5 Cents: The Doctor is In

A Change of Name…

2019-03-04T13:42:00.000-08:00

I am happy to announce that my groups for people living with chronic pain, anxiety, depression, and chronic illness have a new name:

Stop Your Pain! Groups: Learn Powerful Tools that Work

These groups were formerly called “A Change of Mind: Neuroplastic Tools for Healing,” to highlight the importance of using neuroplasticity (the way the brain changes itself) to decrease symptoms. The impetus for the name change is to make it easier for people living with physical and emotional pain to find us. We all want to stop our pain, we all want to feel powerful again, and above all we want it to work.

Changing the name of the groups reminds me that the nature of life is change, that change is inevitable, that change is the most constant experience that we all share. The brain itself changes constantly throughout our entire lives, and does so according to specific principles of how that change occurs. The neuroplastic method taught in the groups helps us to direct the change we want to see in our own brains: a decrease in our symptoms.

See these other blog articles to find out more about the neuroplastic method:

New sessions start soon — register here:

Stop Your Pain! Group: Learn Powerful Tools That Work

Online group:

Wednesdays 3:30–5:30 p.m. Pacific Time

In-person groups:

Mondays 6:00–8:00 p.m. Pacific Time

Tuesdays 11:00 a.m.–1:00 p.m. Pacific Time

A New Year: Reflection

2019-01-05T14:11:00.000-08:00

Illustration by Mohamed Hassan

Reflection, looking inside ourselves to find a clear image, gives us the information that we need to decide where we want to go from here. It is the necessary prequel to making conscious choices about the next part of our lives and involves noticing who we are in the present moment. Reflection is often associated with particular calendar events, which can include a birthday, a religious or secular holiday, other events with individual meaning, and January 1.

Illustration by intographics

The new year has arrived, and there is a tradition at this time of making a set of personal “New Year’s resolutions.” These resolutions are promises that we make to ourselves, often about changes that we want to make related to our own habits. Two of the most common resolutions are to “eat healthier” and “get more exercise.” A large percentage of these promises are broken before the end of January, however if we choose simple goals, create action plans, take small steps, tolerate some inconsistency, and stay positive, we can feel good about our progress.

While reflection is the first necessary step into the possibility of change, it is the next steps that can help us most in choosing and creating what we want for ourselves. It begins with deciding on goals. It can be as simple as deciding on one goal for the immediate future. It can be as complex as creating a list of short term, intermediate term, and long-term goals. The first part of choosing goals is to give ourselves enough time and space to think carefully about what is most important to us at this time. Be sure to write down and save these goals in whatever format works for you. Possibilities include keeping a list in a notebook, on paper or 3 x 5 cards in a folder, on an app or your calendar on your phone or computer, or posted where you can see it.

While some think of long lists of goals to accomplish, in making an action plan it is important to decide on individual small steps toward each goal to avoid becoming overwhelmed. If you have 10 goals, it may work best to prioritize them and start with one step toward one goal. Each step should be small enough that it seems almost “too easy.” If you have not been exercising and want to begin, start walking a distance that is very easy at least three times a week. Slowly and gradually, the distance and frequency can be increased. Support this process by noticing and appreciating each step (and yourself!), no matter how small.

The most important personal qualities to cultivate while making change in support of goals are self-compassion, the ability to notice and release self-judgment, and positive outlook. When we are judgmental and have negative feelings about ourselves, it is harder to sustain the desire for change, and we are more likely to give up and fail to accomplish our goals. We are most able to create change and accomplish goals when we maintain self-kindness and focus on the positive.

Illustration by John Hain

In order to engage in this process of reflection, notice our current state, and choose a path to the future we want to see, we must feel that we have personal power and the ability to go through this process. Living with symptoms of chronic pain, anxiety, depression, chronic illness, and other conditions can lead to feeling powerless. It may be hard to imagine having enough energy to consider taking steps to have a better life. Here too, it works best to focus on one step at a time: learning to cultivate a sense of personal power. The first step is noticing the feeling of being powerless and interrupting that feeling, the same way we interrupt symptoms such as pain or anxiety. The Neuroplastic Method teaches us to interrupt our symptoms by using a Tool every time we notice them. One example uses words and language as a neuroplastic tool. We start by noticing the desire to change something in our lives, and the feeling of being too overwhelmed to even think about it. The minute we notice this feeling, we “catch it in the act” and say out loud “this is a feeling of being powerless and it’s NOT TRUE! I can take one small step at a time and eventually change will come.”

In this way we can recapture a sense of personal power and ability that will allow us to take steps toward achieving our goals.

Training the Puppy in Your Brain: “Catch It in the Act”

2018-08-21T17:48:00.001-07:00

The brain changes itself constantly throughout our entire lives. All of our experience changes the brain. Symptoms such as pain, discomforts of illness, anxiety, and depression also change the brain — because they are part of our experience. The brain “learns” those symptoms, and builds them into pathways that stay in the brain. These pathways become stronger and stronger with repetition.

How can we “unlearn” symptoms? I remember learning trigonometry in high school, and then never used it again. Eventually, I forgot how to do it — I “unlearned” trigonometry.

If we want to “unlearn” pain, we have to stop “using” it. To understand how, it helps to know something about dog training.

How is the brain like a puppy dog?

If you’ve ever trained a dog, you know that it takes a lot of time, patience, and repetition.

The trainer also needs to have three very important qualities:

Stay positive
Be consistent
Always “catch it in the act”

When I walk in the house and see my dog with her nose in the garbage, I want to interrupt that behavior as fast as I can (in a neutral way) and then immediately get my dog to demonstrate a positive behavior so I can praise her: “good dog!” It looks like this:

• Stop! (Catch it in the act)
• Come, sit! (Be consistent)
• Good dog! (Stay positive)

On the other hand, if I come home and see garbage on the kitchen floor, with the dog happily lying on her bed in the other room, I’ve lost my opportunity for training. If I call her into the room and show her the garbage, she doesn’t understand. There is no perceived connection between the garbage and her doggy brain. That is why I have to “catch her in the act”!

Similarly, if I want to extinguish a symptom (remember that symptoms are reinforced by connections and pathways in the brain) I can “catch it in the act” by

immediately noticing that I have pain, or anxiety, or depression (whatever symptom I have) stopping the experience of the symptom right now by taking my attention away from the symptom itself and
quickly counter-stimulating the brain using one of many positive attention-grabbing techniques, such as telling my brain to stop! the symptom, and remembering a fun activity, thus
helping my brain feel like my dog, “wonderful, good, happy brain!”

Consistency

We learn from dog training that when the trainer makes a mistake (gets tired, overworked, doesn’t feel well) and does not immediately stop the unwanted behavior, the training itself will ultimately be more challenging and take longer, leading to more garbage on the floor!

Training the brain (unlearning symptom-related pathways) requires

interrupting the experience of the symptom every time we notice it
developing many techniques (tools) — immediate positive and engaging experiences — to counter-stimulate the brain (like singing, looking at photos of vacations, or viewing pet videos!)
patience and persistence — changing the brain is a slow process!

Why is it so important to interrupt the symptom as soon as we notice it?

The answer has to do with the rules of Neuroplasticity — how it works in the brain:

What is fired is wired (and nerves that fire together wire together): When brain cells (nerves) are activated, cell by cell, it makes a pathway (set of connections between nerves) that stays in the brain. Repetition strengthens the connections/pathways.
Nerves that are activated at the same time in the same place make connections and pathways together
Use it or lose it: The pathways that have been created in the brain disappear if you don’t keep using them!
When you make them you break them; when you break them you make them: In order to make new connections (pathways) in the brain, existing connections are broken; in order to break existing connections (pathways) in the brain, new connections must be made. This way the brain conserves its resources.

We want the brain’s “use it or lose it” principle to break up connections and pathways that reinforce symptoms of chronic pain/discomfort, anxiety, and depression.

The brain will do this only when symptom-related connections and pathways are not being “used.”
Therefore, we must interrupt the experience of the symptoms as quickly as possible to stop “using” those pathways.

The brain keeps changing – we can do it!

When we consistently interrupt the experience of our symptoms, eventually the brain will decide that the symptom-related pathways are no longer being “used.” That is when the “use it or lose it” principle will be activated. Pathways associated with pain, anxiety, depression, and other symptoms will be broken up to help the brain make new positive connections and pathways. As pathways are broken up, symptoms reduce more and more. I’ve been using this practice for almost six years, and experience vastly reduced pain and greatly expanded energy and abilities. The puppy dog in my brain is as happy and well-trained as my wonderful dog Grace.

Learn how to do it for yourself in my group:

A Change of Mind: Neuroplastic Tools for Healing

In-person:

Monday evenings 6:00–8:00 p.m.
Starts October 8, 2018

Tuesday mornings 11 a.m.–1:00 p.m.
Starts October 9, 2018

Online:

Wednesdays 3:30–5:30 p.m. PDT
Starts October 17, 2018

For information and to apply, please see:
http://medicalcounseling.net/groupenrollpage.html

Individual Appointments Available

How an Online Group Can Help You

2018-01-10T13:57:00.000-08:00

I’ve lived with chronic pain myself for 28 years, and for the last 5 years, since I’ve been practicing the neuroplastic method, it’s gotten better and better – and I’m able to be active from morning until night!

You may have looked at my website, thought about your symptoms, and wished that you lived in the San Francisco Bay Area, where my Medical Counseling practice is located. Or perhaps you live with chronic pain and read Norman Doidge’s book, The Brain’s Way of Healing, and wanted to learn the neuroplastic method developed by Drs. Moskowitz and Golden — but you live in the Midwest, or the East Coast, or the South, or Canada. Maybe you have a friend who was in one of my groups, “A Change of Mind: Neuroplastic Tools for Healing,” and who already has less anxiety, more energy, or less pain, but it’s simply too far for you to drive to Berkeley.

If so, you are the person who inspired me to take my group to the Internet. My first online session of “A Change of Mind: Neuroplastic Tools for Healing” was held in autumn 2017, with participants from many different places. Using Zoom videoconferencing technology, and with the help of “Steve the Tech Guy,” every participant was able to connect with me and with each other, support and be supported, and learn about the brain, neuroplasticity, the neuroplastic method I adapted from Drs. Moskowitz and Golden, as well as many techniques, all of which help us (yes, me too!) change brain pathways associated with symptoms of chronic pain, anxiety, depression, negative/unhelpful thought patterns, and symptoms of chronic illness. By doing so, over time, we begin to rewire our own brains so our symptoms can gradually be reduced, and some can even be eliminated.

The new online session of “A Change of Mind: Neuroplastic Tools for Healing” will begin February 7, 2018 — Wednesdays 3:30 to 5:30 PM PST

There will be eight meetings of two hours each. It’s easy to use the technology, and the Tech Guy will be there each time to help anyone as needed. You can be in your own home, in any position that’s comfortable, and you have a choice each time of being seen by video or simply heard by audio (you can participate even if it’s a “bad hair day!”).

The cost is $500, and if you are experiencing financial limitations, there is a sliding scale available. I want you to feel better!

A few representative comments from both online and in-person group participants:

This group was a great way to connect with others facing health challenges and to learn to use tools to improve symptoms. Overall, a high-quality group!
Being in a group of people who understand pain is a huge thing.
This group was very helpful to me as I struggled with illness.
Being part of an online community for 8 weeks, especially the check-in at the beginning, helped with motivation.
I use many of the tools to help me deal with symptoms and anxiety.
I am more cheerful and happier.
Wonderful. Inspiring and encouraging. Way more positivity with purposeful upbeat thoughts. Mood better. More hope.
Using these principles (MIRROR) to apply to other important life issues beside pain is also very life-changing; it opens to moving in another direction.
I have less pain already – a real breakthrough after 30 years of chronic back pain. It’s uneven, but to move and not have pain is amazing!
The facilitator is excellent – I don’t know where else I would get this process from someone who could present it so well for non-medical people.

In addition to the online group, I have two in-person groups starting in early February. More information and sign-up form are on my website’s Change of Mind Groups page.

Why Doesn't my Pain, Anxiety, Depression GO AWAY?

2017-09-28T14:44:00.000-07:00

We ask these questions again and again: Why doesn't my pain go away? Why do I still feel so much anxiety? Why can't I pull myself out of the dumps? How can I ever get better?

Too often, our doctors and other health providers assume that chronic symptoms of pain, anxiety, depression, and illness are here to stay. We are told, “you just have to live with it.” Or “I’ve tried everything.” Or even, “there’s nothing I can do for you.” At best, we are prescribed medications that may give only partial relief, along with side effects, and are referred to programs, classes, or groups that help us “manage” our pain or other symptoms.

The answers to these questions can actually be found by understanding the brain and how it changes. We used to think that after a certain age the brain never changes. We now know that the brain actually changes throughout our entire lives — until we take our last breath. The brain changes from every bit of experience we have, and it changes the most when we have repeated experiences.

When we have persistent symptoms such as pain, anxiety, depression, and symptoms of chronic illness, this repeated experience creates changes in the brain that actually tend to perpetuate the symptoms themselves. Regardless of the original “cause,” which may have been healed or resolved, the brain itself now keeps us experiencing these symptoms.

Once we understand how our persistent symptoms are related to the way the brain changes itself, we can learn how to induce changes in the brain that can eventually help us feel better. Because this understanding is based on relatively recent brain science, most doctors and health providers don’t know about it yet.

Dr. Michael Moskowitz and Dr. Marla Golden are two pain specialists who developed a neuroplastic method, based on how the brain changes itself, that can change brain pathways and decrease or even eliminate symptoms of persistent pain. I have found that this method can be adapted to reduce other symptoms, such as anxiety, depression, and symptoms of chronic illness. This work is revolutionary in that it is about reducing or eliminating symptoms, rather than merely “managing” them.

I have been using this method myself for my long-term chronic pain for more than five years, and have been teaching it to individuals and in my support and educational groups, A Change of Mind: Neuroplastic Tools for Healing, along with many techniques, or “tools,” that are important in changing the brain.

What is my own experience? Life-changing! I feel unbelievably better. I keep doing more and more activities I hadn’t been able to do for years. I have energy all day long. When I have pain, it’s mild, temporary, and inconsequential to me.

It’s important to understand that it takes time to change the brain. We need to persist in noticing every symptom in order to counteract it by creating new experiences in the brain. Each of us has had many experiences of learning something new that takes a long time to master. We can be experts at patiently practicing what we need to do in order to change our brains and change our lives.

New sessions of the support and educational group A Change of Mind: Neuroplastic Tools for Healing are beginning in October 2017. Each group meets eight times, for two hours each.

Group A – Monday evenings 6–8 p.m., starting October 2, 2017

Group B – Tuesday mornings 11 a.m.–1 p.m., starting October 3, 2017

New:

Online Group – Sunday afternoons 4–6 p.m., Starting October 1, 2017

For information and to apply, please see: http://medicalcounseling.net/groupenrollpage.html

Contact me — I'd love to hear from you!

Danielle Rosenman
510-701-0134
drosenman@medicalcounseling.net

What Is Neuroplasticity?

2017-09-22T11:31:00.000-07:00

A Change of Mind: Neuroplastic Tools for Healing is the name for my groups and classes designed to help you feel better, work toward eliminating pain and discomfort, reduce anxiety, and get more done. Obviously, neuroplasticity is the core principle we use. What exactly does that mean?

When I was younger, we were taught that the brain doesn’t change in adulthood, except to lose cells in injury or disease. We now know that isn’t true at all. Neuroplasticity is the ability of the brain to change itself.

The brain changes itself constantly throughout our lives. The brain changes as our experience changes.

What does that mean, specifically?

Everything that we experience, think, feel, believe, and learn changes the physical structure of the brain, the chemicals in the brain, and electricity in the brain.
This ability of the brain to change is called neuroplasticity.

Having pain, discomforts of illness, anxiety, and depression also changes the brain — because these are part of our experience.

Usually, those symptoms only last a short time and then go away, so the brain doesn’t change very much.
However, sometimes symptoms last a long time, and happen over and over.
With repeated experience, the brain “learns” those symptoms, and builds them into pathways that remain active in the brain.
Once the brain has established strong pathways leading to those symptoms, they keep going and going, even if the initial cause has been resolved.
At that point, if we want to stop the symptoms, we must work directly with the brain to “unlearn” the pathways that keep manifesting symptoms of pain, illness, anxiety, and depression.

Artwork by Džoko Stach

We can use the principles of neuroplasticity in many ways. Neuroplasticity lets us learn through our entire lives. The more often we repeat a task, the better we learn it. Repetition helps us learn things like reading, adding numbers, or playing a musical instrument. We often call this type of learning practice. Repeated practice creates strong pathways that make it easy to repeat learned behaviors.

When we understand how neuroplasticity works, we have the opportunity to change symptoms of pain, illness, anxiety, and depression. In my Medical Counseling practice, and in my support and educational groups, A Change of Mind: Neuroplastic Tools for Healing, I teach people how we can change the brain ourselves by understanding:

more about how the brain works;
the principles of neuroplasticity;
the neuroplastic brain-retraining method adapted from Dr. Michael Moskowitz and Dr. Marla Golden; and
a variety of techniques or tools.

New sessions of the Change of Mind groups begin in October 2017. Each group meets eight times, for two hours each.

Berkeley Group A – Monday evenings 6–8 p.m., starting October 2, 2017
Berkeley Group B – Tuesday mornings 11 a.m.–1 p.m., starting October 3, 2017

New:

Online Group – Sunday afternoons 4–6 p.m., starting October 1, 2017

For information and to apply, please see: http://medicalcounseling.net/groupenrollpage.html

Contact me — I'd love to hear from you!

Danielle Rosenman
510-701-0134
drosenman@medicalcounseling.net

Brain Health: Workshops and Storytelling

2016-05-03T17:56:00.000-07:00

Since I’ve been working with neuroplasticity over the past few years, I have become increasingly aware of how important it is to keep growing and developing, in many ways, as part of keeping the brain healthy. Yesterday I attended a moving demonstration of this principle at a storytelling competition, involving themes of aging, for adults in San Francisco. I admit that I went because my husband was one of the six storytelling workshop participants chosen to continue in this event (and he was great!).

It was hosted by San Francisco sports anchor Mike Shumann and featured award-winning storyteller Olga Loya. Part of the Laugh Lines event series, it was sponsored by “What Is Brain Health?,” a national campaign sponsored by the U.S. Department of Health and Human Services Administration for Community Living. The campaign helps raise awareness about brain health while empowering older adults to make the most of their brains as they age. Visit http://www.brainhealth.gov to learn more.

The stories that were told were inspiring, as were the storytellers. Storytelling is one of the Tools that I use in my groups “A Change of Mind: Neuroplastic Tools for Healing.” When we’re telling or listening to stories, our brains are actively engaged and making new connections. Not only does this improve the health of our brains, but it is part of a strategy, which I use and teach, that helps us decrease and eliminate symptoms like pain, anxiety, depression, and symptoms of chronic illness.

As part of my own professional (and brain!) growth, I have been developing workshops to teach these methods in a variety of settings. Here are 2 workshops which will take place in May and June 2016.

In May:

Frank Wildman, GCFT, PhD and Danielle Rosenman, MD are teaching a new workshop:

PRACTICAL NEUROPLASTICITY AND FELDENKRAIS

Saturday and Sunday, May 14-15, 2016

Berkeley, CA
See this page for details.

Dr. Rosenman uses materials developed by Michael Moskowitz, MD, who some of you might have read about in the first chapter of Norman Doidge's book, “The Brain's Way of Healing,” and Marla Golden, DO. Dr. Wildman will discuss some very specific ways of using neuroplastic principles to greatly empower both Awareness through Movement® lessons, as well as Functional Integration®. This workshop will also be of interest to therapists-- psychological and physical-- and coaches, as well as anyone interested in the topic.

For more information, see this page.

In June:

I’m doing a workshop, "A Change of Mind: Neuroplastic Tools for Healing," at the Northern California Group Psychotherapy Society annual meeting at Asilomar June 3-5. This conference has a variety of very interesting workshops for psychotherapists.

For more information: http://www.ncgps.org/pages/news.html#Asilomar

There are many ways that each of us can continue to grow and change, become healthier and feel better. Sometimes we need the experience of others to help us do that. Telling and listening to stories is one way we share our experience. Teaching and learning is another way. You are welcome to contact me through my Web site, and I will be happy to talk with you about your own process of becoming healthier and feeling better!

Beginnings 2015

2015-01-29T16:29:00.000-08:00

There are many traditional times for beginnings. Mine has come at the New Year, 2015, coincident with moving into my new office.

It came about because my old office was on the second floor with no elevator. When I began to offer groups, A Change of Mind: Neuroplastic Tools for Healing (formerly Tools for Healing), I was able to use ground-level disability-accessible rooms, but only through 2014.

Skipping over the trials of finding a new office, I can report that my new office is a wonderful place. It is large enough for groups. I was able to choose new paint and new carpet, it has a lovely large window which looks out on trees, and I am enjoying the pleasure of full artistic control.

The New Year is also a time for pledges to oneself. I will go one step further and pledge to you that I will blog faithfully and regularly. In fact, my interface with the world is about to receive an electronic boost. My website, which I have loved, needs to be updated. I am certain that I will love the new website, along with the attendant changes to social media. I might even learn to Twitter, but that is not yet a promise.

Like many of you, my life has ups and downs, and gets complicated. I was particularly involved in the last two years with family support. I lost my wonderful mother Adele in June 2014 after she had progressive health problems, though she never lost her wit and wisdom. I no longer have any children in K-12 school, my daughter graduated high school and my son, mid-college, is teaching English to elementary after-school students in Korea.

Now I am focused on you, and on my work with you. I am passionate about developing the groups, which have helped so many people already, and about my continued work with individuals.

In this blog I have had the opportunity to publicly notice the heroes who are all around me. You continue to inspire me, and I will continue to write. Thank you!

The Power of Community

2013-09-25T15:52:00.001-07:00

I was thinking about healing on Yom Kippur, a holy day of reflection that comes every year in the fall, a time for evaluation of our experience and actions in the past year and redirection, hope and personal dedication for the coming year. We do this as a community during services, in which we collectively take responsibility for the past and the future. It is an acknowledgement that we do not really live alone, isolated from others, and that our actions affect more than just ourselves.

When we live with illness, pain, anxiety and depression, the struggle feels personal, isolating, and sometimes overwhelming and without hope. We each do the best we can to care for ourselves, sometimes supported by a medical team and, if we are fortunate, a partner and family. We might feel or have been told that there is “nothing that can be done.” Some of us may know a few techniques (“tools”) which can help us to feel better, but it is often not enough.

Even if we know some of the tools, it is in community (groups) that we can understand what has happened to us and where we can find the truth of ourselves as whole, as healed, as active, so that possibilities open for us, and our lives open up once again.

It is that, more than anything else, which we seek. Pain, illness, anxiety, and depression have been prisons. The bars have closed around us so slowly that we may not have even noticed.

We become defined by “I can’t,” “it won’t let me,” “I never will,” “I’ll stay here while you…,” “you go on without me…,” “I wish I could…”

What steps can lead to removal of those bars that cage us in? How can we open to possibilities instead of sadly turning our heads away? Who around us who can hold the space open for us, so we can then find our way to reach out for those possibilities? How can we feel effective and powerful, so that we can be effective and take power?

An Invitation to Our “Tools for Healing” Groups September 2013

2013-09-17T14:29:00.000-07:00

I am very excited about the “Tools for Healing” groups that my associate, Dr. Jan Chambers, and I have created to help people who live with illness, pain, anxiety, or medical conditions. Our new sessions begin next week, and we are offering Monday evening and Tuesday morning groups to accommodate different needs.

In these 8 session experiential groups, participants learn principles of brain science (neuroplasticity), and well-studied techniques such as meditation, imagery, journaling, expressive arts, and many others, which can change the brain to decrease pain, discomfort related to illness or medical conditions, anxiety, and depression.

Jan Chambers, M.D.

These groups also function as support groups and we have a lot of fun with the activities!

This is an opportunity to acknowledge and nurture your inner hero in company with others who are on similar journeys.

It has long been known through experience and medical studies that using these techniques, such as meditation and imagery, gives us the tools to feel better. Now, with the newest brain research teaching us how the brain changes throughout life, we can get even more benefit from using these tools consciously to change the brain. In addition to feeling better, we can actually decrease or even eliminate symptoms of pain, discomfort, and anxiety.

I invite you to call me for more information: 510-701-0134

Or email: drosenman@medicalcounseling.net

A Question of Value

2013-07-21T11:06:00.000-07:00

The killing of Trayvon Martin was not an isolated incident of violence.

On the 8th day of January, my daughter told me that a seventeen year old boy, known by most of her friends, had been shot and killed a few days before in Oakland. She said that this was the second death in her peer group since the beginning of the New Year just 8 days earlier.

Two months ago my daughter’s friend called her at 3 a.m. to tell her that there had been a shooting at a house party after the prom. My daughter reassured me that she and her friend would never have gone to a house party in that section of Oakland because there are so many shootings.

Every year that my son was in his small Oakland public high school, students came to school mourning the death of a relative or friend who had been killed, some wearing T-shirts with memorial dates and photos. The 10 year old brother of one of his classmates was “accidently” killed in a drive-by shooting.

We live in Oakland where there is an epidemic of gun violence. For youth it is common to know many teens or children who have been killed. This is especially true for our African-American and Latino youth.

Our youth are not apathetic, but they are in despair. Even my daughter, a high school student who is committed to making the world a better place, could not imagine anything that would change the risk of death to our youth through gun violence.

In the national and local debates and questions and hand-wringing, as we agonize over the Sandy Hook and other mass shootings, as we respond to the killing of Trayvon Martin, it is easy to feel that everything has been said. It is easy to feel helpless and hopeless, without power, marginalized, and alone. And yet each of us actually has something important to add in this time.

Each life begins through a series of chances. Somehow, our reproductive cells find each other, combine, and gradually evolve into a human life which is capable of living in the world. Because humans are born helpless, and remain so for a long time, the infant must have every need supplied. It is many years before a child can even take a bowl of cereal and milk from the kitchen without assistance.

Humans are pack animals. It is thought that we originally bonded with each other into community because of the specialized needs of our helpless infants, and the inability of just one mother to care for the infant while providing all the food and safety for the pair. Over a long time, each group developed into its own culture, but in every culture, care for the young is central.

Here in the United States, we encompass a multiplicity of cultures. There are, however, “American” characteristics which underlie collective ideas and values. As an American culture, we value the rights of the individual, and have a long tradition, a mythology rich with storytelling, which asserts that an individual who works hard can become successful on his/her own. With these assumptions, come others, less positive, about the meaning of needing help, or being cared for by the community. The common good can be less important than the desires and achievement of the individual. There can be the sense that if a person is struggling, financially or personally, it is because of personal weakness. It is possible to turn away from problems such as homelessness, poverty, ill health, and violent death, without seeing the faces of those affected as being essentially the same as our own.

In this setting, care for the lives of the young, evolutionarily the highest priority in any social group, has become secondary. As a society, we have turned away from protecting the lives of our youth, choosing instead to direct our attention and funding to protecting the right to own firearms. The point is that we are prioritizing the privileges of gun ownership over our responsibility to safeguard the lives of the next generation.

Looking at statistics from one year (data from the Center for Disease Control) in 2010, there were 2,315 deaths from firearms (excluding legal intervention) in the 15 – 19 year old age group (1564 homicides and 668 suicides, 72 “unintentional”). In the same time period, there were 369 firearm deaths in children ages 1-14 years. Firearm deaths in all age groups (excluding legal intervention) were 31,328 in just that one year.

Studies show that people who have firearms at home are at greater risk for both suicide and homicide. Whereas unsuccessful suicide attempts use other methods, a person using a firearm to commit suicide is much more likely to die. Proponents of gun ownership often say that it makes them safer at home, however studies show that gun ownership does not keep homeowners safe from criminals. Instead, guns in the home are often kept where children can get them, causing death by accident, suicide, and homicide. The guns used at Sandy Hook were taken from home.

Legal gun prevalence is a large contributor to illegal gun violence. In the Youth Gun Violence Fact Sheet published by the National Association of School Psychologists, a 2003 study is cited which states that 80% of school-related homicides and suicides related to firearms used guns taken from the home of a relative or a friend. Three of the weapons used at the Columbine massacre were bought legally from a private dealer at a gun show by an 18 year old friend, and given to the 17 year old shooters.

It has become increasingly difficult even to do the studies relating to firearms and public health, because public health funding has been cut for this purpose. My medical school classmate, Dr. Garen Wintemute, a noted researcher on this topic, has spent hundreds of thousands of dollars of his own money to fund his research.

It is fundamentally a question of value. What is the worth of a human life? How much is this one life worth to the mother, the father, brothers and sisters, grandparents, friends? How can anyone know what contribution will be made in the fullness of that life, what would be lost to the world without its fulfillment?
What if Albert Einstein, Rosa Parks, Cesar Chavez, Malcolm X, or Martin Luther King Jr. had been killed at the age of 18? Why is there so much shock about incidents of mass shooting, yet there is silence about the daily loss of life in so many of our communities? Why don’t we recognize that “your child” is to you what “my child” is to me? And aren’t we each some mother’s child?

I can’t let this go. I am a mother who cares for the life in my care. I am a physician whose care is for all life. I am part of the community of people, and it is given to us that we raise the next generation.

So I ask you to consider your priorities. Why is it more important to be allowed to have a gun than to preserve the lives of our children? Why should anyone be allowed to have a gun without a background check, attending a gun safety class and providing proof of a locked gun safe at home? Why aren’t guns manufactured with safety locks that open only to the licensed owner? How do we take away the enormous number of illegal guns that are easily available to youth? Why should the National Rifle Association’s money and influence dictate laws encouraging the proliferation and use of guns with fewer and fewer restrictions and safety concerns?

Send a message to President Obama that you support him in asking for new research and funding related to prevention of gun violence. Demand background checks for any gun buyer. If you live in a state with a “Stand Your Ground” law, work for its repeal and instead teach people to retreat from confrontation. Ask your local police to develop problem-oriented initiatives which address the culture of gun violence as well as its prevention. Don’t turn away from vulnerable youth. Join with others in your community to insist on zero tolerance for dead children.

Independence Day

2013-07-04T12:02:00.000-07:00

Last night I sat with my family around the table, already hearing sounds of firecrackers. The conversation wound its way to focus on who lives here, in the United States, and in what conditions. My daughter pointed out that there is a huge immigrant population, and many are living in poverty. Both my son and daughter went on to talk about poverty, in the United States and in the world, with the statistic that 80% of people in the world are living on $10 or less each day, many on less than $2 a day. There is significant poverty in this country, generally not to that level, largely because of minimum wage laws for people who are able to find jobs. However, in this country, homelessness is increasing. We went on to talk about different levels of poverty, and that in this country, most people do have sanitation and clean water, whereas that is an enormous problem in other parts of the world, making a big difference in complications of illness and death. Per UNICEF, 22,000 children die every day because of poverty.

Immigrants originally came to the “New World” looking for economic and religious freedom, and new opportunities. They, too, were strangers to this land. Since then, many waves of immigrants have arrived, each culture adding something important. If you are not a Native American, you or your ancestors came here from somewhere else. Many people have come to escape poverty or war, longing to have their children live. Many continue to live in poverty.

Today is Independence Day, with parades and fireworks, picnics and music. It celebrates a separation in which this country’s founders pushed away dependence on the “old country” and its policies and taxes.

Independence has different meanings. For the young, it means separating from parents, being able to make your own decisions, assume financial and personal responsibility, and is more about the maturing brain. For the old, it means being able to live on your own, handle your activities of daily living, and is about both the aging body and the aging brain. For both, it involves taking responsibility for personal health and well-being, to the extent that this is possible within the larger context of the surrounding political and economic conditions.

In the arena of nations, independence has not meant taking responsibility for the health and well-being of all inhabitants. Sanitation, clean water, adequate food, shelter, healthcare, and education are not available to all the people of this planet. It is true that all nations have poverty, but some have much worse conditions than others. People come to the United States because they hope to find work, and have better lives. They have heroic qualities of persistence, hope, determination, and self-sacrifice. These people are the same as those who became the founders of this country.

On this Independence Day, let us remember that independence comes with responsibility; this nation is independent and sovereign, yes, but it needs to care for people’s basic needs. Let us rededicate ourselves to helping people who are in need. Let us eradicate homelessness. Let us welcome immigrants, for we ourselves were strangers.

Generations of Mothers — Mother’s Day 2013

2013-05-11T14:41:00.001-07:00

This week my youngest brother and his son arrived from Florida. They were here primarily to visit my 86 year old mother, who recently declared “I’m not getting any younger” and demanded that my brother and, separately, my sister, come visit and spend time alone with her. Steven picked up Jono and his son Charlie from the airport and brought them to our house, and my mother arrived about an hour later via her helper. As she carefully descended the few stairs inside the front gate, she kept looking up to see her son’s face as he waited for her. Her eyes were shining. She is very little, even shorter with age, and my brother is tall. He carefully bent over to hug and kiss her, his son standing just behind him, and I could feel her overwhelming joy in the moment of reunion, mother and son.

Last year, at the end of June, my son returned after spending 10 months in Israel (The Summer of Impending Loss, He’s Gone). The day of his return, my husband, our daughter, and I went to the airport and waited in the baggage area. I kept looking for him… and then I spotted him. The first to reach him, I was the first to encircle him with my arms and be held by his stronger ones. During that long hug, I surprised myself crying for joy, for the breathtaking feeling of a mother reunited with her son.

Just days ago, as I watched my mother reunite with her son, I remembered. And then I also remembered all the years when I was the one visiting my mother, happy to see her, but also happy when I left to return to my own life, not quite understanding her towering joy when I arrived, or her plummeting sadness after I was gone. Now, in one moment of awareness, I became joined to my mother.

Our son is coming home from college on the east coast in just one week. I can hardly wait. He has decided to transfer to college here and live with us at least for the next year. I now realize what an incredible gift of time we are about to receive. I think about our daughter, a junior in high school, and wonder what it will feel like when she, too, leaves to go to college, and how I will miss her even as I encourage her to start out on her own journey. Before I know it, they will both be visitors when they come home.

On this day of honor to mothers everywhere, let us celebrate our unity as mothers, or as children of mothers, or as grandchildren of mothers. Let us remember that each mother’s child is as precious, unique, and beloved as our own children. May all children and mothers experience the joy of happy reunions.

Growing Life

2013-05-08T10:28:00.000-07:00

I have had a “dry spell” in my writing – a time when my metaphoric pen ran out of ink, and I couldn’t replenish it. My ideas were all focused on family needs and transitions, my counseling practice, and more recently, learning the personally and professionally exciting field of neuroplasticity, how the brain changes itself, and how that can be applied to eliminating persistent pain.

Now my thoughts and desires turn, again, to the traditional preoccupations of spring. I am planting my garden, choosing plant starts and seeds, following the sun through the day to see where it lingers most, and planning where each plant will (hopefully!) be able to grow and produce its vegetables, fruit, or flowers.

With any physical enterprise, I usually need help. Heavy digging of our clay soil and pulling of weeds, clearing underbrush, and taking out deeply rooted unproductive or dead plants, is not safe for my precariously balanced physical structure. I am fortunate indeed to have my husband Steven, who is willing to partner with me in this endeavor. This year he is recovering from a knee replacement, and so we also asked our neighbor’s gardener to do some of the heaviest work for us.

Now it is my turn. I buy soil amendment and plants and seeds, direct the placing of compost, and finally get my turn to put my hands into the soil itself. I love to do the lighter digging of prepared soil, plant the seeds and starts, and water them. It’s fun to figure out what needs to climb up a cage or which vine will need a support to twirl around as it grows, then find the ones I used last year or the year before, and use them again. I pulled the wisteria back where it shaded my vegetable bed in the front of the house, and tied it onto the fence rail so the tomato and beans I planted would get more sun.

As I work in my garden, I am growing hope. Each plant and seed contains the potential to become large, lush, beautiful, and delicious. I am growing nourishment, of the body and the spirit. I am growing pleasure, mine as I engage all my senses to see, touch, smell the plants, hear the spray as I water them, and ultimately taste the fruits of our labor. Pleasure is shared with my family as we watch the growth, anticipate the wonderful food we will make and share further with our friends, and the beautiful flowers we will enjoy all summer long.

Weather is unpredictable. There are times of rain and times of dryness. I hardly noticed that my writing was drying up, but when I did, I prayed for rain. And then I waited…

Somehow I didn’t notice that even in the dry time, seeds were forming and dropping into the dark, conserving their energy and potential to grow, and getting ready.

Examining Our Lives

2012-09-25T08:46:00.000-07:00

This is the time of year when, in the Jewish tradition, our lives are examined. We bring the previous year to mind in order to find its truth. What is the truth about myself? Were my words and actions what I meant them to be last year at Rosh Hashanah and Yom Kippur, when I made resolutions for the New Year? Were there times my words were not as kind and compassionate, as patient as I wanted them to be (ask my teenage daughter!)? Could I have done more for the community, for the earth, for my mother?

Questions such as these are always answered in the affirmative. We could always do more, do better. No archer, not even Robin Hood, can hit the center of the target every time.

The truth, however, is greater, and also requires other questions. Did my words make a difference for another person? What were my deeds that supported others and made the world a better place? What did I say or do that nobody else in the world could have done? How did I keep the promise that I made to myself last year?

Sometimes it is very hard to acknowledge the truth of misdeeds, and make amends. We do so in order to “clean the slate” and make ourselves ready to do better in the coming year. However, it can be even more challenging to acknowledge the truth of our good deeds, and thus accept ourselves as complete human beings.

Every culture has its own system of social rules. In ours, politeness dictates that we do not focus on our accomplishments or good deeds. When we speak of them, we don’t want others to think that we are “bragging.” We are taught that the highest form of giving is that which is anonymous. Similarly, it is expected that we will do the right thing without the expectation of praise; however, our mistakes are routinely criticized. In time, this is internalized, and we hardly notice our successes, while criticizing ourselves, sometimes repeatedly, for our mistakes.

And yet, it is the knowledge of ourselves as good people which allows us to understand when we have missed the mark and gone astray. In some way, the more we are aware of the times we have gone out of our way to help, the times we have made a difference, of when we have acted in accordance with our own ethical principles, we create a conscious pattern of good deeds.

So how has this last year been for you? How did you “hit the mark”? Can you remember when your words made a difference to another person, when your actions helped someone, when you did something to make the world better? Is it possible for you to accept your truth, and from the wholeness of self-knowledge, make choices for the coming year?

Focused on the wholeness of our beings, we awaken to another year, rededicating ourselves to strengthen the pattern that we create out of compassion, kindness and love, commitment to social justice, and our intention to make the world a better place for all life.

Shana tova – have a happy and healthy new year.

Magic

2012-06-28T18:53:00.000-07:00

“Star light, star bright,

First star I see tonight,

I wish I may, I wish I might

Have the wish I wish tonight.”

Tonight I wished upon a star, the first that caught my eye when I looked up into the night sky. I recited the verse, long cached in the storage closet of memory, with the ease of repetition, and felt a sense of relief. The worry that had prompted this particular wish was alleviated, at least for now.

We wish on stars, on pennies thrown into fountains, ponds, or wells, on eyelashes blown by our breath from a forefinger. We wish on birthday candles as we blow them out, on breaking the “wishbone”, on rainbows. These are some of the wishing traditions I grew up with, and there are so many different wishing traditions around the world.

We also create our own wishing traditions. When we were children staying with our grandparents in Nogales, Arizona, my sister and I would walk down the 2 hills to school or the library, and as we walked back up the hills, near the top there was a tree stump. We named it the “wishing stump” and always took a minute to take turns standing on the stump to make a wish, before continuing home. One of my friends has named and calls on the “parking goddess” to find a parking place, and I have developed my own version of the “parking goddess” ritual – I think it helps!

Wishing rituals are often outside traditional religions, though there are certainly wishing traditions within religions. In my religion, Judaism, there is a ritual of placing pieces of paper with wishes written on them into chinks in the Western Wall in Jerusalem.

We read all kinds of fairy tales in which wishes play a central part. Sometimes three wishes are granted. Sometimes the wrong wish is hastily made, and sends the story in a different direction. Powerful fairies grant wishes to a newborn baby, as in “Sleeping Beauty”. The central longing in “The Wizard of Oz”, one of my favorites as a child, is the wish to go home.

As modern scientific adults, we often think of wishes as childish and unproductive. However, in actively wishing, we exercise a powerful tool that utilizes practices which are known to benefit physical and mental health. Hope and positive thinking have been studied and found to increase a sense of well-being and alleviate stress. Even the simple act of making a wish helps us to feel more in control, calmer, and without as much anxiety, more able to access creative problem-solving.

Furthermore, we are using imagery, which can positively affect the immune system and many other physiologic processes. The words we say actually can cause the body to activate release of transmitter chemicals and hormones, either harmful or healing, depending on what is said. Consider being in the kitchen, accidentally cutting your arm, calling out, and then someone comes to help you. If that person says “oh my God, I’ve never seen so much blood,” the sympathetic nervous system releases adrenaline, the “fight or flight” hormone, which can cause elevated blood pressure and heart rate, thus possibly increasing the bleeding. If that person says “I’m here to help, the worst is over, relax and let me see your arm,” the chemicals that are released are likely to be parasympathetic, which lower blood pressure and heart rate, which is likely to make it easier to stop bleeding.

Finally, there’s magic. All human cultures have some longing for magic – a way of using personal power to affect what is around you. We live with the reality of events which we cannot control. Perhaps wishing on a star is much more than a ritual of childhood. Perhaps the ability to do so is actually one of the heroic qualities that sustain us. When we really, really wish with all our strength, when we can imagine the future we want so much, and find a ritual into which we can channel our love and longing and hope and dreams, we internalize that hope and find a way to articulate our dreams. At the same time, by speaking the truth of our desires, by acknowledging them, we can unlock the creative thought process that will help us find a way to change or find peace with our lives.

Ray Bradbury

2012-06-21T18:53:00.000-07:00

Ray Bradbury died June 5, 2012, at the age of 91 years. I found out a few days later, in the morning, a snippet of the Times in my email, my thoughts immediately overtaken, remembering stories of windswept landscapes on Mars, and dark warm nights illuminated by fireflies.

Ray Bradbury was an icon to me -a writer whom I read from childhood to the present, whose stories contained elements of science fiction, fantasy, and poetry, who used deceptively simple clear images to portray complex ideas. He had been a friend of my father, Leonard Rosenman, who was a composer, and my mother, Adele Bracker Rosenman Essman. He once inscribed a copy of "Switch on the Night" (about a child who is afraid of the dark): "To Danielle and Gabrielle, who I am sure will never need this book, from a very old man named Ray Bradbury." (Gabrielle thinks he was about 30 years old at the time.) That copy of the book is long lost - but I read a newer copy to my children.

By happenstance, my family was visiting Los Angeles during the week-long celebration of Ray’s 90^th birthday. Gabrielle & Peter, my sister and her partner, took us to two wonderful events during that week. We saw the initial performance of a play he had written, and a screening of the movie, Fahrenheit 451, and I was privileged to speak to him for the first time since I was a child. My son and daughter were able to hear him speak about being a writer. He recommended that anyone who wants to be a writer should write a story every week. He himself wrote every day.

Ray Bradbury wrote about magic in everyday life and the intersection of everyday life with magic, especially the fantastical experience of children. Of course, we didn't call it magic when we were children, and he doesn't call it magic either. The New York Times said that he did not use the "technical jargon" that was prevalent in the science fiction of the day, and this helped his writing reach a broader audience. His writing used the evocative language of the imagination, and reading his stories felt like the images from his words on the page reached directly to me, and activated my own imagination, so that I could see, hear, feel, smell the landscapes and characters in his books.

Imagination is the quintessential human quality, and a longing for magic lives in the deepest part of our souls. Like Ray Bradbury, we may not call it “magic”, yet we find ourselves reaching out with a sense of wonder for that which is mystical, evanescent, transcendental, spirit, essence, God. We find ourselves asking the great questions about the meaning of life: what is the place of humans in existence, who inhabits the next galaxy, what happens after this life is over, and who switches on the night.

So I do not say to Ray Bradbury, “Rest in peace,” but rather, “Rest in wonder.”

A Change of Plan

2012-04-14T22:43:00.000-07:00

Recently I learned that my friend Hester had been suddenly diagnosed with Stage 4 cancer. She had been focused on daily living, her long road stretching out to the horizon, attending to friends, creativity, work, and related pleasures and struggles. Within days, her life abruptly made a hairpin turn into a new path, narrow and poorly lit, and short. One week after I spoke to her, she died.

It is at these times that the veil, which protects us from certain knowledge of our impermanence, draws back and we glimpse the evanescence of all life. This happens rarely for most of us, and we usually focus our attention on the events and circumstances of our lives as if we will always be living, here on this Earth. Younger people, especially, tend to feel personally immortal, even when they know people who have died. At a certain age, that veil becomes thinner, and somewhat frayed. We have family and friends who have life-threatening illness, or who have died. The numbers increase with our own age. It becomes easier to imagine “that could be me.”

Still, the veil is there, even if thinner, and those moments when we recognize the brevity of life disappear back under the veil.

How do we live life fully, completely, inhabiting each moment we are granted? In those moments when the veil is drawn aside, can we still live in the present? Is it possible to do so despite knowledge of what awaits us at the end? Or is the veil necessary, like blinders, to keep us focused in the present? Is this a universal phenomenon, or just a product of our own culture, which keeps illness and death at a distance, and encourages everyone to hold on to the appearance of youth?

Certainly there are other cultures in which illness and death are regarded as part of life in a different way from our own, in which people are cared for at home among family of all ages. Also, there are places where death comes more frequently to people at a younger age, because of infectious diseases, hunger, and war. In these circumstances, there may be very little left of the protective veil.

Though the many religions and spiritual traditions of our world offer guidance, ultimately we each find our own way to co-exist with these questions. Like many of us, I spend most of my time focused on the details rather than the overview. I attend to my family, do my exercises, see my patients, care for our pets, plan and cook dinners, go out with my husband, my attention directed to the events carefully listed, by color and category, on my phone calendar.

These last two weeks, however, my veil has thinned, and I know that, as I go through my day of details, my life, too, could change suddenly and irrevocably. This awareness brings so much discomfort that I immediately turn away into mindfulness practice, name it “anxiety,” and return my attention, not to my breath, but back to the specifics of daily life.

Still, I find my mind meandering at odd times, wondering about meaning. What are humans here for? Why does each life seems so expansive, and yet so brief? When people die, how can they suddenly not be here? What am I here for?

I sometimes see time stretching in a line from the past to the future, or not in a line at all, with everything happening, in some way, simultaneously, and all life connected into a vast web. In some way, everyone who was ever here, is still here. In some way, it is life itself that is the meaning.

Physicians Have a Natural Role as Advocates

2012-01-27T21:45:00.000-08:00

This is an article I wrote that was published on Kevin Pho's blog: KevinMD.com

As physicians, we are often called upon to be advocates for our patients. Sometimes they have no other person to turn to. At those times, in particular, we evaluate their health in the context of relationship, family, and workplace. Having practiced family medicine for so many years, and now in counseling medicine, I have had the responsibility of advocating for my patients with their health insurance companies, within their families, and with their employers. I take this responsibility very seriously. more

New Year’s Resolution

2012-01-25T13:57:00.000-08:00

Tradition asks us to use the onset of the New Year as a time to make resolutions for changing our behavior for the better in the coming year. In fact, making – and breaking – those resolutions is the topic for conversation and news articles every year at this time.

I actually get this opportunity twice a year: January 1, with everyone else, and in the fall during the Jewish holidays of Rosh Hashanah and Yom Kippur, with others of the greater tribe. One would think that I would get used to it, perhaps even good at it – that somehow my resolutions, like the bare root trees of winter, would ground themselves in the fertile soil, and grow strong and leafy, signaling my success to everyone.

Instead, I find myself revisiting the same basic resolutions twice a year (at least!), though the context and details may vary slightly.

So, again, it’s January, and I plan, over this next year, to take better care of myself and to put myself and my own needs, first. Just writing that I will “put myself first” makes me so uncomfortable that I feel compelled to add, “most – or more- of the time.” Then, feeling that I have chickened out, I go back to the stronger statement, and say “yes, I will put myself first.”

Why is this so hard for me that I must resolve, over and over again, to make these particular changes in my life? The concept is not foreign to me; as a physician, I advise my patients not only to take care of themselves first, but how to do it. With this advice, I have told my favorite parable (“Reflections”), familiar to all who travel by airplane, where, at the beginning of each flight, the flight attendant tells the passengers “In the unlikely event that the cabin should lose pressure, and the oxygen masks are released, put on your own mask first, before you help others who need assistance.”

What would it mean for me to put myself first? Certainly, it means prioritizing behaviors and activities which make me strong and diminish pain, decrease stress and make me happy. These include exercise, regular rest, meditation, creative expression, and attentive scheduling. In reality, I actually do these things, but not consistently and not enough.

So it is ironic that I have counseled innumerable people, my patients, through these same lifestyle changes. The results are varied - often people make at least some changes, but sometimes they don’t. Perhaps most of them, similar to my own experience, do take on practices that help them focus on their own health, but can too easily get derailed by the needs of others.

Our personalities, experience, and training influence the direction of attention. Some of us tend to turn our attention first to those around us who are in need. As a woman, a mother, and a physician, my natural predisposition to notice and attend to those in need became more compelling. It is what I tend to do first. It becomes automatic.

The antidote to automaticity is mindfulness. When we notice our thoughts and feelings as they occur, we can recognize that we have options, and choose what to do in that moment. In choosing, we do not react automatically, but thoughtfully. If I plan to go to the gym and exercise, but before I leave my daughter tells me her computer isn’t working and I need to fix it so she can do her homework, my automatic response would be to try to fix the computer because her homework seems more important than my workout. But if I stop and examine my options, I realize that this is the only time today I could go to the gym, that my exercise is very important, that she could clean her room first, or hand-write her work for now, and that I can easily look at the computer when I return, while I rest after exercise.

We don’t usually think about heroes as making choices to care for themselves. Heroes traditionally care for others at the expense of themselves. Yet when we examine the qualities of heroism, we find courage, steadfastness, and the ability to make split-second choices which save lives. The hero does what is right, regardless of the expectations of others.

Sometimes we find the qualities of heroism inside ourselves, and apply them to situations which do not seem like the stuff of legends. Still, they are the same qualities, which we use on a micro-scale every day. With them, we do things to save our own lives, a little bit at a time. In the Jewish tradition, the person who saves one life saves the world.

The Longest Night - Finding Light

2011-12-26T10:34:00.000-08:00

It’s dark – the darkest time of year. Short days and long nights, however cold or warm the climate, evoke the search for light. Many of our traditional holidays at this time of year have imagery of bringing and sustaining light out of the darkness. My own tradition of Judaism builds the light, increasing candle by candle, over 8 nights.

Our DNA fears the dark, prehistoric dangers remembered in the primitive brain. We light fires and candles at this time of year as an anodyne for fear. Imagine our distant ancestors wondering if the sun would really return. Even now, our children often need a nightlight so they can go to sleep.

When we are ill, or in pain, or depressed, or things are not going well, it feels sometimes like being surrounded by the dark - not a warm friendly dark, but rather the dark of winter, cold and bleak. At those times, without even knowing it, we crave the sun’s light – hours of it.

Imagine that inside you, in a safe place, is your own life-giving sun, containing light and warmth. Imagine its rays carrying healing light through every fiber of your being, floating gently, exactly where you want it to be. This lovely sunlight wraps around you, inside and out, completely relaxing you, reminding you of your own well-being, and wholeness. Finding the light inside you can transform the dark of the year into a soft dark, a velvet dark, the dark of being tucked into your own bed by someone you love, and snuggled under the covers. With your own light inside, you are always safe, and all is well.

I wish everyone a New Year filled with good health, happiness, and joy, and always, peace.

Vaccines, preventable disease, and the nature of risk

2011-12-23T14:39:00.000-08:00

This is an article I wrote that was published on Kevin Pho's blog: KevinMD.com

Two nights ago, I was watching, with my family, an old episode of Dr. Quinn, Medicine Woman, in which a young woman is bitten by a rabid wolf, develops rabies, and dies. That same night, I read a post on Facebook decrying the dangers of immunizations, with a link to an online “news” article blaming immunizations for everything from spreading cancer to HIV.

My mother, as a girl, was bitten by a rabid dog. More...

Kinship

2011-11-26T19:09:00.001-08:00

This year we celebrated Thanksgiving with a family dinner at our home, bringing together family from both sides and various parts of the country. This morning I woke up reflecting on families and how we think about them.

Most physicians majored in science as undergraduates in college. I majored in anthropology. A generalist even then, without even the hint of medical school on the horizon, I was drawn to the study of humans, especially within the social and cultural matrix. This gave me license to also take any courses that interested me, which I happily did, including literature, psychology, sociology, the arts, language, and a variety of student-initiated courses through a pioneering and activist program called the Center for Participant Education (CPE), where I was part of the student staff.

In anthropology, we studied kinship, drawing elaborate diagrams of personal connection. It was important to understand that in different cultures, the meaning of family is also different, that the mother's brother might have a role in one culture which the father has in another.

I think that I have always perceived all humanity as connected in a vast web, ultimately kin, though the details at the edges vary in ways that can define separation and difference.

My family has its own definitions. I’m the oldest of three, with a sister 2 years younger and a brother 7 years younger. My parents divorced when I was young. My mother Adele’s family was enormous and present in my life. People traveled across the country to attend weddings, Bar/Bat Mitzvah celebrations, other important life events, and funerals. My father Leonard’s family was distant; his parents were people from whom he escaped as soon as he could, and who, after the divorce, weren’t there at all. Somehow we also lost touch with the rest of his family, though many years later, there was a marvelous reconnection with his brother’s family and his aunt and uncle and cousin. My mother remarried to Phillip when I was 15, and I suddenly had 2 stepbrothers, and there were five siblings instead of three.` My father remarried once, giving me 2 stepsisters, then again, then again, finally giving me a wonderful “wicked stepmother” Judie, and turning me into a “wicked stepdaughter.” My mother and Judie became close, supporting each other through each husband's last illness, and still calling each other "my wife-in-law."

When my mother remarried, she invented a new kinship category that described the relatives of her husband’s first wife, who had died. They became “our third family relatives.” She continued to use that descriptor, without explanation, into the present, as if everyone knows the meaning of this kinship term. My mother also fostered many teens, who came to her for respite and an accepting environment. This included some nieces and nephews as well as friends of friends of her own teens. These latter sometimes became permanent family members, especially Bayla, who we always considered to be another sister.

When I married Steven, not only did we now have each other’s family as our own, we also took on all the official and non-official family that each of us had accrued. Thus, his brother, Charles, became mine, but also his brother-in-law Calvin from his first marriage, became my brother-in-law as well.

There have always been different ways that we have the children that we raise. However they come to us, they are our children, the foundation of our families. We give birth to them, we adopt them, we foster them, we are drawn to each other as adults and adopt each other. Their children are our grandchildren. We also foster, adopt, and choose each other as grandparents and grandchildren.

Often, we become such close friends, that the relationship transcends even friendship and becomes family. This has happened to me, to my husband, to our children, and to so many others.

What is really important, it seems to me, is to acknowledge and cherish our families; however they come to be our fathers, mothers, children, grandparents, sisters, brothers. And then to do so for their fathers, mothers, children, grandparents, sisters, brothers. And moving on and outward through every connection and every generation, until we know without a doubt that we are all indeed part of the same family, connected irrevocably, our fortunes and fates linked forever.

Giving Thanks – Opening to Hope - Making Peace

2011-11-23T11:30:00.001-08:00

My teens remind me that this holiday of Thanksgiving has a checkered past. Its origin reminds us of when the generosity of one people was met with oppression by the other. Yet the tradition of giving thanks for a successful harvest, and later, gratitude for making it through a variety of difficult times, is a long one and is shared by many people of different cultures.

What keeps us going in difficult and challenging times? We are certainly living in such a time now, with widespread economic hardship and disparity. Is there something essential that we can access under any circumstances that gives us strength and brings us peace?

The practice of gratitude allows us to find the beauty in our lives, acknowledge the love we give and receive, and experience ourselves as grounded and balanced. It is not the same thing as being in denial of adversity. It does not preclude realistic analysis of the situation, or take away from tough decision-making and planning. Rather, it helps us appreciate and understand what we have, which is necessary to illuminate our view of the path ahead.

So for me, Thanksgiving is an opportunity for gratitude practice within the context of the greater community. It’s important to know its checkered past, to do everything in our power to transform a history of oppression into appreciation and gratitude for diverse cultures and peoples. And, of course, we celebrate with a great feast of thanks for the delicious harvest.

Two years ago, my son was a junior in high school and studying in Israel for the fall semester. He was about to travel with his group to Poland to study the Holocaust. The parents were asked to write letters which would be given to the students while they were there, for support during a difficult time, while they visited the death camps. I wanted to write something for him about hope, and started writing a poem, but it morphed itself into a poem about bread and peace. I think the two are strongly related, for we must have hope to be able to envision a world in peace.

Recipe for Peace: Bread of the Earth

Take a very large bowl

And put the world into it.

Stir carefully while adding:

-1 measure of pure warm rain

-a double measure of the milk of human kindness

-1 teaspoon of wildflower honey

Sprinkle with your hands full of the leavening of humor.

While it starts to rise

Go away and leave it alone.

Use the time to lie in the sun

With your ancient Labrador retriever,

Arm resting on her lumpy softness,

Her breath whistling in your ear.

After all, DOG IS MY COPILOT.

After she gets too hot, check the bowl.

The bubbles are proof that it will all come together.

Time to add more ingredients, this time by feel:

-seeds of change – be sure to put in enough

-breezes of hope fanned by millions of wings

-a mixture of human endeavor soaked in spirits

-some squeaky wheels liberally greased

-a few salty tears to bring out the flavor

Knead it with compassionate hands,

All the hands around the table,

Each sliding off the others

As the dough is stretched and compressed,

Formed, shaped, irrevocably changed by every touch.

While you are kneading, sing –

Find the notes that bring

The work and the workers together into harmony.

Then – you will know when – rest the dough.

Cover with good intentions.

Use this time to learn someone else’s language,

Talk to a stranger,

Or wonder who lives in outer space.

The time has come.

Now the dough can be brought

Into alignment with the stars,

Shaped into the peace that will perfectly fit

The pan it was meant to inhabit.

Slipping the pan into a crucible

Of uncounted starfire, you wait.

The scent is tantalizing –

It is what you have always longed for,

Yet do not know.

Finally, it is here, in your own kitchen.

And you sit with all the others,

Feeling the purr of your warm cat

Extending her vibration from your lap

Out to the universe,

While inside is Peace.

Danielle Rosenman

c. November 11, 2009

Occupy Hope

2011-11-06T20:35:00.000-08:00

This week Occupy Oakland, in solidarity with the Occupy Wall Street movement, sponsored a General Strike, which culminated in a 2 mile march to the Port of Oakland. I was not there. All that I am, forged in the heat of the protest marches and demonstrations against the Vietnam war, in favor of ethnic studies classes at U.C. Berkeley, in support of the people’s right to the use of land, sent my heart and my husband out to march. My body, constrained by chronic back pain and more recently chronic foot pain, was unable to be there.

Invisible disability is more common than anyone knows. There are so many of us who look just like everyone else, but who live with limitations of physical, mental, emotional, or intellectual function.

Our nation, and indeed the world, is impaired by dysfunction that has been increasing, under the surface of awareness, for a long time. As a society, we have been living with invisible disability. Just as the individual’s unseen disability is so difficult for others to recognize, most people simply have not noticed the magnitude of the dysfunction in social institutions, or its affect even on the people that they know.

Now the dysfunction, the disability, in our nation has become so widespread that it has broken the surface, and everyone can see it. No longer invisible, it affects 99% of the people, and it can be experienced personally with all the senses, and not just seen as affecting someone else. We and our friends are burdened with financial difficulties, worried about caring for our aging parents and getting our youth through college without leaving them crippled with debt. We and our acquaintances are struggling to keep our homes, or have lost them, or never had a chance of owning them. We and our families have lost our savings, or lost our jobs, or can’t get a job. We all know single parents who can’t afford childcare or someone who retired after a full work life who must now try to find a job to pay the bills. Around us, schools and universities and libraries and community centers and services for the aged, ill, and disabled are being closed, unfunded, unstaffed. And, as my disability is something I cannot ignore, that of our society also must be addressed by us all.

If we are to engage with these issues, it helps to understand more about ability and disability. The World Health Organization International Classification of Functioning, Disability and Health (ICF) has updated the discussion of ability and disability. It defines “disability” as “an umbrella term for impairments, activity limitations and participation restrictions.” The ICF emphasizes that anyone can experience disability, which thus becomes a “universal human experience.”

Even more important, the meaning of a disability depends on the context of a given environment. The environment can make a difference between the “level of capacity” and the “level of performance.” If my environment is my home or my office, where I can sit on my reclining chair, I have less back pain, and my “performance,” or what I can actually do, is close to my “capacity”, or what I can do under ideal conditions. On the other hand, if my environment is marching in a demonstration in the streets, my “performance” is less than my “capacity,” and I will have to stop in just a few blocks and go home.

The importance of these definitions is the concept that changing the environment can completely change the meaning of the disability. The word “ability” can be defined as “the power to act.” The previous, or medical, model is to try to fix the disability. As a physician myself, it is always very tempting to put energy and resources into fixing the problem. However, as an experienced physician, I know that this is not enough, and that the results are often limited. The new model is to bring the person with the disability into balance with the environment, by changing the environment.

Now we are in the realm of healing. As physicians, we support healing, which derives from the word for wholeness. As such, we are obligated to attend to the whole person within the whole partnership/family, within the whole community. It is attention to the wholeness of our community, in the broadest sense, which inspires the Occupy movement.

What else does the Occupy movement have to do with healing? I’m not referring to the fact that so many people in this country have limited or no access to medical care, that the chief cause of bankruptcy is medical bills, that people die because they do not have health insurance (I personally have 2 friends whose death certificates should have included the diagnosis “due to lack of health insurance”). I’m not discussing the lack of preventive medical care, which drives up unnecessary health care costs on top of the enormous human costs of illness. I’m not even talking about the differential between the 1% and the 99%, and how the worth of a life and of health is measured in money.

The Occupy movement, grassroots assemblies across the whole country, is composed of a true representation of the 99%, different ages, genders, races, ethnicity, religions, work histories, interests, and ideas. These assemblies promote wholeness, coming together for group consensus decision-making, helping each other with the activities of daily living of a society (housing, food, etc.), and focusing on healing the dysfunction of society as a whole. It is a movement that rejects special interests, has no leaders, and has a single issue:

people together making change, resisting greed, corruption, and the hoarding of resources by the 1%. They are changing the environment in the process of trying to fix the problem.

This movement is our hope. Any physician can tell you that we must have hope to go on, even in the most desperate circumstances. When we have hope, we can tolerate the most difficult treatments, smile despite the pain, and plan for the future, to make a better world for our children’s children’s children.