Category Archives: Observations

Train love

Last week, I spent two days in LA for a training. I noticed these two cuties waiting for the metro on the way back to Union Station. The held hands waiting for the train…

And they didn’t let go as they got in the car…

And their sweetness just made me smile.

Happy Wednesday :)

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Five star health care inequality

As the Senate barrels forward with an attempt to cut our health care so rich people can get a tax cut, a new health care issue got my blood boiling this weekend: uber concierge medicine. This article, on the cover of the Sunday business section, enlightened me on a new inequality fronteir.  The story profiles the rising prevalence of private health care managers in the Bay Area.  These health firms for the ultra-wealthy command $40-80,000 a year in fees and ensure their clients have five-star health care experiences (i.e. shorter wait times for specialists, better referrals, coordinated services).

Can’t help but wonder when this story originated, but reading it at a time when Congress wants to take away health care from 23 million Americans (or, if they’re lucky, just increase their premiums by 800%), was extremely unsettling.

While I’ve always been concerned about wealth and income inequality, the move to Stockton makes me hyper-aware of the growing disconnect between the wealthy and poor.  (I can’t include the middle class in that sentence, because sadly, it seems as though the middle class disappearing. It terrifies me to say that, but living in the Central Valley and working in the Bay Area, I primarily observe examples of poverty and wealth–no real signs of a growing middle class in Northern California).  Anyway, one area of hope for equity, thanks to the Affordable Care Act, was health care.

With the ACA, in states that expanded Medicaid, the health benefits protection helped many more people get access to essential coverage.  As a Kaiser member, observing patients of all socio-economic levels accessing health services always gave me a bit of hope for the future.  In the last two years, between David’s pneumonia hospitalization, my miscarriage, pregnancy and delivery, I’ve spent time in Kaiser health centers in Oakland, Modesto, Walnut Creek and Stockton. These cities vary significantly in economic, education and health outcomes.  And yet, while economic disparity grows stronger between the coastal and inland cities, the ACA’s massive coverage improvements provided hope for a narrowing health outcome gap.  In my purely anecdotal experience, the quality of care and dignity of service in Walnut Creek was the same as Stockton, or any of the other cities. I can find few other public services examples where that is the case, and I attribute that to the ACA’s role in lifting standards and quality for all.

Apparently, feeling hopeful after observing waiting rooms of diverse patients is not a universal reaction.  From the article:

“Whenever I bump into a bleeding-heart liberal, which I am, I mention that schools, housing and food are all tiered systems,” he said. “But health care is an island of socialism in a system of tiered capitalism? Tell me how that works.”

Dr. Howard Maron, who founded MD Squared, is similarly candid about the new reality of ultra-elite medical care.

“In my old waiting room in Seattle, the C.E.O. of a company might be sitting next to a custodian from that company,” he recalled. “While I admired that egalitarian aspect of medicine, it started to appear somewhat odd.”

As we “bleeding-heart liberals” lament growing political and ideological polarization, we have to acknowledge it will only get worse if health care becomes even more tiered. (Should clarify, for all the ACA’s promise and potential, we are still far, far from an equitable health system. But the law was a step in the right direction).  The tiered system in public schools, neighborhoods, parks, transit, and more ensure the company CEO never brushes up against the company custodian.  And when that CEO never interacts with the custodian, what does she know of his experience? How will she ever favor policies that help him if she never sees him? It’s the classic Crash opening quote conundrum.

I recognize that viewing a hospital waiting room as a de facto town square, a public center where people of all backgrounds interact, is a deeply depressing statement. But in reality, what else is left? And if wealthy liberals want to take that away (to be clear, the article profiled wealthy Northern Californians; it’s not Texas oil tycoons normalizing this type of income separation, but our “liberal” neighbors) how can we possibly be surprised when Congress wants to barter away health care protections to gain tax cuts?

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Grand Designs

Wondering how much individual media consumption has changed post-election. Guessing I’m not alone in experiencing a significant media and TV habit-shift. Post-election, in an effort to retain sanity, I bounced on-and-off Twitter and FB and FINALLY subscribed to a printed newspaper (NYT, though the Washington Post’s coverage has been super impressive, love their new slogan).

TV-wise, I’ve deliberately slipped into a bubble. Even before the election, nerves already jumpy, I started avoiding shows with “scary” or “stressful” premises. This basically eliminated most thoughtful television. Post-election, I didn’t just want to avoid stress, I needed a distraction, total bubblegum TV to help (momentarily) forget about the concerning reality. 

And what’s the bubble-gummiest TV there is?


Basically, since November, if I’m watching TV, it’s House Hunters or Fixer Upper. Consumption really picked up in the last few weeks of pregnancy, as we waited around for Diego’s arrival.

Anyway-all this to say, thanks to Netflix, there’s (FINALLY) a new show on rotation in our house: Grand Designs.

It’s SO GOOD. Like, good enough that I feel the need to document it in this little journal.

I read about it in the LA Times and was immediately intrigued: one of the most popular and longest running property shows in the UK, Grand Designs profiles: “a unique home-build or renovation from start to finish — however long that might take, whether a few months or many years…the common thread is ambition.”

As someone who loves-and surprisingly never grows bored of-House Hunters and Fixer Upper, it’s surprising how much better Grand Designs is. The determination of the homebuilders, the creativity in the design, te sheer British-ness of it. And this element:

“The show has much more genuine tension than you’d find in a comparable American series, maybe because the British aren’t so cursed with relentless optimism.”

Anyway, highly recommend it!

Photos via here and here.

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No one at the table 

Sitting here, with a nursing Diego on my chest, in my chair that supports my back and c-section soreness, and thinking about the billions of women who’ve done this before me. And yet…somehow, despite their volume and importance, these women were suspiciously absent from this table:

A bunch of old white men sitting around a board room, discussing their importance, is hardly a remarkable event. However, this group convened to discuss health care benefits. Specifically, whether insurance companies should be required to provide maternity and newborn care benefits as part of their core coverage.

And somehow, no one thought this topic warranted a woman’s perspective?* It’s deeply troubling to think that sometime this afternoon, these men, and their colleagues in the House, will vote on legislation to strip women of basic coverage protections.

Policy and optics aside, this whole AHCA proposal (and legislative process) is just completely bonkers. Our country is already so far behind the rest of the developed world in the support we provide for caregivers, for both children and older adults. Now we’re going to take away their care and treatment, as well?

Two days after the c-section, I was able to take my first shower. The whole cesarean process left me feeling incredibly vulnerable, and I was scared to see the incision for the first time. To calm myself from that fear, I thought about was how many other women have done this. And as nervous as I felt, I knew I was in a good hospital, with an excellent care team, and I would have support to help me heal and recover.  Thinking about that helped me feel stronger in that moment.

Everyone should have that reassurance in a vulnerable moment.

But here’s the thing-good care, strong hospitals, excellent coverage-they don’t just happen. It’s not like the “free market” suddenly makes insurance companies cover costly but necessary surgeries, or “charitable giving” alone results in a safety net program that provides low-income women access to quality hospitals. Of course all of that helps, and individual ingenuity and drive improve care for everyone. But the foundation of all of this is our laws and regulations; laws that require a solid Medicaid program, that require essential coverage benefits, that ensure we all have access to the care and services we need to create and maintain a life of dignity. 

The thought of that table of men making decisions that could impact future women, mothers-to-be, mothers and babies–and their partners!–without the input of a single woman is horrifying. 

Going to go make some calls and stay hopeful for this afternoon and the future.

Happy Friday :)

* One article mentioned there were three women in the room: Kelly-Anne Conway and “two unidentified women in the back.” Very reassuring.

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“It can’t be compartmentalized anymore”

Guessing I’m not the only person with a phone and a partner whose Friday began with the following:

“Fay, wake up, you have to watch this.” As I blearily opened my eyes, for a nanosecond questioning the urgency over a BBC interview, the punchline of the toddler and baby crashing their dad’s workday brought a good laugh.

Now, 14 hours later, there is small part of me cringing as I write this as I can’t believe I’m participating, in any small way, in re-sharing it.  It’s been a while since something non-political has so overwhelmingly invaded my newsfeed-the Kelly dad/mom rescue video is everywhere.

Trailing close behind actual Kelly-clip links are articles analyzing every moment and implication of the interruption. I want to play! So, here’s my thoughts on #BBCDad Day.

Despite the fact it’s 2017, and we’re progressive, and social media offers unbelievable access to people’s personal lives, we’re still, at our core, more comfortable when work and family/life sit in their respective corners. And when that line gets blurred-particularly in a public, or haphazard, unexpected way-its unnerving.  It’s the whole being-in-second-grade-and-seeing-your-teacher -at-the-grocery-store phenomenon.  Or, the flip, it’s seeing your parents at work and being weirded out by their “work voice.” People have jobs, people have families, but we don’t like to see them have both at the same time.

As an avid reader of Laura Owen’s newsletter, I thought she nailed it with this comment: “The video shows how incredibly hard it is to separate your work life and your family life…none of it can be compartmentalized anymore, and it’s often when you’re trying to keep up this illusion the hardest that it comes crashing down.”  Despite our natural expectations to separate the two, in reality, this is increasingly difficult to do.

I can’t overlook the fact that a huge reason all of this struck a cord with me today-of all days-is that today was my last day working before parental leave. Because I stopped commuting 2 1/2 weeks ago, I’ve gradually tapered down from my normal routine.  I’m grateful for the leave, and frankly far too tired to have continued with a normal work/commute schedule, and so the process has been just right.

But still, it’s a moment of change. For the past 10ish years, post-college, my primary focus, both in time and mental energy, is on the “work” side of the ledger.  For the next 4ish months, thanks to California’s progressive policy and a great employer, I’ll have the luxury of focusing exclusively on the “family side.” And then, if everything works out, I’ll have the privilege of being part of the 70% of mothers who work, the 70% of women who, every day, manage both worlds.

And simply watching a 55 second clip of one parent in this moment was enough to make my eyes widen.

So, thinking about the future, I’m equal parts curious and anxious about how it will all go. (And 100% super pregnant. And stir crazy.  All likely contributing to this indulgent level of self-analysis).  Feeling very grateful for amazing friends and my mom, who already navigated this transition, who I can call with anxious questions, and who by simply doing the real work of being a mother and having a career, inspire me to know it will all be ok.

Yet, while I imagined stress when I returned to work this summer, I’m surprised by how overwhelmed I feel at the prospect of not working for the next 4 months.  The last few weeks of working from home-while welcome and necessary-helped me realized that being at home full time, for me, is not ideal. Of course, I’ve loved not commuting. The commute is rough and I haven’t missed it at all.  However, as much as I love wearing yoga pants and soaking up the quiet morning sunshine over tea, 5 days a week of quiet at home makes me a little crazy.  Being around people is healthy, and I’m more productive with a routine and a bit of a grind. (Mostly writing all this down so that when the end of June strikes and I’m wishing I could stay home longer, I’ll remember when I was **slightly** more clearheaded: 2 days a week of telecommuting is amazing, 5 days, too much. You work best when you’re working from home part time and in the office part time. It’s going to be ok).

And, of course, these 4 months will be very full of the very real demands of family life. Perhaps I’m overwhelmed thinking about this because it’s a huge change that I can’t entirely imagine, and that uncertainty is mind-boggling.

Anyway, all to say, I have no profound conclusions after #BBCDad Day, but it just got me thinking about this whole family and work thing.  Curious to see how it all goes, and grateful for the friends and colleagues I can look to for tips and examples of navigating it all.

PS-the baby is due on Sunday. Trying so hard to be patient! Not doing so well. Going a little bananas. Been going on lots of walks-these photos are from the other night, during a walk to UOP.  Really feels like spring!

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