The Sunny Side

Last week I flew to Chicago for my last (most likely) medical school interview. I had the window seat on the plane and, surprisingly, wasn’t sleeping as we approached Chicago. I was excited to spend 24 hours in the city and get a feel for a place I hardly knew. I gazed out the window as we started our decent.

Before we decreased our altitude, we zipped along above the clouds, through a bright blue sky with sparkling sun. A thick layer of clouds was below us. The view of bright blue above white divided by shining sun rays conjured images of every version of “seeing the light” imaginable—end of the tunnel, heaven’s gates, nirvana…to name a few. The clearness and stark lines between the blue and white were beautiful.

Slowly, the plane’s path dipped so that we began to approach the clouds. We must have been far above them because it took us a while before we got close to the wall of white. I knew the clouds were a penetrable, gaseous/small particle entities, but they looked solid and impassable. We approached them quickly, and soon the sunny view of blue was obscured and the windows were masked in white. We were in the middle of the clouds and there was nothing to see.

Our journey continued rapidly and, in no time, we were below the clouds, a snowy and gray scene was visible below us. The sun seemed to have vanished, leaving a stark winter city scene. There were no leaves on the trees and the buildings added to the gray of the air between the land and the clouds. It looked cold and brooding. If I hadn’t just observed the sunny blue above I wouldn’t have known it could exist in the same place as we now were.

I smiled as I stared at the houses and streets, a bird’s eye view of the cityscape. I guess it’s just a matter of knowing where to look to find the sun. I held the vision of sunlight within me as I caught the train from the airport to where I’d spend the night before my interview and school tour. I’d been nervous before starting my trip, but I wasn’t anymore. I felt lucky.

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Mental Health and the Emergency Department

Checking into the ED for a psychological complaint

When a person comes to the emergency department (ED) with suicidal thoughts or another mental health state that could be a threat to themselves or others (ex. extreme paranoia, homicidal thoughts, mania, etc.) the processes is simple. They change into paper scrubs and their clothes and belongs are locked in a secure closest, returned upon their discharge from the hospital. A hospital staff member sits outside of (or just inside) the person’s ED room conducting constant observation—which includes observing the patient at all times and recording their location and general behavior every 15 minutes. The constant observation is to ensure that the patient does not try to hurt themselves, try to leave, or try to hurt anyone else during their ED stay. Many people who check in for psychological evaluation are not allowed to leave the hospital until their mental condition has been cleared by a psychologist, meaning they are forced to stay in the ED until a doctor says that they will be safe returning to society. Patients suffering from psychological conditions that require more treatment than the ED can provide remain in the ED until a bed in a specialize treatment facility (or in the hospital psychology unit) opens.

One way to define “a national mental health crisis” in the US

When I think of a mental health crisis in the US, I think of all the people stuck in the ED waiting for a psych evaluation and then waiting for a bed in a facility that specializes in psychological treatment. I think of the patients who remain on lockdown in the ED for 100s of hours because if they leave they might knowingly or accidentally hurt themselves or someone else. These patients have no other safe place to wait for an in-patient bed. I think of the people who come to the ED and, even under the watchful eye of our staff, try to kill themselves. I think of the people who end up in restraints, literally tied to a bed, because their condition escalates to the point that they try to escape, attack hospital staff, or harm themselves. To me, the mental health crisis in the US is that we don’t have enough 24-7 services and specialized treatment facilities to keep patients with mental health conditions out of the ED. To me, mental health is just like any other aspect of health. We need to bolster our programs to help prevent acute mental health problems, but we also need adequate mental health treatment programs for those struggling with psychological conditions. The crisis, I think, is a lack of preventative care and readily available treatment, not the existence of diseases.

The ED does welcome mental health patients as we do all patients, but the ED is not equipped to find long-term solutions for any health condition. It is true that the ED can help with acute symptoms, which is all some patients need for a short period of time, but we don’t have a calming environment nor do we have the staff to provide intensive treatment for mental health conditions. We serve as a gatekeeper to specialized treatment and as a place to go when there is nowhere else to go. Just like the ED is not an appropriate place to perform and recover from surgery, it is not the right place for those who need in-depth evaluation or long-term treatment. The ED was designed to keep patients for ideally a few hours or, at most, for part of a day before sending them home or to an in-patient facility. But, what happens with some of our gravely ill psychological patients is that they must stay in the ED for days, even weeks, because there are no openings in specialized facilities.

Conclusion

Using the ED as a long-term home for people suffering from psychological conditions is neither therapeutic for them nor is it a cost-efficient design of the health care system. We need more mental health treatment facilities in the US. We need more programs designed to help those coping with mental health conditions manage their symptoms at home. We need more people going into the psychology fields and social work. In summary, we need to dedicate more resources to mental health in the United States. I think to do that we need to start by acknowledging how many people struggle with mental health and how weak or absent our treatment options currently are for those people. Next, we need to make mental health a budget and policy priority at all levels of government and in private health care systems. Right now, EDs are serving as the catch-all. They are not the solution. While the ED might be the right place for folks in any kind of acute health crisis to go initially, the ED only works if there are specialists and specialized facilities to refer our patients to once we’ve identified the sustained medical care they need. It’s times we prioritize mental health as we have heart health, lung health, and cancer-free health so that no patient is held in the ED because they have no other safe place to go.  

Closing 2018, Opening 2019

If I had to pick one word for 2018 it would be “success.” I finally got a job taking care of patients, this officially marked my transition from a communications career to a health care one. With each passing day, I grow more certain that I’m headed in the right career direction. I finished my pre-med requirements, took the MCAT, applied to medical school, and got into several medical schools. I made some awesome new friends and visited some of the best long-term ones. The farthest friend visit was to my beloved Paraguay (I also visited friends in DC and Atlanta).   

This New Year’s finds me at a crossroads. In the coming months, I will decide where I will go to medical school. I feel incredibly lucky to have options, especially because I only applied to schools about which I am excited. The cost of school and if I should move to a new state weigh heavily on me. Starting the next chapter in the doctorhood quests is simultaneously overwhelmingly exciting and completely petrifying. But, change and moving are nothing unusual for me.

Earlier this year, I wrote about “name the fear and conquer it” as my general approach to life. A huge part of that is identifying when I’ve fallen into a mindless routine and, then, breaking that routine. I’m the type who as soon as they learn something new looks for how to become better and how to expand my knowledge. I think this trait will serve me well in medical school. It’s served me well in everything else I’ve tackled. But, as I think about these traits and the exciting goals that are coming to fruition this year, I find myself thinking that my biggest New Year’s resolutions have little to do with my career ambitions and a lot to do with the rest of my life.

I have high expectations and hopes for myself as I begin medical school, but I know I will put my best self forward in pursuing those regardless of my New Year’s reflection. Therefore, as we slide out of 2018, my New Year’s resolutions are to focus more on relationships and adventure. In that vein, here are my top 5 resolutions:

  1. Do a better job of staying in touch with old friends, family, and contacts even in the midst of school mayhem. This may include taking more time to visit friends who live far away, writing letters, texting, emailing, or social media-ing.
  2. Focus on developing new friendships. The challenge for me is always ensuring I leave enough time to spend with friends even when school work crescendos.
  3. Travel outside of the country, to a new place, at least once in 2019.
  4. Travel or visit somewhere new (even if it’s a day/partial day trip) at least once a month.
  5. Join some initiatives/groups that don’t directly relate to my budding career in medicine. Ideas I’ve pondered before or relate to interests I have include: joining a gym (I currently workout at home), ballroom dance classes/club, hiking club, book club (currently in one), or writers’ group; taking a yoga or martial arts class; becoming a youth mentor; and/or joining a choir.

Besides the New Year’s resolutions, I plan to continue my daily struggle to smile more, see the best in people, and be the kindest person I can be. I wish you the best of luck in 2019—I’ll be taking it one day, one week, and one month at a time. Happy New Year!

Below the Surface

A pre-holiday Paraguay visit is to blame for the blogging hiatus this December. It had been 2 years since I last visited Paraguay, the country where I lived for 27 months while serving as a Peace Corps volunteer. My Paraguayan friends were amazingly generous. They fed and housed me. They brought me on adventures around their lovely country. We spent hours chatting and eating—recalling old times, catching up on times spent separately, and dreaming about the future. I was reminded of how easily Paraguayans show affection—through food and time given to others. I was reminded, as I’ve been hundreds of times, of how lucky I am to have stumbled upon my Paraguayan community and how spoiled I feel to enjoy the company of my Paraguayan friends.

During this visit as I walked back from church one evening, after attending the celebration that marked the closure of the Christmas in Families (which is where people go to family homes to share passages from the Bible and prayer for 9 days in the month leading up to Christmas), I was reminded of a story shared at my favorite Paraguayan mass years ago. I don’t remember the occasion for the mass or who gave the sermon, but I remember the story the priest shared. I think, regardless of religious beliefs, it reminds us that we must look carefully and patiently to see what’s hidden below other’s facades. It’s what was hidden below the surface that made me fall in love with Paraguay. It was the journey of looking deeper at the land of Guarani that taught me resilience and showed me how to find hope no matter the circumstances. Here’s the story from that mass:

A Ride in a Car

There once was a young man whose rich brother gave him a fancy new car. The young man was so proud of his car, he loved to drive it all around town. One day, the young man had to park his car in a poor neighborhood while he was running an errand.

As the young man walked back to his car after finishing his errand, he noticed a boy circling his car. The young man worried that the boy was trying to find a way to enter or damage the car. The young man hurried to his car and asked the boy what he was doing by the car.

“I’m just looking at your car! It’s so nice. I’ve never seen one like it. I hope one day I will have a car like this one!” the boy said.

The young man explained that his brother had given him the car. “Wow!” the boy said. The boy and the young man talked about the car at length. The young man scolded himself for thinking the boy had been up to no good.

“Since you don’t have a wealthy brother to give you a car, would you like to take a ride in my car with me?” the young man asked the boy after they had talked for some time.

The boy jumped with excitement and jumped into the car. They drove a little way, then the boy asked if the young man could pause in an alleyway because the boy had to deliver a message to someone. Once they stopped, the boy asked the young man to wait for him to return, promising to be right back. The young man agreed to wait for the boy, but again had doubts. He wondered if the boy was getting someone to help him steal the car. The young man waited nervously, thinking of all the bad things that could happen. He thought about leaving before the boy returned, but something made him wait.

After several long minutes, the boy appeared in the doorway of a building in the alley. The young man squinted, the boy had something in his arms. The boy approached the car. Once the boy was close to the car, the young man noticed that the boy had a sickly, disabled child in his arms. “Sir, this is my brother! Can he take a ride in the car too? I want to show him the car. I have just promised him that one day when I am rich, I will buy him a nice car just like yours.”

The young man agreed to take both boys for a ride. The young man scolded himself not only for distrusting the boy, but for thinking the boy was envious of his car.

Friends Forever

I’m an introvert and a dreamer. As an introvert, I have a few close friends rather than a large circle of lukewarm friends. I think of my friends often, like to know them well, and consider them family. Being an introvert also means that I like to have a large dose of time alone. When I’m alone I daydream about the escapades I’ll go on throughout my life. As a dreamer, I think of solo quests and I hash out perfect adventures to go on which each of my friends, knowing every friend’s unique virtues and nature.

Each period of my life has given me one or several wonderful people to add to my friend family. These days, I’ve been thinking a lot about friendship–largely because I’ve stumbled upon some outstanding new friends. But, also, it’s been a long time since I’ve visit some of my friends who live far away; I’m thinking I might move in the next year; and I’m visiting Paraguay soon. Friends of my past, present, and future geographic locations are always on my mind.

Whenever I think about friendship, I remember a conversation I overheard 3 years ago. I’ve decided to repost (again, it’s not the first time) because it’s my favorite description of what true friendship is. While not everyone believes in Heaven, I think the lesson this scene teaches is universally applicable.  

Overheard in Paraguay: Friendship
Repost from October 19, 2015

We sat in a half circle around the grill. The men were cooking large slabs of meat (ribs and some unidentifiable cut) for the mother of the family’s birthday dinner. The husband of one of the birthday mother’s daughters sat by the grill passing one can of beer among the men there. A nephew walked up to the daughter’s husband. The husband was around 30 and the nephew was about 11.

The husband hugged his nephew first with one arm and then the other, squeezing him. The nephew squirmed, and they both smiled. The husband held the nephew at arm’s length and put on an almost serious expression. “Will we always be friends?” the husband asked.

“Yes,” the nephew said.

“Even when I am old and you are my age?” the husband asked.

“Yes, even when you are old and I have kids,” the nephew said.

The husband smiled and pulled the nephew into another hug. The nephew pulled away again and they looked at each other, the husband still squeezed the nephew’s shoulder with one hand.

“Even when you are in Heaven and I am old we will still be friends,” the nephew said earnestly.

The husband laughed. “And I will look after you from Heaven.” They hugged again. “And, when you come to Heaven, we will be friends in Heaven. We will be friends forever.”

The boy nodded and ran off to find his playmates.

Countdown to Visiting Paraguay

It’s been 2 years since I last stepped foot in Paraguay, that little country at the heart of South America where I lived for 27 months as a Peace Corps volunteer. But, I’m going there for 2 weeks this December. It’ll be the second time I’ve gone back to visit since returning to the US.

I find myself falling into a reflective mood as I think about the long journey south. My trip comes at the best time, when snow and cold have descended on Vermont. I need a break from winter even though it’s only just arrived. I’m reflective because I’m a very different person than the one who left Paraguay almost 3 years ago. I won’t bore you with the details of thrusting myself into pre-medicine and the whirlwind of building a new life in Vermont, both adventures that have consumed my time since I moved back to the States. What I will say, however, is that I’m excited to see the red dirt of Paraguay again. I look forward to their fatty foods. And most of all, I can’t wait to sit with the Paraguayans I call my family and friends and discuss the weather and life…and crack jokes. Often, the jokes are about my singleness or professional focus (aspects of my being that are particularly distinct from the Paraguayan way of life) but not always.

Many of the kids I taught in Paraguay have graduated or are soon to graduate high school. I see their Facebook photos of college study and adult life. Many of them have lost parents to illness. Some of those parents I knew and spoke to on my almost daily walks to the school. Many of my students have their own babies now. Few are married yet.

Some of the elderly women I used to spend the afternoons with have passed away since I last visited. Others, I’m not sure if they’re alive because they don’t have cell phones. What I know is that the señoras in my Paraguayan community will welcome me into their homes with just as many smiles and just as much generosity as they did when I was their neighbor. Those women took me in as their daughter. I think they were always torn about what kind of daughter was. On one hand, I didn’t know anything about the right way to navigate life in Paraguay, but, on the other hand, I knew how to travel from my country to theirs and I have so many dreams and goals.

In many ways life in Paraguay is the same as here. But, as I think about going back I’m also reminded by just how difference it is. The food and smells—meat and real animal fat mix with the smell of live chickens, pigs, and cows who idle close to the houses. The topics of conversation vary, but there is something unique about the gossip of families who have lived by one another for so many generations no one remembers any other place they called home. They speak in a mix of Spanish and Guarani (the indigenous language); the sounds of those languages together bring back many memories of the best two, but also the hardest two, years of my life so far. The soundtrack of Paraguay is different—the rhythms of bachata, polka, cumbia, and reggaeton fill the air on hazy, hot weekend days and weekday nights.

In many ways, Paraguay has the indomitable nature of never outwardly changing in any significant way, just like my home state of Vermont. But, just as Vermont, there are the subtle differences of life moving forward. One of my dearest friends has returned to law school (she’s already a lawyer) for a specialty degree and she is now a mother—both new accomplishments since I last saw her. Another friend finished his military training and now works for the Paraguayan Navy—he still visits his family’s home whenever he gets a stretch of days free from duty. Another friend started a local clothing store. All of us are older than we once were. The babies I knew when I lived in Paraguay are now children. The children are almost adults.

As I drink my daily mate alone in Vermont, I often think about my Paraguayan friends. I miss them every day. I miss them because no other people I’ve encountered is so good at sharing time with each other. So good at making you feel welcomed and loved. Their culture has built in values and rituals that allow friends and family to sit together and share a drink or a meal without any other obligation. I miss my Paraguayan families because they are so good at seeing the bright side of everything. So good at ignoring the bad things that happen, almost to a fault.

The nostalgia I feel for Paraguay is one where all the bad aspects of living there are forgotten and I remember only the good. Of course, both the light and dark sides of Paraguayan life will confront me when I land again in that country…but somehow that doesn’t bother me.

I remember the first time I flew to Paraguay, not knowing what awaited me there. It was exciting and petrifying. This time when I go back, I know the communities and families who will greet me again with open arms. I can’t wait to see them. I can’t wait to eat chipa and sip terere in the shade of tropical trees because it is absolutely too hot to do anything else. I can’t wait to walk around my old community and say “hi” to every human I pass because that’s the Paraguayan way. I can’t wait to be reminded there is more than one way to live life, none better or worse than the other, just different.

5 Things I’m Grateful for this Holiday Season

This was a big year for me. I finished my pre-medical classes, took the MCAT, applied to medical school, and then I got into medical school. My youngest brother graduated college. My grandfather was buried in Arlington National Cemetery. I got a new job in the emergency department where I get to spend most of my day caring for patients. One of my dear friends had her first baby, and I’ll get to meet him this December (because I’m visiting my beloved Paraguay!!).

The laundry list above is just a sampling of the year. I’ve also made some great new friends, met some amazing people, done a tiny bit of national travel, and spent good hours learning new things. I could fill pages about the year, but I won’t just now. Instead, as the holidays approach, here are 5 things for which I am grateful:

1) My family who made it possible for me to get into medical school. They’ve listen to me gripe. Told me to stop whining and act. Shared my excitement for small victories. They’ve cooked, visited, hosted, taken me out to dinner, pitched in when I was in a pinch, made me laugh, talked me off the edge of tears, and helped me keep going when I wasn’t sure if going was an option.

2) The friends who stay in touch even though we live lightyears apart in separate, though equally chaotic, universes. The new friends who have joined me in sweating over biochemistry, hiking through Vermont’s woods, undertaking food adventures, and soaking in the quiet moments of life. The hardest part about moving as much as I have is that many of my favorite humans live far away. It’s a testament to their greatness that despite our distance they remain a positive force in my life.

3) The folks at my new job who reminded me what being part of a good team feels like. Who taught me the tricks of a new trade. Who show up every shift ready to do what needs to be done and between saving lives have energy for a smile or laugh.

4) The mentors and teachers who taught me all I know about medicine and science. But, also, my life mentors—the ones who have been there since undergrad (or before), the ones who’ve shown me the ropes of being an EMT, and the ones who set an example of what kind of old person I aspire to be.

5) Vermont. Sometimes my little home state is cold (actually, it’s usually cold). Sometimes Vermont is too homogenous and too isolated to quench my love of the new. But, this year, I’ve basked in perfect summer days where the sun is just right. I’ve soaked in the smells and silence of the forest and absorbed the wind that makes waves on Lake Champlain. I’ve reflected on the mountains that guard the horizon. I’ve enjoyed creemees, apple orchards, and maple syrup. I’ve watched the rain fall with mate in hand. I’m from Vermont. And while I don’t often call Vermont my home, it is the place where my roots have always been and always will be.

I’m grateful for the moments I’ve had to enjoy all the people and places that make life worth the sweat. I’m thinking about those moments as the holidays approach.

Marathon Goals

I remember the conversation I had with my best friend that sealed my desire to become a doctor. We were in our relatively new apartment, in the living room that was an extension of the kitchen. The city sun of Washington, DC filtered in the large windows and onto the bedraggled plants we had lined along the window sills. I’d been contemplating the idea of entering medicine for months. The thought came to me shortly after I started working in health communications. What I liked most about health communications was the medical research, knowledge of life, and opportunities to interact with people. I wanted to find a way to fill my days with those things rather than dabble in them. My friend worked in a primary care office, on the administrative side. She encouraged me as I talked about possibly switching careers. “You’d be a good doctor,” she said. Thus, began my marathon goal to become a doctor, a process I call “the doctorhood quest.”

That conversation was 5 years ago. Recently, what started as a thought became a real possibility. I’ve been accepted to medical school. There’s still the question of financing and survival, but with an acceptance to school, there is hope that the rest of the journey will fall into place. I will be a doctor.

Marathon goals. I’ve always been a planner and as a runner I prefer long distance. But, there is something uniquely challenging about making goals that will take over a decade to accomplish. There is no way to know the future, and absolutely no way to predict a future as distant as 10 years from now. But, somehow, the uncertainty and hidden challenges that the doctorhood quest presents have not deterred me. I reflected on the prospect of doctorhood during my years of Peace Corps service and, once back in the States, I started jumping through the hoops of medical school applications (I had no science background when I began). The long wait to medical school acceptance has only made me more excited to start my studies. The doctorhood quest isn’t even half over—medical school, residency, and board exams will be the longer leg of the journey. Yet, as I sit on an acceptance letter and wait to hear back from more schools, it’s thrilling that I’ve come this far.

People around me, to me or to others, often comment on how intelligent one must be to get into medical school. I usually remain silent, but smirk inwardly. I believe “smart” comes in many forms and not all are suited to medicine. I’m disinclined to suggest one person is smarter than another because life has shown me that humans have different gifts and society needs all of them to function. But, more specifically, my journey has shown me that medical school admittance has less to do with how smart someone is and more to do with how resilient they are. The doctorhood quest requires you to be gritty and determined. It demands that you jump up and try again each time you fall while tackling the perils of the road.

If resiliency and grit is the secret to pursuing marathon goals without losing hope, how does one get those? Experience and inward reflection are my guesses. We learn by doing and we expand our scope of understanding the more different experiences we have. Nothing proved this more to me than my years in Paraguay. I am not the same person I was when I first stepped off the plane in that hot, humid country. The people there showed me how they found happiness; they defined respect and God and love in ways completely different from any definition I’d ever encountered for those things; and, above all, they exposed me to foods, ways of life, and shared moments I could never have imagined.

Experience is the foundation for growth, but to truly grow one must reflect on those experiences. Paraguay, once again, taught me reflection. It is impossible to describe just how lonely and hard it can be to be the only one from your culture in a foreign place unless you’ve experienced it. Your world is turned upside-down and every definition and rule you ever thought was a given is no longer in play. Your default becomes mild confusion and curiosity about the new culture in which you have fallen. Most importantly, you are forced to examine how your culture does things and why. Once you start picking apart your host and native cultures, it’s an easy, logical jump to start evaluating and thinking about different aspects of your personal life—like your interactions, feelings, and activity choices. Once you build in time to reflect on experience you can start to shape your path more purposefully.

The secret to marathon goals is accepting you can’t know the future, but you can influence the present. The secret is celebrating small victories, making educated guesses about the best course of action today, and seeking out the people, places, and experiences that rejuvenate you when your hope falters. We do not achieve marathon goals alone (it takes many helpers) but it is only from within ourselves that we find the strength to withstand what’s hidden behind each bend in the road.

Go Vote on November 6

Elections are November 6. That’s a few days from now. If you haven’t registered, there’s still time. There’s also time to figure out where to go to vote. There’s time to review the candidates and pick which ones you want to lead us. Now’s the time.

Recently, a friend shrugged when I encouraged her to register to vote and fit a trip to the polls into her busy Tuesday. Elections are this Tuesday, November 6, 2018. “I haven’t been affected by the current president,” she said.

“Are you sure?” I asked. I wondered how she hadn’t noticed the ways in which our leaders’ decisions were posed to shape American lives for generations. I wondered when we thought the only person we voted for was the president. I wondered about the apathy of the masses. I wondered when we had forgotten how much politics matter.

We don’t only vote for the president. We vote for the school budget and those who decide how our towns and cities and states should be run. We vote for congress men and women every 2 years and we vote for senators every 6 years…and those two groups make up the Legislative Branch. The Legislative Branch is important because it’s a counterweight, a check and a balance, to the Executive Branch (the president) and the Judicial Branch (the judges, picked by the president on the national level).

US democracy only works if you care about all 3 governmental branches because the 3 keep each other in check. US democracy only works if you care about federal, state, and local politics because they work with and against each other in a constant tug-of-war between different beliefs. When one fraction of the government is ignored by most voters, the voices of a few predominate, and those vocal individuals then make decisions for other people whose lives they don’t understand.

But, let me stop ranting. I have a few points that are more concise. A few issues to keep in mind. A few things I remember when elections come.

  • What’s the price of gas these days? Did you know tariffs and trade agreements made by our politicians can lower the price of gas for the period leading up to elections?
  • What is your voting district? Did you know district borders are drawn by politicians? The lines are often drawn to ensure the current party always wins.
  • How do you feel about access to health care? For the elderly? For the poor? For those who have pre-existing conditions (those who are already sick)? Access to and education about birth control? Your politicians decide how hard it is to see a doctor and get the medications you need to feel well.
  • What is love? Who are you allowed to marry? Who gets legal rights to visit a loved one as they lie dying in a hospital? Who can adopt children? Your politicians decide.
  • Who’s protected by civil rights laws? Your politicians get to set legal definitions of things like gender, sex, and race. Did you know children used to not have protection under the law? They had fewer rights than animals. Politicians changed that—with pressure from lobbyists and people who thought it was wrong to beat children or make children work.
  • Where and when do we go to war? How to we care for veterans? Who do we allow to join the armed forces? Your politicians set those guidelines. What are we doing in Iraq and Afghanistan now? What are American soldiers doing in Syria? Are we going to attack Russia or China? It’s your government that makes those decisions.
  • Are billboards allowed? Billboards are illegal in Vermont, thanks to local politics. Vermont depends on tourism…so were billboards banned for economic reasons or was it because some politicians thought billboards were ugly?

The above are just the beginning. There are so many other things that depend on politics. The price of food, for example. The minimum wage. Life is a complex web. Claim: our immigration policies influence the price of oranges…can you puzzle out why?

The thing about politics is that it permeates life in subtle ways. In the US, we are lucky because political decisions don’t often lead to obvious shortages of essentials or the disappearance of dissenters (we don’t have camps where we hold people prisoner, or do we?). It’s naïve to believe that everything from our wallets to privacy or marriage to jail terms are not shaped by the decisions our legislators, judges, and political leaders make.

My point is simply that your opinion matters. Make yourself heard and go vote. Take part in democracy. Be a citizen of the US and go vote. Go vote because it’s what you should do. Go vote because it’s what others are doing. Go vote because you can. Go vote because your country needs you to vote. Go vote.

Golden Leaves and Golden Sun

Autumn in Vermont is like a pendulum; it swings between cold rainy days and bright sun that reflects off the yellow, orange, red, and brown leaves soon to fall off the trees. The damp days and frost-laced evenings are a prelude to the winter soon to come. The strong sun on the loveliest days of October is not only a reflection of the summer just past, but also particularly appealing because it contrasts with the brisk wind and cool damp air inherit of autumn.

Earlier this October when the sun looked like a flood of gold as it reflected off the hills, I set out with a friend on an easy, wandering hike through the woods, past beaver dams, and up the tame slopes of a hill with an outstanding view. The shade and wind carried the hint of frost, but the sunlight danced so joyfully through the birch, beech, and maple leaves that I didn’t feel cold while wearing only a light jacket. The pleasantness of the day penetrated through my slight haze. The previous weeks had been a whirlwind of adventure, topped off by working the night shift the night before our hike and running a half marathon with my sister two days earlier. But, as we parked the car and started walking I didn’t feel tired. My mate had kicked in and the day was too charming to pass inside. There’s something about the woods in Vermont…they recharge me more than anywhere else. [Text continues after image.]

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I grew up in Vermont, but moved to the city for college and work and then moved abroad. I’ve been back a few years, enjoying the time until more schooling picks my next home. I imagine, just as I did as a new adult, I have more city turns and many places to live before I sleep for good. I imagine many of those places will be about as different and as far from Vermont as possible on our small planet. While I never really miss the Green Mountain State in its entirety, when I live elsewhere I periodically find myself aching for the quiet woods that always awaits me here.

The woods in the fall are my favorite. Fall is my favorite season in Vermont for its smells—piles of leaves, apple cider, wood smoke, and pumpkin baked goods—and perfect temperatures. The leaves already fallen rustle underfoot and the tangy, earthy smell of the soil and crisp foliage tingles your nose in an only pleasant way. The natural world is getting ready for sleep and a long stretch of harsh weather. The chipmunks and squirrels are in overdrive, jumping about like bunnies with cheeks full of nuts. Wild apples, acorns, cherries, and berries adorn the trees, weighing the branches down and feeding the deer and other woods dwellers. There’s an influx of geese and other migrating birds—their flocks fill the ponds and trees and raise a chorus of excited chatter about their long journey south.

The forests of Vermont aren’t epic like those of California and Washington state. They aren’t misty, exotic, and lavish like the Amazon or the jungles of Central America and Africa. Nor are they tangled and concealing large snakes, jaguars, and anteaters like the forests in Paraguay. In contrast, it’s their humble scale and unassuming beauty that brings thoughts of the Vermont woods, my childhood haunts, to me when I’ve spent too long away. I always know when those thoughts percolate it’s time to visit.

My friend and I paused on the hilltop to enjoy the view and take in a few golden rays before our descent back into the forest. I sat, knees pulled up against my chest, and gazed out over the rolling patchwork of gold, green, and bronze. The stone face on which I sat was slightly warm thanks to the sun. We were shielded from the breeze. No one else was around. There was a quiet that’s forgotten even in the smallest of towns. The calm was a relief after the rush of work in a hospital and traveling for medical school interviews—places full of complicated thoughts and human interaction. In those moments on the hill, I was thankful for the forest. I also felt a pang of bitterness about the cold winter soon to come, but I know (as I’ve said before) that the cold is one thing that keeps people from flooding Vermont. And, anything that keeps the autumn woods here quiet so I can sneak away and meditate on life’s challenges is welcome.

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