Saturday, August 29, 2009

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.

I was thirsty and you gave me drink,
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,

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

Thursday, August 27, 2009

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.

Wednesday, August 26, 2009

End of an Era

"My brother need not be idealized or enlarged in death beyond what he was in life, to be remembered as a good and decent man, who saw wrong and tried to right it, saw suffering and tried to heal it, saw war and tried to stop it.

Those of us who loved him and who take him to his rest today, pray that what he was to us and what he wished for others will some day come to pass for all the world."

-- Ted Kennedy's eulogy for Robert F. Kennedy, June 1968.


Please read this beautiful post about Ted Kennedy by Lisa Johnson, author of the blog Anali's First Amendment.

Monday, August 24, 2009

Nada Te Turbe

I've been thinking a lot lately about the what stresses me out most in life.  It's not the tough clinical scenarios, busy days, practical aspects of maintaining a household, or parenting responsibilities that get to me, I find.  It's the toxic nature of certain people.

I tend to get very strong "vibes" from, and have equally strong reactions to, other people.  I'm not claiming that the vibes I sense are always accurate - though my husband and I believe they are, actually - but only that they can create very strong feelings in me, and sometimes the intensity of these feelings causes me great stress.

Today I had the kind of day that might have been stressful for a number of reasons.  I had to come in extra early to relieve the night doc.  I was the physician in charge today and that, in and of itself, usually raises my blood pressure a few notches.  There's always a lot of busy work to do as the charge person, with constant interruptions by beeper tones, phone calls, surgeons with questions, nurses with questions, patients with questions.  Moreover, we had at least two clinically difficult patients in the rooms today, one of whom almost coded on me.  But I wasn't that stressed.  In fact, I was pretty calm and content.

And I knew why.  The absence of toxic coworkers made all the difference.  

There have been a few people in my work life, at other hospitals and at my current one, who are like poison to my day, for any number of different reasons - lack of integrity; pathetic or non-existent work ethic; arrogance; contentiousness; snide or critical speaking tones; biting hostility; back-stabbing tendencies; bullying; hypocrisy; narcissism; disrespect; a lazy or indifferent attitude to patient care.  When I sense "vibes" of this nature from other people, I tend to develop very strong feelings about their behavior patterns.  More than anything else, the effects of their actions on the quality of my day, and the feelings they inspire, are a noxious presence in my life - largely because I allow them to be.

I know, however, that I have some control over that.  That I can train myself to choose not to let my strong reactions to toxic people have such a hold on me.  I know I can be a little less perturbed by the scripts others are acting out and just focus on my own.  But like any spiritual habit, this effort to reclaim an inner peace, this way of living in the world with less reactivity and stress and greater mindfulness of what's truly at work, is going to take time and practice.

Pray more, said a voice in my head when I was meditating during Mass this weekend.  I guess that wouldn't be a bad way to start; after all, prayer - or meditation, or focused awareness, or connection to the sacred, or whatever label suits your understanding - does have the power to transform us, whether or not anyone seems to be listening.  I've been too content with the idea of my entire life being a kind of prayer; I haven't been proactive enough, like an athlete training to keep her body in shape.  It's time to stop neglecting that dimension of my life and start practicing a little better.

Friday, August 21, 2009

Guest Post: Notes on Copland's Fanfare for the Common Man

It is my great honor and pleasure to commemorate this Philippine holiday, the 26th anniversary of Ninoy Aquino's assassination, with this reflection by my talented friend Jeffrey E. Salzberg (used by permission; photos added by me):

I had an epiphany some time ago. I listened to Aaron Copland's Fanfare for the Common Man.

I'd heard it before, of course - it's long been one of my favorite pieces of American music, actually - but this time I really listened to it. And, for the first time, I understood it.

It helps to know the background. In 1942, the Cincinnati Orchestra invited 18 composers to submit new pieces expressing their feelings about America. At the time, Nazi Germany had conquered most of Europe. Much of Asia was under the control of Imperial Japan. Mussolini was carving out his own empire in Africa and southern Europe. Freedom and democracy, it's not an overstatement to say, seemed doomed.

Aaron Copland entered the competition.

Tympani - the cannons of war.

...And silence...Evil appears triumphant and unstoppable.

...But a single horn enters, playing the theme...a single man, who realizes that Evil must be opposed, even though opposition will surely cost him his life.

More cannons.

A second person, seeing the first, stands with him. It's still hopeless - what can two people do against such an overwhelming enemy? - but Evil must be opposed; it cannot be allowed to stand.

...But a third person stands...and a fourth...and a fifth. The tide begins to turn.

...And now there's a mighty army, invincible. Evil is vanquished.

...Because one person had the courage to stand against it.

-Jeffrey E. Salzberg, February 6, 2009


For more about Ninoy, please see my post about him from last January here, a Wikipedia article here, or an online tribute for him here.

Thursday, August 20, 2009

Patient: "One Who Suffers"

[Picture source.]

We all have patients sometimes with whom we absolutely dread interacting.  

We had one such patient recently - a sullen, angry, hate-filled man who acknowledged others only rarely and, if he did deign to respond to inquiries at all, did so with unabashed hostility.

Imagine my delight when I was informed that five or six people had attempted to get an I.V. into this gentleman without success while I was in the operating room taking care of another patient. By the time I came out no one wanted to go near the man, or speak to him, much less try again.

When I approached the patient and introduced myself he didn't look at me or reply.  He ignored every question I asked.  When the first I.V. cannula I inserted entered the vein but then refused to advance further, he swore and threatened to leave.  I couldn't blame him; he had been made into a pincushion by several others, after all, and now by me too.  I finally managed to get the I.V. on the third attempt and was able to bring him to the operating room.

All the while despite his unpleasant manner and occasional sniping comments I made a special effort to speak with calm and respect, to touch gently, to be attentive to his comfort.  It wasn't so easy.  Gradually his manner softened a little.  As I was applying the last of my monitors I told him I would be giving him the anesthetic soon.

"Can you..." he began.

"Can I what?" I replied, trying to encourage him to ask what was on his mind.

"You could make it so I don't wake up, couldn't you?"

"I could, but my job's to make sure you do wake up."

"No, please, I don't want to."

All of a sudden he sounded scared, and very, very sad.  Not at all the hard, furious man from the preop area.

"Please don't wake me up. Just let me die."

"I can't do that."

"No one would ever have to know.  Please just kill me.  Please.  I know you can."

"But I can't.  It's not up to me," I said.

"But I don't want to wake up.  Please."

All the layers of anger and hate he had put on over his hurt and fear had lifted like veils.  When I saw his face, his true face, all I could see was suffering profound enough to make his life unbearable to him, and my own negative feelings melted away. I felt unkind for having resented his earlier demeanor so, and clueless for not having remembered that hostility almost always conceals some kind of fear or pain.

"All I can do is give you a brief rest," I said.  "That I can give you."

The disappointment in his sigh cut deeply.

We still have so much to learn from you, I thought as the anesthetic took hold.  So much to learn.

Sometimes the ones we think we don't want to take care of are the ones who teach and take care of us.

Wednesday, August 19, 2009

Bracing Ourselves

This is one of my favorite pictures of my daughter.

The first thing I noticed when the orthodontist e-mailed it to me, of course, was the beautifully patent airway, a dark passageway beside the column of stacked cervical vertebrae.  

After that I couldn't help admiring the specter of her facial features over her bone structure, so lovely and young yet also with the timeless look of a wise old soul, a spirit that has known lifetimes of joy and sorrow, or one that is innocent of it all - a pure heart.  She is Nefertiti looking out across the Nile toward Amarna, she is the Little Match Girl of Andersen's tale, she is Mary with her secret garden, she's the Princess of Genovia.  She's all these and none of these.  She's the girl we love most in all the world.

She has a will of iron and a heart of gold.  She is bubbly and carefree, yet capable of a depth of feeling that might seem well beyond her years.  She's a "Tween" through and through:  on the phone rhapsodizing about Twilight's Edward one moment, hugging her teddy the next; pushing our rules to the limit, and sometimes overstepping them; developing political opinions and a social conscience; sweet and loving with us, certainly, but also possessed of a tone and attitude that sometimes send her stomping up the stairs and us throwing up our hands wondering how to get our messages through.

She got braces this past week - a reminder that time just keeps flowing onward, and we have to try and keep up.  Every adolescent needs braces of some kind.  Little guiding supports, pushes and tugs to maneuver things into place and get them in the best possible alignment.  We're just trying to figure out how to apply ours without too much hurt and discomfort, and with some hope of compliance.  

Already I've messed up.  Pushed a little too hard, shown sometimes more anger than understanding, perhaps expected too much.  

I wonder if she'll look back and resent this period of tested limits and battling wills, or whether like a patient I had today she'll look back on her parents' "strictness" with an understanding that it sprang from a deep caring about her choices and her well-being, her health and her character.  I hope she does see someday that the "tough love" that sometimes drives her up the wall is the same love that lights up my face whenever I see her, that makes me hug her extra hard for no reason at all, and that keeps her always in my mind and heart even when I'm faraway.

Tuesday, August 18, 2009

If I Weren't An Anesthesiologist, I'd Want to Be...

...someone like Tim Hammack.

When I heard about the work of Chef Tim Hammack on NPR's Morning Edition this morning, I was filled with such admiration that I was talking out loud into an empty car at 6 o'clock in the morning. (Click here to read about him in the New York Times and here to see a feature about him in The California Report.)

Chef Hammack left his post at Bouchon in the Napa Valley to be executive chef at the Bay Area Rescue Mission because he wanted to put his creativity, passion for food, and talent for preparing it to the service of those without means as well as those with.  

Can I just say, MY HERO?!

I must admit there's a fine line between admiration and good-natured career envy.  This is a man who gets to work with food all day, transform the ordinary into the extraordinary, and serve others, not only by providing nourishment and comfort but also by providing some useful skills to those who want to learn them and need a little boost in the right direction.  What GREAT WORK!

You can just hear the deep satisfaction and love-of-the-work in his voice as he describes one meal at the Rescue Mission, which serves meals to 1200 people a day:

"Yesterday for lunch we made a creamed vegetable soup, garnished it with fried carrot shreds, and we made a home-made crême fraiche, croutons, and some shredded bacon on top - you know, something that I would serve in a restaurant...Their eyes open up and they say, 'Wow, this is really something special!' "

It really is.  Bravo, Chef Hammack.  You're an inspiration!

Saturday, August 15, 2009

End-of-Life Preparation Is a Responsibility, NOT a "Death Panel"

"Anesthesia, STAT to Unit Five.  Anesthesia to Unit Five, STAT."

I bolted up the stairs and then down a long corridor.   The room I needed to find was of course the very last one.  Just outside the doorway a woman with greying hair stood weeping, and beside her a younger woman was wringing her hands.  Beyond them I saw a male patient lying on the bed.  A man in a white coat was performing chest compressions.  Another man in a white coat stood at the foot of the bed managing the code.  There were a respiratory therapist and two nurses assisting, one to record data, another to fetch and push drugs.

The man at the foot of the bed turned and saw me.  "Good, the anesthesiologist is here."

He turned to the two frightened, distraught women in the doorway.  

"If we're going to continue with the resuscitation, we need to get a breathing tube in.  May we proceed?"

The bewildered women turned to each other.  "What?  Um, I don't know.  I don't think he wanted that," said one of them.

"Yes he did - he said we should do everything," said the other.

"But he told me he didn't want to linger on machines..."

Meanwhile, the doctor and nurses in the room were trying to get our attention.  "We need to intubate him now." 

The first doctor turned to the women once again.  

"I don't know, I don't know!"  they said, with panic in their eyes and voices.  

I started preparing equipment and drugs, but eventually, the family decided against continuing the resuscitation.  They sent me away.  The other doctors and nurses stopped what they were doing.  The patient died.


It's because of situations like this that I cannot believe, absolutely cannot BELIEVE, that anyone, solely for political scare-mongering, should be so misleading and ludicrous as to attack the idea of end-of-life counseling - especially considering the fact that the proposed counseling is VOLUNTARY.  

Frankly, as a physician I actually think it SHOULD be mandatory rather than voluntary.  Too few families are prepared for their loved ones' impending deaths - the decisions that have to be made, the ability to respect their loved ones wishes.  How can families make sound decisions if they are completely uninformed of the choices they have?  
The House bill requires "an explanation by the practitioner of the continuum of end-of-life services and supports available."  It is insulting to the public's intelligence to try to propagate the idea that the government is trying to end people's lives sooner simply by proposing the means by which to educate the public about their options and to encourage dialogue both among family members and between health care providers and families.  How can doctors and nurses provide the care and service patients want if patients haven't reflected on their own wishes and made them known?  

I mean, are people like Palin, Grassley, and Isakson really that obtuse, or are they just faking it, twisting the truth or downright making stuff up, for ideologic reasons?

Health care is ALREADY rationed.  It's called being DENIED health insurance claims for things like cancer surgery, denied coverage because of a "preexisting condition," and the like.  While we might complain about the details and be concerned about the funding, we really shouldn't be complaining about the idea of making health care more AVAILABLE.

The woman who is worried that people over the age of 65 are going to be "told to decide how they wish to die," and others like her, should realize that that's EXACTLY what they should be thinking about and working on, for their own sake and the sake of the loved ones and caregivers who will be part of that final journey.  Artificial feeding or not?  Breathing machines or not?  Comfort measures only, or full invasive resuscitation, including cracked chest and internal cardiac massage?  People SHOULD decide as best they can how they wish to die.  They should then make their wishes known as clearly as they can, both to their families and to their physicians.  Then their FAMILES in concert with their PHYSICIANS, NOT their insurance companies, should come to some final decisions together. Maybe then they can actually have a chance at exiting this life with the peace and dignity that each person hopes for and deserves.

Wednesday, August 12, 2009

Julie & Julia On My Day Off

I never get tired of this view of Boston.  Even after living in the area off and on for the last twenty years, I still catch my breath every time the Red Line train emerges from the Kendall Square area and is met by this view while crossing the bridge from the Cambridge side of the Charles River.  When I'm going into town for something enjoyable, like lunch with a great fellow-blogger and friend, seeing this skyline fills me with a special kind of excitement.

Lisa, a.k.a. Anali, author of Anali's First Amendment, and I took advantage of "Restaurant Week" and had lunch at Aquitaine, a French bistro on Tremont Street.  I'd been looking forward to this lunch since we firmed up our plans last night while I was between cases on call.  I already knew what I wanted:  moules frites, or a "Bourride of Mussels with Leeks, Fennel, Roasted Tomato, and Parsley," served with toasted bread and basil garlic aioli.  

Bourride, I learned, is another occitan word which, according to Merriam-Webster online, refers to "a fish stew similar to bouillabaise that is usually thickened with egg yolks and strongly flavored with garlic."  I detected no egginess in my mussel broth, which had just enough of a hint of garlic to be tasty without being overpowering.

I was not disappointed:  it was exactly what I wanted in an appetizer dish of mussels. For the main course Lisa and I both had tagliatelle with golden raisins, pine nuts, spinach, capers, and hand-pressed ricotta - delicious and al dente, just as it should have been.  Then she had a lovely pink grapefruit sorbet while I finished with a lemon pound cake.

After lunch we caught a matinee showing of Julie & Julia at the the Loews Theater on Boston Common.  I am a huge admirer of Meryl Streep.  I think she is one of the most talented actors out there, and her portrayal of Julia Child is a delight and a tour de force - for me, the whole reason to see this film, beside my great love of food and cooking.  The memorable cooking scenes - Julia practicing her onion mincing and Julie trying to pull off a lobster thermidor - were captivating.  And I loved the husbands in the movie - they were so supportive and so nice, and they reminded me so much of mine.  

Here's my honest opinion:  while I like Amy Adams' work and enjoyed the film, I found myself wishing it were a film about Julia and Paul rather than Julie and Julia, and perhaps the wonderful Stanley Tucci has something to do with that.  I kept feeling wistful every time the story would cut away from the Childs and go to the Powells, wanting to see more of the love story and events in the lives of the Childs, more of Paris (admittedly a personal bias), more about Julia's culinary journey in France.  The film was very nicely written, and well-acted by all, but Streep and Tucci really had me hooked to Julia and Paul.  

I don't own a copy of Mastering the Art of French Cooking, but now I'm thinking, how have I lived till now?!  I'm going to have to check out some French Chef DVDs too...

I tried to think if there's any person I look up to in the way Julie idolized and was inspired by Julia - that one muse you're dying to meet, or to whose home you'd want to make a pilgrimage if you could, or whose every piece of writing you want to read, or whose life and work you'd want to emulate - but no one person fills that role for me so far in quite the same way, though a few might come close.

I appreciate so much better now what Julia Child has meant to the world of food and cooking.  With the support of those who cared about her, as well as her own pluck and exuberance, Julia Child was able to follow her heart, truly be herself, and make an enormous difference. What a great example of using one's greatest passion in life to transform oneself and change the world!

Tuesday, August 11, 2009

Clafoutis Comes from Clafir

I'm obsessed with feeding people.

Let me back-track a little: what I'm really obsessed with is food. I love food. I love eating it. I love preparing it. I always feel a little annoyed when I get food that's been carelessly prepared. I believe the act of cooking should be truly a labor of love and attentiveness - love of the material, the work, and the people who'll be receiving the fruits of one's labors.

I feel the same way about writing and about medicine. Every little object or act matters. We're pouring out of ourselves to others; such work requires meticulous attention to detail and the highest of standards.

We have a young guest in our home this month - the fourteen-year-old son of family friends - who's visiting from France. I want all my guests to eat well, but I especially want our borrowed children to be well-fed. But how to do this for someone who comes from the world center of good eating? Where cattle are grass-fed, dairy is rich and creamy even at 2%, and even an "ordinary" loaf of bread is simply incomparable? (Not to mention, where his mom is an amazing cook, to boot?)

I wandered down the grocery aisles here with despair in anticipation of his arrival. How to offer a sample of American life without putting crap on the table? All of a sudden the bread aisle embarrassed me. The dairy section embarrassed me. The boxes and boxes of processed food embarrassed me.

I was concerned, too, about his metabolic needs. He's athletic, taller than my husband, still growing, thin as a rail. You know the type. An active teenager who can eat mountains of food without gaining an ounce and is perfectly capable of eating more an hour later. How I envy these young people their physiology!

I guess I needn't have worried. I've been cooking what I ordinarily cook every day for my family, and we've eaten well. It helps that this lovely young man is adaptable, easy-going, sweet, well-mannered, helpful, and gracious. We've had an abundance of seasonal fruits, vegetables, and other foods - lots of corn-on-the-cob (I know, I know, corn can be evil, but it was something I missed while I was in France recently, and the local farmers are growing them sweet this summer!); tomatoes (with fresh mozzarella); zucchini (soufflé and sautéed), and some really American stuff, like chicken pot pie, apple pie, homemade cole slaw, and taco salad with bison (this, coincidentally, on the day he sat watching our DVD of Dances with Wolves...).
We've had balsamic chicken, broiled flank steak with lime juice and cumin, seafood pasta with shallots. For dessert we've taken advantage not only of the yummy frozen treats from Trader Joe's but also of the seasonal berries and cherries galore (both fresh and, thanks to my friend KP's recipe, transformed into a delicious blueberry cake similar to this plum torte, and a cherry clafoutis from Julia Child's recipe).

I've also thrown in some Filipino food, something I don't often do even for my own family (not sure why, really). I've learned in the process that our signature dish, "Adobo," derives its name from a medieval French term, adouber: to dress a knight. But of course!

I made an easy variation of Adobo Sa Gata, marinated chicken and/or pork with coconut milk (recipe adapted from the book Kulinarya: A Guidebook to Philippine Cuisine by Barretto et al.):

Adobong Manok at Baboy Sa Gata

Marinate 2 lbs cubed meat (chicken or pork or both) in the following for about 30 minutes:
  • 1/2 c white vinegar
  • 8 crushed garlic cloves (or more - use the whole head if you want)
  • 1/2 tsp salt
  • 1/4 tsp white pepper
  • 2 bay leaves
  • optional: 1-2 Tb soy sauce (I didn't use this)

Remove meat from marinade and brown on all sides in a small amount of hot oil (1 Tb or less).
Add marinade (minus the bay leaves) plus contents of one 13.5-oz can of coconut milk (the Thai kind is best).
Bring to a boil, then simmer 20 minutes.
If sauce is too tart, can cut it with 1 tsp sugar.

Serve over rice. [My favorite way to make rice: In a large pot, mix two cups of rice (Nishiki or Kokuho Rose brand) with 3/4 tsp salt and enough olive oil to coat (about two "glugs" from the bottle); pour in four cups of water and stir; bring to a boil, then cover and simmer on very low heat till all water is absorbed.]

Eating is in many ways such an ordinary part of daily life, but it has such power. It nourishes us and gives us energy. It brings people together. It calls us to be grateful for simple pleasures, for abundant graces. It sustains our lives. The French (actually, occitan) word clafir, to fill up, sums up its blessing: what greater contentment is there than a life filled with peaceful shared moments, good food, great company, loving hands, hearts that care for you, a home in which to rest and have the freedom to be oneself?

Friday, August 7, 2009

A Short Story (untitled)

[Photo credit.]

Flor spotted her mother from the ferry, high above the pier. Almost everyone had black hair, brown skin.  A few men in the crowd had colorful bandanas over their mouths and noses to guard against dust and smog. Her mother’s hair was the color of storm clouds.

The crowd seemed restless.  People were milling around, calling to loved ones on the gangplank, texting; but her mother, she noticed, stood perfectly still.

On the ride to the waterfront she had been silent, too.  What could she say?  She had already asked Flor not to go. She had expressed her dread in countless what-ifs.  What if you get lost.  What if someone steals your money.  What if he’s cruel to you.  What if you don’t come back.  A lifetime of worry packed into weeks of what-ifs.  All that was left now was this panicked silence.

The ferry was colossal beside them as Flor embraced her mother on the pier. 

“Be careful,” her mother said.

“You too.”

She boarded the ferry and found a place at the railing.  She could see the road they had taken, with green fields on both sides, and in the distance, some palm trees and mountains.  There was rain over there, she could tell - a grey curtain of it between the sky and the mountainside, drifting toward the mango orchards.

The waterfront vendors had long poles fitted with little baskets so they could reach passengers on the upper decks. There was an honor system: pesos in the basket in exchange for peanuts, cigarettes, or whatever else they were selling that day.

Flor rummaged through her bag.  Cell phone.  Make-up.  Wallet.  Snacks. Umbrella.  Some e-mails.  A magazine.  Her copy of the photo and profile information she had sent.  His picture.

He had light brown hair under his baseball cap.  He looked like a baseball player, actually – or at least, what Flor imagined a baseball player might look like.  He was smiling.  He wasn’t handsome like a movie star, but he looked nice enough.  His skin was very white.

She had heard bad stories, of course.  Everyone had.  But she also knew of people who had found new lives with decent men.  She had to hope that this one was as nice as his e-mails.

There was a small commotion on the pier.  Someone was calling one of the vendors, putting something in his basket, pointing up toward the ferry.  Flor looked down and saw her mother gesticulating.

“Over there,” her mother was saying.  Flor could read her lips.  Her mother held her folded hands to her mouth in anticipation as the vendor reached up toward Flor with his pole. Flor reached into the basket expecting yet more food, or a holy medal – St. Christopher, maybe, or her mother’s favorite, St. Jude.  

Her fingertips brushed against soft, tiny things, cool and tremulous.  A garland of small, white flowers, so fragrant that nearby passengers had to turn and look.

She wanted to wave one more time, but she couldn’t find her mother in the crowd.  The ferry blew its horn and pulled away from the pier.  Flor searched through the blur of dark heads.  They were getting smaller, less distinct.  She thought she saw her for a moment:  a tiny cloud on the edge of a black sea – but she couldn’t be sure.

She leaned on the railing and put her chin in her hand. The scent of white flowers broke over her in waves. The garland dropped noiselessly into the water as she watched the people on the shore disappear. 

Thursday, August 6, 2009

Letting Off a Little Steam

Create Fake Magazine Covers with your own picture at

Create Fake Magazine Covers with your own picture at

Just wanted to have a little fun. Hat tip to K. for clueing me in.

Tuesday, August 4, 2009

Remembering Two Presidents Today

[Photo: Reuters/Romeo Ranoco]

An e-mail from my mother with a first-hand description of events in the Philippines - history from the trenches, as it were:

We spent another day at Cory's wake. She was transferred from LaSalle Greenhills, where she was for two days, to Manila Cathedral. You should have seen the thousands of people who lined the streets all the way from her through EDSA and Makati, to Roxas Blvd and Intramuros. They were wearing yellow shirts, waving yellow flags, carrying yellow balloons, and some holding up huge banners saying, "Maraming Salamat President Cory"* and "Mahal ka namin Cory!"** and "Hindi ka nagiisa, Tita Cory!" The people's spontaneous outpouring of love for Cory gave us goose bumps and was very moving.

The coffin was borne in an open truck and draped with the Philippine flag. The open truck was festooned with yellow flowers and ribbons. There were so many people in the streets that it took the cortege five hours to reach the cathedral from La Salle.

At the cathedral grounds, long lines of people waited to get in to have a glimpse and a chance to say their last goodbye to Cory. I went with C. and B., and this time I took L. too. She had been dying for a chance to pay her respects but was discouraged by the long lines of people standing out and waiting under the bright sun or heavy rains. With us she was able to get in through the entrance reserved for family.

...We stayed for the 8 p.m. mass celebrated by the cardinal, three bishops, and about fifty priests. By the time we got out it was almost 10 p.m. We have one more day today of the wake and 8 p.m. Mass, then tomorrow is the funeral. She will be buried in Manila Memorial beside Ninoy...We don't know how long it will take for the funeral cortege which we will be following to get to Manila Memorial. If the crowds along the way are anything like today it may take us all day. The whole thing is reminiscent of Ninoy's funeral.

Kris came on T.V. and gave a detailed description of her mother's last days. She said before she died Cory was looking upwards with a smile and expressed that she saw Ninoy holding his hand out to her. They urged her to take his hand and go with him.

* "Many thanks, President Cory"
** "We love you, Cory"
***" You're not alone, Aunt Cory"


A facebook upload by my daughter on her President's birthday (an application she found called "Obamaize yourself"):

We wish the President of the United States a blessed and peaceful birthday.


8/5/09: My daughter and I watched the livestream of the funeral Mass last night and went to bed at around 11:30 p.m., just as the motorcade was getting ready to drive to the cemetery. This morning I checked in on its progress at 6 a.m. and the motorcade had only gotten about 2/3 of the way to the cemetery, because of the crowds of people who had gathered in the streets and around the vehicles to pay their respects. The mood was festive - one of celebration for a meaningful life well-lived. The police have been reporting a crime rate of ZERO. Such is the power of a truly good person to bring people together and make a difference...


8/6/09: My parents' vehicle wound up being the lead car in the funeral procession, ahead of the truck bearing Corazon Aquino's remains. For them it was indescribable experience to have tens of thousands of people surrounding, caressing their vehicle and the ones that followed, with cheers and chants in support of Cory. They had never seen so much love expressed for one person on one occasion. People from all walks of life celebrated together in the streets with the unsurpassed joy - joy side by side with the nation's grief - of a people who knew their own dignity, all because of this heroic individual and her martyred husband. Click here and here for on-scene photos and blog posts by Noemi, "A Filipina Mom Blogger" who was there.  These last two pictures are from her blog.

8/22/09:  attended a Mass in honor of Ninoy and Cory at St. Ignatius at Boston College, our current parish and the parish closest to the Aquinos' former home on Commonwealth Ave. in Newton, MA.  Beautiful songs in both English (I Am the Bread of Life by Toolan and Blest Are They by Haas) and Tagalog (Bayan Ko and a tribute by a rondalla in native dress).  I got a little homesick.

Monday, August 3, 2009

Detour / The Space Between

[Photo by Brian Stansberry.]

It was supposed to be a routine pre-op visit. An opportunity to make sure he'd be ready for surgery.

There would be the usual round of questions: Do you have any allergies?...Have you had any trouble with anesthesia in the past?...Do you get short of breath when you climb stairs?...I need to examine the inside of your mouth. Could you open wide for me please and stick out your tongue?

He, in turn, would ask me about the anesthetic plan. I would get his signature on a consent form. We might make some small talk about past hospital visits, family, work, local restaurants. I'd make sure all the labs and paperwork were in the chart. Then I'd move on to the next patient I had to see on rounds.

But at the end of the visit, during the small talk part, as we were winding down, dotting our i's, crossing our t's, something happened. Perhaps a wave of dread over the impending procedure came over him. Perhaps the loneliness of being imprisoned there, alone, in an edifice filled with sick people, of whom he was one, finally cracked open his already wounded heart and released a rush of emotions. This patient, whom I had never met before and whom I would probably never see again (because someone else would be providing his anesthesia the next morning), began to cry.

"I lost my partner last spring," he said.

"I'm so sorry," I said.

A tear escaped down the side of his face. I took a tissue out of a small box at the bedside and dabbed at the corner of his eye.

He told me a little about their relationship. How they had been married to others earlier in life, then had found one another and been together for decades. How they had held hands in the end, while the pain medicine was running, and how when death finally arrived, his partner's hand simply went limp in his. Another tear rolled down his cheek. I took his hand in mine, and his grasp was tight, as if he might never let me go.

"Your partner didn't die alone. That's a blessing."

The patient nodded, then began to sob quietly.

We talked a little more about his loved one, and about the day ahead. At the end of our conversation I squeezed his hand and said, "Have no fear."

"No fear," he repeated with a shake of his head, willing negative thoughts away.

"You won't be alone tomorrow."

He thanked me and gave me a compliment, then let go of my hand. I returned to the nurses' station and put his chart back on the shelf. It stood in a row of a dozen others exactly like it, now almost indistinguishable from them, anonymous. A collection of data. History, but no story.

I pulled out the chart for the next patient and resumed the night's work.

Saturday, August 1, 2009

Grieving for Corazon Aquino

January 25, 1933 - August 1, 2009

"An unassuming, soft-spoken, self-described housewife, she became a symbol of democratic change and hope for millions around the world." -Frank James

[Photo credit.]

I was between cases on what would be a long night on call when I got the news about Cory's death.

Anything I could possibly write in tribute to her would be inadequate to express my love and admiration for this extraordinary woman. I cannot think of anyone more courageous or more heroic.

Please click here to read a little more about her and here to see the first few minutes of the United States Congress's welcome of her back in 1986.

A commentator can be heard saying of the applause, "This is much more than the usual reaction a leader would get coming into the Chamber...That is a real show of emotion that you can see out there, and that's coming across the board, Democrats and Republicans, liberals and conservatives. You can almost feel it."

Thank you, Tita Cory, for restoring democracy to our country, for being an advocate for peace and nonviolence, and for being an extraordinary role model for both women and men.


Prayer by Corazon Aquino

Almight God, most merciful Father
You alone know the time
You alone know the hour
You alone know the moment
When I shall breathe my last.
So, remind me each day,
most loving Father
To be the best that I can be.
To be humble, to be kind,
To be patient, to be true.
To embrace what is good,
To reject what is evil,
To adore only You.
When the final moment does come
Let not my loved ones grieve for long.
Let them comfort each other
And let them know
How much happiness
They brought to my life.
Let them pray for me,
As I will continue to pray for them,
Hoping that they will always pray
for each other.
Let them know that they made possible
Whatever good I offered to our world.
And let them realize that our separation
Is just for a short while
As we prepare for our reunion in eternity.
Our Father in heaven,
You alone are my hope.
You alone are my salvation.
Thank you for your unconditional love.



Articles and tributes

Cory Aquino's Life in Photos