Dream Dress

Is it wrong that I am going to buy this dress for Lu because I really want it for myself?

It's a confection of a dress, with gauze and cotton ruffles, but done in that subtle, offbeat J. Crew way. The moss green will match her eyes. It costs too much money. I am buying it anyway. But don't tell her, because she is "earning" it, thus providing us the leverage we need until Santa-power kicks in.

And, no, there's no way I would look up the size chart and consider the possibility of squeezing myself into a little girl's XXXL. That would be weird. And, yes, I realize there's a psychological term for this (though I may need an expert to tell me if this is technically projection or lack of separation-individuation). Whatever. It's a really great dress.

Scholarship Material?

After Lu's parent-teacher conference with Ms. B., I felt...[insert adjective to describe a combination of disappointment, lack of surprise, pride, amusement, concern. Am sure the Germans have one]. Ms. B. has high standards and she runs a tight ship, both good qualities for any captain of Lucy. She found lots of nice things to say, but I could hear the strain in her compliments. I wanted to tell her, "Save the 'stroke-then-kick' corporate coaching method for the people wearing tennis skirts, because it's a little obvious for the rest of us." I didn't. I listened.

I listened to her talk about how Lu is a gifted reader, the best in the class, but her writing is below where it should be given her reading skills. I listened to her catalog Lu's behavior problems: the constant talking, the attention-seeking spazzing out. I listened to her describe Lu's compassion and sensitivity (Ms. B teared up). I listened as she explained how Lu had scored on a beginning-of-the-year math assessment: in the middle.

In the middle. She had been a math superstar in kindergarten. Maybe she was just riding the Montesorri advantage. But the middle?

To be clear, Jason and I are not geniuses. We are both smarter than our academic achievements would imply, yet we're pretty regular. While I love to imagine that I am an untapped savant (what is my undiscovered gift??), I have enjoyed a good life as a bright person whose special skill is getting to know other people. It ain't bad, but Stanford doesn't give scholarships for Conversant in Current Affairs/Delightful at Parties.

But Lu...we have expected scholarships. Is it possible that her exceptional verbal skills have masked her mediocrity in math? Jason is starting to do math drills with her. I am upping our contribution to the 529.

I'm No Girl Scout

Last weekend, Lucy and I joined her troop at Camp Texlake for the weekend. The girls in the troop had a great time singing, kayaking, swimming and meeting other scouts. The moms in the troop had a great time chasing the girls around, getting to know each other better and drinking wine out of coffee cups. And getting busted by the director of the event after we were ratted out for aforementioned wine drinking.

You Know You've Been in the Hospital Too Long When...

...you know your way around....you have a regular sandwich order in the "Bistro." ...you've had the same nurse more than once. ...your United Nations of Nurses represents most equatorial countries from the Western and Eastern hemispheres, and you develop a nuanced understanding of the strong British colonial influence on women's names (Jocelyn...from Thailand, Maureen...from Cameroon). ...you've spanned the full spectrum of feelings from deep gratitude ("I love this place, they saved Dad's life!") to appreciation ("We should bake them cookies.") to wearied relief ("Well, they are keeping him pretty healthy.") to anger ("What are you people doing? Why do I know more than you?"). ...you understand that the system works to benefit all the participants — the patients, the nurses, the docs, the techs — but the interests of the group fight the interests of the individual. ...you hate your surgeon and love your internist.

Dad went home yesterday, and he seems to be headed in the right direction. Which, I hope, is the opposite direction of North Austin Freaking Medical Center.

Observations from an ICU, 3

Today is Friday, 9/24/2010 I know this for sure because it's written on the whiteboard in Dad's room. Every room in the ICU has one of the whiteboards where date is rewritten faithfully every day. The days do run together in here. And some of these folks are in sorry enough shape that I see why they'd need to write the year down too.

Dad is definitely on the mend physically, and now his mental health is a concern. He's just been cleared to receive liquids, which means he will get his bipolar meds after four days without them. He's begun to show signs of mania (only got about 1.5 hours of sleep last night -- on his current dose of narcotics, he should be asleep most of the time, which means he's manic in slow-motion). Right now, he's Fun Jim, the mildly manic, jokey version of himself, yukking it up with us and the staff. We just need to get this under control before he's running around the floor with his rear end flapping out of his gown while the staff tries to sedate him.

Observations from an ICU

The film on the windows in the ICU casts the room in perpetual dusk. The fluorescent light, while politely dim, only adds to the gloom. The effect is meant to help the patient sleep, I suppose, but sleep seems to wait at the door for the constant shuffle of clog-clad feet and the business of monitoring, checking, asking, helping. Since we got in here, Dad has been in a half-sleep, like he's covered in the same film from the windows. His surgery went well — less than the four hours we were warned it might take, and they took the ventilator out right after surgery. He lies wizened and tiny in the big hospital bed, arms folded over his chest and whole body covered with a blanket, which hides the various devices and tubes that do more of the business of monitoring, voiding, squeezing and helping him get better. Which it looks like he is doing, thankfully.

Hospital New Hampshire

Last week, I drove all around the state of New Hampshire with a film crew, talking to various community health clinics, physician group practices and hospital-associated groups about a radical new concept called Patient-Centered Medical Home: the idea that every patient should have a primary care doctor in a consistent setting. Where a patient is known and welcomed. Where all aspects of their medical care are coordinated (even those things may not immediately seem related to medical care, like getting a ride or getting all your forms filled out). Where a patient is an active consumer of healthcare, an accountable partner in their own health outcomes. Where healthcare providers are paid not only for a visit or procedure, but for all the services they and their staffs provide, from phone calls to referrals to refills. Where people get better — and the system gets better. Really, the idea is not so radical or new: it's old-fashioned family medicine, the kind my grandfather practiced. They are doing good things in New Hampshire. Wherever you stand politically, we can probably all agree that our very flawed healthcare system should realign around people getting better.

After five days in New Hampshire, I landed in Austin and fetched my much-missed children, only to receive the phone call that Jim Dear (Granddaddy) was being admitted to the hospital with an abdominal aortic aneurysm. The fact that they caught it is a miracle, and while the situation is serious, we are optimistic that Dad will recover from the surgery scheduled on Tuesday. We've been happy with the care he's received so far: mostly efficient, caring and effective.

But it's nothing like what I witnessed in New Hampshire. It would mean the world to me and my sisters and my dad to have a Medical Home right now: someone to call and ask the 72 odd questions we have, someone to help us understand what the hell the out-of-pocket maximum is for Medicare Part A (oh, and what the hell is the difference between Part A and Part B), someone to help us get a second opinion about the stent vs. the open surgery. We are Medical Home...less. For all the good care he is receiving, we are adrift in a sea of questions.

Ah, New Hampshire. Keep up the good work.