Moving away

So, after a number of years of owning the domain but never really updating my webpage, I've decided to move my main blog/website to my domain at www.keelamonster.com
So there won't be much in the way of posts around here.
Certainly there are plenty of things I really like about Blogspot, but I figure if I'm paying for the domain I should be using it.
I may post an occasional update here and there to remind you to go to the other site, but this blog will be pretty quiet.

I haven't decided if I'm moving my "Insights from my kid" blog over or not, we'll see how it goes with this one.

Better a Diamond With a Flaw than a Pebble Without

There is an aphorism among philosophers, often attributed to Voltair whose poem, La Begueule contains the line "In his writings, a wise Italian, says that the better is the enemy of the good."
This refers to what is commonly known as the principle of the golden mean, or the middle between extremes.  An excellent example from Aristotlean thought would be that courage is a virtue, but its extreme, recklessness, can be dangerous.  I bring this all up because I've been thinking about it since Blizzard announced the upcoming release of their new first person shooter style, team oriented game, Overwatch.

You can see the cinematic trailer for the game on Youtube here.
You can see the gameplay preview also on Youtube here

There are a couple of great things people are saying about this game:
It's all new intellectual property (IP).  No recycled Starcraft, Diablo or Warcraft characters.  No more Azeroth, Sanctuary or Koprulo Sector.  This is a whole new place, new story and new characters.
And it's gorgeous.

here's the final poster for the game (obviously (C) Blizzard)

The characters are rich, the roles are interesting, and I, for one, can't wait to play it.  Blizzard is getting some great and well deserved initial feedback after introduction of the game concept at this year's BlizzCon.  The one thing that seems to have really resonated among the folks in the circles I follow is that there are so many female characters.

Blizzard isn't the first game studio to put women in the game, obviously.  But they very obviously made an effort to include a variety of playable female avatars in this environment of controversy, particularly on the heels of the Assassin's Creed fiasco of "animating female avatars is hard."  And all of the GG foolishness (which I'm not going to recap here).

However, an interesting counter point has arisen to counter the praise being given to Blizzard for these characters and it's a valid one.  Look carefully at the 5 female characters in the poster.  I'll show you three of them here:

 

So, here's the problem: All 3 women have more or less the exact same body type.  Impossibly tiny waists, obvious chests, pretty sexual in the way that they stand.
  More women characters, but only one female body. I won't lie, it is a bit disappointing.

   While I completely understand that games are an escape and I want to be something different or unusual while I play a game, it's disappointing that in many games, even in WoW, my only female options are an ideal of somehow a perfect female body.

 I will probably never look like that.  And that's okay.  I can say that, because at 43, while my body is far from a perfect ideal of the female figure, it's mine, and it's brought me this far. It's taken me a very long time, but I finally love this body, even with all its imperfections.  I also love the things about it that are great, and the things I'm improving all the time.  Body acceptance is an important part of self acceptance, we all get that.  And I'm not asking for games to give me a chunky middle aged lady gasping her way through a battleground (that certainly wouldn't fit with the story in any way).  But, given that Overwatch also includes a simian style male, a robot and a dwarf, I'd like to see that variability given to the female characters as well.  I think we all would.

Look, my username is based on an archetype of the girl who isn't really interested in role playing games but wants to play in order to spend time with the boy she likes, so she plays a healer.  It's a longstanding joke in our family: my boyfriend at the time convinced me to try World of Warcraft, told me I could be his healer girlfriend.  Given that I'm a physician in real life and was his girlfriend (now his wife), it was sort of the perfect joke on an archetype.

But here's the greater point, I do not dismiss this game out of hand, and I think that neither should you or anyone else.  I do not think that it should be used as an argument that there really hasn't been progress in gaming (as seems to be what I'm seeing on the tweets by some pro-GG, anti-SJW types).  It's actually quite the opposite: there are female avatars that are playable and they play very different roles (not just healer girlfriends).  

So, yeah, what I would say about this game is pretty simple: Blizzard missed the target, but they hit the tree.  And that is powerfully, meaningfully important.  In arguing "yeah but the body type is inappropriate, it sucks!" we would be allowing the perfect to be the enemy of the good.  So very much time is spent focusing on the extreme, we're missing the common middle.

Is Overwatch perfect?  No.  Is it striving to get there? Yes. And the journey is as important as the destination in many cases: that's where the growth happens.  That's where the ideas change.  That's where we learn to work together as a team.  This game, and by no means is it the first to do so, is helping to take us down this path, and should be lauded for doing so.  Should it stay here?  Of course not, but this is the start, and this race is a marathon rather than a sprint.

This game is what I would certainly consider to be a flawed diamond, but a diamond nonetheless.

My Confusion about Gamer Gate.

Okay, look.  I've been following the Gamergate fiasco for some time.  Well, actually since the whole thing blew up.  I like games.  I like some gaming sites.  I like other gamers.
I'm not, like many other writers, going to sit here and spit out my gaming credentials here.  I should not have to. And neither should anyone else.
I'm also not going to recap the GG story.  You can read that here.

So here's my problem.  GG has so far only come to be associated with a roving, leaderless band of online people who are spamming advertisers on gaming sites and who are harassing women who are critical of games.  They like to insist that it's about journalistic ethics.  But the person who was harassed in the catalyst event that led to the very claim wasn't a journalist at all, but a developer.

I just don't get it.  You want ethical games journalism, but what the heck does that look like?  I'm not being facetious. Is it a game walk through? Is it is a list of technical specs?  Is it a neverending twitch stream of people paying to play games and taking no money from anyone while quietly playing without commentary?

Games "journalism" is completely and utterly subjective.  Gaming magazines are a series of blogs that are supported by ad revenue, often paid by gaming studios.  Most gaming magazines (online or in print) are a series of game reviews.  These are, by their very definition, subjective opinion.  How do we make that more ethical?  Uh, it's an opinion. How is it unethical?

Look, entertainment reporting (and that's what this is, just like ESPN and E! network) relies on a positive relationship with the form of entertainment being reported.  ESPN reporters, producers and executives need a working relationship with the sports it covers.  Why do you think so many athletes become commentators?  Not because they have such a great command of the language or because they know anything about broadcast journalism, it's because they have contacts and an insider's view.  Same is true with movie or television reporting: people are usually part of the industry before they become reporters on it.  No one is surprised or shocked by this.  Well, no one but the people who want to do actual investigative reporting on sports (Ask the guys who made the League of Denial documentary).

In order to write reviews, those in games journalism get advance copies of the game, they get access to new hardware and software so that when the release date hits, we can decide based on someone's review if we like it.  A good reviewer acknowledges his preferences in games ("I don't like exploration requirements" or "I love jumping puzzles" for example) and reviews it in that context.

My real point here is this, though: at what point will the GG horde feel like it has won or at least done something?  When the current standard gaming sites crumble to dust?  Probably won't happen.  When women stop saying "hey I kind of like these games, but don't like that I can't play a female avatar"?  Also not going to happen.

All I can glean from the pages and pages (and believe me, I've read more than I ever wanted to of GG tweets, 8chan posts and reddits) is that they just want everyone who isn't them to stop playing games and to stop demanding a better, more inclusive product.  They are the old white guys in the current GOP asking for why they can't have their country back. (You know the one, where women just cleaned the house, served the drinks and shut the hell up? That same one where blacks knew their place and didn't get uppity.  That country.  By the way, that country did awesome things like help end 2 world wars and build a powerful economy, and it did some tremendously awful things like eugenics programs, Jim Crow and segregation, institutionalized sexism, internment of Japanese Americans, and the list goes on and on and on.)

I hate to break it to you guys, like it or not, and believe it or not, other people play games, too, now.  Jocks, nerds, musicians, brainiacs, dorks, they have all played games at some point.  Your mom plays video games, so does your sister and your cousin and your friends and your enemies.  Pitching a royal fit will not change that.  Claiming that you liked it first and so no one else loves it or understands it like you do doesn't change that other people are open about loving games too, now. Bullying, threatening and harassing women won't stop that.  Threatening websites and advertisers will not stop that. It may cause them to rethink their ad dollars, but it won't make them stop making games, it won't make them stop advertising elsewhere and it won't make other people stop hearing about the games you so dearly claim to love and to want to save from the rest of the world.

So where's the end game here?  I sincerely want to know.  If your goal is to make feminists shut up and go back to the kitchen, it's not going to happen, so at what point does it stop?  Do you even know?  Do you even care?  Or are you just looking for an excuse to cry and whine that while you only got one cookie, someone else got two?

Infection control

If we're wondering why we're failing at protecting health care staff from Ebola, take a look at this picture:

Aren't they cute? Can you imagine the number of bacteria they carry from patient to patient?

  Check out all of those adorable stethoscope covers.  There are patterns you can get, you can make them your own. I even saw a super cute alligator one.
And don't worry, I'm sure every nurse, doctor, medical assistant, and tech takes them off between patients and washes them, right?  I mean, they do that, right? (No. They don't. And good hospitals have made it clear that these covers are nothing more than infection magnets, but they are still sold to clinicians in health departments, surgery centers, and clinics across the country.)

Here's the scary part of the game, kids: very few medical staff actually are enforcing good infection control in the average clinic or hospital.  Most staff got a quick OSHA training on it and then just do what they're told by their supervisor.  We couldn't control infections enough to prevent MRSA from becoming a household name. It's not that medical staff are stupid.  It's not that they're malignant.  It's that we are complacent.  We haven't seen a truly terrifying plague like Ebola in the US since HIV/AIDS. (To be clear, I do not consider Ebola a plague or even an epidemic in the US.  I'm comparing it to HIV/AIDS only in the level of fear among US citizens, not in its scope or reach or impact on the actual health of the population.)

It was the HIV epidemic that introduced us to the idea of universal precautions against blood and body fluid exposure in the first place. But then more people were tested, treatments improved, and we realized that the people at risk were generally gay men and injection drug users.  So, well, we stopped worrying.  Magic Johnson got it and he didn't die, what's the big deal?  I mean, does the guy who gives me my flu shot really need to wear latex gloves anymore?
According to a 2010 article in the NY Times,  in the United States, the Centers for Disease Control and Prevention estimated roughly 1.7 million hospital-associated infections, from all types of microorganisms, including bacteria, combined, cause or contribute to 99,000 deaths each year.

The problem here isn't that we don't have the technology or the sophisticated medical care or access to great treatment.  It's that we rely entirely on those things, and we have become complacent.  I've witnessed in my career numerous blood draws done where the phlebotomist took off his gloves because the patient was "a hard stick" and the vein was hard to feel through the gloves.

 I've seen vaccines administered by nurses and medical assistants without gloves where the syringes were then stuck into the table to prevent a needle stick, rather than the clinic paying for the safety needle systems, pictured to the right, that are so readily available.  I've accidentally stuck my own finger a few times.  Luckily for me, it was only in the stage where I was drawing up the medications I was about to use, and the needle hadn't been used on any one else.  I've seen dirty gloves removed in the course of treatment and tossed casually aside on a counter top or even the floor, only to be picked up by cleaning crew or other staff, who were sometimes wearing gloves and sometimes were not.  I've seen simple procedures, such as incision and drainage of an abscess or removal of a skin lesion performed without eye protection.  And, I'll admit, I'm guilty of that last one.

I'm not saying these things to say that doctors, nurses and medical assistants are lazy or malignant.  I'm saying them because we're complacent.  But it's not limited to just clinicians. There's an entire community of complacent parents out there who have never seen a case of polio or measles or whooping cough outside of a movie or a historical documentary.  Those parents have decided that their non-scientific based fears are more important than some imaginary or historical disease, and refused to vaccinate.  And now, the epidemic we should be fearing and working to stop isn't Ebola, but rather measles.

Look, no medical system is perfect.  No individual is perfect.  But if medical systems (clinics, health departments and hospitals) don't take this opportunity to review their infection control models, don't put into place aggressive hand washing programs and don't take the time to update their processes for dealing with communicable diseases as they present, then this is a lost opportunity that may cost people lives.  Those lives won't be lost to Ebola, as the chances of getting Ebola in the US right now is less than the chances of winning the lottery or being struck by lightning.  Those lives will be lost to MRSA, to nosocomial infection, to influenza.  And that will be the policy fail that is unforgivable, not that a nurse got on a plane or that we allowed a man who had recently traveled to west Africa to leave the ER with symptoms.

Women in Sports

There was an interesting commentary on NPR this morning about women in sports journalism and CBS sports is launching a women's show called "We need to talk" or something like that.  It's sort of like The View but for sports.
I think the huge thing most sports broadcasting has missed is this: most women sports fans don't need a "chick sports" show.  We just want to see more women doing the journalism, coaching and game announcing.  We don't need to have a show (or a channel, for that matter--did you guys know that there's an ESPN-W for women) that just tailors its content to what they think women are.  We just want to see really good women journalists have their place at the table.
We only see women on the sidelines asking the coaches what they should do to adjust at halftime (and then are taken to the men in the booth who actually tell us what we already know).  We only see women as scantily clad weather girls.  Women in sports journalism have come a very long way, baby.  But women sports fans don't want to just watch women's sports (we enjoy them, yes, but we also still like watching men's sports) and we want to see other smart women who are fans talk about sports and be part of the process.
ESPN, CBS Sports and other broadcasters need to stop pigeonholing women into a little coffee klatch style show and then congratulating themselves for paying attention to their female fans.  Just put the good journalists who are doing good work in places like ESPN-W, a channel that no one really knows about, and put them front and center on ESPN.  Have a few women on Inside the NFL.  Have a few women on the pre-game show.
Don't shove us into what you think we like.  We like football.  We like golf and basketball and baseball.  I personally love seeing a great defense sack a quarterback.  I can appreciate a great Hail Mary, the Music City Miracle, or Russell Wilson's magical, scrambling performance on this week's Monday Night Football this week.
Just include the smart women who are already reporting on the mainstream sports that we already watch in your reporting stable.  Don't limit yourself to former athletes only.  Don't limit yourself to men only.  Women have a voice, their opinions about sports are often well considered and informed.  Don't make a big deal out of it, just do the right thing.  Don't look to be a pioneer or some sort of ground breaker, just take great talent--no matter what gender it might be--and use it.  Stop trying to make us watch something we don't want because it's "targeted at women."  Just give us good sports reporting, let us watch great sports, stop assuming all fans are men, and we'll all be fine.

1985

We all remember dates, times, markers in our journey.  Where we were when the space shuttle Columbia went down.  Where we were when we heard the President had been shot.  In my case, that president was Reagan.  The day we watched the Berlin wall come down. The day those planes hit those towers and changed everything.

But the thing that changed me the most wasn't a national event.  It was a choice by a teenager that damaged a family.  My family.  In February of 1985, my then 15 year old sister sat in the car in our family garage and ran it for several hours with the garage door closed.  My younger brother woke up with a belly ache, and when my mom went to the kitchen to get him something to help, she heard the car and found my sister on the floor of the garage.

The next weeks were filled with mourners, well wishers, family and friends.  There were phone calls, the ever present stream of food that people bring to the bereaved, the retelling of the events, the choosing of the casket and clothes.  We wrote an obituary, we made scrapbooks.  We packed a suitcase of her favorite things to save, and over the months that followed, we cleaned out her room.
It was shattering to the 13 year old girl that I was to see my parents grieve in such a powerful and personal way.

My parents weren't those sensitive new age parents who sit with you and coax you through your emotions.  That was something they'd never learned to do from their own parents.  My dad threw himself more fully into his work, which wasn't much of a stretch, and my mom struggled to make sure we knew that she loved us and needed us, and she spent years blaming herself.   I'm not sure she's stopped doing that, but she's learned to live with the ache, to celebrate the life that her family has gone on to lead.

We all feel that way with a loss as acute as that one: we never stop loving the person we lost, but some days we can't remember what she looked like.  Some days we're angry at her leaving.  Some days we just feel melancholy for no reason.  No one ever forgets, we all just sort of compartmentalize and move on.  Death is part of life and all that.

It's like an old clock that sits on a shelf, mostly there for decoration.  It doesn't really run anymore, and it collects dust.  Sometimes we dust it off and try winding it up again to see if we can get the pendulum to swing again.  Sometimes it just rings on its own.

Today was the day when the clock started making noise on its own again.  Riding to work, listening to the radio, every story seemed connected to 1985.
For the first time since 1985, the Kansas City Royals have made the playoffs.
Since 1985, the Europeans have won the Ryder cup 10 out of the 14 matches.
Switching from talk and sports radio to the pop station only to hear Bowling For Soup's "1985"

Funny how the reminders come in waves.  At the end of my commute, still contemplating all of the reminders and references, one of the first patients on the schedule was one struggling with his own loss.  His own grief.  After 29 years, for me it can feel as distant as a black and white photo or as close as a punch in the arm.  For him, while it's not brand new, he doesn't have the same distance.  Our shared losses allowed me to help guide him, to tell him it's okay, to remind him that it does eventually get better, more distant.  It gets less sore.

And maybe that was the reason for the reminders: to help me remember that loss, that acute feeling in the context of the distance time has given me.  It's like having an old back injury.  Some days it's as if it never happened, some days it keeps me from being able to function effectively.  With the right rehabilitation, it doesn't stop me, but it never quite goes away.  A missed step, a wrong motion and there it is, reminding me.  And it's what reminds me to be thankful for the days when it doesn't hurt, doesn't ache, doesn't stop me.  Just like remembering my sister helps me appreciate my parents, my brother, my husband, my family and friends so much more.  The gap is always there, it just gets a little smaller all of the time.

More on the NFL

So, I've really been troubled by my relationship with the NFL, and I thought that I could get my thoughts out in the previous post, but it didn't seem that satisfying.  Which is pretty much a summary about how I feel about what's happening in the NFL right now.
I was delighted to see that the Vikings took a stance last week by deactivating Adrian Peterson.  By the end of Sunday evening, they had decided to reinstate him.  They claimed that they had reviewed the case and studied all of the information.  No new information came to light about the case for which he was indicted, but there were apparently allegations of his involvement about abuse with another of his children.  So, apparently, if you beat one kid, you get deactivated.  If you beat them all, you can play.  Oh, they're also insisting that it wasn't because they got slammed by the Patriots on the day that their star running back was out of the game.

The Vikings are claiming that they're going to let due process take effect.  There is no reason that sitting Peterson will interfere with said due process, but it will send a message to players in that organization: don't beat up your children.

Unfortunately, we don't have a video of Peterson beating his child.  We don't have a video of him causing head injuries to another child while "getting a whoopin' in the car."  So we can't all be outraged and do the right thing.  We have to use the pictures of the child's bruised and cut legs (which they absolutely should not have released, in order to protect the privacy of the child, not the abuser).

Again, the more I see (or, more accurately, don't see) in terms of leadership from the NFL on these fronts (Greg Hardy has already been convicted  of assaulting his girlfriend and threatening to kill her), the more sick to my stomach I become over the game I once loved, the game that gave me so much connection to my dad.

At this stage, I've been waffling about dropping my NFL Sunday Ticket subscription.  I admit it, straight up, that I'm weak about this.  Destroying memorabilia that I already own won't get me my money back from the league.  But stopping my subscription, refusing to watch, that is voting with my dollars. Am I really ready to put such a huge gap in my September through February?  We're talking no more NFL on 3 days a week, no more ESPN radio discussing football, no more using NFL sponsors when possible.  It would literally be a shift in my entire paradigm to take that step.  Maybe I'm not ready to give up.  Again, I don't have a good answer.  It may still take me a while to make that decision and get my money back from DTV.  I wish I were more full of resolve and less disappointing to myself. I understand that implied hypocrisy.

Pink gloves and socks aren't going to be enough this time, NFL, to make us believe you care about women or our dollars.  Bring us something meaningful and true.

My abusive relationship

I realized it this year.  I'm in an abusive relationship.  It's not with my husband or my work or my family.  It's with the NFL.

I became a football fan back in college, but I watched it long before then.  I watched it in high school when I was in the marching band, but my relationship with football started long before then. My dad was a high school football referee.  Each week, usually on Friday night, he'd sit on his bed with a big black leather bag at his feet.  He'd start to empty the bag on to the bed, and make sure he had what he needed: the striped shirt, the white pants, white socks with black stripes.  He'd sort through the various tools of the trade: the bands to count the downs, the yellow flags with the weighted clips, the small bean bags to mark the site of an interception or important play.  We'd rifle through the bag, looking for the coins he used for the coin toss or playing with the whistles, all while he quietly sat there and polished his black leather shoes.  It was that ritual every week that taught me the difference between cream shoe polishes and wax shoe polishes.  I learned about when to use a brush, when to use a buffing cloth.  Eventually, by the time I was in sixth grade, I was getting to polish one shoe and use the things I'd learned while he polished the other.  I almost got as good at that as he was.
Then, one year for Christmas, we bought dad an electric shoe buffer.  After the first couple of weeks of using that, polishing shoes just lost its shine.  Ahem. Sorry about the pun. 

Anyway, even prior to those memories of sorting through the referee's bag, paging through the rules of the game in dad's rule book, and pretending to throw the penalty flag at my brother, I had already staked my claim with the NFL. I was a Seattle Seahawks fan.  The team was established when I was 5 years old.  I didn't care.  My family, like many other Montana families, had thrown their lot in with the nearest NFL team: the Denver Broncos.  My dad had grown up just north of Kansas City, so he was a Chiefs fan and, more importantly, a Raider hater.  I was okay with most of that, since I didn't really care, but as I grew older, I had to do what all teens do: I had to separate from my parents.  I did it with football.

Why football? I hear you ask.  Well, it was simple.  My dad loved talk radio.  This was before the modern era of talk radio.  When we traveled to those small towns to referee games, we listened to the radio in the van.  It was always one of two stations: KOA, a talk radio station out of Denver (which we could get better at night than during the day, due to the way AM radio works) or NPR.  We listened to "A Prairie Home Companion" and "Whad'ya Know?"  We listened to callers in Denver complain about local ordinances and politicians.  And, of course, when they were on, we listened to Broncos games.  My mom got tired of listening to NPR as much as we did and was constantly asking my dad on Sunday afternoons to find a Broncos game.  We just sat in the back and desperately wished he would let us listen to music, for once.

As I grew up and moved away for college and medical school, and then established myself somewhere far away from my parents (living in Tennessee for residency, then Alabama and finally settling in North Carolina), I had less and less locally in common to discuss with my dad.  But there was always football.  We could talk smack to each other about how whose team was doing and who was going to the Super Bowl.  We could discuss trades and player achievements.  Where there had previously been a teenage daughter fighting with her old fashioned dad, there was now solidarity in the love of football.

Unfortunately, as I've grown and started my own family, the NFL has become harder and harder to love.  The ticket prices and souvenir prices have become astronomical.  The work the NFL has done to raise revenues has been exhausting.  The game has changed, always under the guise of "player safety" but with players still ultimately unsafe.  Criminal charges among NFL players seem like an acceptable part of the game.  Every week, it feels like there's a new story of a player involved in some sort of crime, up to some sort of bad behavior.  Racist and homophobic and other controversial comments and actions by players are more and more common. It was starting to get harder and harder to swallow.

And now, this season, the issues related to players involved with domestic violence has come to a head.  I'm not going to recount the Ray Rice story here, you can look it up elsewhere.  More disturbing are the other stories of other players involved in these cases, the way that the NFL treats cheerleaders (who are paid less than minimum wage), the way they take advantage of breast cancer awareness month to sell more products and tickets, all of their bad behaviors. And, of course, the Redskins.

And I find myself making excuses: it's not the individual players' faults.  If I stop watching or boycott, it won't make a difference.  Maybe as I fan I can encourage them to change by voicing my opinion.  There aren't other sports that I enjoy as much or as consistently (even hockey, which I love).
 They are all weak excuses.  None of them is a good one. But I still find myself struggling to boycott.  I flirted with not re-ordering the NFL Sunday Ticket package this year, and I put it off until the very last minute. . .  at which point I caved and clicked on the "activate package" button in my Direct TV account page.  I make myself feel better by following players like Derek Coleman and Russell Wilson on Twitter, who are outstanding citizens and men in their lives off the field, as are hundreds, if not thousands of players and former players.

I know that I should boycott, stop wearing my Seahawks shirts, stop giving the NFL my money.  I know I should boycott their sponsors.  Well, that's easy with Budweiser and McDonald's but what about the others who aren't so obvious?  Granted, for domestic violence offenses, the claim is that a player will get a 6 game suspension (the first time that now you can miss more games for hitting your girlfriend than you miss for hitting a bong--which is a 4 game suspension).  But that was only after the outcry at the initial 2 game suspension.  And Rice got suspended indefinitely, but only after we saw real, video proof of the hit (nevermind that we saw him drag his now wife out of the elevator and he was CONVICTED in court-with an incredibly lenient sentence).  Hardy, who plays for the Panther, was also convicted of assaulting and threatening to kill his girlfriend, but he's still playing (well, his team de-activated him--like he's a toy or a bomb, just hit a switch).  Peterson, who beat his son with a switch so hard that a doctor reported him for child abuse hasn't been punished by the league.

So I have to have that conversation with myself all of the time: is it time to leave?  How can I stay? And, disappointingly, I haven't come up with what I know is the right answer yet.  I guess I'm still attached to watching the team run in, remembering reading a book in the sun at the games my dad was refereeing.  The simple joy that comes from remembering that time with my dad, helping him unpack and then repack that gear bag.  The smell of shoe polish still makes me think of football.  I know I won't be giving up those memories if I stop supporting the NFL, but a wee part of me is afraid it might fade.  And maybe that's what I don't want to quit.  I don't have a good answer.  I just know that the Chargers just recovered a Seahawks fumble, and that means now my team needs me.

Schedules, appointments, time. Also, I'm bored.

I love my job.  Love it.  I can't express to you how interesting, challenging, joyful, agonizing and marvelous it is to get to do what I do.  I share with people, I counsel people, I grieve with people, I rejoice with them.  I get to learn and I get to teach.  And that's all before lunch time on an average day.
I'm not perfect and I'm certainly not the smartest doctor in the world.  I try pretty hard to keep a life/work balance.  I try even harder to stay current, to challenge my knowledge, and to be compassionate and kind.
I love my clinic: we have a very personalized approach to excellent care that is affordable.  We maintain a high ethical standard of practicing medicine with up to date knowledge and patients as a priority. Are we perfect?  By no means.  Do we strive for excellence?  By all means.

Having said that, there are days when the job can really feel like a drag.  I'm not talking about days with irascible patients or bad outcomes, which happen no matter how hard you try to avoid it.  The worst days for me are the ones with cancellations.
Now, there are many reasons you might cancel your appointment: you got a flat tire, your boss changed your work schedule, your kid is sick, you forgot you had the appointment and there's a conflict in your schedule. I don't blame people at all for having lives outside of my office.  However, there's little for me that is more disappointing than checking my upcoming schedule for the next day when I go to bed, and then arriving at the office only to find a couple of gaping holes in my schedule due to cancellations.

Our office doesn't over book.  Of course, occasionally we get a few appointments at the same time, generally during cold and flu season when everyone is sick and walking in to be seen.  But the advantage of our care model is that each patient is allotted an appointment time that varies between 30 minutes to an hour, depending on their need (routine follow up is 30 minutes, a physical is an hour or more).  We don't over book.  We don't book 4 patients per hour.  We don't overlap appointments.  Ten to twelve patients a day is a busy day for any one of our providers.

That means a couple of things:

• When you come to our office, you see your doctor for more than 7 minutes, which is the average amount of time that a family physician in a traditional out patient office spends with each patient.  You'll probably spend more like 15 to 20 minutes in face to face time with the doctor, if not more (given the 5 to 10 minutes it takes to be checked in).  
• Our doctors (specifically, me) tend to be closer to on time.  I remember when I worked in Alabama at my first job out of residency, I had a patient who said that she could drive to Birmingham, 45 minutes away, see a doctor there, and be back home in less time than it took to be seen in the clinic where I was working.  Why?  That clinic was driven by getting high numbers of patients to be seen every day.  So, routinely the providers had anywhere from 25 to 40 patients scheduled each day.  We also did obstetrics and some limited gyn surgery.  So the other providers not only would schedule a solid wall of patients each day, they would break out to deliver a baby or do a tubal ligation while patients were waiting in the office through their appointment times. 
• We tend to be less distracted.   As any medical provider knows, the winding down end of an appointment is often when the "oh, Doc, by the way" problem pops up. Sometimes it's as simple as a toenail fungus that needs treatment, other times it's as serious as a heart attack.  "I have chest pain when I walk up a flight of stairs, is that a big deal?" is an actual question a patient asked me as an "oh by the way" on the way out the door.  If we can wind up without the press or rush of knowing other people are waiting in the other exam rooms, I'm much more likely to be still focused on you and what you are saying to me.  

This is the beauty of working in an office where we aren't pressed to see 20 to 30 people a day just to stay liquid.  It's also the agony.  If you call at 8:30 am to cancel your 10:00 am physical, I now have an hour long gap in my day.  It's boring.  It's a total drag on the rhythm of a good, busy day. Sure, I know I can read, I can catch up on email and paper work (and blogging), but I want to be busy, to see patients, to care for people.  Add to that the fact that patients who no show or who cancel last minute actually cost any doctor's practice money (we have the staff here and the lights on whether you show up or not) and it's frustrating.

The same is true in a beauty shop, an auto repair place, or even a restaurant that requires reservations. There is a reason places charge a "missed appointment" fee.  

As Americans and as consumers, we take for granted that we can just walk in anywhere and get anything we want at any time.  We also assume that not only can we, but that we deserve to be able to get what we want the second we want it.  And this is because, frankly, as Americans in this age of convenience, we generally can. We can decide at 2am that we need to go to a grocery store for milk.  We can stroll into an urgent care or Minute Clinic and see a provider for our med refills within a relatively short period of time.  We can drive up to the oil change chain store and get our car repairs done.  But none of that care is personalized or tailored to our needs, it's just shaped to fit our demands.  And it often lacks the continuity that we need to truly experience high quality of care (from our doctor or our mechanic, frankly). 

So, whether it's your stylist, your dentist, your mechanic or your doctor's office, keep track of your appointments.  Keep a calendar, use reminders (email yourself appointments).  That way when you get that flat tire or sudden schedule change, we might wave the missed appointment fee because we understand.  But make an appointment, carve out the time, give it importance. 

 If your doctor's office keeps you waiting for hours after your appointment time, fire them and tell them exactly why.  Find a place that respects your time and your needs, and then do them the same courtesy of respecting theirs.  

Don't Break The Other Leg

Earlier today, I saw this image on the Book of Faces:

Photo credited to Meg Gaiger (harpyimages)

It was a bit shocking, somewhat troubling, but mostly heartbreaking.
I was this little girl.
In many ways, I still am this little girl.
So many of my friends were and are this little girl.  We get bombarded with images of what is beautiful, what is desirable, what is considered gorgeous or even acceptable.  And many of us just simply don't fit that mold.
Strides have been made to recognize the multifactorial causes associated with childhood obesity: easily available high calorie but nutrient poor foods, reduced physical activity, increased screen time, genetic predisposition, the list goes on.  This entry isn't about those things, there are plenty of blogs about those things.
There have also been plenty of blogs and articles about fat shaming and how it affects people in their journey for health.  Let's face it, we live in cruel times where people like to point to strangers on the internet or celebrities and critique bodies, clothes, style.  The 'love your body, we're all beautiful' campaigns have been met with the 'stop making it okay to be unhealthy' response.  Who has the right answer?  I honestly don't know.

I do know this, though, it's a disturbing place to be with one's daughter.  I have a gorgeous, funny, intelligent, active, healthy 8 year old daughter who is overweight.  She loves to run, she loves to swim, she loves to play outside.  She loves art, books, music, television and video games.  We don't live in a neighborhood where she can play outside with other children.  She doesn't want to play group sports or join an after school group that does physical stuff (basketball, soccer, gymnastics), even though she loves all of those things.
She, like most of the kids her age, loves pizza, macaroni and cheese, junk food, sweets and other fattening snacks she has access to, either at school or home.  She, like most kids her age, hates to try new foods, especially when they're vegetables.  I desperately want her to be healthy and to love her body as a vehicle for allowing her to do what she wants, but I don't want to turn her into the girl pictured above. I don't want her to see pictures of 'beautiful' women and allow that to drive her opinion of herself. I don't want her to measure her self worth based on her clothing size or her body shape.  I don't want her, at 8, to talk about being on a diet for the rest of her life.

The truth is, I don't want to turn her into me. I hated my body, hated myself, for so long.  I hated being fat, being clumsy, being slow, being weak.  I hated being 'on a diet' for most of my young adult life.  I hated buying every new fad to lose weight that was out there. I knew I should have eaten better, knew that second helpings of mashed potatoes or spaghetti weren't good for me, knew that vegetables were.  It wasn't that I didn't know, it's that I felt helpless to try and change.  Every time someone made fun of me at school for trying to wear a dress that didn't flatter, every time my dad mentioned that I needed to stop eating, every time I couldn't find the dress or pants or cute outfit in my size, my self-loathing multiplied, and the only thing that made it stop for a few minutes was food.

I will never forget the day I bought a pair of jeans in size 12 and assumed it would be my last pair of jeans ever, because I didn't know at the time that there was a Women's department hidden in the back of the store with the Petites and foundation garments. I was horrified, ashamed and resigned to that pair of jeans as my last, and that if I didn't lose weight, I would be trapped wearing my mom's clothes. Let's face it, in the 80s, women's size clothing styles were hardly something a 17 year old girl would have wanted to wear. But I also knew that I would never lose that weight, that something in me was broken if being on the swim team and swimming 2 to 3 hours for months didn't solve the problem.  And it didn't. And I hated myself even more, to the point where I gave up on all of it when I went to college: I stopped swimming, stopped running, stopped caring about what I was supposed to eat, and just ate what I felt like eating. My "freshman 15" was more like a "freshman 40."

When talking about those experience with one of my dearest friends, she told me "don't break the other leg."  If you break your leg, you don't lie on the couch and tell yourself, "well, the left leg is broken and I can't walk on it, I might as well break the right one."  And yet I find myself doing it all the time: well, I didn't eat well at lunch today, I might as well just have a pizza for dinner.   I didn't walk yesterday, what's the point of going today?  I have to learn that it's okay to make a mistake, but that it's not okay to allow that mistake to define who I am or what my potential may be.

In order to stop breaking that other leg, I have to learn to be mindful.  I need to be mindful of where I want to be.  I need to set a fitness goal or a diet goal, absolutely.  While "eating better and exercising more" is simple and effective, it is far from easy.  To get from one size body to another, it seems simple enough, but I have to know and have a true awareness of where I am before I can start the journey to where I want to be.

If I'm driving to an address previously unknown to me, my GPS enabled phone won't be able to guide me there until it knows where I am right now.  And I think that's what allowing me to love myself, even in this body that requires plus sized clothes, is all about.  I need to be okay with where I am now, to know where I am right now at the start, so that when I hit a detour or a bump in the road or blow a tire, I can make a plan to get back on that journey and arrive successfully.

I have to stop being ashamed, I have to love myself enough, right here, right now, in order to get to where I want to go, to get the body I want to have.  No longer am I needing to look like a model, but my quest is more pressing: I need a body that will allow me to function for the years that I will get to see my daughter learn who she is and what she wants.  I want to keep up with her, to run with her, to watch her grow and enjoy her adulthood with her the way that I hope my mother is enjoying mine with me. In order to stop breaking the other leg, I have to recognize that the broken one is still a part of me.  It's something I can allow to heal and that I can rehabilitate back to strength and utility again.  It's something that will help carry me on my journey. There is a difference between loving myself, and my body, where I am right now and being happy about it.  While I can be disappointed at having a broken leg, I have to continue to love the broken leg in order to stop myself from breaking the other one.  In order to stop breaking the other me.

ALS Ice Bucket Challenge

Okay, I'll admit it.  When the ALS Ice Bucket challenge started making the rounds on the social media sites, I rolled my eyes.  I even shared the Salon.com link about how you don't have to do the ice bucket challenge, just give money.  It was snarky (why I didn't link it here), and it was sort of self-righteous.
And then something amazing happened: videos and more challenges kept coming in.  Families touched by ALS made their own videos of gratitude for the money raised and the awareness created.  Last time I read about it, ALSA was up to $23 million raised in a few weeks.  It won't be sustained, no one is fooling themselves into thinking that.  This is literally a flash in the pan.  But that's okay.
The majority of medical research done in this country today is funded via either academic grants (which come from government sources such as the National Institutes of Health, or NIH) or via grants from private industry.  Obviously, private industry grants, primarily the pharmaceutical companies, are generally driven by a profit motive: we find the new treatment for this disease, we patent and sell that treatment, we make money.
Don't get me wrong, there is nothing wrong with making money.  Nor do  I believe that there is anything wrong with doing medical research with the intent to make money on discoveries made, although that is a very murky area, ethically for me.  The inherent problem with this model is that there are diseases that just do not lend themselves to profitable treatment.  Pediatric and childhood cancers, ALS, Rett Syndrome, and multiple sclerosis are all examples of such diseases.
The beauty of this sudden infusion of money to the ALS Association is that research done on ALS specifically can be applied to neuromuscular diseases in general.  Now we're talking about benefits to multiple sclerosis, to Rett Syndrome (a genetic neuromuscular disease that affects girls), and possibly even Alzheimer's and Parkinson's disease.
Hopefully the ALSA will be wise and understand that this infusion will likely be short lived, even if the challenge continues for several more months.  Hopefully, they will use the money wisely and carefully, and, in the words of everyone's parents when we were handed a surprising amount of cash, they won't spend it all in one place.
Either way, I'm here to say it, "I was wrong."  I was wrong about "just give money" instead of giving into an internet meme.  The more videos are made, the more people watch, the more that they're aware of the campaign to raise money and awareness and the more money is donated.  If you just give money (and you're not Patrick Stewart), then there is no sense of  passing the challenge to give on to your friends and family.
So, in that spirit, here are the videos my family made to raise money and spread awareness both for ALS, as well as for Rett Syndrome (and in my case funding for the NIH, as determined by our members of Congress).

Traffic Stops

So, the world is on fire.  It just is.  From the Ebola crisis in Africa, the crisis in Gaza, the activities of ISIS (specifically the beheading of journalist James Foley, but among many many others).
And locally, we're not immune.
Ferguson.  Mike Brown.  Darren Wilson.  Riots.  Looters.  The Wiki has been created, and the link is here.  I don't have the energy to go through it all here.
But I have read and watched so much about it, my head aches and my heart is broken.  Again.
I've read articles from law enforcement supporters about the danger they absolutely face every day to protect and to serve.
I've read the articles from men and women of color who have been mistreated at the hands of authority in the name of safety.
I've scrolled through the #IfTheyGunnedMeDown posts on Twitter, and watched some of the town hall discussions.  We all have our thoughts about it and bring our own experiences to it.

But somewhere between reading news reports and blogs and watching news coverage, an idea has come up several times.  The riots, the protests, the shooting itself isn't about race.  It's about class.  Kareem Abdul Jabar even wrote a well thought out piece about it.

Here's my main problem with that.  I don't think that's entirely true.
So I'd like to do an exercise.  Given that I only have like 3 readers, it probably won't be entirely statistically significant, but maybe I'll feel better or I'll get an answer I wasn't expecting.  I kind of hope that's the case.

Think of all the times you've been pulled over by a state trooper, local police, or sheriff.  I'm not talking DUI here, leave those out, if that's the case for you.  I'm talking routine traffic stop: speeding, illegal turn, expired plates, running a light or stop sign, etc.   Consider those traffic stops and answer the following questions:

1--Were you alone in the car?
1a--If the answer to #1 is no, that is, if you had passengers in the car with you, were your passengers' identification requested by the cop?

2--Were you asked or required to get out of the car?
2a--Were your passengers required to get out of the car?
2b--Was your car searched?

I ask this for a couple of reasons.  Let me give you some stories from my own experience as well as people I know.

In Savannah, GA, my brother in law, who is Puerto Rican was driving his wife (who is white) to work.  They had a friend (a black teenager they had more or less informally adopted) in the back seat.  The driver did a rolling stop at a stop sign.  A cop saw him not come to a complete stop, and pulled the car over.  On asking for the driver's license and registration, he also asked for the ID of the passengers in the car.  My sister in law was shocked and confused.  She had never once, when being pulled over, had her passengers asked to pass over their ID to the cop.  She tried to refuse, but her husband and their teen both told her that this was routine when being pulled by the cops.  Read that again, friends.  Her Puerto Rican husband and black teen adopted son both were neither surprised nor inclined to question a policeman asking for the identification of passengers in a car that was stopped for nothing more than a rolling stop at a stop sign (something we've all been guilty of at some point in our driving careers).

In Mebane, NC, a rural town, 2 relatively young black men were driving a country road.  The passenger was a patient of mine.
   Let me give you some of his history: this is a young man who had surgery on a ruptured disc in his lower back about 8 to 10 years ago.  During the course of that surgery, he developed an infection in his spine.  That infection completely paralyzed him from the waist down.  He was told that he would never walk again and there was nothing that they could do.  He decided that this just wouldn't be the case.  He worked with therapists, and after leaving the hospital in Atlanta, continued to exercise and work and by the time I met him, he was walking with a walker, but debilitated by constant pain.  I was his pain doctor.  I started him on a pain patch that give him mobility back and after 8 months, he was walking with a cane, mostly for balance but not support and he was doing a light weight routine at home every day.  The guy was inspirational to me as a doctor and as a human being.
  Anyway, he comes in for an appointment one day and he's using his walker again and walking with a limp.  I asked him what happened and he told me this story.  He was riding in a car with his friend on a rural country road near Mebane.  His friend did a rolling stop through a stop sign (seems like a common problem), and a sheriff's deputy pulled them over.  His friend was asked to get out of the car and hand over his license and registration.  The deputy then went to the passenger side and asked my patient to get out of the car.  Remember, this was a guy who rolled through a stop sign, that's why they're stopped.  My patient told the deputy, "I'm getting out, but I am disabled and need my cane, and I move kind of slowly."  When he did not exit the car at the deputy's desired speed, the deputy grabbed my patient by the back of the neck and yanked him out of the car.  My patient instantly fell to the ground.  The deputy yelled at him to get the "f***" up and refused to let him hold his cane.  The driver asked the deputy to leave him alone, and that he was injured and couldn't walk well.  Another deputy arrived on the scene, and my patient told me that at that point, the first one was much more professional: he checked their ID, issued the ticket and let them on their way.  The damage to my patient was done, however, he had a 2 to 3 month set back in his exercise routine and required more pain medication during that time.  All because he was riding in a car while black.

The reason I present these stories is simple: I am a white woman.  I grew up lower middle class, and if there were a middle class remaining in this country today, I guess I'd still be in it.  I've been pulled over for speeding, for ID checks, for an expired license plate in the past.  Not once, in any of those traffic stops were my passengers asked to show their ID.  Nor was I ever asked to get out of my car.
The only stories I've heard like that are either from people in traditionally black neighborhoods or from people of color.
So I want to know: what's your experience?  If you're white, have you ever had to get out of the car for a routine traffic stop?  Have your passengers been required to show ID?

Modern Problems

So I haven't talked much about it, but here it is:
Robin Williams's death hits and the news surrounding it hits me in a few ways.  First, my sister committed suicide at 15.  I can't say what she was thinking or feeling at the time, I can only say that it shattered my family.  Shattered it.  We all regarded one another differently. We couldn't help it.  In some ways it brought us closer.  In some ways it tore us apart.
More recently, my father, a retired politician and public figure in my home state of Montana, suffered a stroke in 2009.  While we were showered with love and support from friends, family and loved ones as well as former staff and supporters, the comments on the news stories of his stroke were--how to say this kindly--horrifying.  People said he deserved it.  People told him a debilitating stroke was too kind for him.
As a daughter, it was devastating.
Look, I get it.  You might not agree with my dad.  Hell, I didn't always agree with him.  But he was, first, foremost, and always, my father.  He taught me how to catch a pop up fly ball. He taught me to change a tire.  He taught me that you could change your own oil.  He taught me to catch a fish.  He taught me to love the land.  Believe it or not, he taught me how to be a woman who respects herself.  He was the man who expected great things from me and any partner who might consider himself good enough for me. He was, by no means, perfect.  But he was my dad.  He hugged me when I cried, he rewarded me when I succeeded, he bragged on me constantly.
Having been a U.S. Senator for nearly 20 years, I knew that not everyone liked his policies.  Hell, I didn't like them all. But when he suffered a stroke that left him nearly paralyzed on his left side, politics didn't matter.  He was, and is, my dad.
The comments on the local Montana newspaper websites were devastating.  I wanted to respond to every commentor: you don't know him, he didn't hold you when you got beat up by the bully down the street, you just don't get how much he cares.  But obviously I couldn't.
All I can say is this: thank God that Twitter and FB weren't the big part of my  life they are now back in 2009.  I would have shut down completely, much like Zelda Williams.
I can't change internet trolls.  I can't tell them how hurtful and horrible they are, since I believe in my heart that they already know it.
All I can do is to shrug and to understand.  And that, frankly, sucks.
The mere idea that a person can't be who he or she is because of celebrity by relation sucks.  The idea that someone lives to torture the already grieving heart distresses me in a way I can't express.
While I think the conversation that is happening now regarding mental health and suicide is important, I think the more important conversation is that of torture.  We've had plenty of chances to discuss mental health, and we as a society are unwilling to admit that mental health is important.  I get that.
What is so horrifying, and no I'm not using hyperbole here, it's fucking horrifying, is that people on social media are allowed to literally torture family members who are grieving via their posting of disparaging and mean (that's right, just plain mean) content on sites like Twitter and Instagram.  But more importantly, it also happens on news sites (as it did in my family's case).
While I understand that free speech is a sacred part of what makes us a republic, I do not understand why news sites, which often review comments on stories before allowing them to be posted, do not filter out hateful or mean comments on stories of personal tragedy.
Why doesn't the Billings Gazette filter out comments like "serves him right, I hope he dies" comments on the story of my father's stroke?  This was a comment I actually read, I'm not making this up.
It's not censorship, it isn't.  Those sites have a policy regarding comments that violate their policies.  Hate speech is not allowed.  If this isn't hate speech, what is?
My heart breaks for Zelda Williams, and the family of any celebrity that grieves a personal tragedy.  I only had a very very VERY small taste of what she must have experienced, and it broke my heart and tore at my soul.  I applaud her for leaving social media, but grieve that she had to do so.

Tracking this Trek, a Treadmill Desk Update

So, we're 2 months in on the treadmill desks.  And we're still walking.  And walking.  The weight loss has slowed down, mostly because we haven't really made huge changes in how we eat.  And the sore feet have slowed me down from my weeks where I'd have a few days with 40k steps.  But here are the stats for the last 2 months (well, 2 months and a week, technically).

Now, something has changed in the last couple of weeks, and it's that I'm now also walking with a FitBit One.  This is an activity tracker that I clip into my pocket or to my waistband if I don't have a pocket.  It tracks my activity, and can tell when I'm active.  I will admit, though, that we have arguments daily about what a "very active" minute feels like to it and to me.  There are several different activity trackers out there, and I was having a hard time deciding which I would like more.

The FitBit band or bracelet wasn't ideal for one simple reason: I'm walking on a treadmill at a desk.  That means that instead of swinging my arms when I'm walking, I'm usually typing or clicking or 'keyboard mashing' my way through a video game.  So it wouldn't be as ideal a way to measure my activity: I'm not going anywhere and my arms really aren't moving.  The FitBit zip was cheaper ($60, compared to the $95 I paid for the One at Target, taking advantage of my 5% off with the card and a handy sale on the day I went in there to browse), but it has a replaceable battery.  I've met me: once the battery died, if it's not AA or AAA, which it's not, then it's going to sit in a drawer until I remember to buy a watch type battery to replace it.  And that's useless to me.  Self-awareness is kind of important.

There were other trackers to look at: the Jawbone Up, the iFit, the Polar, Samsung, Garmin.  If you Google "activity tracker", the variety is a little daunting.  The problem with most of these activity trackers is that very few of them have an actual heart rate monitor, and, like the FitBit band, rely on you moving your arm to detect activity.  Again, not really helpful.  The One doesn't have a heart rate monitor, either, and that's not what I was looking for, but it is what Noah wants, and the main reason why he's not using a tracker at this point. There are some standalone heart rate monitors, and the Misfit Shine seems to be the best heart rate/fitness combo (it can even be used while swimming, which most of the others cannot).

The advantage of the tracker for me is that it can measure my activity outside of the home.  I walk a bit at work, and I was curious how many steps I wasn't measuring.  Turns out it's around 3000 per day.
The other advantage is that I can use this tracker (and a number of other ones) with the My Fitness Pal application.  This is great, because now I can set weight goals, friend up with people, keep a food journal, view calories in and out, etc.  It also has a pretty thriving community and many of my friends are there.  I also can invite patients to 'friend' me via MFP or FitBit's app, so that I can cheer them on as well.

I will say that I'm disappointed that MFP doesn't allow me to set the calorie or carb recommendations (they recommend a really high number of calories and carbs for me, based on old recommendations that 30% of daily calories come from grains, which is an outdated view).  However, I know that I should be closer to 150 grams of carbohydrate, so I ignore their 'gift' of 270.

According to the support person at Lifespan Fitness (the makers of my beloved treadmill desk), they are working on improving their app, which is blessed news at our house.  Their current set up only works with PC or iPad, and no android tablets or phones.  It also has a few glitches here and there, but all of them do.

It's been great for tracking my daily activity and my overall data (the stats above are from the Lifespan console).  They're also doing some other upgrades, which I hope includes integration with other fitness trackers (right now they're only compatible with the Garmin) like the FitBit and integration with other fitness apps like MFP.  There are certainly a million apps and it seems half as many trackers, so I understand if they don't get them all, but I really would love to see all of my data in one clean place.

For right now, I'm sticking with the Lifespan data for this blog, since that's what I started with.  I feel like it would be a bit disingenuous to start adding in all day information, when that's not what I was doing to start. However, the My Fitness Pal has really helped me to continue to monitor all of my fitness.  Maybe after the first year, I can switch over to the more comprehensive measures, and heck, maybe the Lifespan app will allow me to do that as well.

So far, however, tracking my activity and my food has been really rewarding and fun.  Seeing the little tracker tell me how many pounds I'm down and how many I have to go is a fun visual reminder that I'm doing great (although since I started in, the results are not quite as dramatic as they were initially).  Knowing that if I have a night where I'm tired and don't want to push for those 10k steps on the treadmill desk, I can check my FitBit and see that I've still gotten between 3 to 5k steps already and sleep a little better.

I know it says 0 lost but that's just since I started with My Fitness Pal

Breaking Up Is Hard To Do

We often take breaks from WoW.  We stopped to play Champions Online when it released, we've stopped to play other games or just to stop for a while. The main reason we aren't still active in Champions isn't because the game isn't good, it's that we don't have a lot of other friends who play it.
I also tend usually quit around the end of the year when I'm madly trying to finish knitting all of the Christmas projects I should have started in August and not November.
This time around, we find ourselves drifting from WoW for a couple of reasons: the state of world PvP (our favorite thing) is dismal if you're not a raider (our least favorite thing), the response of the devs to such issues is flippant at best, and Wild Star.
Everyone claims that each new game release will be a WoW killer.  Wild Star isn't that.  And I don't think it needs to be.  But the game is gorgeous, the NPCs in the world are challenging, the professions trees are interesting, and the adventure of a new game has really sparked more fun in gaming for us.
The problem isn't that Wild Star is going to be a World of Warcraft killer, it's that WoW is slowly killing itself.  The new expansion isn't going to be out for at least 4 months and that is really optimistic at best.  The changes being made in the context of my favorite part of the game, PvP, all bring us back to the problems that were evident in vanilla WoW: casters have no mobility, crowd control is useless against players, etc.
Because there was so very much crowd control from a few classes, they've basically done everything that they can to hose cc.  Because a few healers were very mobile and some casters were constantly running and casting, they're turning all casters back into turrets.  PvP looks like it's going to be all about just standing and hoping to out gear your opponent again, which I find very discouraging.
After spending the last few months in my max level PvP gear earned through the conquest system being gunned down by raiders in a legendary cloak that was more or less handed to them the first week it was available, I'm not encouraged.  And I'd be okay with that, kind of, if I felt like it were going to get better.  But it just doesn't feel like that's going to be the case.
I get it, juggling PvE vs PvP is hard.  And end game PvE players want to, and should be, rewarded for their work.  But so should PvP players.  Also, there's the balance between the random/casual PvP player in battlegrounds for honor and rated battlegrounds or arenas for conquest.  Although even then, WoW forces a specific type of play onto PvP players that they do not for raiders: if I want to cap my conquest points for a week, I must play in a rated battle ground.  Forget that I don't enjoy them.  Forget that I'd prefer to play arenas with my 2 partners who are also my friends (one of them is my husband).  No, if I want to cap my conquest, I either need to play enough games (far more than just 10 wins if experience of other highly rated players is to be believed) to get my rating higher or I have to play in a rated BG.  There is no comparable experience for raiders: they can cap valor in raids every week.  No one forces them to do dailies, there's no requirement to do heroic dungeons or scenarios.
Again, I get it that PvP is complex: something that may balance a priest in 3s may make her overpowered in rated battle grounds.  Something that makes a paladin less brutal in RBGs may totally hose her in arenas.  Something that saves a monk in the world from being ganked may make her unkillable in a 2s match.  I do understand.  And I could be okay with the balance that is created by WoW's developers if they were more transparent about why they make certain changes.
Unfortunately what I'm seeing is more and more homogenization of the classes, particularly in the case of healers.  I really really adored the new playstyle of the mistweaver monk.  I LOVED fistweaving and learning to be able to hit and heal.  It certainly wasn't for everyone, but those people could play priests or pallies or shamans if they wanted more standing and healing, and that's okay.  That's the beauty of a game that offers 11 classes.  They should all feel and play differently.  But, particularly with healing, that concept is being lost.  Racials are being changed.  Profession bonuses are being removed (instead of just giving a similar buff for every profession to people).  I just feel that the more I see and read, more of the richness of the game is being removed.
So, I play Wild Star.  It's a game that is new enough and has enough depth out of the gate to feel like that richness has been returned to me.  Will I deactivate my wow account?  Probably not this week.  But if, come the expansion, Wild Star still has a grip on me like it does now, I suspect our three WoW account household will likely drop to 2 or fewer that are active.  And that makes me sad a bit for WoW and how much fun and joy it brought me for the last 7 years, but sometimes you just outgrow one another, I guess.

An Open Letter to Disney Channel and "Girl Meets World"

I have an 8 year old daughter.  And that means that she loves Disney.  We're not one of those No Television or Social Media <tm> families.  We watch TV.  We go to movies.  We end up consuming a lot of Disney: the princesses, the movies, the tv channel, the shows, the whole damn thing.
Most of Disney is pretty solid: we like seeing diverse families, we like the family friendly fun, we like that they're okay with LGBT folks.
But lately, watching the Disney channel, I've been increasingly disappointed.

It started with the show "Kicking It" about a guy who runs a karate dojo and the kids he teaches.  That's all well and good, other than the fact that there is a character, I'm not kidding, named Bobby Wasabi.  He's pictured to the right.  If you hadn't noticed or can't see the image or live in the 1950s you might not realize that he's a white guy who is doing what is commonly referred to as 'yellow face.'  Using Asian stereotypes in the form of his makeup, his stick on 'fu man chu' beard, his wig and his over the top Asian dress.  I was offended enough by this that I made the kid stop watching the show.  I'm not sure if they're making new episodes, but we still see the occasional ad for episodes, so possibly they are.  But we don't watch it.

Fast forward to this summer and the introduction of their new show, "Girl Meets World."  If you were or had a kid in the 90s, you might have seen this show's predecessor, "Boy Meets World."  I wasn't, so I didn't.  But it was a coming of age show that centered around the main character, Cory and his experience from elementary school through college and marriage.  It explores his relationships with his family, with his friends and his place in the world.  Well, at least that's what I understand of it from the few episodes we watched leading up to the "Girl Meets World" premiere this summer.  Cory dealt with his friends, a relationship with the girl who ultimately becomes his wife, his family, and so on. It focused on Cory but wrestled with a number of heavy issues, if the Wikipedia page is to be believed.

So now, 14 years after the original went off the air, we have Girl Meets World, where Cory and Topanga are now married and they have a pre-teen daughter, Riley.   Now, admittedly, BMW likely had a while to grow and improve, being a sitcom in the 90s during ABC's TGIF heyday.  This was back when shows were often given a few seasons to find their feet and figure out what they were and their message.  Also, in fairness, we're only 3 episodes into the new show.  I'd recap the plots for you for those 3 episodes, but there's Wikipedia, so why not let them do it?

I'll give you the recap from a mom watching this with her 8 year old daughter: Riley meets the new boy in school, he's cute, she's in love, she spends every episode obsessing over him.
It's weak.  It's beyond weak.  It's as offensive as Bobby Wasabi.  It's a parade of bad caricatures and stereotypes.

This show is supposed to be about a girl figuring out who she is in the context of her family, her friends and her new middle school.  It's supposed to be about the challenges of starting to recognize that she's growing up and needs to make the world her own.  Instead, she's a perfectly gorgeous girl who is quirky and adorable in her affects and dress.  She has her entirely too worldly aware friend, Maya (also perfect in appearance. We don't know much about Maya yet other than she's a 'bad influence' in that she doesn't like to do homework and she knows all about boys.   Then there's Farkle.  They had to call him that because "Ducky" and "Geek" were already taken.  You guessed it: he's the nerdy kid in love with the gorgeous girls who don't realize how gorgeous they are (they, of course, tolerate him and use him as a friend but don't love him back).  And of course, there's Lucas.  Lucas has no depth, other than being the new boy from Texas.  He's got an occasional country/southern accent and he serves no purpose other than to be obsessed and fawned over by Riley.

Not even a character who was developed over 7 years on television and widely lauded can survive the sexist stereotypes this show shovels out.  Cory is now reduced to a neurotic dad who doesn't want his kids to grow up and spends all of his time as Riley's teacher trying to keep her and Lucas apart, lest that boy corrupt his sweet, innocent girl.  (By the way, there's no chance of that happening yet, Riley can't get up the courage to speak out loud to him in 90% of the 3 episodes we've seen.)

Unless a meteor hits this school and Riley is suddenly charged with leading her friends to safety from the oncoming zombie hordes, or, I don't know, she takes a class other than history or expresses an interest in something other than Lucas, this show is going nowhere.
More importantly, my daughter won't be allowed to watch it.  Which sucks for me, since she seems to like it, but I can't stand the idea of showing her yet another show that tells her she is only an interesting character in relation to the boys in her life.  Riley could be a strong young character with all of her requisite 7th grade fears and problems, but the only one this show and its writers have chosen is that related to boys: the nerdy one who loves her but whom she doesn't want and the gorgeous one for whom her heart is all a flutter.  They haven't shown her worry about her grades, her classes, family conflicts, or even just fitting in with other kids (well, other than that one episode where she was insanely jealous when another girl in school shows interest in Lucas).

All I can say here is this, shame on you, Disney.  Shame on you for bringing us heroines like Merida whose main conflict and resolution have to do with her family for the right to choose her own husband, should she choose to marry.  Shame on you for showing us that an act of true love doesn't have to be romantic love, like the one Ana showed Elsa*.  And then on the heels of those strong messages, you bring a whole generation of little girls (and boys) this sexist drivel on a weekly basis. I guess you were afraid girls would learn to define themselves outside of their relationship to boys, so you had to shut that self empowerment down.
Unless this show turns around right quick, it's going to find itself in a place of honor at our house: on the "blocked" list.


*FYI, Disney, as an aside, you only get partial points for Frozen, since when Elsa decided to "be herself" she got completely tarted up in her low cut dress with the slit up the side to her hips.  She couldn't be herself in something less completely and obviously meant to be sexy?

Service. All of it.

It's the 5th of July.  The day after Independence Day.  We celebrated, talked about the importance of freedom with our kid, watched the Schoolhouse Rock videos with our kid on youtube.
You know the drill.
Tonight we made the fairly short trek to the home of my sister in law and her family and we celebrated being a family in a free nation.  Okay, long on the family and short on the free nation bit.
But we celebrated.
And then, we came home and I caught up on my social media, like you do. 

This one post on the Book of Faces, as I like to call it, caught my eye and my heart: 
"First if all, Senator, I'd like to thank you for accepting my friend request. Secondly, I want to thank you for what you did for me. In 2000 I was in the MTARNG as a medic. I decided to go back to Active duty an was denied a hearing waiver. I took all my paperwork to your office. In December it was overturned. And reported to Fort Campbell after t h e birth of my son, in January. I'm now a Disabled Vet from my tour in Iraq. Which is fine. Because of you I was able to live my dream of serving my country as a Soldier. Thank you again, so very much. I'm am deeply in your debt."

It was posted on my father's FB page from a  high school friend.  In this very moment my worlds all collided: social media, high school, family, world.
This grateful friend was delighted at the opportunity to serve.  To serve. In a time of war.  A war that was based on lies for some and freedom for others.  A war we didn't ask for but we received.  And this friend, and I do call him a friend, answered the call, and asked (nay, pleaded) to be part of the ugliest, scariest, most dangerous part of it all.  And my dad, having been a servant of his country and his state, obliged him with his service.

My dad's service to his country started in the US Marine Corps and has never ended.  Despite his honorable discharge after a few short years of service, he never forgot what it mean to be a Marine.  And he is still that corporal at heart today. And in his years in the US Senate, he was dedicated to every plea for help from any  serviceman, whether it was to help a soldier home to give half of his liver to his mother or to help my friend return to active duty during wartime.

And that just makes me think how proud I am of this nation and her people.  While we are far from a perfect society, we are striving to be better.  We are striving to accept our fellow men and women more completely for who we are.  In the same week that SCOTUS made what was seen by many as a disappointing ruling that gave corporations the same rights of religious freedom as individuals, anti-gay and LGBT legislation was struck down by courts in individual states.  We seem to take one step forward and one step back.

BUT WE ARE TAKING STEPS.  The fight is being fought.  The conversations are being had.  And that, as much as anything in this time of turmoil and unrest and religious fanaticism around the world gives me heart.  We are having the conversation. The response is not a foregone conclusion.  We are becoming a nation who no longer is content to sweep injustice under the rug.  We may not be, and we are far from, perfect.  But we have not given up on the idea of freedom.  We simply haven't.

As disappointed as we may be with this issue or that, steps are being taken that can't be taken back.  My daughter will grow up in a world where it's okay for her to stand up and say "I fight like a girl" and maybe it won't be an insult anymore.  It'll be okay for her to love whomever she chooses.  And it'll be okay for her to speak her mind, to be a 'fangirl', to be smarter than the boys in the room, and to be "girly"-- whatever that will mean when she's a young woman.

On this day when I have celebrated family and joy and freedom.  I thought it would be disappointing if all of these things went with out saying.

Thank you, sincerely, from the bottom of my heart, to those who have served in the war zones abroad.  Thank you to those who have questioned the loss of life and treasure for a trumped up reason. Thank you to those who protect me and my family from fire, from danger, from loss.  Thank you to those who serve to make this nation the example of true democracy our founding fathers hoped for, but could not create.  To the the outsider, the disenfranchised, the hopeless, I say to you today: there are people who see you, who hope for you, who work for you and who love you, as our Creator loved you.

Happy Independence Day, America.  This feels like our cantankerous teens, and we have a long way to go. But we've grown so much, and we have much to celebrate, and we should not neglect to do so.

It's Gotta Be The Shoes

So we're well into our 2nd month with the treadmill desks.  As I posted before, Noah's down 18 pounds or so, and I'm down 11.  The past week and a half or so, I've sort of scaled back.  Not because I don't want to work hard, but because my time constraints are a little wacky.  Also, my feet were killing me.
When I was in residency something-teen years ago, I had a problem with plantar fasciitis.  It's basically an issue that causes inflammation and pain in the heel through the arch of the foot.  It's usually a challenge to treat, given that it takes a long time of daily stretches, ice and occasionally night splints.  I am pretty sure that 3 years of spending quite a bit of my time on my feet wearing what probably weren't the most supportive shoes caused it.  Once I got into private practice and wasn't walking the hospitals for hours at a time or standing in surgeries and so on, it resolved.  Oh, that and the daily stretching, icing and night splints.

Anyway, about 2 weeks into the walking, my old friend was back.  My arches hurt, my heels hurt, even my ankle hurt.  I assumed the ankle was just the tweaking of an old injury.  I've turned my ankles what feels like 100 times.  Four or five days of wearing an ankle splint and the ankle was back to solid.  The heels and arches?  Not so much.

So, I started looking at my shoes.  I'm a shoe girl.  I have lots of shoes.  My husband finds it crazy, since I pretty much wear the same 3 or 4 pair of shoes all the time.  And him?  He's got 3 pair: a pair of sandals for summer, some boots for winter and some dress shoes that he's probably had for 15 years.  I have sneakers, running shoes, walking shoes, dress shoes, work shoes, boots, sandals, strappy shoes, well, you get the idea.

I started digging out all of the vaguely athletic shoes I own. These vary from shoes I bought for trips, for hobbies, because they were cute, whatever.  Most of them were buried under other, more professional shoes.  I sort of gave up wearing sneakers for much, given that I had discovered the Chaco sandals for summer active wear, and really the only time I used the athletic shoes was for walking or when I flirted with running.

So I started with the Brooks.  The main problem I had with them was that they're old.  Like almost 10 years old.  Somehow my feet have changed enough and these shoes are old enough, they were pinching the backs of my heels and my achilles tendon.  After a day of wearing them at work, not even on the treadmill, I had more or less constant pain.  They got tossed on to the Goodwill pile.

Then I moved on to the Asics gel shoes that I got sometime last year.  I'm not sure why I got them, I guess I just like them.  They weren't bad.  The gel definitely helped with some of the heel pain, but really didn't seem to lost with long walking sessions.  Once I'd take a wee break, as soon as I started back up again, my heels and arches were aching.  So they were better than the Brooks (again I think their main issue was their age more than engineering), but not ideal.

So, I broke down.  I went to the sporting goods store.  The local one nearest my work is Dick's.  Or, as we like to call them, Richard's.  You know, to keep it family safe.  Now I know that Richard's is not staffed with experienced runners.  At noon on a May weekday, the chances are, it's not really going to be manned by running experts who will measure my shoe, watch me walk, assess whether I pronate or supinate, and so on.  I already knew a lot of that stuff based on buying the Brooks at Ninth St. Active Feet in Durham.  I got a guy who asked me what I'd like, he pointed me at the shoes on sale (I didn't want to spend a fortune), and I tried them on myself, walked around the place, decided out of the 3 pairs I tried that I liked the Saucony Cohesion, and bought them.  I still spent too much on them, but it was under $70, so no problem.  I liked the shoes.  I liked how they felt.  But like the Asics, after a while, my arches and heels started hurting again.  So close, but no cigar for the standing pair of shoes for wearing.

Realizing that I had bought a pair of the Saucony Kinvaras a couple of years ago for the Couch to 5k running program, I dug them out.  When I got them initially, I didn't like the way they fit.  I remember them being too small.  Once I had them out and tried them again, they seemed to fit fine.  Maybe my toes lost weight?  The thing I love about these shoes?  They are light.  I mean SUPER light.  Like, both of them together weigh less than a pound.  The mesh keeps my feet super cool.  They are super flexible in the sole.  They have a nice, ridged arch support, which felt great.  At first.  Then after about an hour and a half at any speed over 1.4 MPH, my arches started to ache, and how.  Once again, disappointment came in the form of my shoes.

In the process of all of this, I was mixing my Keen sandals.  The first day I walked in these, I hated them.  They are just a smidge too small around the ankle where the foot goes in.  They're the right length and have a great open toe box, but getting my feet in them is a challenge.  So I gave up on them fairly early, since after about 45 minutes, I was starting to have tingling in my toes.  No pain in the arches or the heels, which was a damn delight, but no feeling in my toes, which was very disconcerting.  So I gave up on them for anything other than weekend kicks, nothing to be used on the treadmill.

Then, earlier this week, Noah was bragging about a new pair of Skechers he picked up.  They had memory foam insoles.  They were comfortable and affordable (he had gotten a pair of Saucony running shoes, also at 9th Street Active Feet, after being measured and evaluated by an actual runner who was trained to put people in the right shoes).  He liked his shoes he had been using, but he had started to subscribe to my theory: shoe switching.  My best solution for the shoe issue was shoe rotation.  I don't mean wearing one pair one day and another pair another day.  I mean wearing one sort of shoe to work (usually Danskos or Clarks), slipping in to a pair of runners when I get home and then changing in a couple of hours.  Some particularly long walking days, I would change shoes 3 or 4 times.  In his search for a similar pair of shoes to swap out with his new running shoes (but ones that cost less than $170), he had found these memory foam insoled sport shoes.

They came today.  They're bright (although I have the option for blue laces, but what's the point of that?!?), they're light, and they're comfy.  I had to try them on twice, since the first time I put them on, I forgot to take out the cardboard insert on the bottom of them.  They have a built up heel, which takes a little getting used to, but that isn't as much of a problem as I was fearing it would be.  The raised heel seems to help with the PF pain, without putting too much pressure on my arches.
I think these shoes aren't going to be a miracle solution.  I mean, I like them, and I like them more than any of the others at this point.  However, I'm still fairly convinced that I'll need to stick with the shoe rotation approach.  The real challenge will be when I get into the bed tonight: how long will my feet ache before I fall asleep.  I am hoping the memory foam, and the experimentation with more compressive socks will be the ticket.
Either way, I'm on my 2nd mile today, with probably 2 more to go, and they're holding up pretty swell so far.