past failures, he moved forward and tried to be a better man.  He worked tirelessly to better his country.  I agree with what President Obama said in his eulogy - we should celebrate what he became.

After the Mass we began our drive to New Hampshire for a weekend of rest.  We glimpsed Kennedy's motorcade on its way to Hanscom Air Base as we waited to merge onto 95 North from Route 2.  As we exited 93 North in New Hampshire, we saw a large American flag at half-mast at the first intersection.  Now we are watching the ceremony at Arlington National Ceremony.  We've heard the final correspondence between the Senator and the Vatican.  The gun salute and Taps just ended.  His grandchild is describing sitting on the porch with him in the early morning looking out over a sea of "freedom and possibility": 

"We talked and we talked, and the world was just right." 

Rest in Peace, Ted Kennedy.

"Eternal rest grant unto him, O Lord

and let perpetual light shine upon him." 

- from the Prayer for the Dead

Saying Goodbye to the Age of Myths (But Wanting to Cling Just a Little Bit Longer)

My children's birthdays are occasions of profound happiness for me.  Today my son turns nine - his last year in the single digits.

This is one of those ages that makes me wistful, that tugs at some primal chordae tendinae, making them vibrate with joy and melancholy all at once. 

I was about this age when I first arrived in the United States.  I remember it as a time of discovery and wonder.  I watched 3-2-1 Contact, played with a leathery-smelling old basketball in our front yard, read novels by E.L. Konigsburg, Louise Fitzhugh, Madeleine L'Engle, and Katherine Paterson, and marveled at the way the seasons changed.  

My son loves books too, as I did at that age.  He can spend hours absorbed in books like D'Aulaires' Book of Greek Myths (in fact, we gave him their volume of Norse myths as a birthday present today, along with a book entitled Cool Stuff and How It Works). He dreams of being an astronomer but has also entertained the idea of being a zookeeper.  He has a healthy love of fantasy but has voiced some opinions about the workings of the real world as well. Already he sounds  a little more worldly in his own cerebral way, a little less magical in his thinking.  He has managed to maintain a very sweet kind of innocence for years, but I expect him to lose more and more of that in the coming year.  I am awed but also a little sad.

Because I had already found out the biological facts of life at a much earlier age (by accident, at a book store), I was able to prolong that idyllic childhood time, in a way, without an abrupt transition from "not knowing" to "knowing."  It was a done deal; I knew already; I could just enjoy the rest.  With him, though, I can see that the "loss of innocence" talks will occur as discrete events - much like his learning to crawl, and walk, and speak.  

The birds and the bees are already hovering.

"What's menopause?" he asked me the other day after hearing the word on television.

"Do you know what periods are?"  I asked.

"No," he said.

"Well, let me explain that first, then I can tell you about menopause."

"All right, I'm outta here," my daughter said, picking up the laptop and leaving the room. This is old hat for her.  

I pulled out a sheet of paper and drew a rudimentary uterus on it.  I explained that when babies grow inside their mothers, they're not just floating around in the abdomen; they grow in a special place meant just for them.  I drew fallopian tubes and ovaries - a little too large, not really to scale.  

"It looks like a moose," my son observed.  He was right; my fimbriae, tubes, and uterus indeed looked rather moose-like.

I explained about the ovum's journey and the monthly thickening of the uterine lining, and about how it was passed out of the body if the egg wasn't supposed to wind up growing into a baby inside the uterus.  Soon my husband and I will have to sit down with him to explain Part Two (what happens when the ovum does nestle into the uterine lining to develop into an infant, and how that comes to pass).  

Herein lies the bittersweetness of this age for me.  At some point we have to let go of the simplicity and innocence of that world in which the arrival and growth of a baby are accepted as blessings without biological mechanisms.  Our son will grow in knowledge and expand his ideas, and that is only right.  But oh, that trusting look of a child who needn't know too much just yet - whose questions are completely without guile or cynicism, and who is just as content to find answers in stories as in facts - that look will be gone. 

I don't want it to come too fast, but the time is upon us.  And we do celebrate it:  his wisdom advancing.