Archive for June, 2011

Searching for Attachment at Home

This article first appeared on the PBS affiliated Website This Emotional Life. This content is provided in conjunction with This Emotional Life’s Early Moments Matter initiative. Early Moments Matter is dedicated to making sure that every child has the best possible chance at emotional well-being. Find out how to receive the Early Moments Matter tool kit and provide one to a family in need.

“Not until we are lost do we begin to understand ourselves.” –Henry David Thoreau

Yesterday I awoke feeling somewhat uncomfortable. Looking around the room, I checked the facts before me.  Yes, it was my home, my family, my face in the mirror, but something was still missing. Concluding this to be a typical morning sensation, I decided to follow tradition: Make some coffee and read the newspaper.  In recent years, however, the newspaper has been for me little more than a spring and summer luxury within which I can scan baseball box scores and statistics. Still, with nearly 80% of the season left, I thought I should have no problem catching up quickly.

With coffee and toast at the ready, I was soon armed with key baseball facts — the American League only of course — and ready to move on to the Wall Street Journal.   As I thumbed through page after page of news, digesting financial facts and perusing stock market tables from the day before, it suddenly hit me that I could not honestly answer my wife when she asked me why I still received the paper’s print edition. Returning to the local paper one more time, I finally understood what was so unfamiliar with my morning:  I had nothing to do, and I was restless.

It was only the other night that I joined forces with the other nine percent of our nation’s unemployed, but on this first wayward morning my overall sense of detachment proved uninspiring. For nine full years I had headed a community hospital in southern Los Angeles, and I was used to a little drama with my morning meal. The drive to find something new on which to focus had not yet overpowered the need to put out any potential fires that had erupted at the hospital overnight, and my instincts were still primed to react to quick moving scenarios where the balance between life and death hung fast, waiting for a reaction. Today, however, I had no crisis to manage, no dragons to slay, and no urgent phone calls or emails to return. The only real enigma I faced on this first morning was to ask myself why I felt like a stranger in a home where a three-month old infant served as the poster child in support of the very idea behind positive attachment. Warily, I considered my options, and quickly concluded that ignoring this situation until it escalated into something dramatic and life threatening that my health care focused brain could understand was not a healthy way of looking at this first new day. For nine years running I had proven that I could solve almost any problem with which I was presented, and today I was determined to find some attachment.

To my knowledge, there are five permanent “entities” and one guest living in my home, aside from myself, and so I decided to work my way up the ladder in reverse order, in search of attachment. I began with Max, an arrogant but often lovable Pekingese who was unfortunately busy with a mid morning nap.  Then came Amnesia and Segundo, two black cats full of kindness and compassion, who, like Max, were also sleeping, which was not entirely unexpected, as they are cats. I then proceeded to the more animated individuals in the home, those with whom I knew I could communicate, where I believed I would find the attachment I so desperately sought.

Jackpot. My wife and son were feeding, and I thought to myself that symbolically, at least, my quest was now complete.  My mother-in-law was telling what appeared to be a very engaging story, and I smiled to think that this moment reflected the positive domestic light of a home based on solid and secure relationships with free and easy conversation.  Unfortunately for me, however, the tale was told in Russian, and I simply could not follow. Still, I held my ground, and a few minutes later I made my move, scooping up my son to effectuate the necessary post-feeding digestive adjustments, and for a brief moment I was able to bask in the glory of this fleeting victory.

Sadly, my success was short-lived, as not twenty minutes later I was informed that my son, my wife and her mother were late for a class that I had neither business nor interest in attending. So I opted to stay put and lower my sights, still determined to find some attachment with the dog and cats.

But the animals proved fickle, as house pets tend to be, and their desertion had been at least in part expected. What was worse, though, was the fact that the desk in my office, my old battle-mate, brought no relief either. Just last week my computer stood as a portal to another world where healthy, meaningful relationships roamed in great abundance.  Today, however, this connection seemed lost, and I learned a hard lesson about the dangers to be found in errant, virtual attachments. Feeling abandoned and lost, with no point of focus, I left the house to complete some menial tasks, none of which were necessary, all of which proved unfulfilling. After completing every menial errand I could concoct, I returned home with the somewhat forced notion that I deserved to consume a well-earned lunch.

But then I stopped. Let it here be said that we all have fictional boundaries in our lives, boundaries of our own devising, some of which are more accepted and important than others.  For the record, I have many, most of which I break, but there is one hard and fast statute on which I simply will not budge.  I refuse to eat lunch at 10:30 am.

And so, with a grumbling stomach but without much choice, I resigned myself to the couch and watched a pre-recorded episode of the television show House.  As I relaxed and gave myself over to the drama unfolding before me, it hit me that this would be as close as I was going to get to a hospital for the rest of the week.  And just when I thought I had failed in my one and only objective for the day, Max the dog materialized from under a table, jumped on the couch, and rested his head on my leg with one eye fixed on the television. Together, we watched in silence.  Indeed, we bonded.

Still not quite lunchtime, I reflected on why I have had such a difficult time finding my attachment this Monday morning. While it is true that the past few months I have spent transitioning a hospital (with a 24/7 emergency department) between owners have made me a stranger of sorts in my own home, my thoughts have always been primarily with those who rest beneath my roof, and it is to them that I have sought to return. When it comes to my son, I feel at times that I have arrived late to the party, though I marvel at the energy my wife has spent building a safe and secure environment for him. In fact, the bond she has formed with my son during this period in which I was preoccupied is exactly what gives me hope for the free time which now stretches before me. It is in many ways a gift for which no amount of education, experience or desire can prepare me.  The key to any bond rests with time spent together. And I for one cannot wait to begin.

Go to www.earlymomentsmatter.org to learn about attachment and to get an award-winning toolkit that introduces ways in which parents and caregivers can help their children build secure attachments.

 

The House that Barack Built

As the former CEO of a small community hospital, I am reminded daily of the frustrations set upon today’s sick as our nation’s health care system struggles to adapt to fundamental changes in its core structure.  In many ways it calls to mind the trials and tribulations inherent in former New York Yankee owner George Steinbrenner’s attempt to build a new home for his beloved team.

Steinbrenner first began campaigning for a new stadium in the 1980s, alleging that the House that Ruth Built was no longer sound and posed a threat to all those in attendance. When his idea was met with resistance, the Yankees considered several options, including a move across the Hudson to New Jersey as well as one to the West Side of Manhattan.  At long last, after myriad delays caused for the most part by New York City politics, the proposal for the new stadium was unveiled in 2004.

Groundbreaking ceremonies took place on August 16, 2006, the 58th anniversary of Babe Ruth’s death. Thanks to the proximity of the two fields, the Yankees were able to continue playing in their old home throughout the 2007 and 2008 seasons while their new stadium was being finished across the street.  As one would expect, Yankee fans stayed loyal to their team throughout, and the new stadium was officially opened on April 16, 2009.

Whether you loved or hated him, it was largely thanks to Mr. Steinbrenner’s business acumen that the Yankees could afford to play in the old stadium while the new one was being built.  It would be equally appropriate if health care reform could work this way, shifting from a dilapidated system to a fully functioning alternative on a specific day. However, the foundation of an innovative health care system is much more fluid than Bronx bedrock, and the necessary combination of time, logistics and money (trillions of dollars over decades) makes this an impossibility. Instead, we must “feel” the transition, painful though it may be.  As with any endeavor of this magnitude, patience is essential to success.

While the idea of a Yankee fan cheering for his team as a pile driver goes about its business in the next row may seem absurd, that is exactly what the American patient is currently being asked to endure.  That said, the growing pains felt by the effects of the Patient Protection and Affordable Care Act (PPACA) are an inconvenient yet vital step in the evolution of a solidly functioning health care state.

In their very first year in the new stadium, the Yankees won the World Series and the fans went wild.  Whether the citizens of America will be as appreciative of their new health care structure remains as yet to be seen.

This article was originally posted on ModernHealthCare.com.

 

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