Dear America, I'm Breaking Up with You

Dear America,

This is a very hard letter for me to write, but I think I need a trial separation. I want to see other countries.

As you've probably noticed, I've been pretty unhappy in our relationship, and over the past few years our interactions have become increasingly strained. I've become judgmental and short-tempered with you, and that's not the sort of person I want to be.

It's hard to say when it started. It just seems like you aren't the same America I fell in love with.  As a little girl and even as a young adult, I remember you struggling with growing pains -- you are, after all, only about two hundred years old. But most of the turmoil seemed to involve people struggling for equality, and (mostly) achieving it: women marching for equal pay, people of color striving for respect and equality. But overall there seemed to be a sense of unity, of one nation coming to some sort of improved condition for all its citizens. ... 

But now? I don't get that feeling. You're different, somehow.

And maybe I've changed, too. I have, after all, been visiting other countries and experiencing their cultures during vacations for over the past few decades. And while I realize there is no "perfect match" or "soulmate" country, I can't help but wonder if the values of another culture might coincide more closely with my own than yours have, especially as of late.

We've been together over fifty years now, and I want you to know it's very hard for me to leave. There are so many things I love about you. Your youthful enthusiasm. 

The sprawling vastness of your diverse states and their varied terrain and peoples. The freedom of individuality lacking in many other cultures. And the wealth -- yes, America, you have been a bit of a sugar-daddy to me, and I have enjoyed the spoils of such riches.

So, then, you might ask, why am I leaving? Look, I don't want this to be an America-bashing letter -- letters are so one-sided, after all. And maybe you have some complaints about me, too -- that my eyes have been looking elsewhere for a while now and I haven't been truly committed to improving our own relationship instead. I have to admit that's a fair accusation, and not entirely inaccurate, but even if I wanted to "fix" us, where would I begin? After all, I'm only one of three hundred twenty million voices wanting... needing... your attention.

But I guess there are some things that bear mentioning:

Probably the biggest thing is that your ego has grown in leaps and bounds. 

It's always, "America's the Best" and "We're Number One!" I don't know how you've come to think so highly of yourself. Yes, there are things you do and have done amazingly well. But that doesn't make you "the best." (The best at what, anyway?) You yourself would have to admit it's disgraceful that you don't have universal health care for all of your citizens and that the quality of public education has deteriorated significantly. The gap between the standard of living of your poorest citizens is no longer even within sight of those of the "top one percent." And even the middle class is barely squeaking by, many of them working multiple jobs. A little humility would go a long way toward making you more attractive. 

(Also, could you shelve some of your flag paraphernalia? Honestly, I've been to France six times and I do not believe I have ever seen even one person waving a French flag, much less a t-shirt or hat or bumpersticker.)

But it's more than just the money. What happened to the love? What happened to the sense of family or community? Nowadays, it seems like you're constantly at war with yourself. You're so angry. The gloves have come off and there's no more respectful and dignified debate, just insults hurled back and forth. -- No love. No respect. No dignity. No more compassion or empathy. I wonder what would happen now if a big earthquake destroyed California -- would the citizens be criticized for having chosen to live on a fault line? Would that justify blame and maybe even lack of your assistance?

And of course, the guns. I think on this point, you and I just have to agree to disagree. I don't like guns. And I don't think ordinary people should have them. There's just too much potential for things to go badly wrong. And I'm not naive. I don't fail to understand that there will always be people who want to do bad things to other people, and there are always knives and homemade bombs ... any number of methods, really. But your refusal to discuss the possibility of giving up even certain types of guns ... Well, America, frankly, it's creepy. The whole thing smacks of addiction, like gambling or pornography. Maybe you should consider a 12-step program, ... but of course first you have to admit you have a problem. -- Just something to consider.

And, follow-up question: America, why are you so eager to go to war with everyone? What's that about, anyway, so much war? Personally, I think the military industrial complex is pulling the wool over your eyes and just stroking your ego to keep you lining their pockets.

I admit, with our history, guns are going to be a hard problem to solve (or even manage) since you've had them since the beginning. But Australia managed somehow; maybe you could ask them for advice? Oh, that's right, you don't ask for help, because you always know best. I forgot.

But maybe you aren't even sad to see me go. Maybe as a fifty-year-old woman with no children, I've already disappeared in your eyes. I'm only as good to you as the resources you squeeze out of me -- taxes to fund your war machine, votes to further your political agenda. Certainly, you seem to value youth and vitality far above wisdom and experience. As I'm getting older -- not "old," mind you, just older -- I feel squeezed out by you. In a word, neglected. There's no place for me in your life. 

What am I to you? According to the commercials I see on TV, I'm only considered sexual when I'm the bait for some guy who needs erectile-dysfunction meds. I have plenty of good years left in me, America -- yes, I have a few dents and bruises over the years, but doesn't that make me more interesting overall? -- What's that? It doesn't? Unless I can party until three a.m. and dress and look like a twenty-year-old, I have no value to you? -- This is why I have to leave. I enjoy and appreciate being fifty. I think it adds to my value, not detracts from it. And you seem to disagree. Always, always, your eyes are on youth.

All right, look, I don't want to belabor the point. Maybe your system works for you, and it just doesn't work for me. Obviously, I've been thinking about this for a while, so you may ask "Why now?" Well, it should be obvious:

It's not that he exists -- he or someone like him will always exist. It's that, not only was he not laughed right off the platform, but he was actively embraced by millions. I don't know how you let this happen, America. Come November, it may surprise some that he would be chosen to lead us all for the next four years.... but it won't surprise me. Because I think he is that ugly pimple on your face that shows up after you've already had pain and itching in that spot for several days -- you just knew something terrible was going on, and now here it is. But he's just a symbol. He's a manifestation of the anger, bigotry, racism, misogyny, -- did I mention "anger"? --- that's rampant from coast to coast. And your very broken political system has made it such that, once again, there are only two choices come November: Us or THEM, and sure as hell, NObody's gonna vote for THEM!

So then, you might ask if there's a specific "someone," a specific country I have my eye on. And, y'know, there isn't. As you know I've always been a little bit in love with France. They love food and wine, and appreciates leisure in a way that's very appealing. 

But the UK has been drawing my gaze lately, as well. Of course, the UK's sense of humor is right up my alley. And I heard a commentator on BBC the other day say the Brits do "melancholy" very well, and that appeals to me, obviously. And the BBC TV shows -- have you noticed that someone always has a medical issue? I appreciate the acknowledgement of that reality. On "The Good Wife," does anyone have a heart problem? Or dementia? No, that's not very American, to get sick. 

And then there's Finland, Norway, Sweden -- education is important, a sense of cultural support, ... all very appealing, and all values you seem to lack these days.

In any case, I'm leaving you. Whether that turns out to be forever or just temporarily, I can't say for certain. I'll be watching you, always. I do love you, after all. My life with you has given me so much -- I could never properly express my gratitude. But gratitude -- and a bit of fear -- are not enough to prevent me from wanting to try to find a country where I feel more at home. 

What Hernia Surgery Taught Me About Veterinary Medicine

Four weeks ago, I had surgery to repair a hernia in my abdomen. Even though it was a fairly small and uncomplicated hernia, the surgeon implanted a small piece of fortifying mesh and instructed me not to lift anything heavier than twenty-five pounds for the following six weeks. He said I could return to work for half-days in the first week post-op, so that was a nice little laugh, thinking about an ER veterinarian working a "half-day," ... What would that be? Only seven hours?

I've been an ER vet for about fourteen years, non-ER for about five years before that. All small animal. My job is very busy, very active, and very physical. But I don't think I ever knew how physical until my doctor placed a restriction on me. Still, I thought, I can probably do most of my job unaffected... right?

I should also mention I tend to be a "doer." I dive right in and help out, especially if the staff is occupied with another patient. So, in an effort to remind myself not to over-do, every day at work I would write "20#" on the back of my right hand in black Sharpie. (Much like ventilating a patient, if you don't exceed twenty pounds, then you'll never exceed twenty-five, right?)

From the very first day, I realized two important things about my job of twenty years:

1. The technicians and support staff have underappreciated challenging jobs; and
2. Veterinary medicine (even small animal) is very very physical.

I mean, I already knew both of these things on some level -- you can hardly work in a clinic without that awareness -- but from this new perspective, it really hit home.

From the very first day, when I still had pain and inflammation around my surgical site, in spite of nonstop NSAIDs and between-appointment ice packs, I felt the impact. My first appointment was simple -- a two-year old labrador for an ear infection. He was a nice dog -- but he weighed about ninety pounds. In fact, he was a bit too nice, wanting to greet me by bouncing up at me, in spite of the owner's hold on his leash -- my hands instinctively covered my surgical incision, in case a stabby paw or toenail made contact.

Typically, I just get down on the floor with the dog and perform my exam there, get the ear swab samples, do a little demo of cleaning and medication treatments, all while the patient is bouncing around underneath me. But with my post-op restrictions, I had to come up with a Plan B. I asked the client to walk their dog up onto the low-table, and then we'd use the motorized foot pedal to lift the table. She did so, but the dog kept jumping off. I explained I had an activity restriction from my own doctor, pointing to the "20#" scrawled on the back of my hand, and asked her to try again, this time keeping a hand on the dog's collar and comforting him while the table was raised. That went much better, and I was able to get the samples needed and the treatments administered.

The rest of the day went much the same way, with me guiding clients into helping me. For the most part, they were happy to comply, even though I almost always had to ask. However, there were a few clients who seemed to either be afraid of their dogs or even to feel it was not their job to provide assistance. So for these pets, I would go find a tech to go into the room to get the dog and bring it back to the treatment area.

And if I ever didn't appreciate my techs before -- and I do, I really do. -- I do now! Lacking the ability, myself, to wrestle even friendly patients (not to mention those who were fearful and/or aggressive), I had to rely on the staff to do all the restraint and lifting. Sometimes it took three or four techs to restrain a pet, between the safe handling and distraction. -- But you already know this, how "it's just a nail trim" quickly turns into a bodily fluid wrestling extravaganza involving a change of clothing for at least one staff member.

(Watch the video clip here:  
https://www.youtube.com/watch?v=8JQlsyWbxKM)

But here's what I also noticed: most of my techs are in their twenties and thirties. And they're handling patients that weigh ninety, one hundred, one hundred fifty pounds. Every day. Even if cooperative, those pets have to be lifted up and down from radiology and surgery tables, sometimes while unconscious ("dead weight"), sometimes awake and flailing. -- And you know as well as I do that most techs consider themselves part Superman and try to lift those eighty-pounders all by themselves, usually less often out of pride than unwillingness to trouble their coworkers who (especially in an ER practice) are equally busy caring for other patients.

(If our clinic ever starts see pigs as patients, we're hiring this guy.)

Here's what I also know: I'm fifty years old, and my body isn't what it used to be. Among other ailments, I have intermittent lower back pain and an occasional flare-up of a pinched nerve in my neck. I haven't had any specific accidents that have caused these conditions, just the day-to-day wear and tear of everyday life. And maybe also my career in veterinary medicine. So I can't help but wonder about my young coworkers, who have two and three decades before they reach my age. And I wonder why we don't all just take that extra two minutes to wait for a colleague to come help us carry a heavy patient, instead of trying to do it all on our own? Surely the bites and scratches and occasional head-butts are physical trauma enough, aren't they?

And then a collapsed and pale hundred-pound Lab comes through the door, and I remember how urgency trumps logic and planning, as we all dive into action around this critical patient.

But not every patient is critical, and we have to remember this is a marathon and not a sprint. We must pace ourselves and take care of our bodies, if we want to last. And so when I am cleared of my weight restriction by my doctor next week and can erase that Sharpied "20#" from the back of my right hand, I hope the spirit of its message remains.