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I’ll Be Watching Mueller’s Congressional Testimony…I Hope You Will Be Too

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This Wednesday, July 24, beginning at 8:30 am ET, Special Counsel Robert Mueller will testify—reluctantly—before two committees of the House of Representatives. I believe it is extremely important that as many people as possible watch his testimony and listen to his responses to questions.

I am deeply saddened for our country that The Mueller Report, its findings, and the man himself have become such partisan issues. According to every reputable intelligence source we have, it is indisputable that the Russians interfered with our 2016 elections.

This is cyberwarfare–and more–and it is as serious an attack as any that could have occurred. Its intentions were to disrupt our democracy and make us distrust our government and its institutions. I believe the Russians were successful beyond Vladimir Putin’s wildest dreams.

An easily digestible exploration of The Mueller Report is available in a multi-issue podcast from Lawfare, a national security blog produced in cooperation with the Brookings Institution.

Lawfare calls The Mueller Report “one of the most important and consequential documents of our time,” but adds: “most people aren’t reading it.” That’s why they’ve put together the podcast, which they hope will be widely shared.

I have just listened to the first episode, “Active Measures,” and it is a fascinating examination of the report, with added interviews and just a sufficient amount of drama to hold the listener’s interest. I strongly recommend it to you all.

I will not spend much time now mentioning my dismay that Republican officials—elected and unelected—and the Republican party, which has long been deeply concerned about national security, have sought to distort the findings, malign Mueller—a lifelong Republican with an impeccable career of service—and repeat President Trump’s oft-stated meme that this is “fake news” and there was no collusion, no obstruction of justice.

The fact that Attorney General Bill Barr misrepresented the findings at the outset, thereby planting seeds of doubt in the minds of many, is another huge disappointment. But at least we will finally hear what Mueller himself has concluded—in his own words.

My intention had been to read every one of the 448 pages of The Mueller Report. However, like most Americans and—more importantly and regrettably—most members of Congress, I didn’t get around to it.

But my husband did—every page, every reference—and though he’s not an attorney, he’s a careful reader and a thoughtful and skeptical individual. So I am grateful to him for providing me with his findings and insights.

I hope you’ll find the information that follows a helpful “primer” for viewing Mueller’s testimony. And if you don’t watch or listen, I hope you’ll think very carefully about the implications of the findings for our democracy.

VOLUME 1: THE RUSSIAN ATTACK.

The primary question: Were there willing accomplices, and if so, is that provable?

What follows is background information to give context to those of you who may not have followed these developments as closely as we have.

The “Internet Research Agency”

The Russian attempts to “mess with” our democracy began with the work of the Russian-based “Internet Research Agency” (IRA) in 2014.

At that point, the intent was to gain a toehold in the US, learn about what Americans were thinking and where our divisions lay, and begin gaining online followers through social media–specifically Facebook and Twitter, with seemingly innocuous efforts appealing to cat lovers and the like.

In 2015, even before Hillary Clinton declared her candidacy, the efforts began to discredit her with phony stories, including with regard to her role as Secretary of State, delivered through bots whose origins, unknown to observers, were in Russia.

It wasn’t until 2016, when Donald Trump declared his candidacy and demonstrated strong sympathy for Russia, that the IRA’s campaign focused its considerable Internet presence of fake sites on building him up and continuing to tear Clinton down.

Based on their reconnaissance, the IRA sought to sow dissension in the US by, for example, creating fake pro-Muslim and anti-Muslim groups and staging competing rallies, in the hope of fomenting violence.

(And as we are clearly seeing today, they had rich raw material to work with: they didn’t have to create dissensions–they simply had to exacerbate already existing ones.)

When Facebook began taking down the fake sites in 2017, they had reached hundreds of millions of people and amassed hundreds of thousands of followers.

Triggers for the 2017 FBI Investigation

A series of events and media reports led to the FBI’s 2017 investigation of the Republican Party’s presidential campaign because they generated speculation about a possible conspiracy to undermine Hillary Clinton’s candidacy to become President of the United States. They included:

*US, European Union, and Canadian sanctions against Russia for its military annexation of Crimea and an attempt to move eastern Ukraine closer to the Russian Federation.

*Multiple contacts with Russia by individuals close to then-candidate Trump.

*The deteriorating relationship between the US and Russia.

*Putin’s animus toward former Secretary of State Clinton, including his belief that she sought to undermine the Russian regime.

*Trump’s past financial history [which he often denied] with Russian financial people to maintain credit for the Trump Organization (theory: that this would make him vulnerable to blackmail)

*Wikileaks’ pseudo-journalistic public exposure of the Democratic National Committee’s internal communications.

*The FBI’s receipt of information of Russian involvement in US politics sufficiently serious to generate a counter-intelligence investigation into what role—if any—the Trump campaign played with Russia’s interference into the 2016 election.

Then, after the election, then-Attorney General Jeff Sessions recused himself from the investigation due to his own contacts with members of the Russian government.

President Trump fired FBI Director James Comey, expressing anger that Comey refused to publicly say that Trump was not a subject of the investigation.

Deputy Attorney General Rod Rosenstein appointed Robert Mueller as Special Counsel, an outside party who would carry on the investigation.

After the 2-1/2 year investigation, Mueller reported he could not find a conspiracy between the Russian government and the Trump campaign.

He noted, however, that people lied or claimed executive privilege to avoid questioning, making it difficult to get all the relevant facts.

Our questions: If Trump, et al, had nothing to hide (‘no collusion!”), why did they feel the need to lie repeatedly, attempt to interfere with the Special Counsel, and refuse to cooperate (while claiming that they were cooperating)?

And why are they still trying to prevent Congress from performing its Constitutionally guaranteed oversight function?

A major stumbling block was the refusal of the President to sit down for a face-to-face deposition with the Special Counsel. The President was allowed a “take-home exam,” making a comprehensive testimony with follow-up questions impossible.

As noted above, it now seems evident that by 2016, Putin thought that Trump could be nominated for US President. Putin saw Trump as sympathetic to Russia’s interests and able to blunt US interference with Russia’s plans for Eastern Europe. (Why Trump was, and continues to be, so sympathetic has been the subject of much speculation.)

In contrast, Putin viewed Clinton as a major disrupter who probably wouldn’t accede to Russia’s desire to have the US lift sanctions levied because of Crimea. The Russians began their campaign of disruption by hacking into the DNC computers and establishing a vast presence of Internet trolls planting phony stories about Clinton and the Democrats.

It may be that certain persons who were investigated for possible unlawful Russian contact were, in fact, either willing or unwitting conduits of Russian messaging (eg, Flynn, Stone, Manafort, Papadapoulos, Assange), but this information has not been proven.

It does seem that most of the activity and efforts to communicate flowed from Russia to the US.

It is difficult to say how successful Russia was in tipping the election in Trump’s favor. Polls were within the margin of error for Clinton. Without Russian involvement, Trump may have lost any advantage he received from Comey’s last-minute reopening of the investigation into Clinton’s emails (an investigation that was again closed before the election, but in the words of Trump’s campaign aide Kellyanne Conway, “The damage is done.”)

Mueller’s reference to the difficulty in nailing down  information due to lying and claims of executive privilege is significant.

There were also unanswered avenues for inquiry, such as Trump’s son-in-law Jared Kushner’s meeting with Russian ambassador Kislyak and Sergei Gorkov (VEB Bank, a major Russian-owned bank). Were these diplomatic or business—or diplomatic for business?

VOLUME TWO: INTERFERENCE WITH RUSSIA INVESTIGATION

Mueller did, indeed, specify areas involving the President that could be within the legal framework of “obstructive act,” ”nexus [connection] to a pending or contemplated official proceeding,” and “intent.”

If the House of Representatives decides to open an impeachment inquiry, some or all of the following will probably become the basis for that action.

*Pressuring FBI Director Comey to end the probe of Michael Flynn.

*Firing Comey, deemed obstruction because Trump understood that the continuing investigation would give rise to personal and political concerns, ie, Trump’s attorney Michael Cohen pursuing the Trump Tower deal until June 16, 2016, after Trump had stated that he’d had no business with Russia after he’d been sworn in.

*Attempting to fire Special Counsel Mueller for alleged conflicts. Trump asked White House Counsel Don McGahn to fire Mueller through Rosenstein. McGahn, fearing a Saturday night massacre akin to Watergate, refused.

*Seeking to curtail the Special Counsel investigation. The President asked Corey Lewandowski to call upon Jeff Sessions to end the investigation to prevent scrutiny of the president. Lewandowski didn’t do it.

*Seeking to keep emails about the June 9, 2016 Trump Tower meeting from the public. (Since he didn’t attempt to keep the emails from the Special Counsel, this point didn’t fit all the criteria for obstruction)

*Asking Sessions repeatedly to “unrecuse” himself so that he could shield the President from the investigation.

*Ordering McGahn to deny that the President tried to fire the Special Counsel. McGahn refused.

*Acting toward Manafort in a manner suggesting he was dangling a pardon to keep Manafort from cooperating with the Special Counsel.

*Reacting to Michael Cohen in a way that would discourage Cohen from cooperating with the government.

*Expressing skepticism publicly about Russian involvement with the emails while he and his staff were actually trying to get more information about Wikileaks’ releases.

MUELLER’S CONCLUSION:

(The Special Counsel was operating under “longstanding” Department of Justice [DOJ] policy that prevents charging a sitting President with a federal crime.)

“BECAUSE WE DETERMINED NOT TO MAKE A TRADITIONAL PROSECUTORIAL JUDGMENT, WE DID NOT DRAW ULTIMATE CONCLUSIONS ABOUT THE PRESIDENT’S CONDUCT. THE EVIDENCE WE OBTAINED ABOUT THE PRESIDENT’S ACTIONS AND INTENT PRESENTS DIFFICULT ISSUES THAT WOULD NEED TO BE RESOLVED IF WE WERE MAKING A TRADITIONAL PROSECUTORIAL JUDGMENT.

AT THE SAME TIME, IF WE HAD CONFIDENCE AFTER A THOROUGH INVESTIGATION OF THE FACTS THAT THE PRESIDENT CLEARLY DID NOT COMMIT OBSTRUCTION OF JUSTICE, WE WOULD SO STATE.

BASED ON THE FACTS AND THE APPLICABLE LEGAL STANDARDS, WE ARE UNABLE TO REACH THAT JUDGMENT. ACCORDINGLY, WHILE THIS REPORT DOES NOT CONCLUDE THAT THE PRESIDENT COMMITTED A CRIME, IT ALSO DOES NOT EXONERATE HIM.”

On May 6, more than 400 former federal prosecutors who had served under both Democratic and Republican administrations made a public statement saying the following:

“Each of us believes that the conduct of President Trump described in Special Counsel Robert Mueller’s report would, in the case of any other person not covered by the Office of Legal Counsel policy against indicting a sitting president, result in multiple felony changes for obstruction of justice. “

You can read the entire statement here.

A few additional thoughts:

The President was saved from putting himself into even greater jeopardy by aides (McGahn, Lewandowski, and probably Hope Hicks) who advised him against certain actions and/or did not follow through on his requests that they implement illegal acts.

We think—as do others—that separating the two parts of the report weakened the Special Counsel’s effort. The items of obstruction were proof to us that the President felt that the investigation could lead to something so damaging that it was worth the effort to interfere and discredit and/or fire Mueller.

These actions strongly suggest that he either knew or at least recognized that Putin was doing plenty to tilt the election in his favor.

As far as we know, the impetus for the Russian contacts came from Russian sources. However, by soft-pedaling Russia’s activities—most recently laughing with Putin about the findings at their last meeting—he certainly seems complicit in Russia’s efforts.

At best, he appears to be responsible for serious dereliction of duty in denying the implications of Russia’s cyberattack, refusing to denounce Putin, and failing to marshal all efforts to prevent a repeat in 2020.

One final, related note:

Richard Clarke, a White House counterterrorism advisor to four presidents, who tried to warn the Bush administration about the imminence of an attack just before 9/11, has written a new book about cyber threats. He points out that there are more than 4000 counties in the US running their own elections. They need help. But, he said in an NPR interview:

:...Mitch McConnell, the Senate Republican majority leader, is standing in the way of a bill that has passed the House to give hundreds of millions of dollars’ assistance to the counties and to the states so that we can improve their cybersecurity. Right now, it’s impossible to have all of these counties and all these state governments even know when they’re under attack. Many of them say they’ve never been attacked. Well, they have no capability of knowing.” 

Why is McConnell refusing to allow this bill to come to a vote in the Senate?

The public and the media must press McConnell to give us an answer.

Where are the patriots? Who is protecting us from foreign cyberattacks and other interventions in our elections? How will we know if the results of the 2020 election are valid? And what would the lack of certainty mean for our democracy?

Annie

Where Are the Lights of Liberty? We Are Better Than This!

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I stood with nearly 300 members of my community Friday night at a “Lights for Liberty” candlelight vigil in protest of the horrific treatment of immigrants on the US southern border.

This was one of 800 such vigils worldwide, all designed to persuade the government of this nation, a nation of immigrants, to stop using cruelty and dehumanization against children and families.

Think about that: people throughout the world gathered to register their horror at the policies and actions of the US government.

Two aspects of the presentations moved me the most. The first was a speech by a councilwoman from a neighboring community. She introduced herself as a “proud American” and an immigrant and described her journey from India when she was 11 years old.

Her mother was traveling with her and her two brothers to reunite with her father, who had arrived in the US two years earlier to make enough money so that he could bring his family to this great country for a happier, more financially secure life.

The councilwoman said she was apprehensive, but she was with her mother, so she knew everything would be OK. “I can’t imagine,” she said, “what it would have been like to have been taken away from my mother and brothers, and not know whether I’d ever see them again. I can’t imagine having to live under the conditions we’re hearing about—to have no food, no toothbrushes, no bedding, no clean clothes…”

The other presentation that brought me to tears was made by a series of teenagers, who took to the podium to read from the actual statements made by young people in our nation’s care.

These statements were recorded by attorneys who visited the Customs and Border Protection facilities in late June. You can find them at newsweek.com. Here’s a sampling:

“At 3 a.m. the next day the officers told us that our grandmother would be taken away. My grandmother tried to show the officers a paper signed by my parents saying that my grandmother had been entrusted to take care of us. The officers rejected the paperwork saying that it had to be signed by a judge. Then the officers took my dear grandmother away. We have not seen her since that moment.” -From a 12-year-old girl

“At Ursula, we have not been able to shower. The toilet is out in the open in the cage, there is no door for any privacy. There is water but no soap to wash our hands. There are no paper towels to dry our hands. We have not been given a toothbrush or toothpaste to brush our teeth.” -From a 17-year-old boy

“The day after we arrived here, my baby began vomiting and having diarrhea. I asked to see a doctor and they did not take us. I asked again the next day and the guard said: ‘She doesn’t have the face of a sick baby. She doesn’t need to see a doctor.’ My baby daughter has not had medicine since we first arrived. She has a very bad cough, fever and continues to vomit and have diarrhea.” -From a 16-year-old girl

The Trump Administration has made deliberate decisions to deter immigration by separating families and forcing children—from babies to adolescents—as well as adults to live in inhumane conditions. Threatened surprise raids on immigrants are part of this cruelty. American citizens are among those who have been rounded up and deported.

And we, the taxpayers, are footing the bill for all this: $200 daily in government-run cages; $700-plus daily in private facilities through which people such as former Chief of Staff John Kelly profit financially.

Who among us can turn a blind eye to the horrors that are being perpetrated by our government right now?

Border security is a legitimate issue—one that Congress should have resolved years ago. In fact, they came close: a comprehensive immigration reform bill, The Border Security, Economic Opportunity, and Immigration Modernization Act passed the Senate in 2013 by a vote of 68-32. But the House failed to act.

Is it now possible, with Democratic control of the House, that if such a bill were proposed, Senator Mitch McConnell, who delights in calling himself The Grim Reaper, would even bring it to a vote?

He has already refused to consider more than 100 House-passed bills on healthcare, infrastructure, voting machine protection, and other issues on which large majorities of Americans agree.

But this is now an even more complex issue. Immigration had been down for several years. The increases lately are due to the grievous conditions in Central America (immigration from Mexico is actually down): poverty, homicides, gangs trying to recruit young teenagers, drug lords, and climate change.

Climate change is part of the worldwide impetus for migration that many countries in Europe are grappling with.

The situation on our southern border should send an alarm bell concerning what we have to look forward to if we continue to deny the existence of climate change and don’t act promptly.

Erik Kobayashi-Solomon, a contributor to Forbes, pointed out that the three countries from which most immigrants seeking asylum at our southern border are now fleeing—El Salvador, Guatemala, and Honduras—are part of an “ecologically fragile ‘dry corridor’ that has been hit in the last few years by alternating droughts and drenching precipitation which climate sciences have shown is related to warming global temperatures.”

Since about 1/3 of the people there depend on subsistence farming, it doesn’t take huge variations in climate to wreak havoc on their crops. They are then compelled to leave their homes and set out for cities—cities rife with corruption and run by criminal gangs. The author observes:

“So they make the rational choice to head north for economic security and rule of law.”

“Recent reporting from Jonathan Blitzer at the New Yorker and John Carlos Frey at the Marshall Project makes a convincing case that climate change is a major underlying cause of the recent pick-up in northward migration from Central America.”

Poverty isn’t currently considered by our government a legitimate reason for asylum, but it’s realistic to believe that many of these people requesting asylum also fear for their lives. Why else would they make the obviously dangerous trek from their homes, their children in tow?

Instead, they are caged and deprived of basic necessities. And even though family members in the US are often available to take them in, the government doesn’t contact these people, deliberately worsening the overcrowded facilities situation.

President Trump did inherit an unresolved immigration problem. The New York Times has editorialized that “All Presidents Are Deporters in Chief.”

That dubious honorific was given by immigrants rights groups to President Obama, though his administration sought to deport primarily criminals and created the Deferred Action for Childhood Arrivals (DACA) program, a pathway to citizenship for the young people who were brought here as babies and have known only the US as their home.

Though we may wish to embrace every last soul seeking refuge here, that isn’t possible.

But the question The Times raises is what kind of Deporter in Chief a President is—or will be.

In faulting this President, the editors state:

“For Mr. Trump, deterrence of illegal immigration has been a guiding principle — if not by means of a wall, then by means of cruelty toward migrants, from the squalid conditions in detainee facilities to separating children from their parents.”

“It’s the complete, 100 percent focus on harsher options that will deter the influx, with a disregard for managing what’s happening,” a Department of Homeland Security official told The Times earlier this year. “We have a lot more families, a lot more unaccompanied children, and the focus has just been on how can we deter, rather than how can we handle.”

But, writes The Times:

“…deterrence alone can’t explain a slew of other moves — scaling back a program that protects the families of members of the military and veterans from being deported, for instance. It doesn’t explain the frantic — yet unsuccessful — effort to put a question about citizenship on the census, which experts agree would lead to an undercount of people in immigrant-heavy communities. Nor does deterrence explain removing deportation protections from nearly one million people who live in the country under the auspices of humanitarian programs or because they were brought to the country as children.”

As one of the signs at the “Lights for Liberty” vigil I attended said: “We are better than this.”

We must insist on a rapid end to the cruelty, the family separations, the conditions that are leading to epidemics of scabies, lice, and chicken pox in the overcrowded facilities—even to several deaths.

In addition to comprehensive immigration reform, we need adherence to legal processes and humane care for those who seek asylum—and a Marshall Plan to improve life in their countries of origin so that many of them can return there safely.

One more thing isn’t getting enough attention. The dirty big secret is that illegal immigrants are an important part of our nation’s economy.

Undocumented immigrants pay an estimated $11.6 billion a year in taxes,  and since they tend to live in the shadows, they use fewer governmental services.

If Trump succeeds in substantially lowering the numbers of undocumented immigrants, our economy will suffer. The jobs he claims the immigrants are taking? They are jobs most Americans refuse to accept. Hotels are already worrying about who will clean the rooms; farmers are wondering who will harvest the lettuce.

What’s more, Trump’s policies have also been directed at reducing legal immigration. That, too, will have a negative impact on our economy. Here, verbatim, are some myths and facts about the issue from PBS NewsHour:

Myth #1: Immigrants take more from the U.S. government than they contribute.
Fact: Immigrants contribute more in tax revenue than they take in government benefits.

Myth #2: Immigrants take American jobs.
Fact: Immigrant workers often take jobs that boost other parts of the economy.

Myth #3: The U.S. economy does not need immigrants.
Fact: Immigrants are key to offsetting a falling birth rate.

Myth #4: It would be better for the economy if immigrants’ children were not citizens.
Fact: Children with citizenship are more productive workers.

And an AP fact check on this issue, also from PBS NewsHour, notes the following:

“The fact is that 75 percent of immigrants arrived legally, according to the Pew Research Center. In general, the entire immigrant population is increasingly better educated than native-born Americans.

They’re more likely to have jobs. They’re less likely to commit violent crimes. They help fuel economic growth. And as a group over time, they’re no more a drain on taxpayers than native-born citizens.

Moreover, for all the attention to the southern border, in recent years immigrants to the U.S. have been more likely to come from Asia than from Mexico.”

So I return to the sign I saw at the “Lights for Liberty” Vigil that said: “We Are Better Than This.” I emphatically agree.

And I hope that sometime very soon, most Americans in this, our nation of immigrants, will dismiss the lies and distortions and appreciate the value of welcoming new immigrants (who often become our friends and neighbors), knowing that when it comes to understanding their role in our country—and in our economy— We Are Also Smarter Than This.

Annie

A Cautionary Summer Tale

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I have a few friends who are medical nihilists (several of them are married to physicians). They avoid medical care whenever possible, rarely see a physician, and when they go, generally ignore the physician’s instructions.

I am cut from a different cloth. I go to the doctor for preventive care, get my flu shot every year, and seek medical guidance if I’ve had a problem for more than a few weeks.

I do have several chronic conditions and a bionic knee and wrist. However, I am fortunately, at this point, in good health. (Cue my late mother’s voice here, making clucking sounds to ward off the evil spirits.)

I tend to be super vigilant about medical matters. In fact, as I’ve written previously, I tend to catastrophize. That sudden pain in my leg? The one that’s probably a pulled muscle? Well, it feels hot, so it could be a blood clot, couldn’t it? (I also meditate, but sometimes the worry forces overwhelm the calmness regimen.)

And, having worked as a medical writer/editor in the past, I realize that I possess just enough medical knowledge to be a danger to myself and others. (I do, however, refrain from prescribing–and for the most part avoid misdiagnosing my friends and family.)

Although it’s gotten worse in recent years, as those around me have died—or narrowly escaped death—this tendency on my part to focus on all things medical has been ever so.

I think I’ve known the seven warning signs for cancer since I learned to read. For those who don’t share my fixation, the first sign is “Any sore that does not heal.”

But the tiny mark on my nose seemed insignificant—certainly not a sore as I understood the term. Occasionally, a little dry skin flaked off and the skin beneath looked slightly pink; then it quickly returned to its previous state. I found it curious, but not at all alarming. This went on for months.

One night, when the spot looked pinkish, I dabbed it with a little cortisone cream that my dermatologist had given me for a previous condition.

Shortly thereafter, I stepped into the shower. When I stepped out, I caught a glimpse of my face in the mirror, and blood was gushing from that tiny spot on my nose—it seemed like several tablespoonfuls.

My dermatologist saw me the next day. “It doesn’t look like anything,” she said, poring over it with her magnifying glass. “But whenever there’s bleeding, we do a biopsy.”

The biopsy was definitive for carcinoma, but wishy-washy as to type. At varying times I was told it was a basal lesion with some squamatization, a squamous lesion, or a “collision lesion” of both cell types. The latter made me envision two small bumper cars packed with differing cells, going at each other at high speed.

One point was certain: the innocuous looking thing had to go. I was referred to a Mohs surgeon for a procedure in which the lesion is removed layer by layer while the patient waits for the biopsy report stating that the margins are clear: the cancer is gone.

At the pre-op visit, the surgeon’s nurse drew a fairly large circle around the lesion with a green marker pen. That should have alerted me to what was ahead; it did not.

The surgeon explained her procedure and then said, “I think we should have a plastic surgeon on standby to close the wound.”

I was puzzled. It was so small—surely a few stitches would do. Then she said, “You have a fine aquiline nose; I think it’s wiser to have a plastic surgeon do the closure.” OK. The plan was that I would see a surgeon she works with on such cases; she’d complete her work, bandage me up, and he’d close the wound later that day. Seemed reasonable.

But when I met the plastic surgeon pre-op, he began describing what sounded like pretty dire procedures. “We can take a skin graft from another part of your body that’s close to the color of your nose,” he said. “Or we can do a flap from your forehead.” All of a sudden, this tiny lesion was wreaking outsized havoc on my face.

I spoke with the Mohs surgeon’s nurse, who assured me that the plastic surgeon gave “worst possible scenarios.” I felt better—for a time. I had agreed to the graft, if needed, because the plastic surgeon said if I didn’t like the results, he could always do the flap. But once the flap was done, no revision would be possible.

Fast forward: the cancer was gone after a single layer’s removal: very good news. The plastic surgeon told me to come right over. He looked at the wound and said, “We’ll take a graft from your clavicle; do you mind a scar?”

I was willing to forgo a pristine clavicle for a chance that my “fine aquiline nose” wouldn’t be seriously disfigured. I will acknowledge that my attachment to it has been more than physical and utilitarian.

I was awake through the surgery, and we all laughed at the surgeon’s stories of his parents’ youthful indiscretions. Not sure why he raised that issue, but it did pass the time and take my mind off the snipping and sewing.

He had warned me the healing would take about a year, so I’m more than three-quarters of the way there. There have been bumps along the way—just recently, one quite literally.

I was walking through a revolving door and, certainly not practicing my mindfulness, stepped ahead before the opening had reached me—like a tiny bird ramming into a window. The only part of me that hit the glass was my nose—straight on.

I began icing it as soon as I could and called the plastic surgeon’s office to see if I should do anything else. He returned my call in minutes—an unusual attentiveness that suggested concern.

“In a battle between a door and a nose, the door always wins,” he said brightly. (He’s a good surgeon, but I didn’t need the wisecrack.) “Do you think it’s broken?” he asked. I said I really didn’t think so; it didn’t hurt that much and was simply quite red. “Keep icing it on and off all day,” he responded. “It should be OK.”

The next day, when I awakened to find the skin graft in place and not beside me on my pillow, I appreciated how fortunate I was not to have damaged myself seriously.

Now that I have a portion of my clavicle attached to my nose, I’ve thought about whether it’s still appropriate to call it a nose. It seems more like a hybrid of two heretofore autonomous body surfaces, finding their way to peaceful coexistence.

It’s a strange phenomenon, but I profoundly recognize that in the scheme of things, so many people struggle with far worse medical conditions for many years. I’m very grateful for my situation and do, mindfully, appreciate every day.

Some mildly annoying lifestyle changes go with this new territory. I’ve had three squamous lesions in less than two years (two were in situ—precancerous), of which two were on my face. Thus, I’ve been warned by both the Mohs surgeon and my dermatologist that although the skin damage happened years ago, I must now take extra precautions: sunscreen (more than 30 SPF) all year round, rain or shine; hats with brims; sunglasses; and long sleeves.

In this 90 degree heat, I get some strange looks, but so be it. A woman of mystery–perhaps a secret agent, who has traded her traditional trench coat for UPF (ultraviolet protection factor) garments.

So ends my cautionary summer tale for you—especially those who are young and carefree. Just one or two bad sunburns can do a lot of damage, and mine occurred before we were worried about losing the protection of the ozone layer.

Don’t be cavalier about your exposure to the sun. And please: don’t ignore any small lesions, no matter how innocuous they may appear, if they hang around for a while.

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One more thing: if you’re even thinking about going to a tanning parlor, fuggedaboudit!

Your thoughts, experiences…?

Annie

What Is…?

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It is terrifying and large—
Resembling a giant ink spot, but much more ominous.
Its effect on me seems surreal:
I was comfortably at my desk, fingers moving along my computer keyboard as they always do.
Invariably, my curiosity about the world spills onto the virtual page with relative ease.

But not now.

Wait! I mustn’t. I can’t. I watch as a bystander while that hovering image, imprinted in my brain, constrains me. I have known writer’s block. This is no writer’s block.

Too much, it says. Think again, it commands. Gain control, it insists. 

What is happening to me?

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NOTE:

As anyone who has visited this blog is aware, I do not usually write with brevity. I started writing my posts with a self-imposed limit of 1000 words, understanding that readers have busy lives and don’t always want to plow through long treatises. But I blew through that one fairly quickly because I’m always so fascinated by my topic that I make the assumption (undoubtedly sometimes erroneously) that you will be too.

The above is an experiment in what has been called “flash fiction.” It was inspired by several of my posts receiving “likes” from an entity known as The Drabble, “a site dedicated to publishing original fiction, non-fiction, and poetic works of 100 words or less.” If they could look at my 2000-word essays and assume I could pare down a story to 100 words, that was a challenge I had to take up.

The people behind The Drabble have written:

“You may wonder if it’s even possible to write a good story in fewer than 100 words. We say yes, although it’s certainly not easy. Most modern narrative art adheres in some way to Shakespeare’s three-act structure (i.e., conflict, rising action/crisis, resolution), whilst presenting a clear theme. Must all these elements be present to tell a good story? Grant Faulkner, co-founder of 100 Word Story, thinks so. In his essay, ‘Writing with Gaps,’ Faulkner says,

‘I think the best 100-word stories move with the escalation any story has. They have a beginning, middle, and end—a telling pivot, an emotional velocity.’”

And they add this description from Hemingway:

“If a writer knows enough about what he is writing, he may omit things that he knows, and the reader…will feel those things as strongly as though the writer had stated them. The dignity of movement of an iceberg is due to only one-eighth of it being above water.”

The concept of “flash fiction” is reportedly traceable to three men at the UK Science Fiction Society at Birmingham (England) University—and inspired by the wacky Monty Python group, who wrote about it in Big Red Book, published in 1971. According to drablr.com (The History of the Drabble),”The participants gathered around a fire, sipping brandy and partaking of pleasant conversation with friends and challenge each other to write a novel. The first to finish wins.”

I won’t go into the origins more deeply, but they actually stretch back to Mary Shelley (author of Frankenstein) and have more recently included works by such prominent science fiction writers as Arthur C. Clarke and Isaac Asimov. If you’re interested, you can read more about the history of the form here.

This background provides you with the impetus for the piece above. It is precisely 100 words, so I succeeded in terms of brevity, which was my own big question mark. Brevity alone is fine, but not enough. I am eager for your reactions. Did this mini-story catch and hold your interest? Do you think I met the sense of the Drabble as it’s been outlined? Is this a welcome change from my verbosity—or not? Please be candid in your responses. I am a nonfiction writer dabbling/drabbling in a new garden.

Annie

From Three Cookies to One–or None: How Do We Break Our Bad Habits?

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Did you know that Facebook Addiction Disorder is really a “thing”—and not a FAD? (Sorry, another bad pun—and so soon!) It’s not in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but it, and obsessive Internet use in general, is increasingly drawing the attention of psychiatric researchers.

I plead guilty. Not to checking Facebook frequently, though I do look at it most days. But I am heavily Internet-dependent—so much so that I recently had to upgrade my iPhone because I ran out of space and couldn’t get access to many of my apps (including my mindfulness app, which is, coincidentally, supposed to keep me in the moment).

There’s just so much stuff out there to learn, including what all the wonderful bloggers I’ve become acquainted with are up to, and why the plural of octopus is octopuses, not octopi (which I’ve written about), and what’s the name of that movie I saw years ago/last week, and, in truth, how many people are visiting my current post?

(My new phone has a feature that I could live without—almost as though it’s in league with these researchers [?]: it tells me my average daily screen time from the previous week, in hours and minutes.)

None of this may sound very serious, but it’s all tied up with how our brains function. And, perhaps not surprisingly, it’s connected to all those other areas of our lives that we know we should better control—such as overeating, smoking, and stressing about things real or imagined.

Why, if we’re so smart, and we know what we should do, is it so hard for us to follow through? Are there ways that we can take better control of our lives—without investing a fortune of time, money, and energy?

Judson Brewer, MD, PhD, thinks there are. Brewer is an addictions expert, an associate professor in psychiatry at the School of Medicine at Brown University, where he serves as the Director of Research and Innovation at the Mindfulness Center, as well as a research affiliate at MIT.

He’s the author of a book with the less-than-succinct title: The Craving Mind: from cigarettes to smartphones to love, why we get hooked and how we can break bad habits, published by Yale University Press in 2017.

Brewer has successfully used mindfulness training to get people to stop smoking, lose weight, reduce anxiety, and break all sorts of bad habits. I haven’t read his book, and none of the three videos of him that I watched mentioned “love,” so I regret that I can’t enlighten us in that regard. The quotations in this post are primarily from a TEDMED Talk he did in 2015. The bolding for emphasis throughout is mine.

It’s no small irony, by the way, that he’s now creating apps to bring this training to people where they’re most likely to use it. See www.goeatrightnow.com; www.unwindinganxiety.com; www.cravingtoquit.com. He offers free trials, but I’m not endorsing these, and I haven’t tried them.

If you’re thinking, “Oh, Annie, not another thing about mindfulness,” I can tell you that although I am a practitioner and I believe both individuals and the world would be better off if more of us were, I think you can put some of Brewer’s insights to work without getting deeply involved in the practice.

Let’s start with the brain because that is, of course, central to this approach. The prefrontal cortex, which Brewer points out is “that youngest part of our brain from an evolutionary perspective,” is where cognition resides.

So we can figure out, for example, that having a dozen brownies in a single sitting is not a smart thing to do. But they taste so good, and if we’re sad, or stressed, we just keep that hand-to-mouth action going. Sometimes we don’t feel very good afterward, but that doesn’t stop us from doing it again.

This behavior is linked via evolution to our needs for survival. In a convoluted way, here’s how we get to that dozen brownies. Calories equal survival. And sugar, as we’ve increasingly learned, holds a special allure. As Brewer explains, our bodies send a signal to our brains:

”Remember what you’re eating and where you found it…See food, eat food, feel good, repeat. Trigger, behavior, reward.”

Then we learn that the food we began eating for survival can serve other purposes:

“You know, next time you feel bad, why don’t you try eating something good so you’ll feel better? We thank our brains for the great idea…and quickly learn that if we eat chocolate or ice cream when we’re mad or sad, we feel better.”

What began as survival has become something more complex.

“We’re fighting one of the most evolutionarily conserved learning processes currently known to science, one that’s conserved back to the most basic nervous systems known to man.”

That is positive and negative reinforcement. And the problem is that, as sharp as our thought processes may be, they’re simply not strong enough to hold back the forces of stress. As Brewer says:

“We’re using cognition to control our behavior. Unfortunately, this is also the first part of our brain that goes offline when we get stressed out.”

Of course, the process is more complicated than this, involving the neurotransmitters dopamine and serotonin, as well as other portions of the brain, but I think we can get the idea without a detailed neurology lesson.

Brewer doesn’t mention the reptilian brain, the oldest portion, the one that enacts the fight/flight/freeze response under stress. When we need cognition the most, the reptilian brain slithers to the forefront. (I’ve written about my personal struggle between my prefrontal cortex and reptilian brain previously. Guess who won?)

To find out how to break this cycle, it’s worth looking at the success Brewer and colleagues have had in helping patients stop smoking, which is the toughest addiction of all to overcome. They tested whether mindfulness training could help people quit.

Brewer has explained that when he started practicing mindfulness meditation, it was a terrible strain to keep his focus on his breath, to try to continue paying attention. I think anyone who’s ever tried mindfulness understands this challenge; I certainly do.

But he resolved the struggle when he realized that he needed to turn to the “natural reward-based learning process” of “trigger, behavior, reward,” adding what he called “a twist: What if we just got really curious about what was happening in our momentary experience?”

He applied the concept of curiosity to the smoking research. Instead of telling their patients not to smoke, he and his colleagues said the reverse. “Smoke, but be really curious about what it’s like when you do.” And here’s a report of how it worked. One woman said:

“Mindful smoking: smells like stinky cheese and tastes like chemicals. YUCK!”

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Says Brewer:

“Now she knew, cognitively, that smoking was bad for her; that’s why she joined our program. What she discovered just by being curiously aware when she smoked was that smoking tastes like s—t.

“Now she moved from knowledge to wisdom….the spell of smoking was broken. She started to become disenchanted with her behavior.”

This happens over time, he emphasized: “as we learn to see more and more clearly the results of our actions, we let go of old habits and form new ones.”

Brewer refers to one study they did that found mindfulness training (MT) was twice as effective as the American Lung Association’s Freedom From Smoking (FFS) treatment, which is considered the gold standard. The MT group both reduced their smoking and showed continued greater abstinence during followup.

It’s still not easy. The prefrontal cortex, Brewer says,

“understands on an intellectual level that we shouldn’t smoke. And it tries its hardest to help us change our behavior, to help us stop smoking, stop eating that second, third, fourth cookie. We call this cognitive control.”

And then we fall back into our old habits. But like the woman smoker, once we understand our habits on a deeper, more visceral level, our interest in pursuing them lessens.

With mindfulness, instead of turning away from unpleasantness or fighting it, we turn toward it and regard it with curiosity, which is naturally rewarding. And it helps us see that cravings are discrete sensations that come and go, so we can manage them from one moment to the next, “rather than getting clobbered by this huge, scary craving that we can choke on.”

In an interview, Brewer differentiates between intellectual curiosity and experiential curiosity. The one that makes a difference is the latter.

Our curiosity, he contends, permits us to

“step out of our old, fear-based reactive habit patterns, and we step into being. We become this inner scientist where we’re eagerly awaiting that next data point.”

So people who smoke or eat due to stress or feel compelled to do any of a myriad of things they know they shouldn’t can be encouraged to be curiously aware when the urge hits them. To paraphrase an old adage: Curiosity becomes its own reward.

And now we return to the Internet. Do you surf or check your email when you’re bored, or lonely, or just feel you have to? And then feel bad about all the time you’ve wasted, and what else you could have accomplished, but didn’t?

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Brewer suggests trying instead to be curiously aware of what’s happening in your body and mind at that moment. You’ll have the chance either to “perpetuate one of our endless and exhausting habit loops—or step out of it.”

He concludes:

“Instead of ‘see text message, compulsively text back, feel a little better,’” he says, do this:

“Notice the urge, get curious, feel the joy of letting go. And repeat.”

How does all of this strike you? Do you find it feasible? Are you tempted to try it? Do you have stories to share about how you have overcome bad habits—or have failed to do so?

Annie

23&WE: The Democrats Debate (With apologies to Chaucer for imperfectly borrowing his rhyme scheme)

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From The New York Times:

“Two nights, four hours, so, so many candidates: the first Democratic presidential debates will be like nothing we’ve ever seen. A former vice president on stage with a self-help author. Three female candidates on one night, three female candidates the next — more than have ever been on the debate stage at once. A 37-year-old squaring off against two septuagenarians.”

******

Now listen, friends, as I unveil the chorus
Of those I’m calling 23&WE.
We’re not discussing folks who came before us;
It’s those who say what this country should be
And how they’ll make enough of us agree.
They’re poised to set out from the starting gate,
And one of them may well decide our fate.

How do they call attention to their vision
And talents that will make them best to lead?
So many voters now voice skepticism
Re: turning those fine words to solid deeds
To build a worthwhile new American creed
That knits together vastly different types
Of folks who harbor vastly different gripes.

The polls agree the leader’s now Joe Biden,
A man well known who was a fine VP.
Experienced in world affairs, he’s ridin’
On hopes he’ll bring us back to normalcy
And thus is safe to take down Covfeve.
But some say Uncle Joe is just too dated,
And can’t forget Anita Hill deflated.

There’s Bernie S., who never seems to waver;
In 40 years he hasn’t turned the page.
He’s moved the Dems on issues gaining favor:
Medicare for all; a $15 wage.
But others now are acting on that stage.
A Democratic Socialist with pride,
If he falters, would he just step aside?

Someone to watch, the pundits say, is Warren,
On each issue she has a plan, for sure.
An ultra-millionaire’s tax could be transformin’
With free child care for all and so much more.
For inequality she has a cure.
But will pro-banker, moneyed folks resist,
Despite her self-description: “capitalist”?

One candidate whose fame has come quite quickly
Is South Bend, Indiana’s Mayor Pete
(Trying to rhyme his last name is quite tricky)
His scholar/military resume is neat,
But politically he fits into a tweet.
Still, he has generational appeal
And messaging that sounds both wise and real.

Kamala Harris, tough in prosecuting
Won plaudits for her querying Bill Barr.
She says in office she’d be executing
Punishments for employers who’re sub-par
In the male/female equity pay bar.
A woman of color, bona fides deep,
She’s on a lot of short lists for the Veep.

Amid the current tones of acrimony,
Cory Booker’s words sound so very nice.
He talks of love, civic grace, and harmony
And exhorts men to protect women’s rights.
And cares a lot to end our urban blights.
This Rhodes Scholar who’s certainly no fool
Has Wall Street ties and supports charter schools.

Amy Klobuchar is praised quite highly
Across the aisles in a once true blue state
She’s also known to view events quite wryly,
And humor’s in too short supply of late.
Some feel her plans don’t carry enough weight.
But one’s important, not just symbolically:
Her push for statehood for Washington, DC.

Beto leapt to fame by losing narrowly;
In Texas that was seen as quite a feat.
His campaign started off quite powerfully
And then began to lose a bit of heat,
Though he engages each voter he’ll meet.
His message is important as can be:
Immigration: with “respect and dignity.”

I’ve long thought that the job of governor
Makes President a ready move to make.
There’s Hickenlooper, Inslee, and another:
Steve Bullock, who will miss next week’s debate.
Each has records touted as first-rate.
And each has worked to combat climate change
With Inslee’s speech most often in this range.

It’s time, say many Dems, to crack that ceiling
Re: healthcare, equity, diversity,
To all these goals the party is appealing
And I believe that voters sensibly
Will weigh their thoughts while seeking to agree
And try to find which candidate’s around
Who’s most likely to find that common ground.

I see I’m in trouble here numerically,
And fear my rhyme is starting to grow weak.
I’ve gone through less than half the twenty-three.
There’s still a dozen more of whom to speak,
And showtime’s coming middle of next week.
But since to verses’ end you’ve still held tight,
You’ll find all contenders’ pitches through this site.

******

I clearly gave only the briefest attention to the candidates I covered, and none at all to the rest. Here is how they present themselves to voters:

  1. Joe Biden: JoeBiden.com
  2. Bernie Sanders: BernieSanders.com
  3. Elizabeth Warren: ElizabethWarren.com
  4. Kamala Harris: KamalaHarris.org
  5. Pete Buttigieg: PeteForAmerica.com
  6. Cory Booker: CoryBooker.com
  7. Beto O’Rourke: BetoOrourke.com
  8. Amy Klobuchar: Amy-Klobuchar.com
  9. Andrew Yang: yang2020.com
  10. Jay Inslee: JayInslee.com
  11. Julian Castro: JulianForTheFuture.com
  12. Tulsi Gabbard: tulsi2020.com
  13. Kirsten Gillibrand: 2020.KirstenGillibrand.com
  14. Marianne Williamson: marianne2020.com
  15. John Delaney: JohnKDelaney.com
  16. Tim Ryan: TimRyanForAmerica.com
  17. John Hickenlooper: hickenlooper.com
  18. Bill de Blasio: BilldeBlasio.com
  19. Steve Bullock: SteveBullock.com
  20. Michael Bennet: MichaelBennet.com
  21. Eric Smalwell: EricSwalwell.com
  22. Seth Moulton: SethMoulton.com
  23. Wayne Messan: WayneForAmerica.com

I know it’s early, but if you’re committed to the idea that we need new leadership in 2020, these debates are important in winnowing the field, and you may find yourself wanting to support someone who hasn’t yet gained much public attention.

So I hope you’ll watch the debates, review the candidates’ positions as they state them on their web sites, and support the candidate(s) of your choice. Small donations will be vital for qualifying for subsequent debates, so please consider even minimal financial support of candidates as well.

FIRST DEBATES: JUNE 26, JUNE 27 ON NBC, MSNBC, AND TELEMUNDO

Annie

Music to “Stretch Our Ears”: Beethoven, Beatles, Blues…

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I can’t carry a tune, and no one would ever accuse me of having perfect pitch. But I love music—so many different kinds of music, preferably live. At some point in my life, I’m determined to see Bruce Springsteen in concert—even though I hate crowds.

But one type of music really transports me: the fully realized magnificence of a fine symphony orchestra. Fortunately,  there is such an orchestra that performs fairly close to my home, and my husband and I have had a series subscription with friends for the past few years. 

Thursday night was the season finale—and it was a whopper, appropriately titled the “Blockbuster All-Orchestral Season Finale.” For those of you who don’t love classical music, imagine attending a concert given by your very favorite band, and I think you’ll get the mood.

First of all, the conductor is a wonder: a tiny slip of a woman who exudes energy, power,  and artistry with her every move and gesture—sort of a woods sprite with a baton.

This was the only time she’d appeared this season, as there were guest conductors, and when I told my husband I wished I could have seen her more often, he said, “Just put her in your pocket and take her home.” She’s really really tiny.

I’ve been told that the orchestra loves her, and it’s clear she returns the favor. So from the time she reaches center stage, everyone is happy and optimistic.

The program featured Mendelssohn, Selections from A Midsummer Night’s Dream, Op. 21, which begins very softly and ends with The Wedding March, which you’d recognize immediately.

According to the program notes, the young Mendelssohn had been sitting with his family as they entertained an astronomer, their guest describing the contents of the sky far above.  When Felix went out for a walk, he headed for the garden 

“to gaze at the stars that had been the primary topic of conversation at the dinner table. His attention was diverted by the gossamer activity of the summer night.” 

Four evening breezes were purportedly the inspiration for the four woodwind chords that open and close the overture. The delicate violin string segments were his “musical impression of fireflies flickering about the nocturnal atmosphere.”

Years later, Mendelssohn said, “That night I encountered Shakespeare in the garden!”

That lovely piece was followed by a Rachmaninoff symphony: No. 2 in E Minor, Op. 27. Absolutely breathtaking. Apparently, it took the composer years to complete, as he was filled with self-doubt. 

The program notes state: “The music is lush and relaxed. This is an expansive symphony in the late Romantic vein: heartfelt, emotional and long.” (Not long enough for me!)

As is often the case with classical music, one of this symphony’s themes has made its way into popular music: it appears in the song “Never Gonna Fall in Love Again,” which was a hit in 1976.

I find that one of the delights of listening to a beautiful symphony, in addition to the aural pleasure, is being in such a civilized environment. As those of you who are familiar with my blog know by now, I’m always seeking common ground. Sitting in a large group of people enjoying a common experience—away from all politics and divisiveness—is a joy in itself.

But here’s the rub. Entering and leaving the concert, I see a vast number of people with canes, walkers, and wheelchairs. It’s inspiring to see folks who don’t let their infirmities stop them from participating in these events, but I wonder how viable this orchestra, and others, are when I’ve read that the average age of symphony orchestra attendees is 60. (I suspect in our locale, that average may well be considerably higher.)

I’m not the only one to express such concerns, of course, and it’s not a new one. I did find one optimistic note from a 2004 article titled: ”Probing Question: Is classical music still relevant in today’s world?” According to George Trudeau, Director of the Center for Performing Arts at Penn State, 

“Classical music is alive and well. What has changed is there are more avenues than ever before for classical performance and public education, including public radio, the internet, and other digital technologies.”

Penn State’s Center was actively seeking to stimulate appreciation of classical music in students, faculty, and community members through a diverse program involving artists in residence and such efforts as “experiencing the music in alternative venues and informal settings such as our Classical Coffeehouses.”

Trudeau said then that attendance at the various classical music performances by Penn State students had risen from 26% of total sales to 40% in three years, and that students told him “exposure to classical music was enriching their lives.”

So perhaps there’s hope that coming generations will still find their way to the symphony. I have noticed that when a very young guest performer appears at the programs we attend, many very young people show up in the audience. 

Similarly, several months ago, my husband and I attended a One Day University lecture on “How to Listen to (and Appreciate) Great Music,” given by Orin Grossman of Fairfield University and featuring several incredibly talented young musicians from a local arts public high school. 

There the emphasis was on chamber music, and Grossman discussed melody, recurring themes, the dominance of the piano, the way the composer would get himself far out on a limb and then musically work his way back, and other elements.

He demonstrated his points by asking these gifted musicians to pick up the relevant pieces of the classics and play them—and they did, flawlessly. It was a joyous occasion—and wonderful to see these young symphony performers in the making.

Yesterday, I found that One Day University had a revised version of Grossman’s lecture available online. The title was the same, and the purpose was once again to encourage active listening “in order to ‘stretch our ears’ and get more pleasure from the musical experience.”

While I’d been worrying about the diminishing presence of symphony orchestras, Grossman was underscoring how much luckier we are than people long ago, who had little or no access to great music.

“We have the opposite problem,” he said. “It’s so accessible we try to tune it out and become very passive.” It’s fine to use music as background and simply to relax, but he was stressing how much more gratification we get when we “stretch our ears.”

In contrast to the live lecture with Grossman that we’d attended, the selections of great music this time were more varied–and he was the sole performer. The focus was on melody and how the composer treats it. Yes, there was Bach, who’d either combine two melodies or, more commonly, create a “dialogue” of melodic fragments, as in the Concerto for Oboe and Violin.

Grossman easily segued from Bach to the Beatles, whom he considers the best musicians in decades and whose music he believes “holds up very well.”

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The Beatles, holding up very well!

Using John Lennon’s song “Girl,” he illustrated how Lennon pushed the boundaries by introducing second melodies, returning to the melody with a guitar backup.

Next, he spent time on Duke Ellington, saying he had been misunderstood as merely a bandleader when he was “one of our greatest composers. From the 20s to the 70s, he gave a name to the Swing Era: ‘It Don’t Mean a Thing If It Ain’t Got That Swing.’” Grossman played and stopped a recording of the song several times so we could hear the call and response as the brass swings.

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Duke Ellington: Composer, musician, bandleader

“The harder you listen to where it’s going—you’ll be tricked,” he said impishly.

For no reason I could discern, he returned to the classics and Beethoven at this point, which was fine with me once I got accustomed to the temporal whiplash. He pointed out that in the movie “The King’s Speech,” Colin Firth as King George VI must address the nation despite his stuttering. As he gets to the microphone, in the background we hear the chords from the second movement of Beethoven’s 7th Symphony in a repeating rhythm. 

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Ludwig van Beethoven

The intensity and power of Beethoven’s music are often built through fragmentation of the melodies, which finally explode into heroic sounds, as “metaphors of victory through struggle,” Grossman said. Perfect reinforcement for the King’s message to his people.

He ended with George Gershwin’s “Rhapsody in Blue,” which combined elements of life in New York–and by extension, America–the Blues, Latin rhythms, ragtime, and Broadway band ballads, to illustrate the “clashing and blending” of the various cultures.

“The imagery interlocking the piece is trying to show one version of the United States,” he said. “At heart, it’s a good mystery: you wouldn’t want everything explainable.”

No, we wouldn’t. And if you have an extra 17 minutes and would like to test your active listening skills for discerning the various elements Gershwin intertwined, go to YouTube’s video of Leonard Bernstein and the New York Philharmonic playing “Rhapsody in Blue.” (You can skip the ads.)

I return to the sense of civilization and common ground that I feel when I listen to the soaring music of a symphony in concert with fellow music lovers (a little pun here). Regardless of your taste in music, at any live venue, there’s always a sense of community, of sharing your enjoyment with others. And music is so often tied to memories that such a sharing can be a part of your pleasure even when you’re listening alone. I felt that way watching the video of “Rhapsody in Blue,” in which Bernstein both conducted and played the piano.

Do you like to “stretch your ears” with active listening to music? If this is a new idea to you, is it appealing? What type of music do you prefer, and what role does music play in your life? Do you/did you play an instrument? How often do you hear live music? Would you go more often if it were more convenient? Less financially burdensome?

I look forward to your comments. In fact, I’m all ears.

Annie

My Journey From DNA Test Skeptic to Participant

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Not so many months ago, I wrote a post about the “Wild West Marketplace” of consumer genetic testing. That description came from Laura Hercher, a highly respected genetics counselor whom I interviewed for the piece. Though our focus primarily was on the entertainment aspect of consumer DNA testing (tracing one’s ancestry, etc.), we also discussed the more serious health implications. I find the topic fascinating, but I thought I’d leave it there. Hercher pointed out many of the flaws and potentially false results that these tests may yield.

Then events made me take a second look at the feasibility of genetic testing in my own life: my sister died of pancreatic cancer, only 43 days after she’d been diagnosed. (Despite our grief, in view of the horror of this disease, we all realized that the brief time period was a blessing). Knowing that my mother had had bilateral mastectomies for breast cancer, and that her mother had died in her 50s from what we thought was liver cancer but could have been a metastasis from breast or other site, I began to think about my likelihood of developing a heritable cancer. 

And—even more to the point—I thought about my daughters. My gynecologist had told me years ago that I owed it to my daughters to find out if I carried variants in the BRCA1 and/or BRCA2 genes, which are associated with cancers of the breast and ovaries and—it turns out—pancreas as well. At the time, genetic testing cost more than $5000, so I never followed up on her recommendation. It’s worth noting here that the preponderance of women who develop breast cancer have no known risk factors.

As a former health writer/editor and continuing catastrophizer, I immediately felt I needed more information about pancreatic cancer. The heritable component ranges from 5% to 10%. But I knew that unlike some cancers, which are now being regarded as chronic diseases, pancreatic cancer carries a prognosis that is usually dire. The American Cancer Society reports that pancreatic cancer accounts for about 3% of all cancers in the US—and about 7% of all cancer deaths. That high mortality rate is because it’s nearly always diagnosed late, after it has metastasized. 

But I wondered: if I tested positive for the pancreatic cancer variant, were there any monitoring programs that might make it possible to find the disease at an earlier stage? And were there medical genetic tests that were more reliable than some of the “consumer DNA” ones that Hercher had discussed?

My research led me to Johns Hopkins, one of the medical centers doing considerable work in this field, and they did, indeed, have a surveillance study for those who’d tested positive for heritable pancreatic cancer. Knowing that gave me a sense of control in the midst of my personal concerns and while my sadness at the sudden loss of my sister was still quite raw. The people I spoke with there suggested that I have heredity genetic cancer screening done—and they recommended as a reliable company Color Genomics.

I contacted Laura Hercher, told her about my sister’s death and my family history, and sought her advice. She and a friend/colleague who specializes in cancer counseling agreed that my family history of breast cancer merited testing and was more likely to be associated with a positive test result than the pancreatic cancer: “likelihood of a positive test result there is 10% times 1/2, since there is a 50% chance you share any gene your sister had—but I would say less than that because the cancer occurred over a certain age.”

But she also included a link to an article suggesting that every pancreatic cancer patient should consider genetic testing. Although she had been skeptical about pancreatic cancer screening because there’s no proven way to do it, this article suggested that screening may be effective for both patients and families.

However, she added a caveat: “Understand that our track record with screening for cancer is pretty dismal. Many things that sounded great on paper didn’t result in fewer deaths…but still worth considering.”

She recommended Color Genomics, the same company that Johns Hopkins had suggested, so I felt confident with those dual recommendations from trusted sources. I’m not suggesting they are the only reputable firm, of course.  A friend who works in cancer education for oncologists said she’d heard positive things about Invitae, and I’m sure there are others as well. 

I encourage anyone who is considering this action to do some research and talk with medical sources you trust.

I spoke with my physicians. My primary care physician was skeptical, asking me to think through what I’d do with the results. Both my gynecologist and gastroenterologist thought testing was a good idea in my circumstances and offered to write the medical requests necessary to get the test (more on this shortly). My gynecologist said that although many of her patients who test positive for these mutations opt to have their ovaries removed, if I chose not to do so, I could have half-yearly ultrasounds and Ca-125 blood work, which indicates the presence of cancer.

I also had intense interest in joining a pancreatic cancer surveillance study—for myself and my family, as well as to add to scientific understanding of the disease that took my sister’s life and is occurring with greater frequency.

But I had to think long and hard about my mental mindset. Which way would I worry more—if I had the test and received positive results, or if I didn’t have the test and was left to wonder? Of course, as Hercher had stressed in my interview with her, and we all should keep in mind: testing positive for a cancerous genetic mutation does not necessarily mean an individual will get that cancer, and testing negative doesn’t mean that individual won’t. We’re advancing our knowledge of genetics all the time, but so many other variables may play a role in specific cancers—diet, lifestyle issues, environmental aspects, and plain dumb luck among them. 

I also did some due diligence: checking resources from the American Cancer Society, the U.S. National Library of Medicine, and the National Cancer Institute. The latter carried this caveat about using Direct to Consumer (DTC) genetic tests:

“Even when people have DTC genetic tests for gene variants that are known to be associated with inherited cancer susceptibility syndromes, there are potential risks and drawbacks to the use of DTC testing. For instance, some DTC genetic tests look for variants in the BRCA1 and BRCA2 genes that are associated with Hereditary Breast and Ovarian Cancer Syndrome (HBOC). However, this testing looks only for three specific variants out of the thousands that have been identified. Therefore, someone could have a negative result with this kind of test but still have a harmful BRCA1 or BRCA2 gene variant that was just not identified by that test. In particular, without guidance about the most appropriate genetic testing to do and interpretation of the genetic test results from a knowledgeable health care provider, people may experience unneeded anxiety or false reassurance, or they may make important decisions about medical treatment or care based on incomplete information.”

This is an important reminder that if you opt for inherited cancer genetic testing, you must be cautious about the source you select.

Ultimately, I couldn’t get past the idea that if I didn’t get tested, I wasn’t doing everything I could to protect my daughters. What they did with the information would be their decision, but I felt I needed to get it for them.

I bought the Color Heredity Cancer Test from Amazon for less than $200. It tested for 30 known gene mutations associated with breast, ovarian, pancreatic, stomach, colorectal, and uterine cancers, and melanoma. 

Here’s where the doctor issue arose. My physicians were right that a doctor’s authorization was needed, though that information wasn’t provided on Amazon or on the Color site—until I registered to proceed. Then I was told that I needed my doctor’s approval. Color company representatives were accessible by phone and said that since I didn’t have that approval, one of their doctors would review my personal and family history and the final results at no extra fee.  I also knew a genetic counselor would be available for me to talk with once I received my results.

It was time to act. After reading the directions not to eat, drink (even water), smoke, or chew gum for 30 minutes before providing the saliva sample, I followed the three simple steps as described: 1) Activate your kit online; 2) Provide your saliva sample [tube included, and a clear video available to answer any questions]; 3) Return kit via the US Postal Service. 

I was promised results within four weeks. I then did an amazing thing for a catastrophizer: I put all thoughts of the test and its implications out of my mind and didn’t agonize at all.

Two weeks later, an email arrived informing me that my test results were attached. I felt fortunate that the timetable was earlier than stated: I didn’t have time to anticipate the arrival.

I took a few deep, cleansing breaths, relaxed my tense shoulders, and opened the email.

I had tested negative for all 30 genetic variants. 

I breathed deeply again—this time with considerable relief—read all the disclaimers (which I knew: results meant no guarantees one way or the other), and decided that I’d avail myself of the talk with the genetic counselor just to see whether there was additional information I could learn. 

The woman I spoke with said my findings “didn’t give us much insight.” There was a possibility, she said, that my mother had a genetic mutation that I didn’t inherit—or a gene that hasn’t yet been identified as playing a role in these diseases. 

And she observed that since new genetic information is becoming available all the time, it’s probably a good idea to be tested every two to five years. That recommendation struck me as having a bit of a marketing tinge. 

As far as I can see, I’m done now. I’m grateful for the results, which mean I won’t have to worry about what I might have passed along to my daughters in this regard. And I won’t need extra monitoring myself—or to enter into a pancreatic cancer surveillance program.

Time to remind myself of mindfulness meditation: not to regret the past or worry about the future—just savor the present, each and every minute of it.

How does all of this strike you? Aside from ancestry testing, if you know you have a family history of cancer, have you, would you, will you consider cancer heredity genetic testing for future medical issues?  If so, under what circumstances? (I certainly understand the thinking of those who choose not to know.)  Your insights, opinions, and stories are, as always, most welcome.

Annie

 

How Do We Talk About Race in America? An Unfortunate Update…

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In these highly partisan and polarized times, there’s been a fair amount of talk denigrating what’s referred to as identity politics. Why should we be talking about the needs of individual groups when we really should be finding ways to unite us as a country?

Many well-meaning people stake out this position, and as my blog is devoted to finding common ground, I understand that sentiment—and feel we must pursue both goals simultaneously. I long for the time when we are all so comfortable with one another that we embrace our differences, while those differences recede in importance in the ways we respond to each other. But we sure aren’t there yet.

In Part 2 of my exploration, “How Do We Talk About Race in America?,” I spoke with Doug Glanville, a friend of my daughter’s whom I’ve known since they were children. After graduating as an engineering student from the University of Pennsylvania, Glanville has gone on to do great things in his life: his rich and varied career, which included nine years of playing major league baseball (twice with the Chicago Cubs), now involves being a sports commentator, writer, podcast co-star, and lecturer at Yale University, teaching a course titled “Athletes, Activism, Public Policy, and the Media.” He is a uniter and optimist by nature—confronting racial injustice when needed but always trying to put it into perspective and not overreact.

In my previous post, we discussed his being profiled by a police officer from a neighboring town while shoveling the snow off the driveway of his Connecticut home. His response was to work toward what eventually led to a change in state law governing police jurisdictions. He received an apology from the governor, who appointed him to the Connecticut Police Officers Standards and Training Council.

Somehow, due to his largeness of spirit, he retained no animus toward the police officer who confronted him, viewing the episode instead as an opportunity to work with the police to improve their procedures. He told me when we spoke that he likes to “take lemons and make lemonade.”

Well, life just handed him another big lemon, which he described in The New York Times Sunday Review. (He’s also a contributing opinion writer for the Times.) I hope everyone will read his entire Op-Ed: it’s a powerful, nuanced, sophisticated view from a very thoughtful person about issues we should all be aware of and thinking about. Here’s the beginning:

“Ambiguity has always been a friend to racism.

On May 7, during a television broadcast of a Chicago Cubs game at Wrigley Field, I was on camera doing in-game commentary for NBC Sports Chicago when, unbeknown to me, a fan behind me wearing a Cubs sweatshirt made an upside-down ‘O.K.’ sign with his hand.
The meaning of this hand gesture can be ambiguous. It has long been used to simply say, ‘O.K.’ Some people also use it to play the ‘circle game,’ where you hold your hand below your waist and try to get others to look at it. And most recently it has been co-opted to express support for white supremacy. The man accused of committing the New Zealand mosque massacres flashed this sign during his first court appearance.

Because I am a person of color, the fan’s gesture suggested its sinister meaning.”

He wasn’t aware of what had happened until after the game, when he noticed his Twitter feed “overrun by strange avatars, unrecognizable handles, aggressive trolls and a heated debate about racist imagery.” There was considerable discussion about whether the man’s actions were or were not sinister.

And that ambiguity is precisely the point, Glanville writes.

“According to the Anti-Defamation League, users of the online message board 4chan originally introduced the idea that the ‘O.K.’ sign was a white supremacist prank to get the media to overreact to innocuous gestures—but the sign soon morphed into a genuine expression of white supremacy as well.”

In other words, we are all being gaslighted by the most racially extreme elements among us. But for people of color, including those like Glanville who still manage to be optimistic about race in America, this gaslighting is particularly odious and exhausting—the degree of fatigue varying with the extent of racism they’ve experienced in their lives.

Glanville seeks to explain what it’s like by depicting a coordinate graph in which people of color might plot the various episodes that could be racist that have either happened to them or they’ve heard about.

“The x-axis represents the passage of time and the y-axis represents the degree of racism of an episode—from someone’s assumption that you’re a valet when you’re parking your own car to the burning of a cross on your lawn. For each experience, you mark a dot.”

The pattern that emerges when those dots are connected, Glanville says “allows you to notice correlations, to make predictions. You are learning from evidence, in part for your self-preservation.”

Then comes the tricky part, when someone who has learned from such evidence meets with an individual who hasn’t had similar exposure.

“He sees evidence of racism only from time to time, and when he does, it tends to be stark and unambiguous—the use of racial slurs, an explicit avowal of hate.”

To this person, “racism seems to be a rarity, maybe even invented.”

Glanville, who teaches courses focused on communication, wonders how he can convince such a person of the pattern he sees, when the listener is inclined, based on his own experiences, to depict subtle racism as an “isolated incident” and even accuse Glanville of “playing the race card.”

How often have we heard that phrase in our political rhetoric?

Equally troubling, the person may say all this talk about racism is just making things worse.

Glanville stresses that he, and most people of color, continually look for the innocuous explanation, trying not to think the worst of people. He recognizes that despite the overwhelming evidence from the data he’s experienced, he can be wrong in a particular instance.

“An ‘O.K.’ sign means nothing on its own. But racism thrives in ambiguity, in shadows. In this form, it is cowardly with double meanings.”

Despite his instincts, he didn’t immediately condemn the Cubs fan who made the gesture. He waited until the facts were in. Indeed, the Cubs quickly did an investigation, found that the fan’s intent was malicious, and banned him from Wrigley Field.

The Washington Post (May 8) quoted the Cubs’ president, Theo Epstein: “We’ve made clear how egregious and unacceptable that behavior is, and there’s no place for it in our society, in baseball, and certainly no place in Wrigley Field.”

Said Tim Elfrink, the Post writer:

“The case marks the latest high-profile emergence of the hand symbol and suggests yet again how thoroughly troubling language and memes pushed by the alt-right and adopted by hate groups have infiltrated American culture. But such gestures, which can run the gamut from ironic jokes to long-running games to outright symbols of intolerance, are also notoriously difficult to interpret.”

It bears repeating that ambiguity is precisely the point. The Post quotes Salon writer Amanda Marcotte, who observed that the O.K. sign was to serve as both white supremacist symbol “and also one that is just ordinary enough looking that when liberals expressed outrage, the white supremacist could play the victim of liberal hysteria.”

And as Glanville points out, the impact of ambiguity on people of color can be profound, making them feel…

“That their sanity hinges on a single verdict. If the Cubs fan was flashing a white nationalist sign, we are in danger; if he was not, we are ‘politicizing’ things or ‘race-baiting.’ This is an incapacitating position to find yourself in, especially when you are just an innocent bystander. You are thrust into the public eye and forced to relitigate the existence of racism. Before you know what has happened, you find yourself on the defensive.”

And Glanville draws the very straight line from such soul-bashing episodes of racism as symbol to racism as system:

“…institutional power that can crush neighborhoods, generations of children, stripping people of validation, self-worth and opportunity. Those who have been on the losing end of this power are never certain that they will be O.K.”

Still, he holds out hope that we as a society will “choose the path of empathy and hope.” pointing out that baseball “is played by teams of people from all walks of life, following universal rules, competing on a level playing field.” Acknowledging that this image may be part mythology, he still sees it as an “aspirational ideal, a goal for us as a society.”Doug Glanville 56ff1f7494371.image

But only if we are willing to acknowledge

“that racism operates not only with fire hoses and police dogs but also in whispers, in fine print, in invisible ink, in coded language. Until we are fully against it, we are letting it fester, and while we try to sort out the ambiguities, people are suffering.”

His closing sentence: “They will still suffer once we have our answers, no matter what we find out.”

Though that is more hard truth than optimistic conclusion, I know Doug Glanville will continue his work of building bridges, teaching and writing about social justice, guiding his own children to focus on the good around them and rise above the rest.

Of course we’ve made progress since the Jim Crow era, but with the current trends, including deliberate attempts to deny or make it nearly impossible for people of color to vote, and the far too numerous killings of unarmed black people by police officers—many of whom are not held accountable—how can we possibly expect people of color to ignore racial slights or “put them in perspective” when, regardless of their accomplishments, they know how close they are to the next indignity—or worse?

How does it feel to hear TV commentators focus on how important it is for Democratic candidates to appeal to the white voters in Pennsylvania, Wisconsin, etc., when the water situation in Flint, Michigan, has still not been fully resolved five years later, and we don’t even know how many other predominantly black cities are similarly affected? What will it take for us to care—as if they are our own—about the children being poorly educated and poisoned by environmental pollutants that are getting worse as the EPA standards are lessened or removed?

And why does the shocking data that African-American women are three to four times more likely to die in childbirth than white women—regardless of their income and education levels—not cry out for national attention?

With so many hate crimes and “anti-isms” against various groups on the rise in this country, some may be tempted to belittle the kind of assault Doug Glanville recently experienced. After all, he wasn’t physically injured.

I don’t use the word “assault” lightly: when someone so accomplished—a good-hearted, caring individual with a long history of trying to ease tensions among groups—lets us in on how devastating the accretion of these insults can become, we dare not ignore his words.

Yes, we must strive to overcome our differences and reduce the terrible polarization that threatens us now. We must always seek those things that unite us, rather than divide us.

But we’ll never do so until we realize that the original sin of slavery still hovers over us, and in 2019, we have much more work to do. I am grateful to Doug Glanville for so eloquently sharing his pain with us. He’s still ready to do the hard work to make our country better for us all. Are those of us whose lives aren’t disrupted by the types of incidents Glanville and so many others continually experience ready to do the same?

I welcome your thoughts, opinions, and stories.

Annie

NOTE: You can hear an audio interview in which Glanville describes the episode and its aftermath on WBUR’s Here and Now (May 29).  Notice that he ends with a positive observation, as he always tries to do.

 

“I Thought of Her as Leonardo da Vinci’s Descendant”

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I’ve found, on occasion, that some of the most life-affirming experiences I’ve had have occurred at a funeral or memorial service for someone whose life has been well-lived.

I had that honor today (Sunday), attending a memorial for a 92-year-old woman whose friends’ recollections often included the phrase “Renaissance woman.”

The woman being memorialized was not someone I’d known for many years or been extremely close to. I had actually been introduced to her by a mutual friend who knew her much better. But she had such a warm, enveloping nature that I felt our friendship was longer and deeper. That, in itself, is a gift, but this woman’s gifts were bountiful.

Her energy level was one. We belonged to the same gym, and I would see her, when she was well into her 80’s, scrambling up climbing devices and lifting her small frame in successive pull-ups—a strenuous task that requires using one’s full body weight.

One of today’s participants whom I hadn’t expected to see was the terrific personal trainer my husband and I work with once a week. “Pat was one of my clients,” he told me. “She came to me in her 80’s because she wanted to be able to go back to canoeing.”

He’d put her on the treadmill wearing a backpack, and she’d complain, “It’s too light; I need more weight.” He’d add 10 pounds, then 20, then…And before long, she’d returned to her canoeing, even carrying the canoe when necessary.

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“Pat was an adventurer with a particular love of the outdoors, canoeing, and camping,” read her obituary. She traveled widely, and one of her two daughters recalled a canoe trip when she was no longer strong enough to paddle.

With her daughter at the stern, they found themselves heading toward whitewater. “I thought, ‘Oh, my God! I’m going to kill my mother!’” the daughter said. “But she just laughed and laughed, having the best time.”

She was a PhD psychologist who’d had a private practice for many years. Her own life was not easy. There were suggestions of a stormy relationship with a difficult, demanding mother. There was a happy marriage that ended too soon with the death of her spouse, followed by a marriage ending in divorce. There were many health challenges. But still, as one friend, a fellow therapist, said: “She was always a glass half-full person. And she knew when she needed to talk to someone, and she found the best person to talk to.”

When she retired at age 62, she hooked up with Habitat for Humanity, the non-profit organization that builds homes for people in need. This wasn’t her first experience with hammer and nails: she’d been one of the first women to teach shop in a public school in the Bronx, New York. A natural organizer, she brought together fellow Habitat volunteers in her home—a group subsequently called “The GreyHeads.”

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As she told a regional reporter who wrote an article about the group, “My work with Habitat has been the most important experience of my life. I love working with tools and building houses. Every minute is a total joy, and walking through a finished house is the closest I’ve ever come to a religious experience.”

A number of the Greyheads spoke about Pat at today’s gathering. It was clear not only that they cherished and respected her, but also that the presence among them of this tough, small, and tenacious woman had profoundly affected their views of women’s roles and capabilities.

And the hands that hammered and sawed also fashioned delicate, beautiful sculptures made of clay, stone, and bronze. Many were nudes—some more sensuous than others. One of the Greyheads said that, raised as a good Catholic boy, when he first saw her sculptures, he headed to confession. “They were better than those magazines,” he said with a big smile.

images-34What else did those incredibly versatile hands do? They played the piano and harpsichord, and the organizer brought together like-minded musicians for Friday evening musicales in her home. She was known to play with passion, and she was especially fond of baroque compositions. “I knew never to call Mom on Friday nights,” her daughter said.

Is it any wonder that one of the speakers said he always thought of her as a descendant of Leonardo da Vinci’s?

She was also deeply concerned about both her community and the larger world. She marched for civil rights, worked to make the playgrounds in New York’s Central Park safer, and sought to obtain an emergency alert system in her home town following the devastation of Hurricane Sandy.

A few years ago, when it became evident that she could no longer remain in the house and town she loved, she moved to an independent living community near one of her daughters. For a while, she was deeply unhappy, finding little to occupy her time and few like-minded people to talk with.

But in true Pat fashion, that funk didn’t last for long. As one speaker said, when asked what had made her spirits brighten, she responded: “I went to the lumber yard.” Soon she had translated her Habitat for Humanity experience to make Habitats for Wild Birdity: she organized a group to make little birdhouses to hang around her new environs. This action was totally in keeping with yet another aspect of her nature: her love for animals.

When we visited her, her sculptures were in various stages of completion, and she pointed with pleasure at the small garden outside her residence. Before long, we heard about several gentlemen who were vying for her attention. Eventually, her glass seemed more than half-full.

Listening to all the tributes today, I felt as I had when I’d heard her health was failing: regret that I hadn’t had the opportunity to know Pat better and longer. But I felt even more strongly a sense of gratitude that I had been able to spend time with and appreciate this diminutive but huge, indomitable and loving, and truly remarkable woman.

As always, please let me know your thoughts and reactions, and share any stories of your own that this post brings to mind.

Annie