book reviews, healthcare

My review of This is Going to Hurt: Secret Diaries of a Junior Doctor, by Adam Kay…

Many people think of medical doctors as superhuman. Some people think of them as inhuman. Former physician, Adam Kay, writes in his 2017 book, This is Going to Hurt: Secret Diaries of a Junior Doctor, that anyone can be a doctor. Personally, I disagree with that opinion, but then, I have never aspired to be a doctor of any kind. Maybe if someone held a gun to my head and told me I had to study medicine, I might be able to do it. I am pretty math challenged, though, and I have a weak stomach. Adam Kay reminds us that working in healthcare, especially as an obstetrician-gynecologist, can be messy, exhausting, hilarious, and tragic.

I see from Amazon.com that I bought This is Going to Hurt last summer. I don’t remember why I bought it, but buying it wasn’t a bad decision. It IS a best seller, and I did legitimately enjoy reading Kay’s diary entries about being a young doctor in Britain’s famous National Health Service. Kay is often very funny, which stands to reason, as he now makes a living as a comedy writer for television and film. But before he commenced his career making people laugh, he brought over 1200 babies into the world.

So why isn’t he still doctoring? By now, he’d be long finished with the arduous training physicians go through. He might be enjoying a full night’s rest, a couple of days off, here and there, and deference from his more junior colleagues. I won’t ruin the book by explaining why he left the field. Instead, I’ll just say that medicine wasn’t for him. Before he realized that medicine wasn’t for him, Kay spent years climbing the ranks from medical school to senior registrar, just one level beneath consultant. Over the years, he collected many funny anecdotes, which he cleverly recorded in a diary… the basis of this book.

Kay writes that he decided to become a physician when he was about sixteen years old. He’s Jewish, and his family is chock full of physicians, and he was expected to carry on the tradition. In the United Kingdom, medical school lasts for six years and begins after graduation from high school. So, before he really had much of a chance to dwell on the decision, he was off to medical school. Once a person embarks on such a career odyssey, it cam be hard to admit when the fit isn’t quite perfect.

Starting in 2004, Kay chronicled his adventures and misadventures in the British National Health System, often with hilarious anecdotes about patients, colleagues, and superiors. He offers a look at how the British healthcare system works, wryly commenting on the politics that affect embattled doctors in training, who are chronically exhausted, underpaid, and overworked. Some of Kay’s stories are downright disgusting, but in a hilarious way. For instance…

I shared the above passage with friends on Facebook. One friend called bullshit on it, but frankly, I could see this happening. From what I’ve read and observed, doctors in training work so hard that they don’t always pay attention to hygiene. Kay writes that he gets very little time off and frequently has to cancel plans with friends and family because he has work to do. He explains that the NHS is often understaffed, especially on weekends, nights, and holidays. So the mostly young staffers in training do get exhausted to the point of not caring so much about things that most of us would notice and take care of right away after a shift.

Some of the entries are very short, while others run for a page or three. I liked the short anecdotes, which made the book easy to read and hard to put down. I also liked that Adam Kay adds lots of footnotes, which are convenient to read on a Kindle. Click the links, and a brief explanation of certain medical terms comes up. I learned new things reading this book, not just about medicine, but also some British language differences.

I will warn that the book ends on a serious note. Kay was inspired to publish this book when, back in 2015, the Secretary of State for Health and Social Care, Jeremy Hunt, accused junior doctors of being “greedy”. Kay had left the profession by 2015, so he had nothing to lose by speaking out about the realities of life as a junior doctor in England. He reiterates that the job was often awesome, especially when he saved a life, or when he helped someone feel better. But there’s a high price to pay for that privilege of saving lives and being respected for doing that job on a daily basis.

Some readers might not appreciate Kay’s cynicism. Again, I must point out that some of the humor is pretty gross, and Kay isn’t always respectful. Some people might not appreciate his graphic descriptions or use of vulgar language. Personally, I loved it… but I have a very ribald sense of humor and I enjoy scatology. 😉

Below are a few more samples…

On many levels, I could relate to Adam Kay’s predicament. I was supposed to be a public health social worker myself. I can imagine that if I’d actually done that work, I would have eventually become burned out, cynical, and bitter. I don’t know that healthcare would have been the ideal career for me. But I wanted to be employed. Kay says that he was expected to be a doctor, and his family was pretty upset when he gave up his medicine career. I expect he’s much happier as a comedy writer. He doesn’t have to make life and death decisions anymore. Now, he just worries whether his comedy kills, rather than his doctoring skills. It’s a lot less pressure. Since he’s been so successful, it no doubt pays better, too. I guess that goes to show that people really ought to choose their careers… just like they should choose whom they love.

I liked This is Going to Hurt. I highly recommend it, especially to anyone in the medical field, but also to anyone curious about the British healthcare system. It’s a real eye opener.

As an Amazon Associate, I get a small commission from Amazon on sales made through my site.

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healthcare, social media, viral

“A time to be born… a time to die…”

It’s Monday again, and I’m sitting here pondering a discussion I got into yesterday after a nursing friend shared a viral meme about cardiopulmonary resuscitation (CPR). Right now, people are talking about CPR. Professional football player, Damar Hamlin, collapsed on the field and received CPR, which saved his life. I don’t watch football, so even if I had been in the United States when it happened, I probably would not have seen it happen live. But a number of people on my friends list saw it.

CPR saved Damar Hamlin’s life. There’s no doubt about it.

Damar Hamlin is reportedly now doing much better. He will have to recover from this incident, but as a young athlete, he’ll probably be fine. However, as one nurse pointed out, CPR doesn’t always end well for every patient. She made a meme, and it went viral.

A fair point.

I saw this meme because one of my nursing friends shared it. It made me remember a blog post I wrote in 2013. Back then, it was in the news that an 87 year old woman, who lived at an independent living facility in Bakersfield, California, had collapsed. No one rendered CPR to her. Instead, a supposed nurse at the facility called 911. The nurse explained to the 911 dispatcher that it was against the facility’s policy for employees to perform CPR on residents. A lot of people seemed shocked that this was a policy at a place where it seemed like there would be emergency medical assistance available for residents.

The dispatcher, upset that the “nurse” wasn’t acting, reportedly pleaded:

“Anybody there can do CPR. Give them the phone please. I understand if your facility is not willing to do that. Give the phone to that passerby,” the dispatcher said. “This woman is not breathing enough. She is going to die if we don’t get this started.”

But the nurse refused to render aid, and followed the protocol set by her employer. An ambulance arrived a few minutes later, but the woman died at the hospital.

It outraged a lot of readers that the nurse simply let this 87 year old woman die without a fight. Many people posted that the woman’s family should sue. Some felt the “nurse” should be fired and lose her nursing license. Some seemed to think police should arrest the “nurse”.

Inspired by some of the more vitriolic comments, I decided to blog about the situation. In that post, I wrote:

As someone who has studied public health and social work, and lived abroad several times, I was amused and amazed by the comments that came with that article.  There’s quite cultural statement made about this situation.  Look at it.  The woman was 87 years old.  That’s an impressive life span.  CPR is a very traumatic thing to do to another person.  Even if you’re young, CPR can cause cracked or broken ribs, a broken sternum, and internal bleeding.  At 87 years old, I would imagine this woman was a lot more fragile than your average adult is.  Moreover, CPR done to elderly patients doesn’t actually have an impressive success rate.  It’s an emergency intervention and doesn’t usually turn out the way it does on TV shows like ER.

CPR done correctly might have saved her… just in time for her to spend days or weeks in the hospital, hooked up to machines and running up big medical bills that perhaps she had no means to pay.  At age 87, she was likely on Medicare.  She might have made a full recovery… or she might have suffered brain damage, because the CPR wasn’t done correctly and she went without oxygen for too long. She might have lapsed into a coma, where doctors and relatives would have to decide when the appropriate time to let her go would be.  But here in America, we are taught from a young age that we should spare no expense to save a life, even a life that has been well lived and is about finished.  You are seen as a criminal if you opt for death.

I remember posting about the case on my Facebook page. At the time, I had a lot more “friends”, and some of them were argumentative types. The thread about this case got heated, fueling the post even more. I continued:

…there are many places around the world where no one would have raised an eyebrow at what happened to this lady.  In many places around the world, family members or neighbors care for the elderly.  And when death comes, it’s not always seen as something that has to be fought.  Death is a part of life, and it will happen to everyone at some point.

While I can see why it’s distressing to think of a person just watching someone die while on the phone with 911, I can also understand why that assisted living facility has the policy they have.  You can bet it has a lot to do with litigation and insurance. 

It’s hard to think of sitting on your hands in a situation like this.  It is a little unnerving to think about when a person’s life is no longer worth saving due to advanced age.  But I think in this case, it’s likely that this woman had a better death than she might have.  I wish we could come to some kind of consensus as to how we can let people die with dignity.  We can’t have everyone living until they’re 100, though.  The system can’t and won’t support it. 

So… there I was yesterday, looking at that viral meme, and remembering that 2013 case. When I looked at the comments on the original thread, I found out people still seem to think CPR is always justified, no matter what. The person who originally shared the meme is apparently a nurse, and she’s run many codes on people. A lot of the codes she’s run have been on people who are clearly at the end of their lives. They either didn’t have a “do not resuscitate” order or a living will, or their distraught family members feel compelled to keep them alive at all costs. Family members don’t always realize what goes into a “code”, and how violent and aggressive it can be.

Some commenters were profane in their responses, “bravely” stating that they don’t care about broken ribs if it means another day with a loved one. It’s easy to say that when you’re not in severe pain, or dealing with chronic health issues that make life torture. The fact is, everyone dies. And in every life, there will come an opportunity to make an exit. Sometimes, when a very elderly person collapses, it’s simply their time to go.

Later that day in March 2013, I wrote more about the case. I identified the woman who collapsed. Her name was Lorraine Bayless. She lived at an independent living facility, as opposed to a nursing home or even an assisted living facility. The stories referred to the woman who called 911 as a nurse, but it wasn’t clear if she actually was a nurse. It wasn’t clear if she’d had a DNR, either. Some sources reported that she didn’t have a DNR, but at least one other reported that she did. Experts at the time were talking about how “morally wrong” it was not to render aid to Ms. Bayless. But other people in the know were discussing what happens to a person when they get CPR.

I’m 50 years old, and I live with aches and discomfort every day. I’m not in terrible pain yet. A lot of what ails me is helped with over the counter pain medications, or even a glass or two of wine. Unfortunately, as people age, they tend to hurt more. They become more fragile, and develop health conditions that make it more difficult to recover from illnesses and injuries. And, it’s always sad to bring this up, but healthcare is very expensive, especially in the United States. A very elderly person who is nearing the natural end of their life will run up huge bills, even if they survive another day or two.

As many of my healthcare friends pointed out, it’s uncommon for very elderly people to fully recover from CPR interventions. I’m not saying it never happens, but that it’s rare. And that kind of intervention, which almost always involves broken ribs and severe bruising, will mean significant pain in addition to whatever the condition was that caused the collapse in the first place. The whole point of the viral meme I read yesterday was that people often suffer when they get CPR, along with the suggestion that people talk to their loved ones about what they would like to have done to them if they collapse. One would also hope that they put their wishes in writing, so that medical personnel can honor their wishes without risking their careers or their freedom.

On another note…

One thing I noticed and want to comment about is another one of my “pet peeves”. So many people seemed to be deliberately obtuse about the meme’s message. It was as if people thought the nurse was saying that CPR is never justified. That’s not what she was conveying. She was saying that CPR is brutal to bodies. Some people won’t recover from the physical or mental trauma of the violence and aggression of CPR. People should consider that reality before demanding that medical staff resuscitate their very elderly and frail loved ones who suffer from chronic illnesses.

And also… I wish to God that people would read things before commenting. So many people mentioned cracked ribs and other injuries that come from CPR. I think it’s inconsiderate to post comments without reading the post in question or other people’s comments. Why should I read what someone writes when they haven’t taken the time to read what others have written?

In essence, people who comment before reading are telling everyone that their comments are more important than other people’s comments are. That is quite an arrogant and self-centered statement, in my opinion. Reading before commenting saves time in the long run, because you might find that your comment is unnecessary or, perhaps, inapplicable to the situation. I know that making this statement might make me look “mean” or “rude”, but honestly, I think it’s rude to waste people’s time by making statements that are irrelevant or have already been made umpteen times. Just my opinion.

Anyway…

I hope you have a good Monday. I’ll be watching for new inspirations, as I continue to read my latest book. See you tomorrow.

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healthcare, law, politicians, politics, Reality TV, sexism

“Activist judges” in South Carolina have defied the right wing alpha MALES, and I am so here for it!

Featured photo is in the public domain.

Yesterday was an interesting day. After I wrote my too long and too opinionated review of Jamie Lynn Spears’ book, Things I Should Have Said, I waited all day for the Amazon guy to show up with my latest toys. I bought an Amazon Echo Dot for my bedroom, as well as a couple of “smart” power strips that I can’t figure out how to configure. I was inspired to make that purchase because Bill bought me an Echo Dot for my office. I don’t really need one for either place, since I have so many other devices, to include my big desktop iMac computer that is outfitted with Siri. But they are nice to have… and it’s kind of fun when Alexa gives me a notification that turns its ring yellow. Makes me think of all the 70s era space travel shows I missed when I was a kid.

While I was waiting for my delivery, I noticed some exciting news coming out of South Carolina, the state where I spent three years earning my “overeducated housewife” status. The South Carolina Supreme Court ruled that the six week abortion law is unconstitutional. The law has been struck down, as the majority of the five justices determined “that the law that restricted abortions after detectable fetal cardiac activity [is] ‘an unreasonable restriction upon a woman’s right to privacy’.” Thanks to the 3-2 decision, abortion is now, once again, legal in South Carolina until 20 weeks gestation. This ruling comes almost two years after current South Carolina Governor Henry McMaster signed into law the Fetal Heartbeat and Protection from Abortion Act. That law made abortion illegal after six weeks of pregnancy, except in limited situations such as pregnancies that would endanger the pregnant person’s life or were caused by rape or incest.

I was heartened to read the comments by Justice Kaye G. Hearn, who wrote the opinion of the majority. She stated, “Few decisions in life are more private than the decision whether to terminate a pregnancy. Our privacy right must be implicated by restrictions on that decision.”

Naturally, some people were rattled by Justice Hearn’s statement. I noticed the ones who were quoted in the Washington Post article link I unlocked were all MEN. Governor McMaster tweeted, “Our State Supreme Court has found a right in our Constitution which was never intended by the people of South Carolina. With this opinion, the Court has clearly exceeded its authority. The people have spoken through their elected representatives multiple times on this issue.

McMaster added that he “look[s] forward to working with the General Assembly to correct this error.”

I find McMaster’s wording very intriguing. He wrote, “Our State Supreme Court has found a ‘right’ in our Constitution…” That’s right, Henry. It is a RIGHT. I lived in South Carolina and worked in maternal and child health and healthcare policy there. I know about South Carolina’s moronic and ineffective approach to preventing unintended pregnancies… Just tell the girls to abstain.

Well, it’s not their public health approach, really. I found the public health folks working at the Department of Health and Environmental Control to be quite intelligent and informed on the issue, including why it’s important that women have access to abortion healthcare. It’s the right wing MALE legislators who have their heads firmly lodged in their asses. These same folks have no desire whatsoever to do anything to help people who find themselves unintentionally pregnant. They don’t give a damn about making sure those babies are born healthy to people who are prepared to raise them. It’s all about fear and shame, and telling women to keep their mouths closed and their legs crossed. Ridiculous… and completely unrealistic.

I don’t see how McMaster’s comments square with what happened to our federal rights to have abortions. For fifty years, women all across America had that right, and it was unceremoniously taken away from us by Trump’s trio of pro-life “activist judges”. Now, McHenry is accusing his own state’s Supreme Court judges of “exceeding their authority”, simply because he doesn’t agree with their interpretation of South Carolina’s Constitutional law. They were doing their jobs, Henry. You should do yours, and work for the betterment of ALL South Carolinians, not just your hyper-male, conservative, Republican buddies. 😉

The other quote in the article comes from another Republican male, Jeff Duncan, who says he’s “extremely disappointed” with the decision made by “activist judges” in South Carolina. Sounds to me like these judges are compassionate, Jeff. Do you have the same level of compassion for women who, for whatever personal, private reason, do not wish to be pregnant? Do you value the right to privacy for all people? Why should a woman who finds herself unintentionally pregnant have to justify terminating her pregnancy to ANYONE? It’s her BODY, Jeff; not yours. You will never face this choice. You will never have to deal with the multitude of changes that happen when someone gets pregnant. So kindly develop some compassion for the already born, and do what you can to make life better for them. Maybe then, your constituents might not feel like they need to have an abortion for reasons you don’t deem “acceptable”.

It seems to me that people who don’t like abortion should simply not have one. They should not lobby to take that right away from other people. Developing embryos and fetuses don’t have a concept of abortion, nor do they experience pain until quite late in pregnancy, beyond when the vast majority of people would consider having an abortion. And those who do, almost universally do so because the alternative to having one would be much worse.

Even MAGA idiot Donald Trump has recently opined about the foolishness of being extreme about taking away women’s abortion rights. He was recently complaining about the Republicans’ poor showing during the midterms. He said on his very own Truth Social:

“It wasn’t my fault that the Republicans didn’t live up to expectations in the midterms.” Then he added, “It was the ‘abortion issue’, poorly handled by many Republicans, especially those that firmly insisted on no exceptions, even in the case of rape, incest, or life of the mother, that lost large numbers of voters.” Then he finished with, “Also, the people that pushed so hard, for decades, against abortion, got their wish from the U.S. Supreme Court, & just plain disappeared, not to be seen again.”

Those comments are now prompting anti-abortion groups to fire back, and indeed, a bunch of Trump’s former supporters are turning on him. I guess they’re finally seeing what some of us have noticed all along. But, in this case, Trump is actually right. A lot of people in the United States are legitimately angry about abortion rights being taken away. And many of the pissed off among us are women who would ordinarily vote Republican. Those women, many of whom are business people whose livelihoods could be adversely affected by unintended pregnancies, don’t want to be forced back into the kitchen. Quite a few of the rest of them are, like I am, disgusted by the idea that they would have to explain to anyone why they want or need to have an abortion. It’s, quite frankly, no one else’s business, no matter what the reason is. And basic privacy is, if not a right, an expectation, especially when it comes to healthcare. Abortion is healthcare for the already born women who need it, even if it’s not for the developing embryos or fetuses who have the potential to be born.

I, for one, am so ready for this issue to be settled, once and for all. This constant back and forth ping ponging about abortion is ridiculous, and it’s preventing actual work from being done to help the rank and file already born people who are actually struggling to survive. When a person is having trouble paying their bills, the last thing they want to be is unexpectedly pregnant, especially when they live in a state that is notoriously stingy about funding social welfare programs. And I am SO SICK of MEN inserting themselves in this issue, especially since a lot of them don’t even know the first thing about pregnancy or even female anatomy. They just want control over women. It’s plain and simple. Of course, some of the idiot Republican males who are claiming to be “disappointed” about this decision would not hesitate to provide access to and pay for abortions for their knocked up daughters or mistresses, would they?

Moving on…

It was totally random that I reviewed Jamie Lynn Spears’ book yesterday, and she is now participating in a new Fox reality show called Special Forces: World’s Toughest Test. I heard about the show yesterday, which also includes actress Beverley Mitchell, gymnast Nastia Liukin, Kate Gosselin (who has already washed out), and Dr. Drew Pinsky (also already eliminated). The first two episodes dropped on Wednesday, so I downloaded them yesterday and watched. I have to say, I found the show kind of boring and hokey. But… the cast mix is kind of interesting, given that it’s a mix of a lot of different kinds of people, to include reality TV stars, Olympic athletes, and actresses. I’ll probably watch the whole series and groan the whole time.

Yes… they’re REALLY going to let these “household names” die on TV. What bullshit. They must have really needed the money.

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first world problems, healthcare, sex, slut shamers, social media

Repost: I could jump on the FYI bandwagon tonight…

Here’s a repost of my reaction to Kim Hall’s viral blog post about braless teenaged girls in towels or pajamas. I’m sharing it to go with today’s partial repost. It was written for my original blog on September 5, 2013, when I was living in Texas. I’m mostly leaving it “as/is”. I think it’s a pretty good post.

Yesterday, my Facebook feed was positively littered with links to a certain blog post written by a Texas mother of four who wrote an open letter to all the slutty girls out there not wearing bras and taking selfies before they go to bed.  I could link to that post, but I don’t see the point of doing that.  It’s all over the Internet.

To be honest, I’m of a mixed mind about this woman’s post.  I am generally not a fan of people taking slutty looking selfies.  If they are teenaged girls, I figure it’s because they are caving to some kind of external message that they need to be “sexy” in order to be desirable.  I think that’s sad, but I sort of understand it.  Growing up is hard.  Still, if I were a mother, that would not be something I’d want to encourage.  On the other hand, I don’t think “slut shaming” is good, either.  I think it’s best to encourage common sense. 

Of course “Mrs. Hall” immediately made her post the subject of scorn when she included photos of her handsome sons in their bathing suits at the beach.  Her daughter was wearing a modest one piece tank suit and it looked like they were just having clean family fun.  But if you’re going to be complaining about “scantily clad teenaged girls” who might give your sons boners, you ought not post photos of your boys dressed in a similarly scantily clad fashion.  Yes, I know that on the beach, it’s perfectly acceptable to be wearing a bathing suit, while most people don’t think of pajamas or nighties as clothes you’d see in public.  But the fact is, we still see a lot of skin on those boys… and if your point is that girls need to cover up, you’d best take care with your own photos.

Apparently, Mrs. Hall then thought better of it and posted another version of her post with photos of the kids covered up.  But the damage had already been done and lots of folks began posting rebuttals.  These days, America is pretty polarized when it comes to morality.  We have a lot of really religious folks out there who are trying to take back the country, as it were, and at least by my observations, seem to be taking things to extremes.  We also have a lot of folks who are proudly atheist and are also taking things to extremes.  The people in these two groups may not be as many strong as those of us in between, but they are very loud, and some of them are very articulate.  Consequently, the Internet becomes inundated with viral posts that both speak to and repel people who identify with these two groups.

I have friends on both sides of the spectrum, so I’ve seen the FYI post for girls a number of times already.  I have also seen rebuttals and parodies.  I found the initial blog post hypocritical, smug, and ill-conceived… but I also understood where the mom was coming from, even if she came off as quite sanctimonious. 

You know, the one thing that I really came away with is that I’m sort of glad I didn’t have kids.  I wanted them, but raising kids is so complicated.  Even without the FYI blog post, there was an article about how overweight kids are having “fat letters” sent home.  Childhood obesity is no doubt a big problem, but shaming people is rarely the way to get them to reform.  And there are just so many reasons why people get fat.  Could be a simple issue of too many calories, not enough exercise.  Could be because the kid is lonely and eats to soothe emotional pain.  Could be because the kid is being bullied or abused by other kids, their parents, or someone else. 

I just don’t see how sending home a letter about the kid’s BMI is the school’s role.  Unless the school’s staff is going to help the parents do something about the problem, I don’t see why they are more qualified to “diagnose” obesity more than a medical professional is.  Medical professionals also have the added ability to determine how obesity is affecting the children in question.  Moreover, kids whose parents don’t care aren’t likely to care if they get a letter, though the kid probably will. 

Of course, if the school sent home a letter about my BMI, my parents would have been embarrassed and would have taken it out on me.  I remember being in 9th grade and weighing about 115 pounds.  I was weighed in front of everyone and the coach made some comment about how I must have had a big lunch.  I was humiliated, even though now I realize that I was nowhere near fat at that point of my life.  I would love to be that weight today.  Maybe after I’ve been dead a few months…

I got a lot of “fat shaming” from my parents even when I wasn’t overweight and struggled with fucked up eating habits for years.  I’ve reached a point at which I don’t care as much as I used to, but the memories still hurt… and probably had a lot to do with why I was so old when I finally had a real relationship with a man.  Fortunately for me, he turned out to be a great guy who treats me like gold.  It could have easily gone the other way, though.

Anyway, I guess the point of this post is that there are an awful lot of people self-righteously sticking their noses where they don’t belong.  Mrs. Hall’s open letter may have resonated with a lot of people, but she probably should have addressed boys and girls, not just girls.  And she should have practiced her own counsel.  And the fat shaming asshats are not doing anything but making childhood more miserable with their letters home.  Adolescents are vulnerable, especially when it comes to matters pertaining to their self image.  Eating disorders are serious problems that can wreak havoc on those who  have them and those who love them.  

Childhood obesity is a problem.  Teen sex, especially when it leads to consequences like pregnancy or diseases, is a problem.  Something does need to be done about these issues.  I just don’t think shaming is the way to go about it.  Growing up is tough enough. 

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communication, healthcare, holidays

Today is the first day of the rest of the year…

Happy New Year, y’all. I will do a write up of our personal festivities on my travel blog; because let’s face it, that blog needs some love. For this blog, I’ll just say we had a basically nice time… except for the point where I got into a rather serious discussion with Bill about the logistics of my living in Germany and accessing healthcare. It’s not that I have an immediate need for it… but I’m not getting any younger. Because we’re here at the pleasure of the U.S. military, I could either go to a German doctor, or I could go to Landstuhl (U.S. military facility). And because I never go to the doctor, I literally don’t know what I would do here if the need suddenly arose for me to seek medical care. On the other hand, I do know how to call 112, and that’s probably what it would take before I would willingly go see a doctor.

I think this subject came up because we were talking about what our plans will be after it’s time for Bill to quit working so hard. We were talking about younger daughter, and how her husband has launched a good career. They hope to move sometime soon, because the apartment they live in is too small for their family. Bill mentioned that it wouldn’t be long before they might buy a home of their own. And I kind of wistfully said, “They’ll probably be homeowners before we will.”

I always thought by now, I’d own my own house somewhere, and I’d be settled, perhaps with a family of my own. Instead, I’ve been in this weird kind of limbo, where half my stuff is in the United States, and a lot of my friends and most of my family are there… but here I am in Germany, where I’ve been for close to half my marriage. It does feel kind of like home, and yet I don’t really speak the language… and I don’t have a lot of friends. None of my family, except for Bill, lives here. It’s not a bad thing… It’s just not what I expected for my life. Nothing has really turned out the way I figured it would. Well, except for the fact that I went to graduate school.

I do remember in high school, being asked on some kind of government research thing– maybe it was a standardized test– about the level of formal education I expected to attain. Even back then, I assumed I’d get a master’s degree. However, I thought it would be in equine studies, or something similar. I don’t even know if such a program exists. But I do remember, back then, feeling daunted by the prospect of getting a master’s degree. I thought it might be too hard for me. I sure didn’t expect that I would get two of them at the same time, or that they would be in either social work or public health. When I was a teenager, I probably had a better idea of what I was good at, academically speaking. But when the time came to go back to school, I was simply trying to become employable, so I could launch my typical “American dream” lifestyle. And look what happened! I bumped into Bill online, and became a nomad, which made launching that career very difficult.

So anyway, we were talking about home ownership when Bill retires, and Bill said that he would like to buy a house in Europe somewhere… maybe Italy, Spain, Portugal, or even France. Germany is also, of course, a possibility, although I think it might be more expensive here. We do know Americans who have retired here, though. And Bill said that he wanted us to own a home so I wouldn’t have to deal with renting anymore. He says he thinks he will predecease me. I said I wasn’t so sure. Bill goes to the doctor, and I never do. I was very traumatized by an Air Force gynecologist years ago, so even though I “know” better, it really takes a lot to get me to see doctors. I despise military healthcare.

I understand logically why it would be a good idea to go see a doctor and get checked for certain things, like high blood pressure, cancer, and diabetes. Hell, I even studied public health, where I learned about the value of screenings and preventive healthcare. But psychologically, I just have a very difficult time with it. And it’s even worse in a country where I don’t speak the language fluently, and people tend to be blunt about certain things. I can’t imagine my taking it without getting really upset. I know that putting it off only makes it more likely that I won’t have a choice in providers when I finally see one, because it will be in emergency circumstances. On the other hand, I’m not sure how I would choose a doctor here, anyway. And I’m not even sure if it’s worth the time and energy to go to one.

I know Bill would be devastated if I died before he does… but he has people who will be there for him. He has two daughters, and one speaks to him. She has children who call him “Papa”. I don’t have any descendents. I just have a bunch of cousins and three older sisters, who always felt more like aunts. So, I guess I just don’t see why I’d need to hang around. I certainly wouldn’t want to live as long as my Granny did. She was almost 101 when she died. When I consider how stiff and painful I get in the mornings, I truly dread being that old… particularly with no one around who cares about me. I guess it’s just the pragmatic/depressive side of me coming out again. 😉 I have to die anyway, right? So why prolong the inevitable?

I asked Bill if it bothers him that I don’t see doctors. He said it does, although he never says anything about it. He is respecting my “agency”, I guess. So I asked him what he would do if I told him I’d found a lump in my breast (not that I have). He said he’d want me to have it checked, and would probably insist. The idea of that makes me cringe, though. Because it’s been so long since I last accessed the healthcare system that there are many screenings I’ve missed. I know a lot of them would be suggested and encouraged. Or maybe not. Either way, I’d probably end up stressed out and upset. In fact, thinking about this topic is very unnerving to me, so I think I’ll move on.

So… that’s how we wound up on that topic. Bill would like to settle abroad, because the lifestyle suits us. I wouldn’t mind living abroad, either. I truly think it’s better over here, in many ways. It would come at a cost, I guess… weakening family ties and friendly relations, such as they are. But I can’t see myself wanting to live in an American subdivision somewhere, with homeowners’ associations dictating what color I can paint my shutters or whether or not I can have a garden. 😉 But the truth is, there’s no telling where life will lead us. We have no reason to stay or go anywhere in particular. I don’t see us willingly moving to Utah, which is where younger daughter lives. I know it’s pretty there, but I like my communities less religiously oriented.

Fortunately, the subject soon changed, because we happened to be having it while we were enjoying the last of the evening’s libations. It was almost time for the proverbial ball to drop. And once it did, we went outside to watch the fireworks. There were a lot more of them this year, of course. Our neighbors were in the street, setting them off. They set one off very close to our car, which concerned me a little bit. I’m glad to report that no Volvos were injured during the fireworks display last night.

Well… I’m sure there are other things I could write about, and maybe I will later. But for now, I think I’ll go to the travel blog and write something a little less sobering.

I hope your first day of 2023 is shaping up well. Remember, today is the first day of the rest of the year!

The featured photo was taken last night. For some reason, I always seem to think I can capture fireworks on camera. It very rarely happens.

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