Category Archives: Health

Topics dealing with health

Rubicon Programs: supporting and strengthening our local communities

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You may encounter many defeats, but you must not be defeated. In fact, it may be necessary to encounter the defeats, so you can know who you are, what you can rise from, how you can still come out of it.
– Maya Angelou, American poet, memoirist, actress, and American Civil Rights Movement activist

Rubicon's headquarters in Richmond, CA.

Rubicon’s headquarters in Richmond, CA.

My friend Jane Fischberg, whom I’ve known for almost 22 years now, and I were discussing charitable giving over lunch back in January. While I knew Jane has been with Rubicon Programs (510.235.1516, 2500 Bissell, Richmond, CA 94804) for the last 17 years – she is president and executive director of the nonprofit provider of integrated housing, training, employment and mental health services – I didn’t know, but should have known, that raising funds is the “primary purpose,” as well as the most challenging aspect, of her job. Jane invited David and me to attend Rubicon Honors 2014, the nonprofit’s annual gala and fundraising event on April 5th at the Oakland Rotunda, which I accepted. When I brought up doing a profile on Jane and her work at Rubicon, we set aside time in March for me to meet her colleagues at their Richmond office. After being honored to hear their stories, I knew there were in fact three profiles to present – one of Jane (to be posted on April 4th) and two of Rubicon itself and the people who are the face of Rubicon (the second one to be posted April 1st).

More than 40 years of serving the community
Rubicon, founded in 1973 in Richmond, CA, was appropriately named, with its provenance being “a decision from which there is no turning back – the beginning of the journey to change.” The nonprofit’s mission is to “prepare very low-income people to achieve financial dependence and to partner with people with mental illness on their journey of recovery.” By offering a comprehensive set of services, which includes job placement, housing, legal services, and financial literacy, and offices in Antioch, Berkeley, Concord, Hayward, and Richmond, Rubicon is able to serve a significant number of people in the hardest-hit communities in the East Bay.

Rubicon was able to help many community members, including this client.

Rubicon was able to help many community members, including this client (photo credit: Saul Bromberger and Sandra Hoover).

Indeed, from the 2013 Annual Report, Rubicon served 3,400 people last year. After receiving help with interview preparation, resume building, and local employer connections, 657 people – out of 883 people seeking employment – were placed in jobs, earning a collective $17 million. What is even more impressive is that more than a third had been incarcerated at some point in their lives. Nationally recognized, Rubicon is one of only five organizations in the country awarded a special federal grant to help ensure that parents coming out of the criminal justice system can provide financial and emotional support for their children, while staying free of the criminal justice system.

More than 300 families were placed in housing in 2013, receiving help with budget planning, affordable housing connections, and rental application. Eight hundred low-income East Bay residents accessed legal services in the areas of eviction prevention, disability rights, education, and advocacy. Substance abuse recovery, counseling, and medication management services resulted in a decrease of nearly 70 percent of psychiatric crisis visits by Rubicon clients burdened with serious mental illness.

A Rubicon Programs client works with a staff member (photo credit: Pat Garvey).

A Rubicon Programs client works with a staff member (photo credit: Pat Garvey).

Rubicon’s success is due in part to its integrated services delivery model (the other major factor is the staff, but more on that later). People who come to Rubicon – and indeed many of the residents in disadvantaged communities – don’t need just one social service but oftentimes several services across the spectrum. Clients typically fall through the cracks when they’re being referred from one agency offering a single service such as legal services to another organization that only deals with housing, which creates a siloed and alienating experience. The various divisions within Rubicon – Economic Empowerment, Mental Health and Wellness, and Legal Services – work collaboratively, which enables them to work with their clients holistically through one entity and to develop personalized programs for the greatest success and sustainability.

Rickie, "living and loving life clean," at two years of being clean.

Rickie, “living and loving life clean,” at two years of being clean.

Rickie Harris: ‘Begin the journey to change’
Rubicon’s tagline, “Begin the journey to change,” could not be more appropriate for a woman I met who took up Jane’s offer to a conference room full of people at the end of a meeting to talk to me about their Rubicon experience. Rickie Harris, who serves as a substance abuse intern at Rubicon, stepped right up. Rickie had battled drugs and alcohol abuse for 23 years, going in and out of substance abuse treatment programs for two decades. She would stay clean for three years but then go back out, while her mother – whom she gives credit for supporting her though the years – took care of her six children, three boys and three girls, now ages 19 to 28. Rickie kept coming back because her children “were worth it,” but the addiction was overpowering. It wasn’t until she reached a point where she was suffering from the “mental part of the disease” – losing her mind and talking to inanimate objects – that she realized she had to finally get clean and stay clean. But she also realized that while her mother and her children wanted her to stay sober, she had to do it for herself. She was ready to “make the changes and achieve the good” that she saw for herself.

Rickie at 5 years of being clean.

Rickie at 5 years of being clean.

Rickie is painfully aware of the “awful” state of her community, but it also is the source of her determination. “I used to be a problem in the community, but now I’m working diligently to become a solution,” she explained. Sober for more than five and a half years, Rickie completed four of the required certificates for substance abuse case management and dual diagnosis screening from Contra Costa College, with two semesters to go before graduation. She has worked hard, and earning straight A’s and making the Dean’s List without fail since 2010 has kept her motivated. “My mind is still intact,” she said, with pride. “I want more and more.” She will attend the University of California at Berkeley in the fall of 2015 to earn her BA in social work, with bigger sights set on earning her masters and PhD degrees. Rickie vows that she will return to the city where she was born and raised, and make a “powerful impact” for her fellow women and her community.

Editor’s notes: Rubicon Programs Part II will be posted Tuesday, April 1.

If you would like to make a donation to Rubicon Programs, click here.

Rubicon Honors 2014, Rubicon Programs’ annual gala, is set for next Saturday, April 5th, 6pm to 10pm at the Oakland Rotunda, 300 Frank H. Ogawa Plaza in downtown Oakland. Last year, more than 2,000 children in the East Bay were positively impacted by the work Rubicon Programs did with their moms and dads. This year, Rubicon Programs has set a goal of raising $200,000 to change the lives of 2,100 children who are most in need in our shared community. At the gala, come enjoy live music, wine reception, butlered seasonal hors d’oeuvres, sit-down gourmet dinner and dessert, and the live and silent auction. Individual tickets are $225 and a table of 10 is $2,000. You can purchase your tickets here.

Acupuncture with love

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A wise man ought to realize that health is his most valuable possession.
– Hippocrates, ancient Greek physician

Feeling much better, with my blue-gray crocheted capelet and jeans.

Feeling better, with my blue-gray crocheted capelet and jeans.

Last fall I went through several months of working weeknights and weekends. As stress wore my body down, my sciatica returned, my back started aching, the thumb of my left hand, which is my writing hand, began hurting, and I wondered if arthritis had kicked in. My mother had suffered from arthritis, but I was hoping it was from years of packing oranges in the winter and picking grapes in the summer, and that it was not genetic. I kept telling myself that I needed to make an appointment with my acupuncturist. But then I also told myself that I didn’t have time to go because there was too much to do, which is an irrational excuse.

Fast forward to January. One of my New Year’s Resolutions is to take better care of myself. I’ll admit that it took a hard bike seat, the return of my sciatica and back pain, and another stressful time at work to make good on that promise to myself. So I made an appointment with my acupuncturist, Portia Lee, at Traditional Ways Healing Center (6931 Stockton Avenue, El Cerrito, CA 94530, 510.799.8788). My appointment this past week happened to be on the day that I had pulled an all-nighter to fix a botched project by a contracted writer that was due to our client on a tight deadline. I told Portia that I was going through a period of stress in my work, but things were supposed to change.

Vintage rhinestones by Vendome and Elizabeth Ng antique button ring (Abacus, Portland, ME).

Vintage rhinestones by Vendome and Elizabeth Ng antique button ring (Abacus, Portland, ME).

Much of my recent stress was in not knowing if my contracted writers would turn in well-written white papers, as I believe in standing by quality work and wouldn’t dream of submitting an inferior product to a client. The workload had gotten to the point where I had to outsource anything that came in because I couldn’t do it myself. I knew that my writing was capable and dependable, but once a project was out of my hands, I worried about what the contractor would turn in to me. Would it require simple redlining or a major overhaul? Does that qualify me to be a control freak? Then I’m guilty.

Portia listened patiently to my babble as she felt my pulse and asked me to point out where my aches and pains were across my body. I was on my stomach first and then my back, for two long periods of having needles at various points redirecting the flow of my energy. I focused on trying to relax my muscles with the help of a heat lamp and a CD of instrumental music. After the second batch of needles were removed, I was expecting her to say, okay, we’re done, go ahead and get dressed, and I’ll meet you at the front desk.

Vintage love and crochet.

Vintage love and crochet.

Instead, Portia sat down beside the table on which I was still reclined. She told me how concerned she was about my health, how my comment about being in a temporary state of stress every time I came in was in fact my permanent state of being. David has always given me a hard time about this, as well, for years. I knew it at some level, but ignored it. I thought I couldn’t allow myself to recognize it because there was too much to do. I have been able to suffer through these periods and feel none the worse, or so it seemed. In the last few years, I have felt myself slowing down, have admitted it to myself finally. And I promised myself months ago that I would not pull another all-nighter again. But I did. And it will take perhaps a week or more to recover, to get back to the balance I was trying so hard to achieve since the holidays.

Wearing a necklace against lacy crochet is too much, so stick with a bold ring and earrings.

Bold but simple ring and earrings.

Portia went on to say how companies have a way of squeezing so much energy out of us, and at great cost. But once we leave, we are left with having to pick up the pieces of broken health, so to speak. Once we are gone, the company doesn’t care. (One may argue that the company may not care even when you are there!) So we have to take care of ourselves in the here and now, but just as important, for the future.

I was deeply touched by Portia’s genuine concern. I could see it in her face and hear it in her voice and feel it in the room. I promised to be better to myself. I had already planned on coming in more regularly to keep my balance. I thanked her. And as I said goodnight – two hours later, darkness already descended outside – to her, her sweet daughter, and her big but gentle dog, I felt such warmth and lightness. I felt such gratitude to have someone really care about my health. As I drove home, I told myself to be good to myself. As someone once said: “Take care of your body. It’s the only place you have to live.”

Elegant and casual: Silver, blue-gray, and black, with blue jeans.

Elegant and casual: Silver, blue-gray, and black, with blue jeans.

Gray booties and statement ring and silver earrings crafted by Miao Chinese artisans (Caravan Gallery, La Conner).

Gray booties and statement ring and silver earrings crafted by Miao Chinese artisans (Caravan Gallery, La Conner).

At rest and thankful

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Rest and be thankful.
– William Wadsworth, English poet

Comfortable clothing is a must to be at rest: cozy sweater with hem detail over lace dress with asymmetrical layers of lace.

Comfortable clothing is a must to be at rest: cozy sweater with hem detail over lace dress with asymmetrical layers of lace.

We took down the Christmas decorations on Saturday and we were able to get everything boxed up and stored in the attic within a 24-hour period, with a few generous breaks taken, mostly by the kids. That meant our Sunday – the entire weekend was set aside for the take down, which historically is how long the task requires – was wide open. Oh, the possibilities, I told myself with excitement, as I put away the vacuum cleaner and got ready for bed.

Whereas Saturday I bustled with energy, with the mission to get the house clean again and returned to pre-holiday austerity, on Sunday morning I woke up completely spent. I managed to run a couple of errands with my family and did some pruning in the front yard. My form of procrastination – I still have a long list of tasks to accomplish – was to challenge Jacob to numerous games of Sequence. Jacob had gotten Sequence as a birthday present two years ago, and it’s one of our family’s favorite board games to play. He, of course, was up to the challenge – procrastinating and playing.

Carmela Rose earrings (Jenny K, El Cerrito), End of Century cicada ring (NYC), Laura Lombardi necklace and longer A Peace Treaty necklace (both, Eskell, Chicago) against a green cabled sweater.

Carmela Rose earrings (Jenny K, El Cerrito), End of Century cicada ring (NYC), Laura Lombardi necklace and A Peace Treaty longer necklace (both, Eskell, Chicago) against a green cabled sweater.

I went to bed early Sunday night, but I woke up at five in the morning on Monday. I was thinking of all the things I needed to do and all the things I could have done on Sunday. In my mind, I had squandered my “free” day. I sat up in bed after an hour of tossing and turning, and in doing so had awoken David. I told him I was upset that I hadn’t been more productive with my Sunday. His advice: Get over it. What’s done is done. He was right. I was wasting more time by crying over the proverbial spilled milk.

Frye heeled booties complete the sweater and lace combo.

Frye heeled booties complete the sweater and lace combo.

So I accepted that I rested on Sunday and I also accepted that it is okay to be at rest. In our conversation, I told David that a handful of friends had jokingly told me that reading our holiday e-greeting had worn them out because I had packed in so much information and had done so much. I told him that I look back on 2013 and honestly don’t know how I was able to write three blog posts a week, including conducting interviews and writing the profiles, and finish my novel on top of another busy year of work. I didn’t think I could do that now, given how tired I was feeling at the moment. David reminded me that I was getting over a cold, which had sapped my energy.

The more I thought about it as the day progressed, the more I understood that I got my cold because my immune system was shot trying to get the holiday e-greeting out before the end of the year, finishing the novel, continuing with the blogging, and working on a deadline in the month of December. I accomplished a lot but at a price. I hit a wall and fell flat on my behind. As Saturday Night Live’s Stuart Smalley would say, however, “And that’s okay.” Accepting that state of mind is something with which I struggle. Sometimes the body has to step in, scold the mind, and take over. Just to make us slow down. To rest is the first step. To be thankful for the time and ability to be at rest comes next. As I continue to catch my breath, I find myself still struggling but succumbing to gratitude. Soon enough, I’ll be on that next leg of the journey. But I need to regroup, gather my strength, regain my momentum – and do so with a smile on my face.

At rest and thankful.

At rest and thankful. Crochet detail stands out against creamy lace, as do the booties peeking out from the asymmetrical hem of the skirt.

October is Anti-bullying Month: positively no bullying allowed

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I will fight bullying forever because my son will be eleven forever.
– Kirk Smalley, father of Ty Smalley, spokesperson for Stand for the Silent, an educational platform on anti-bullying

The documentary Bully was released in the U.S. in late March 2012. When it came out, David and I talked about going to see the film. As usual, many of the films that we wanted to watch came to theaters and went to DVD, including this film, and we forgot about it. I had an opportunity to see it after Jacob’s middle school PTSA screened it following our monthly meeting last night. I did not realize that October is Anti-Bullying Month. All kids at Jacob’s school will be seeing the film in one of their classes this month and will participate in a discussion about recognizing and standing up to bullying. It’s a good start to educating and making kids aware of this terrible behavior.

Giving your kids lots of hugs and lots of love gives them security and self-esteem.

Giving your kids lots of hugs and lots of love gives them security and sows seeds of self-esteem.

The few negative reviews of the documentary focused on the fact that director Lee Hirsch did not interview either the bullies or their parents. Perhaps this was due to the bullies and their parents not wanting to be filmed. At any rate, such an angle would certainly fill up a sequel, and maybe that’s not a bad thing. I didn’t realize that Jacob would be seeing the documentary in school; I brought both Jacob and Isabella to watch it. Given that we are dealing with bullying in Isabella’s school, albeit a different kind of bullying, I wanted them to see what other kids – the victims – were facing.

On the way home, we talked about not being a bully, seeking family and friends out when being bullied, and also standing up to bullies and not look the other way. I couldn’t help but tell them two stories from my childhood. In my farming hometown of Terra Bella, in the Central Valley of California, there was a girl in my class named Rosie B. She lived around the block from us. Her older parents were poor and reminded me, years later, of the Joads and the Okies from Steinbeck’s Grapes of Wrath. Rosie was slow, so people took her to be stupid. Her face looked disfigured, her mouth was pronounced with a big set of buck teeth. As you can guess, she was picked on, and as I look back, I can’t think of anyone with whom she hung out.

Isabella gives Bailey a hug on Bailey's last day before she died of old age, January 2011.

Nurture nurturing: Isabella gives Bailey a lot of TLC on Bailey’s last day before she died of old age, January 2011.

After lunchtime one day, our class was excused from the cafeteria to have recess on the playground, Rosie fell down the small flight of stairs. The kids never stopped pouring out of the cafeteria. It was a stampede. When she finally got up, she was scarred with a permanent limp. This was 1972. No lawsuit was filed; her parents had no voice. Teachers came upon the scene and I’m sure the principal was notified, but nothing ever happened. I don’t recall if our grade level was lectured or not. I was not part of the stampede, but I was the guilty silent who looked the other way. I ran into Rosie as an adult, when I was home from college, and she eagerly talked to me about how everything was okay now, as if seeing me, a childhood classmate, had compelled her to tell me she had survived. I remembered feeling relieved that she seemed to have turned out okay despite the bullying, but I failed to apologize to her face.

The other story was about Ross M. I met him at a church youth group when I was in either fifth or sixth grade. He was a pudgy boy who giggled a lot, chattered nonstop, and exhibited effeminate mannerisms, which at the time I did not associate with possibly being gay because I didn’t know what gay was back then in our rural community. We tolerated him, but nobody was ever mean to him. I didn’t stay in the youth group and so lost touch with Ross because he went to a different school in the next town over of Porterville. When I was a freshman at one of the high schools in Porterville, I was surprised to see Ross  – only I didn’t recognize him at first. He had slimmed down. He had also stopped laughing and smiling. He didn’t talk much, if at all, and I don’t know if he even had any friends. He was like a ghost, showing up for class and slipping out, unnoticed. I never reached out to him because he seemed like a stranger to me and he never gave any indication of recognition when he was near me. I never saw him again after graduation. It was only when I attended my 25th high school reunion that I noticed his picture among other pictures on a table with candles, memorializing classmates who were no longer with us. When I asked a good friend of mine from high school what had happened, she confirmed what I suspected: He had committed suicide. I don’t know when this happened, after high school, later in life. But one thing I suspect: He was likely bullied in elementary and middle schools.

Happiness is being loved and hugged a lot.

Happiness is being loved in a touchy-feely way.

My kids were quiet in the car as I concluded my stories. Of course, there is always a moral to an Enrado mom story for my kids. I told them not to look away when they know something is wrong, when they know someone is being bullied. They needed to stand up. I reminded them of the damage that bullying does. One of the kids in the documentary, Alex Libby, told his mother, when she found out about the extent of his being bullied, that if these kids who stabbed him with their pencils, pushed and punched him around, choked him, and smacked his head weren’t his “friends,” then what friends did he have? A heartbreaking thing for a mother to hear. Jacob piped up, “I would have been his friend.” And Isabella seconded the sentiment. Hearing them defend him made my heart sing. Nevertheless, I was worried about whatever happened to Alex because his path seemed destined to resemble Ty Smalley’s very sad ending, which was shown in the documentary. Thankfully, the documentary itself was, as Alex’s mother said in an interview months after it came out, a “gift.” The family took a financial hit moving from Sioux City, Iowa, to Edmond, Oklahoma. But now he has real friends and is a spokesman for anti-bullying. A much-needed happy epilogue!

After the screening, our middle school principal and parents talked about this complex social issue, ill, if you will. We talked about what we as parents could do. Here is my list: Raise empathetic children who understand justice and injustice. Teach them how to stand up for others. Be engaged in their daily lives and know what’s going on in their daily lives. Love them by the boatloads and let them know that you have their back.

Contemplation time while walking Rex.

Contemplation time while walking Rex.

As I was walking our dog Rex one morning several weeks ago, I had posed this question to myself: What would be the one thing I could give to my children so that they are successful in life? A fully paid for college education? An appreciation for higher learning? I shook my head. I was equating success with a profession, a college degree, doors opening, financial security. No. I would give my children self-confidence. A child who believes in him or herself will blossom into an adult who stands up for him or herself. Hurtful words will, as I told Isabella on our walk to school yesterday morning, “roll off her back like water on a duck.” He won’t allow himself to stay stuck in a job that he doesn’t like. She won’t allow herself to be in an abusive relationship. Neither will waste away their time in a coma in a dead-end life. A person with a healthy self-esteem will seek the light and surround themselves with similar people. And they will be empathetic. When they see someone bullied, they will feel bullied themselves and know it is not right – and then make it right.

Exude self-confidence and build self-confidence in your children.

Exude self-confidence and build self-confidence in your children.

Save your brain: Take a power nap

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Nature has not intended mankind to work from eight in the morning until midnight without that refreshment of blessed oblivion which, even if it only lasts twenty minutes, is sufficient to renew all the vital forces.
– Winston Churchill, British Prime Minister of the U.K.

Mix stripes and prints when both pieces have bursts of the same bold colors and both fabrics are similar - in this case, shiny.

Mix stripes and prints when both pieces have bursts of the same bold colors and both fabrics are similar – in this case, shiny.

After graduating from UC Davis back in 1985, I remained at Davis and spent the following year working full-time at the School of Law’s library to save money and apply to volunteer organizations. I was bored to tears collecting, shelving, and cataloging books, and replacing old book spine labels with new ones. Boredom made me drowsy and I often fought back yawns by midday. A co-worker friend and I discovered a small room connected to the rarely used downstairs bathroom. It had a single piece of furniture in the middle – a thick-padded elevated, armless chaise lounge. We dubbed it the PMS lounge. I used it for my daily lunchtime naps, despite the fact that the room had a musty smell and the walls were painted an institutional green that reminded me of a state hospital from the 1950s. Every day, my co-worker friend dutifully came downstairs to wake me up after 30 minutes.

I’m reminded of this long-ago ritual because since last year I have indulged in power naps, formerly called cat naps. My acupuncturist recommended naps, especially for sleep-deprived people like me. While my workload has gone from insane to manageable, business trips and deadlines seem to occur at the same times, hence a deadly cocktail of late nights and stress.

Continue the shine factor with pumps and gold jewelry (End of Century, NYC, cicada ring, earrings from Anthropologie, and cuff by Alkemie, Los Angeles.

Continue the shine factor with pumps and gold jewelry (End of Century, NYC, cicada ring; earrings from Anthropologie; and cuff by Alkemie, Los Angeles).

At first, I fought it. Napping took away valuable time from work. But when I couldn’t put together two cogent sentences, I began spinning my proverbial wheels. I gave in to the siren and found that when I woke up, I was – albeit groggy at first – better able to tackle writing that white paper and get things done and do them well instead of operating in a fog, redoing and rewriting, and taking twice as long to get anything done.

Bold earrings means you should keep the neckline spare.

Bold earrings means you should keep the neckline spare.

Articles say ideal naps last between 10 to 20 or 30 minutes and should be taken no later than midday. Longer naps make you more tired and naps late in the day may interfere with your quality of sleep at night. Everybody is different. I have found that I don’t naturally sleep for 30 minutes and then wake up, but I didn’t want to set an alarm – unless I had to – because in the back of my head I would wonder when that alarm was going to go off. I nap during my lunch break but will acquiesce to an earlier time when I’m really struggling to get words down. I’ve even broken the rule and taken a nap at 5PM after picking up my kids from some extracurricular activity. There is no way I can make dinner in this state. My kids tell me it’s okay to have a late dinner and off I go to nap. And when I wake up, I cook dinner that would have taken me twice as long had I not slept.

Another take on the striped blouse: A flowing maize-colored skirt makes the outfit more casual and summery.

Another take on the striped blouse: A flowing maize-colored skirt makes the outfit more casual and summery.

Napping allows me to be more productive later in the afternoon when my energy usually wanes. In the last year or two, I have witnessed – with great sadness – the decline of my energy level (along with my memory, which I believe is connected to my energy level). Getting settled back into a work routine of no travel in the near term, reaching a point in my job where I’m appropriately delegating work and managing the workflow, and eating healthful meals on a regular schedule will help me regain my energy level and reclaim my sleep.

That said, while I didn’t take a nap yesterday, though I was tired, naps will remain a necessary tool that will help me reach the coveted restful state. Now if I can get to bed by 11PM and not worry about projects and deadlines, which is a goal my acupuncturist heartily approves of, I would be ecstatic.

Go bold with chunky colorful bangles.

Go bold with chunky colorful bangles (Anthropologie) and sea glass earrings by Carmela Rose. Necklace from the Brooklyn Flea Market, rings from Sundance and In God We Trust.

I used to make fun of my years of sleep deprivation and even tout my ability to be fine after a marathon 48 hours straight working on a project. But it’s no laughing matter. Your brain chemistry is altered when you are deprived of sleep for prolonged periods of time. I’m very aware of this. Sometimes choices have to be made. I skipped my son’s baseball game last Sunday because leaving the house at 6:30AM for a second weekend morning in a row was too exhausting. I didn’t sleep in, but I lounged just a bit. I went to my mom’s group’s monthly breakfast and had a leisurely breakfast. Later, my daughter and I had a leisurely lunch on our balcony.

It’s so hard not to feel guilty about taking it easy in this crazy workaholic environment. But I have to consciously remind myself: If I can’t take care of myself, I can’t take care of my family or my friends. Power naps, I’ve discovered, have helped empower me. And knowing that Leonardo di Vinci, Thomas Edison, and Albert Einstein were advocates of naps puts me in great company.

Platform sandals complete the summery outfit.

Platform sandals complete the summery outfit.

Jolie’s ‘medical choice’ takeaway: Be an informed, empowered patient

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Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of.
– Angelina Jolie, American actress, film director, and screenwriter

I'm no Angelina Jolie, but I'll pretend I'm on the red carpet.

I’m no Angelina Jolie, but I’ll pretend I’m on the red carpet.

I don’t hero-worship actors or celebrities. I admire people, regardless of who they are and what they do for a living, who work to make the world a better place to live, whether it is through activism for social justice, environmental protection, or other cause. I do admire famous people who use their visibility and money to those ends because oftentimes their celebrity status highlights causes, issues, and injustices that otherwise would go unnoticed. Ever since Angelina Jolie became involved in human rights issues, first as a United Nations High Commissioner for Refugees Goodwill Ambassador in 2001 and later through her establishment of charitable organizations and her screenwriting and directing, I have been an admirer.

She gave me another reason to admire her. I applaud Jolie’s decision to write an op-ed piece in the New York Times about her decision to have a preventive double mastectomy. As many have commented already, her decision to discuss it openly and write about it so thoughtfully is notable because she is a glamorous actress in an industry that worships youth and beauty and eschews flaws.

There were detractors, as expected. Yes, she could afford the $3,000 BRCA genetic test and have the best medical care in the world for breast reconstruction, whereas many economically disadvantaged women do not have the means. Some in the medical community worry that her revelation will influence women with a history of breast cancer and create a spike in what is already a trend toward mastectomies that aren’t medically necessary for many early-stage breast cancers.

Rain cloud necklace by M.E. Moore (Gorgeous & Green, Berkeley), cuff by Alkemie of Los Angeles, cicada ring by End of Century in NYC, and earrings from Abacus in Portland, Maine.

Rain cloud necklace by M.E. Moore (Gorgeous & Green, Berkeley), cuff by Alkemie of Los Angeles, cicada ring by End of Century in NYC, and earrings from Abacus in Portland, Maine.

But here’s the thing: Jolie made her decision after exploring her options, talking with medical experts and undergoing genetic counseling. She is the empowered, educated patient whom healthcare reform advocates want in a healthcare system that we are trying to transform. This is a topic that I write about a lot in my work. Educated, empowered patients are an important component of healthcare transformation equation. As we shift, slowly but surely, from a fee-for-volume to a fee-for-value reimbursement model (meaning, hospitals and physicians get reimbursed not for how many patients they see, but how many patients they can keep healthy or get to a healthy status), healthcare providers need patients to take more responsibility for their own healthcare. (For that matter, healthcare insurers want that, too, but we all should take responsibility for our own healthcare.) Patients need to see all their options and understand the benefits and risks of every option. I applaud Jolie for emphasizing her careful deliberation. That’s the objectivity that is required. But there’s no denying the personal aspect of cancer. For Jolie, it’s her mother’s lost battle to breast cancer and wanting to be there for her children.

I am in an age group in which the number of women being diagnosed with breast cancer and other cancers rises. I have good friends who have survived it. I have met acquaintances who have survived it. When I first met David back in 1995, his mother underwent a double mastectomy shortly thereafter when she was diagnosed in her early fifties. Her mother and sister had died of breast cancer years earlier, and her niece died years later. In a commentary about Jolie, the chief of the breast service at Sloan-Kettering was quoted as saying that she has tried unsuccessfully to talk women out of having a mastectomy when it was not necessary. It is difficult to dismiss the personal, even in the face of evidence-based medicine. For example, I still have a yearly mammogram despite the differing screening guidelines and especially the U.S. Preventive Services Task Force mammogram guidelines which recommend women begin screening at age 50 and repeat the test every two years. On one level, women will be guided by their personal situation and history. So long as they are educated, they will make thoughtful choices, with ‘choice’ being the operative word for empowerment.

Whether you worry about what harm may come out of Jolie’s revelation, the overarching good is that we continue to have discussions about breast cancer and act on those discussions – how we can prevent it, raise awareness for it, raise money to defeat it, and especially support our family and friends who have to battle it. For all the grandmothers, mothers, sisters, and daughters out there, we owe it to ourselves and our loved ones to be brave and to be on the side of light and life.

Post script: Read about another amazing woman who survived breast cancer, Peggy Liou, whom I wrote about at the Dress at 50 here.

Vintage purse from the Fairhaven Antique Mall in Fairhaven, Wash., and Sam Edelman patent pumps complete the outfit.

Vintage purse from the Fairhaven Antique Mall in Fairhaven, Wash., and Sam Edelman patent pumps complete the outfit.