Sunday, May 31, 2009

Teenage Angst

I have been struggling with my teenage daughter. Whenever I get excessively angry, I have to remind myself that she is figuring out how to be independent and be her own person, and part of that is avoiding her family and her home and her life here. I remind myself to just let go and let her be, and then I get pulled in because she is not truly independent or prepared enough to be on her own. I am reminded that every generation bemoans the next. We remember being so capable as young people. Were we really so responsible? What if I have not prepared her well enough for the world? She is off to Italy and France for the summer and has found herself a job in San Remo and Nice. What a resourceful person she is! She has decided not to go to NYU next year and volunteer in Ecuador while we are there. On the surface that sounds like a wonderful idea, but I have all sorts of worries about her and her choices and her safety. But then I remind myself that I have no control over her life. I have given her the freedom to decide where she goes to school and what she studies and what she does with her year off. I find it very confusing when she yells at me and tells me that I control her life and ruin it all for her!

I don't think she believes me when I tell her I want her to live her own life and figure it out for herself. I remember doing exactly that as a young adult, and loving the freedom and the possibilities and the adventure. Turning eighteen was so exciting! Anything could happen and I could make it happen! I don't think Tara has got to that point yet. She avoids coming home and then when she does come home she feels confined and limited and angry at me. And I get angry because she does not participate or involve herself in our lives. Why would she?

So time to let go, let her be, let her live her life. And I feel relieved. I like having no control, I feel better when I pull back and am less reactive and less involved. I am not sure she believes me when I tell her I just want her to be happy, whatever that is and however that happens. I just don't want it to take too long or be too painful to get there. But I have no control over that either.

Clearly it has been a painful few days. We were with our good friends Daphne and Julien tonight, and Daphne pointed out that perhaps it is difficult for Tara to see us packing up the house and moving everything out. Watching your childhood home disappear must be unsettling, even though she has been away most of the past two years! Perhaps she is resistant to helping out because it is painful for her to move on with her life. I can understand that!

Yet at this moment I am eager to go! We will review the lease contract tomorrow and perhaps meet the potential renters and then attack the remainder of the house and be out of here in a few weeks. This is finally happening!

Saturday, May 30, 2009

We Are Not Moving

So much has been happening in our house and with our plans to move that I have not been paying attention to Baltimore. Spring has come and gone and summer is here. It was a gorgeous sunny day. In my normal life I would never stay inside on a beautiful Saturday, but our lives are so not normal now; we are entirely geared toward moving to Ecuador and that takes precedence every moment. I was back in the office today, saying goodbye again and attacking my mountains of paperwork. Maya was at a skating party with many of her friends from school and from dance class. I was delighted that she tried to skate again. Two Christmases ago she had tried skating at an ice rink in Edmonton, and had fallen on her face. She came off the ice screaming with blood pouring out of her nose. She refused to skate after that, and insisted that she would not get on the ice today. But she did skate and she did enjoy it, and it was a good way to say goodbye to her friends.

Moving to Ecuador is who we are now. It defines our daily lives, our relationships with our friends and every waking moment! Our house must be ready at a moment's notice for potential renters/buyers ( I am not selling the house!), Eric and I have university/office work to do anytime, anyplace. and any time at home is devoted to readying the house in some way. There are always more boxes, more tasks, more cleaning, more organizing. And with each day, the urgency mounts. If we accept the recent lease contract, we must get out next week. We will be in Canada with my family celebrating my niece's graduation the week after and Eric will leave for his two month teaching stint in Woods Hole by June 19, so we have literally three or four days to remove every bit of ourselves from the house (except for the suitcase we each bring to Ecuador). I am not sure where Maya and I will live after July 1. I guess we did not think of that. Maya has ballet camp and I had planned to see more patients into July. Perhaps I will crash somewhere, we certainly have not planned adequately! We offered the house for July 1, but Eric and I decided that I needed to work a little longer to create a bit of a cushion....perhaps we did not expect to get renters as soon as July 1. I find myself reasonably calm about this; it will work out.

Moving to Ecuador occupies all our moments and our conversations. I am repeating the story with each appointment, and at Maya's party I am again divulging details about our plans. I had my hair cut today. I had a half hour between patients, enough to run down to the salon near my office. I took the only available slot, and my hairdresser was a large bodybuilder, who when I mentioned my Ecuador journey, told me he had a regular client who worked in the travel business promoting the Galapagos. I heard all sorts of wonderful things about Ecuador, but also worries about the rainforest disappearing and the Galapagos becoming overpopulated. This man had spent much of his time watching Discovery channel and National Geographic and knew Ecudaor well he had never been there. Of course he thought I was incredibly lucky to have this opportunity. I hear that from everyone; what an amazing chance this is. Of course I agree, but it is easy to forget how remarkable this adventure is. I can get so lost in the burdensome details and forget that in weeks, I will no longer be moving to Ecuador, I will be there.

I was supposed to meet my friend Emily at 5 PM today and was grocery shopping with Maya and her friend, knowing that I was supposed to be somewhere else but not quite remembering. Either there is just too much on my plate or I am truly dementing. I was horrified when I arrived 25 minutes late. Emily is a university professor and a mother and is taking a six week sabbatical to Australia and is totally organized , and is buying a new house too! I was in awe! No more complaining for me! Everything is working out well.

Friday, May 29, 2009

Hour By Hour

Whew! I have worked ten hours daily for four days. That is too much for the type of work that I do, so I feel exhausted! Not that every moment has been agonizing. There have been several instances that my patients have been working to support me when I whine about how difficult the move is! Perhaps I am loosening up at the office, focusing on saying goodbye rather than doing what I ought to be doing, but perhaps saying goodbye is what I need to be doing, and it is saying goodbye that is most distressing. In fact, I have not been consistent at all. I start off the session trying to wrap things up and end up adding another session in another month. I am avoiding saying goodbye.

I came home to children wanting food. I felt like a mother bird returning to her nest with her little birds. I cooked and got everything onto the table and then my oldest daughter picked over her food and ate almost nothing. I have to adjust to my college age daughter being home. She is fiercely independent and has been away most of the past for two years, and is accustomed to running her own life and not listening to her mother or contributing to the household. It makes me crazy of course, and she is clearly eager to get out of the house as soon as possible, which both makes me sad and relieved. I am surprised she wants to come to Ecuador with us; I guess she wants to go to Ecuador but does not want to be too close to her family. Which is perfectly normal for teenagers. I cannot remember wanting to be around my parents at that age!!!!

Maya will have only three more days of school. She cleaned out her desk and her locker today and seems to be gearing toward our year away. When I am more positive about Ecuador, she gets more excited. Unfortunately I have been unable to get her interested in learning Spanish. I have Spanish instruction books and workbooks and they do not catch her attention at all. I wonder how we will get her prepared for school. We register next Monday, and pay a big chunk of her tuition, so that will be a moment of commitment. We have a lease offer too, and that will be another move toward commitment. I want to find something wrong with the offer, so I can have some room to keep my options open. Avoiding decisions as usual.

Thursday, May 28, 2009

Coming Together

We may have a renter; a family came to look at the house for a second visit, and the house was clean and presentable today, so it my happen! We may have to be out by July 1! I wonder where we will live through July. It may be that I will have to close everything up earlier than planned. I ought to be more agitated about it; instead, I feel relieved. We will ramp up our moving date! Yeah!

I look back and have to admit that it is only ten weeks or so that we have been organizing the house, and I have been gone for two weeks of that, so that reduces the torture to only about eight weeks. I have let it irritate and overwhelm me, but with the end in sight, I am looking forward to our move. I will check the airfares and try to focus more on closing at least one of the offices by th end of June.

Eric will be teaching in Woods Hole for eight weeks, so Maya and I will be alone in Baltimore for several weeks, visiting Cape Cod on the weekends. Maya will be in a ballet camp and I will be in the office wading through gargantuan quantities of paperwork. My secretary has stopped filing for me. I am not sure if that is because it is such a disaster in the office (it really isn't too awful, I am just trying to understand her behaviour) or as a revolt because I am leaving. I do not expect to return to two offices; that has been far too complicated. After a year away, I will want a more simple life.

I am actually feeling a smidgen of excitement. It is starting to bubble up a bit here and there. Eric and I have worked hard and accomplished alot. I went on the Canadian Embassy website and registered for my stay in Ecuador. Eric, Tara and Maya will sign up with the American Embassy. Although I am sure that if necessary the Americans will be helpful to me, at least as far as I am related to three American citizens, I did not have a good experience with the American Embassy in Rome. I had been there with Tara and Maya several years ago when my wallet was stolen (very skillfully in the subway between the main train station and the Vatican). My green card vanished along with credit cards and cash and I realized immediately what happened and was able to report to the police and walk over to the Spanish Steps and the very reliable American Express office and get some cash and a new credit card. However, without a green card, I could not return to the United States. I called the American Embassy in Rome several times initally asking, and later begging for the appropriate papers to get me back into the US. They rebuffed me over and over again and told me that my children ( 2 and 12 at the time) were welcome to return without me and that I had no status in the US and they would not help me. I was in a panic, running thorugh the streets of Rome to my hotel, to the police, to the Embassy, which was heavily fortified after 9-11. I kept calling them trying to convince someone to help me. I hung out at the Cafe de Paris on Via Veneto eating gelato with the children,waiting for some sign that I could enter the embassy. After a few days I finally was given permission to enter the courtyard of the embassy, with Tara and Maya in tow, to argue my case and procure a letter which would facilitate my passage through immigration. I did finally return to the United States, but have had difficutly entering through immigration almost every time I go through. I have been at Dulles for six hours in immigration. In Maimi it is usually three hours. The immigration officers keep reminding me of my unfortunate status in the United States. But not enough to convince me to get American citizenship. I suppose after 20 years of living in the United States, I am American, but I cannot quite make that step. It would make my travel so much easier.

I expressed my hesitation about our move to more than one patient today. My impression is that my patients were doing the therapy today, encouraging me, supporting me, making me feel far better as the day progressed. One in particular was so convincing that her words keep resonating! This year in Ecuador will be an incredible one; we will be marveling about it for the rest of our lives.

Wednesday, May 27, 2009

Budget For Ecuador

Time for a budget. Just for the next several weeks before we leave. Yikes! I have never actually made a budget. My brother-in-law pushed me about doing one and I had to admit that this is a new experience for me. Ordinarily I work and pay my bills and do not look past the next few days, the next trip, the next project, the next purchase. I live day to day, week to week, perhaps into the next month. So when Eric asked me to make a budget today, I felt hesitant but hastily listed as many items I could think of and when I got to the bottom of the page I was stunned. Clearly I am not prepared for this. I am accustomed to putting in the hours and covering the bills and making things work. Including private school and college for Tara, and ballet and violin lessons for Maya, and repairs on the car and trips to Canada and Rome and Belize and Ecuador. Now that I am winding down my practice and there is a finite end to my life as I know it, I am beset by limitations, which in turn create absolute panic.

On the other hand, for the first time in the ten years that I have been with my husband (and the thirty years that I have been away from my parents), I wonder if I can be dependent on him. Can I just let go of my need to take responsibility? What a novel idea! I am not sure how to be measured in this; either I am in total control or passive and meek (no!) and dependent. Is it the ability to earn income that gives me power? If I earn nothing, do I mean nothing, do I stop making decisions and influencing those around me? I wonder if part of my original eagerness to move to Ecuador was an unconscious wish to let go, to trust, to surrender. I just have not figured out how to be without being in control. Either I make things happen or I lose my bearings and float away. Either I am present and powerful or I disappear.

So writing out this budget means letting go of the life I know and being practical and surrendering to a new reality. I am not sure I am ready for this!

Tuesday, May 26, 2009

Return to Rome

I took a trip back to Rome tonight, and if it was only in my mind, it felt wonderfully real. For two hours and twenty minutes, I wandered the halls of the Vatican, descended into the crypt of St Peter's, screeched through the crowded streets, and rediscovered Bernini's statues in several churches throughout the city. It was quite a heady feeling to have wandered the same paths just two weeks ago. There was much publicity in Rome when I was there about 'Angels and Demons', since it opened that very week. Both the book and the movie were negatively reviewed, but just to see Rome was a treat. It was beautifully filmed and it felt as if I was running from the Pantheon to Santa Maria del Popolo to Piazza Navona to Castel Sant'Angelo. I am ready to see the film again if just for the views of Rome!

Tara has been home but I have not seen her. She stayed for dinner tonight and came to the movie. I have discovered that the only way to keep her close by is to offer entertainment. I have to remember that being nineteen years old means not spending time with parents and family. I worry about her in Ecuador. It will not be safe for her to run around all night. I cannot control her, and she feels independent and omnipotent. It will be difficult to just let go and let her be.

The household has been running smoothly without me. Maya has become more independent and kept asking for the assignment of chores this evening. I wonder if all the packing and organizing and cleaning that has been the focus for the past weeks has led to this eagerness to help out and be a part of the process. I heard her talking to my parents on the phone and explaining that she would be missing a bit of school when we travel to Canada for my neice's graduation, and that it wasn't a problem to miss the last days of classes because not much was being taught anyway--I remember explaining things exactly the same way a few weeks ago! Whenever I am gone for a few days, I am struck by how quickly she is growing and changing and maturing.

My office survived without me too. Is it because I have been organized and carefully transferring and discharging patients? Or because I am distancing myself and letting go? I have had this huge pile of papers on my desk that stare at me dissapprovingly; I pulled everything out of the file cabinets to force myself to face the dreaded paperwork. I have not allowed myslef to shove papers into drawers hide from the work I need to do. Sometimes I am too busy seeing patients so I cannot go through the piles, sometimes I want to avoid them and get busy with everything but dealing with them, but today the stacks were diminished and I can see an end to my work. Who will I be when I have no more charts or patients or papers to examine? Will I be relieved or will I conjure up more to do to maintain my sense of purpose? I keep adding more days and weeks to my schedule as I delay that final day and hour. I am at my other office tomorrow, where similar challenges await me.

Monday, May 25, 2009


I read a harrowing book about early-onset Alzheimers Disease. It was horrifying and frightening. It was about a 50 year old professor at Harvard who very rapidly lost her cognitive function. I thought of my mother and then I convinced myself that I too was losing my memory and that I had only two or three years until I would lose my mind. I could not remember the word for a vespa. I thought of motoped and motorbike and motor..... and I could not figure out for hours and hours that the right word was 'moped', at least that is what I finally decided the word for it was. I started reading at the airport in Santa Ana and then throughout the flight to Atlanta and to Baltimore. I tried the trivia game on the console while I was reading and finishing the crossword puzzle and did not do particularly well, so I became more and more convinced that I was losing my mind. Multitasking has always been my forte! Of course, in truth, there is no indication that I am losing my cognition, at least I don't think so, not yet.

But what I am aware of is time passing and that more than half of my life is over! How did I suddenly become so much older? I think that returning to Newport Beach has reminded me of the time that has flown by. I left almost 17 years ago and so much has happened in those seventeen years! Why does it feel like I have lost those years? I have lived and worked and had another child and traveled and tried all sorts of new things! And Ecuador is one more adventure!

My house is less cluttered than when I left, so that is a relief, but it needs cleaning and a mouse ran across the kitchen floor as I walked in. I wonder if the mice know that we are leaving and starting to take over the house! I did see one a few days before I left. We have had mouse issues in the past, but the creatures had disappeared for a while. Perhaps all the boxes and clearing out the closets has moved them from their former hiding places. I do not like mice and they do not belong in my house. I wonder if we will be living with rodents in Ecuador. Perhaps we will have to live with bigger and scarier rodents than we have here ( although the rats in downtown Baltimore are as big as they come!). What a delightful thought.

Maya and Eric are sleeping. Maya has grown during my absence. She has a week or more of school and then we will get focused on learning Spanish and preparing for school in Quito. I have to send off her medical records and birth certificate along with photos, so that will be first on my list along with ten hour days at the office to make up for having been away. In a little over a month I will no longer be working at my office, so ten hour days for a few weeks are fine. I look forward to seeing my patients but not saying good-bye. I wonder if I have been avoiding that this past week.

Sunday, May 24, 2009

What If?

I wandered around Balboa Island today. I walked past the house I once lived in and peered in through the front window and found it unchanged from 20 years ago. I wondered what my life would have been like had I stayed in southern California. I worked for Kaiser Permanente in Santa Ana as an outpatient psychiatrist. I lived in a cottage on a wonderful street called Heliotrope in Corona del Mar, a few steps from the beach. Tara had a nanny from England named Mia. I had traveled to Montreal for a meeting; I remember missing the shuttle that I had ordered to come to my house and take me to LAX, so I threw my bags in the car with Tara and raced to the airport through the traffic in record time, left the car at the airport and made it onto the plane hot and sweaty. I had a wonderful time in Montreal and met a psychiatrist and his wife from Salt Lake City. Through this contact I received an offer I could not refuse and decided to leave my corner of paradise to start a new life. I don't remember having any regrets for years and years, always returning to visit my friends and always appreciating the beauty and allure of Newport Beach, but also understanding that I could not afford the lifestyle that beckoned. Salt Lake was a sensible choice, and I loved living there. I skied 30 to 40 days a year, I loved southern Utah and I learned to kayak and mountain climb. I camped and hiked and took advantage of everything that Salt Lake had to offer. I enjoyed the mountains as much as I had enjoyed the beach in California. Ultimately I met my husband and had a second child and when Eric was offered a job at Johns Hopkins, we moved to Baltimore.

I have no idea what would have happened in my life if I had made different choices. Would I still live in southern California? Had a second child? Married again? I imagine I would not be moving to Ecuador.

I have expressed much anxiety and hesitation with regard to our move to Ecuador while friends and family have all been enthusiastic and excited. My friend Susan has been most helpful; she has suggested that instead of perceiving this as a move, that I look forward to an extended vacation. I love travel and look forward to vacations; I will be returning to my life after a year , (do I want to return to my life?) and this year offers me an opportunity to take another direction while away or when I come back. Perhaps such an approach will make it easier to manage the next several weeks until we actually get on a plane and land in Quito.

Maybe I can go home now.

Saturday, May 23, 2009

More 'Ahhhhhh California'

More beautiful California. No big hikes today. My sister and brother-in-law brought me to Filola ( Fight, Love, Live), an estate built by the owner of a gold mine a century ago. I liked the house because although exquisitely designed and furnished, it felt like a home, it felt as if families had actually lived in it. The gardens were full of plants and flowers; everything grows well here. I was inspired. Will I have time to grow a garden in Quito? Ecuador is full of rose plantations, so I know that the conditions on the equator are excellent for growing things. Will gardening be one of my projects?

I flew from the northern to the southern part of the state today. The plane followed the coastline with mountains viewable outside my window. It was remarkable that there was so much of the land that was unpopulated, in such contrast to the area around San Jose in the north and Santa Ana in the south. It was interesting to see such a concentration of humans at the two extremes and such emptiness in the middle. It was peaceful to look out the window and compare what I saw to the appearance of the Andes. We often take a short 30 minute plane ride from Quito to San Francisco de Orellana (Coca) to get to the jungle. We have to climb from 9000 feet up over the Andes and then coast down into the oil town. As we climb, the hills are barren and empty, much like the mountains I see below me in California. We are sometimes in the clouds with the tips of snow covered volcanoes peeking out; on the other side of the Andean range, the mountains are covered with jungle and cloud forest before we land in the town. The rainforest is clearly disappearing, being hacked down to grow palm trees for the harvesting and exportation of hearts of palm. The mountains I see today only remind me of Andes insofar as they are a mountain range.

I land in Orange County and marvel at how absolutely lovely this place is. I lived in Newport Beach for a few years twenty years ago. I like the place now as much as I did then, and I understand why so many people want to live here, and come from all over the United States and beyond.

My friend Susan picked me up, and at dinner her husband kept pushing me to explain my reasons for going to Ecuador, and picked up on my ambivalence and doubts about the move. Perhaps he is simply articulating what I am feeling. I did not have answers to his questions, but he had some wise things to say, one of which is that time for me to either embrace this move, participate in it and decide to be positive and hopeful. Once I am 'on board', it will be easier for me and for Eric and for Maya. So to move forward, I have to be positive, and put aside my doubts.

Planning Our Move

Friday May 22

It is super late and I am finally in bed after another long long hike up and down a mountain. I realize that I can walk for as long and as far as anyone, but I am not in the best shape and I could certainly feel the effort today. I was asking my legs and my heart to do far more than usual. The view was wonderful and the company of my sister and my niece delightful.

My brother in law had many questions for me this evening. He asked about our budget while in Ecuador (do we have a budget?). He asked what we do if things go wrong, what sort of resources we have there, what we do if we have a medical emergency, if there is a political crisis or economic disaster, what we do if there is a natural disaster. I had no good answers for him and realize that I am going on blind faith, that I am expecting Eric to take care of everything and I am not questioning anything.

We are moving to Ecuador without much planned. We are 'winging' it. I am not sure that is wise or prudent, but I realize that we have been busy just trying to get out of Baltimore and get our house rented without really thinking beyond that. Or maybe it is me that is not thinking or planning and depending entirely on Eric for too much.

I will have to think more systematically through this.

Thursday, May 21, 2009

Ahhhhhhh California

California living. Sunshine, yoga, ocean vistas, good food, espresso, everybody feeling wonderful. I understand why people come from all over to move here. It is 0 degrees Celsius in Edmonton and it snowed this morning! I was very eager to leave Edmonton after residency to do work in Neuropsychiatry at UCSan Diego. I felt I had moved to paradise and it still feels that way!

I slept well, I slept in, I took a yoga class, I ate Moroccan food, I hiked up in the hills over the valley with an imagined view of San Francisco in the far far distance. It was up and up and hill after hill and more hills. What a wonderful life my sister has in this beautiful place. Drinks, wine, steaks on the grill, conversation with delightful young people planning their lives and adventures. My niece and nephew are just starting their adult lives and there is so much good energy here.

I feel that I am starting this new life of mine too. Leaving the past, being open to everything and anything that presents itself. Before the end of July, I will be in Quito looking for a home, learning Spanish, getting Maya organized for her new school and activities. I am a little worried about the Spanish part. I have not been disciplined enough to get Maya started on learning the language. Everyone says she will have an easy time picking it up once we move there, but school will be a much better experience if she speaks and understands the language before she begins classes. I tried to find a tutor for her in December and January, but the ones I chose did not work out and our lives became far to busy to pursue it. We will stay with Erika and Isabelle in Quito for the first several weeks, and I will try not to speak English with Maya (a great challenge I think). Isabelle is eager to spend time with her and help her learn. I wonder if four weeks is enough. What I do know is that there is no doubt Maya will learn Spanish in our year there and that she will be appreciative of that in time.

Our house has been shown several times and there are possibilities. A quartet of college students were interested, but I do not think that college students would take good care of the house. A family would like to rent for two years, and at first that sounded impossible, but I am starting to see that as a definite possibility. We would return after our year and rent until our house is ready. We could live in an entirely different part of the city and have an entirely new and different adventure in Baltimore.

Sometimes it feels that every step forward is negated by one step back and that we make no progress at all. Perhaps being far away makes it clearer that we are moving toward our year away, or maybe just time passing and the day of departure ever so near simply feels like progress.

Wednesday, May 20, 2009

On to Suburbia

I took a course about yoga and psychiatry and it was awful. I could not meditate with the group and found the day painful and intolerable. The best parts were a walk through the city early this morning for espresso and a scone, and the hour for lunch walking around Market street trying to find the sunny side of the street to stay warm. San Francisco is as cold and fresh today as it was hot and heavy the first day I arrived. I am sorry that the course I took that held so much promise turned out to be a disappointment. Usually at this conference it is very inspiring to expose myself to all the new research in the field and I just wander to different talks and try to learn something by chance. This time I took two courses and missed most of the first one and gritted my teeth through the second. I am ready to leave the conference for this year, except that I purchased some 100 hours of online talks; I expect to review them and catch up with what I have missed, as if I had actually gone to the lectures. I have spent many hours at the conference this year, but have not appreciated it as much as I wish I had. I should have looked more systematically for Ecuadorian psychiatrists, but perhaps I really don't want to meet one anyway. Perhaps I want nothing to do with psychiatry next year, perhaps I want a break. I do not feel burned out, just ready for a new direction.

My hotel was called 'Hotel Diva'. It was just a matchstick box of a room, serviceable but not inviting; a place to sleep, shower and change. It sounded good when I booked it, and it was in a wonderful location near Union Square and six minutes to the convention center by foot. And lots of restaurants and Starbucks and theatre and shops. Monica picked me up and brought me to her home in Los Altos Hills, where I visited with my niece and nephew and caught up with their lives. It was good to hear Lorna's excitement about Ecuador and all her positive energy. I have not been feeling it lately, and it is almost too much of an effort to tell people about our plans. The agony involved in the preparation for our year almost negates any enthusiasm I might muster for the adventure. I certainly hope that changes soon.

Monica has moved many times; from Versailles to Cyprus to Paris to Oxford to Weisbaden to Los Altos. I am not sure how she has managed, but clearly she is accomplished at moving her household. I think not working full-time in addition to moving makes a difference. I wonder if I had a month or so just to devote to organizing the move without going to the office daily, perhaps it would be a different experience. I will be working less and less these next weeks, so I am resolved to focus my energy on the move.

Tuesday, May 19, 2009

Gorgeous City

The day started out cold and drizzly and uninviting. I woke up far too early and tried to sleep longer without success. I finally decided to get to the convention center and learn more about dementia. The problem is that after all these years of practicing, there is little that is new or something that I have not heard before. The field of psychiatry is advancing rapidly, but the basics are unchanged. I keep hoping I will learn something I have not heard before, but today was all about the usual information, nothing new, nothing that will change the way I practice psychiatry. Of course, I do not see much dementia in my practice anyway.

I met my sisters as the sun was breaking through. Monica wanted to show us new and interesting architecture, and I was most impressed with the new UCSF buildings on the waterfront. I had not seen them before, so this was an entirely new part of San Francisco for me. We drove along the water to Golden Gate Park and to a wonderful sushi restaurant. I always like unagi and tempura best, so I indulged myself. The day warmed up as the day progressed, so after a coffee at Union Square, we walked through Chinatown to City Lights bookstore. I realized how familiar I am with this city, having visited many many times. It is stunningly beautiful, with incredible views at every corner. I think if I had to choose a perfect city to live in, it would be San Francisco, not New York, simply because physically, there is no comparison. Not that I could afford to live in either place, unfortunately. I fantasize about not returning to Baltimore to live. What if I could live anywhere; where could it be?

We met my friends Alan and Vickie again for dinner, at a Mexican restaurant next to my hotel called 'Colibri' and I am still feeling the effects of the absolutely best mojitos ever! We reminisced about living in Salt Lake with another friend who joined us. When I tell people about my plans for Ecuador, I do experience double-takes and surprise and I am not sure if the reaction is that I am off my rocker and why would I do anything quite so 'off the grid'. I am never quite sure how to explain why I am doing this or what I plan to do. I realize as I explain this venture that perhaps this is possible for me because I am not particularly attached to our lives in Baltimore. I FEEL connected to our lives and it is more difficult for me to leave than I expected, but perhaps not so difficult as it could be. I do not have much in material things, I don't make much money, I am not attached to a place or an identity or a purpose. I am surprised that I am struggling as much as I am. I am taking all of my family with me, and it is my family that I am connected to, so I am not leaving the most essential part of my life behind.

I guess I am trying to sort this all out.

Monday, May 18, 2009

Refocus on Ecuador

Today was a more typical San Francisco day; cool, windy, overcast. A good day to devote myself to education. I have to try to focus my interest when I come to this massive conference. There are so many choices, so many different lectures, symposia, and courses. I decided to attend a symposium on a mental health program in Ayacucho, Peru, a city of 100,000 about ten hours by bus from Lima. There was no psychiatric care available to this community until a couple of psychiatrists from Yale volunteered their services in developing a program to provide mental health care. They are challenged by limited resources, and work with local nurses, psychiatrists from Lima who volunteer their time on the weekends, interns from the local university, and foreigners who contribute in various ways. There are significant difficulties communicating with the local population, most of whom speak Quechua and Spanish, and often the medical consultations include the family of the patient, the non-Spanish speaking physician, the Spanish/English speaking interprator and then the Quechua/Spanish interprator. Quite the circus. There are all sorts of misunderstandings, both because of the language differences, but also because of the cultural divide.

Most of the attendants of the symposium were from various South American countries, some who practiced in the United States, and fewer from Latin American countries. I was trying to find psychiatrists from Ecuador. I am not sure what I will say when I meet one, but I am hoping to see what possibilities there may be for employment in Quito. I will be unable to get a license, but would like to volunteer in some way. There is an Ecuadorian society of psychiatrists listed in the syllabus for the conference, and I found a meeting in Guayaquil in November at the Hilton Colon, which is where Eric and I stayed when we visited in March. I also found a conference in Columbia, but I am not sure how safe it will be to travel to Columbia. I feel as if this is a treasure hunt, a challenge to find an opening, someone who can direct me, some way to be useful during my time in Ecuador, to offer my experience and skill as a psychiatrist.

On the other hand, I remind myself that the point of taking a year off is NOT to work. Sitting with my sisters yesterday reminded me of how wonderful it must be (and having NEVER taken any time off in all the years since FOREVER) to wake up each morning and do whatever I decide to do. Not to have deadlines and an appointment every hour and no time to read or relax or play. That is part of what I am looking forward to; a life of leisure. Of course, I can hardly imagine what a life without work feels like. Both my sisters have chosen lives without work outside of the home. I do not discount the effort required to maintain a home and a family, because I am very aware of the energy I devote to my family, but my life has also included a full-time 40-plus hours a week at the office. So I am evidently conflicted. I want to play full-time, but I cannot imagine not working as a psychiatrist.

I met with dear friends for dinner tonight, and we caught up with our lives. Included in the discussion about Ecuador is the challenge of changing direction, changing careers. Alan is writing a book aobut retirees starting new businesses. I am excited about making a shift in my life. I have been a psychiatrist since 1983! I feel that after 26 years, that is all I am qualified for. What else am I capable of? Alan's wife Vickie started a new career as a business developer for a pharmaceutical company. She began as an executive assistant just a short few years ago and has taken more and more challenges to reform her career in a very exciting direction. She is my age and this was a completely different move for her. She began in a lawyer's office, moved to a pharmaceutical development company in Salt Lake, moved to New Jersey and then the Bay area, her job evolving and advancing. Very inspiring. The point being that changing my career and choosing a novel path may be the best course of action.

So I spent my day exploring working in Quito as a psychiatrist....but perhaps that is just because this is what I know; what may be much more of an adventure is to choose an entirely different direction.

Sunday, May 17, 2009

Travel Torture

I think that on average I have slept only three hours nightly this week. and I wonder when it will catch up with me and prevent me from functioning.The alarm in my hotel room woke me up at 5 and once up I could no longer sleep so after a shower I put on the same clothes I had worn yesterday and headed for the airport. The sun was shining brightly and the famous 'Mall of America' spread out in all directions. I know this is a destination for travelers, but it feels as if I have seen enough and do not need to return as a tourist. Unfortunately my next flight is delayed and I will arrive in San Francisco too late to make it to the course that starts early this morning. Now I wish I had changed my flight so that I could watch Maya in her ballet today. I had organized this trip long before I knew her schedule and could have changed all my plans to work around her event. Instead, I made the decision that the CME's were important and that I had seen Maya dance countless times and will again in the future. Now that I have gone through with this inconvenient trip and have missed the course anyway, I wish I had stayed in Baltimore one extra day. I enjoy watching ballet. I have seen these children develop in the Peabody program for three or four years, so seeing the bigger girls in the major roles has been incredibly inspiring. In the past I have been one of the mothers who have dressed the children and ushered them on and off the stage. It has taken time and energy, but it has been fun and entertaining. I felt sad when I went to watch the rehearsal yesterday and talked to the mothers who would be doing the honours this year. I missed Maya's practice, and was told she was wonderful. She has several roles this year. Usually she practices for hours and hours and then has a few seconds on the stage and it is easy to wonder what in the world all those hours and hours of rehearsals were all about. Maya absolutely loves going to ballet practice and rehearsals and shines as part of the team effort. It means alot to her and although it feels as if it too much for her and for her parents, we do it anyway. Today is the culmination of all those hours and effort and I am disappointed not to be there with her. Eric will buy the DVD of the show, but the small screen does not feel the same as the live performance. Eric tolerates the experience and I am sure he enjoys watching Maya for the moments she is onstage, but I am sure he would rather be at work or doing something more useful. Maya's passion for ballet is unexpected. she started with ballet when very small, but also did gymnastics and soccer and swimming and skating. At one point I felt she was doing far too much and I pushed her to decide on one activity plus violin, and she had no hesitation when she chose ballet. That was fine for me, until she started to advance and that meant four days a week of ballet, which makes our evenings and Saturdays and sometimes Sundays devoted to dance. I wonder how we got into this routine, and every time I try to divert Maya, she is insistent that we follow the program. Ecuador will be a break from this routine. Yeah! Time for my flight, hours late, hour in planes and airports and crummy hotels.

My flight finally left Minneapolis and despite my greatest efforts I was unable to sleep in the plane. I wasted no time once in San Franciso to race in un unairconditioned taxi to my hotel, shower, change and ran to the convention centre to register and catch the last two hours of the course I was taking, which ended up being about infidelity and the role of the psychiatrist in dealing with both the perpetrator and the victim and the couple. The lecturer clearly felt infidelity was the norm and had statistics to prove it. He felt that marriage was an institution desined to bring up children, and that t was not typical of humans to stay faithful to one person, and that as psychiatrists, our job is to preserve the mental health of the individuals involved, including the children who when exposed to infidelity can be incredibly damaged. The message was to keep the infidelity private and to work on protecting the various participants from excessive suffering. I missed the bulk of the course, which adressed love and desire as well as infidelity. It is unusual for me to choose such a course. Usually I attend lectures on psychopharmacology of depression, ADHD, bipolar disorder, anxiety and PTSD. Perhaps because I am leaving for a year, I decided to look at more psychotherapeutic fields. I like doing psychotherapy, which is the part of my work I enjoy most.

I met both my sisters outside in the incredible sunshine. It is hot hot hot here, the sky is a brilliant blue, and the locals are wearing their summer attire. I will have to shop for lighter clothing---it was raining in Baltimore when I left. Karen is here for a few days and has taken up golfing wiht our nephew Edouard. I had not seen Karen since our visit to France last year! Monica lives in Los Altos Hills (and Boston - she flies back and forth) and visited us with her family at Thanksgiving in November. This is a rare event to have all three girls together. I was starving, having not eaten last night or this afternoon.We caught up over caprese salad and iced tea. I was curious that my sister Karen's reading of my blog has impressed her with how scared and apprehensive I am. I suppose I need to reread what I have written. I usually write and edit and publish, without rereading. The point is that I do have fears and apprehensions, but I was not aware that I was excessivley scared. I suppose all my doubts and anxieties are expressed in my wrtiing. I must think and sort out how fearful I truly am.

Saturday, May 16, 2009

Modern Travel

Whew! I am sitting in a very strange hotel. My flight to San Francisco was delayed on the runway for about five hours due to bad weather and I missed my connecting flight. Northwest put us up in the Ramada Inn next the the Mall of America. The hotel has  a native American Indian theme and all the meeting rooms have native names and the decor is supposed to reflect that. It is not particularly respectful, but perhaps I ought not to say that. It is simply bizarre. The positives are a great looking pool ( but I have no suitcase and no bathing suit and it is two am and I have to return to the airport in a few hours) and free internet! The positives about the flight were great seat companions, who kept me entertained for the hours and hours of waiting, and lots of legroom in the exit row.

I set up four alarms to be sure to wake up in time, I will miss my first course at the meeting tomorrow, but I have all the reading material online if I can't sleep tonight. I will try to sleep.....

Friday, May 15, 2009


I have been in a nightmare mood all day. Going to Ecuador is about leaving everything and I did not realize that was so difficult. Saying goodbye over and over again is increasingly painful, I am not sure I can get through the day, and then I do and look forward to the same the next day and the next. Except that I am leaving again tomorrow for San Francisco for the American Psychiatric Association meeting to get as many hours of educational credits so as not to lose my license to practice medicine while I am away. I was looking forward to the trip because I will see my sisters and friends and of course some 20,000 or more psychiatrists, but perhaps because I have not adjusted to the time, I am struggling to fire up some enthusiasm.

It is curious that I received an email from someone I knew in Salt Lake City, who is involved with a campaign against the Scientologists, who always have quite a presence at the APA and put alot of money and energy into disparaging psychiatry and offering an alternative. Francois tries to counter the Scientolgists power and influence, trying to reveal the negative aspects of the cult. He wrote to me because he wants psychiatrists involved in the fight against scientologists. What a surprise to receive an email from him. I actually went to Cancun one year with Francois, his son Julian, and my daughter Tara when she was three years old, so it was shortly after I moved from Southern California to Salt Lake City. I remember getting very ill there with Montezuma's revenge, and perhaps Francois did too. Somehow we went off our separate ways and I had not heard from him until I received the email last week. I will try to look for him in the group of protestors outside the convention centre. I have ignored the Scientologists all these years and not thought much of their influence; I will have to learn more from Francois about why he is so involved in exposing them; certainly there is something personal in his campaign.

I am not sure how focussed I will be at the meeting. I have signed up for interesting courses, which I feel obliged to attend, but I find myself distracted during meetings, always choosing a lecture which is packed and overflowing and impossible to hear. There are 'industry supported symposia' which are very popular because drug companies provide free food; it is bizarre to watch the scores of psychiatrists who push through the lines to get their free dinner. Sometimes, one has to line up hours in advance to get a table and I never want to get to the talk that early so invariably I get there when there is no food left or when there is no syllabus either. I would rather have the syllabus, but then when I get home, I pile them up in my office and never look at them again. It may be that the pharmaceutical companies are no longer allowed to offer free anything. December 31 of last year was the last day they were not prohibited from giving away free pens and gifts. It seems that many psychiatrists were working for pharmaceutical companies and not behaving very ethically and the APA has decided not to accept free (nothing is ever free) 'gifts'. I believe this is the first APA ever which is not "industry supported". It has been questionable ethically anyway. It will be interesting to see the changes. There is an exhibit area where usually most of the psychiatrists walk through all the exhibitors' booths picking up whatever they can get without paying; sometimes useful gifts such as signed copies of new book, but more often only free pens with the pharmaceutical company label, or other tasteless article that seems great for a moment because it is given away , but later is just burdensome to carry back home in one's suitcase. I resolve each time I go to the APA not to get too excited about the 'free' gifts. More often than not I come home with articles and journals that I forget to read until I clean out my office and discover that they are outdated and useless. Now I am questioning what in fact I get out of the APA; usually it is CME's, which are hours of educational credits necessary to maintain one's license. I have remind myself of that. After a couple of days of missing all the good lectures and dosing off in the ones I find as alternatives, I guiltily decide to do something different. I cannot complain about being in San Francisco, which is a wonderful city to explore.

Karen is visiting my sister Monica, which will pull me away from the meeting I am sure. I will have to remember that I am there to get these CME's! 

I will miss Maya who will be playing two roles in Cinderella Sunday. She has spent hours and hours preparing and rehearsing for this event, and then will be onstage perhaps a minute or two. I will receive a DVD of her performance, but it will not be the same as being there. I will miss it and am feeling horribly guilty. I did not plan this very well. 

Thursday, May 14, 2009

Celebrating Mother's Day

Dinner for a belated Mother's Day tonight at Petit Louis. This is a favourite nearby restaurant for the family to celebrate birthdays, anniversaries and significant events. Late during a difficult day at the office, I received an email form Eric alerting me to the evening reservation.

I suffered at the office.

The enormity of this move has hit me hard today. I am having second thoughts and wondering if this is really what I want to do. Perhaps I was too tired and jet-lagged to feel enthusiastic about Ecuador. I was at my office today and was horrified to find all my charts on the floor where I left them last week. My receptionist has decided not to file for me anymore. Whatever her reasons, I am full of sadness as I write up my discharge summaries and transfer the care of patients to my very capable colleagues. 

Perhaps it was more difficult today because I have also decided that when I return I will not continue at this office. Having two offices is too complicated, and not having the cost of a secretary and billing person makes sense. Whatever makes sense doesn't really matter, it is still painful to say goodbye and leave a place I have spent six years working at. I am relieved to not have to deal with all the issues that have driven me speechless over and over again. Yet the relief is not enough to lessen the struggle of letting go.

Tara is the most excited of our foursome. Maya would rather her life stay exactly the same in every possible way. Eric tells me if I want to reverse course, I have that choice. But what now, do I tell everyone that I have changed my mind and try to get all my patients back? I guess I could, I could unpack all the boxes and fill up all the rooms and not sell the house. I have certainly not gone too far with this, I could still organize my life to stay.....I think I need to sleep and think about this in the morning.

Wednesday, May 13, 2009

Home Again

When I travel, I am forced to relax. I cannot go anywhere, I cannot do much, so I try to sleep, I read, I think. In my ordinary life,which starts in a few hours, there is no time to think or read or relax. Except that my life will no longer be ordinary. I will continue to wind down my practice during the next few weeks, make sure my house comes together, finalize all the details for Maya and her new school, help Tara with her plans, and organize our departure for Ecuador.

I have been up for almost 24 hours, I am hoping Tara will meet me at the airport and that I can close my eyes in the car and wake up in my bed, except that I will have to wash clothes and organize myself for a full day tomorrow at the office. I have checked messages already , and because I have referred so many patients to my colleagues, I am not inundated as usual. It feels odd that my practice has a life of its own and appears to be moving forward without me. I once thought myself as indispensable.

Tara was lost in DC so I had to guide her (the blind leading the blind) to the airport, and tried to stay awake all the way home, to make sure we returned safely. Such a wild three days, odd how I feel absolutely at home in my bed; Tara is watching the final episode of 'Lost', I am reading my email and going through my piles of mail. Have I really been so far away? Maya is asleep curled up in her bed, Eric is carpet cleaning in Tara's room, the house looks much as I left it, life goes on, as if I have not been thousands of miles away.

Ecuador is only weeks away. We move forward.

Tuesday, May 12, 2009

More Splendor

Today was another glorious day in the sun. Rome is shining! I covered the same ground today that I did yesterday. Except that I took my time and entered every church and every courtyard and explored each ruin that I encountered. I found myself remembering places I had explored with Tara, with both Tara and Maya, with my sister Karen. I ended up missing my family and wishing that I could share this place with them. I am not sure I want to travel alone. It is much more fun to share the experience with others.

I sat next to a missionary in the train from Frascati to Rome. He had lived in Grottaferrata for nine years and was moving to Munich. He had started a church in Rome and had lived in Quito many years ago where he had also started an evangelical church. He asked me about my spirituality and worked hard to convince me to look to Jesus for answers and salvation. I guess that is what he does for a living, but I was taken aback by his probing questions and his insistence. He told me that in Frascati there is a large community of Satan worshippers, which sounded very frightening. He also felt that psychiatrists are not believers, and that Catholics worship Mary rather than Jesus, and only by knowing the bible and praying to Jesus can we be saved. It was an unsettling conversation first thing in the morning.

I followed my feet today, and they wandered around the Imperial Forum and the Palatine Hill, to the Circus Maximus to the wonderful church at the Bocca della Verita. I revisited the Pantheon and the Trevi Fountain and lingered at Castel Sant'Angelo and St. Peter's. I made sure to enter every church that was open and sit and look and admire. My mother's favourite church was always Santa Maria Maggiore, so that was my first stop. Before I knew it the day was over, and my feet were sore and it was time to arrange for my trip home. Now that my three days are over, I want to get home as soon as possible and hug my children and my husband! It is wonderful to get away but equally wonderful to be home. 

Monday, May 11, 2009

All of Rome in a Day

I have been wondering at the absolute beauty and splendor of this place. I am staying about 30 minutes out of Rome in a restored 16th century palazzo. There are frescos on the ceilings, perfectly proportioned rooms, and an endless view of Rome and the sea off the garden terrace. The town of Frascati is a kilometre away. I will take the train to Rome tomorrow without an agenda, but I will start with the forum and see where the day takes me. I return to the Pantheon always. The city is a museum, so I do not have to actually enter a building. With the warmth and the sunshine, most likely I will soak in the sun and stop off at the fountains to refill my water bottle. I will not take a map and see where my feet take me.

I wrote that late last night. I slept soundly, woke up briefly at 6 AM and  then slept another three hours. Whenever away from home I find myself catching up on sleep; at home there is too much to do to sleep and I am lucky if I get four or five hours, consequently I am always exhausted at home and always well-rested on vacation. One of my goals for our year in Ecuador is to sleep at least eight hours nightly and catch up on years of sleep deprivation. I wandered through the hotel after breakfast looking at the frescos and admiring the view. It was another perfect sunny warm day. 

Rome is a half hour away. The challenge was the decision of what to do on this marvelous day with so many choices. The city of imperial Rome? The Rennaissance? The Baroque? I decided it would be everything today. I walked from Stazione Termini to the forum and the Colosseum, to the Bocca della Verita and the temple of the Vestal Virgins to St Peter's and the Vatican, from Castel Sant Angelo to the Trevi Fountain, Campo dei Fiori and Piazza Navona, to the Spanish Steps and Via Condotti, to Via Veneto and the Campidoglio and Piazza Venezia and everything in between. Most of the museums were closed, so I did not have to make decisions about entering or not. Most of the churches were closed as well. I spent some time in the Pantheon and the church of Santa Maria Sopra Minerva. I like the concept of the church being built over a temple to Minerva. The paintings in the churches often rival those in the museums and there are statues everywhere to admire. There are ancient ruins being excavated now, and each time I visit Rome, they are excavating more and I see something I have not seen before.

There are tourists, but fewer than I have seen in past visits. Everyone is eating gelato or pizza. There are more ice cream parlours than there were the last time I was here. I ran into two peaceful demonstrations, both with many policemen milling about. Motorcycles and vespas are numerous, and Italians talk incessantly into their cell phones. I could not find public phones in most places and when I did and tried to call my hotel to confirm my arrival time, my phone card did not work. I made it back to the station to catch my train back to Frascati in time for dinner. Every dish I chose had black truffles and I did not dare to order the most expensive item on the menu with white truffles.

I wonder what our lives would have been like had we stayed in Rome and not moved back to Canada. When we lived here we were young and I am not sure we appreciated our circumstances until we moved away. It is during my regular visits back to Rome that I discover more and more. It is my sister Karen who knows Rome best, having lived nearby for years, and visiting often.

I am curious of what the impact of Ecuador will be on both my children. Tara will be volunteering and plans to work mostly outside of Quito. She does not speak Spanish and tells me that is not required for her volunteer positions. Maya will be attending a Spanish speaking school and will definitely learn Spanish. Will each of them fall in love with the country and want to return as adults? There is something different about being American children; both Tara and Maya have a clear identity; my sisters and I were always confused about who we were. We did not identify as Canadians or Italians, so we never quite belonged in Italy or Canada and later Iived in foreign countries for our adult lives. I will have to ask my sisters if they feel French or Swiss or Canadian or Italian. 

I called my daughters and wished them Happy Mother's Day. My mother was delighted to hear that I was in Frascati. When they lived in Rome, my parents would often come to Frascati to eat, but she could not remember which restaurant she ate at. I will ring her tonight again and ask her and check it out tomorrow night.


Sunday, May 10, 2009


I have arrived at my destination for the next three days. I feel peaceful at this moment with much activity happening around me. Eric dropped me off at Reagan International airport and hurried back to listen to Maya's concert and record it for me. Everything was so easy, it felt as if this was meant to be. I flew to Chicago and then boarded a plane to Rome. It was a free (frequent flyer) ticket so I was not fussy about the route. I slept across the Atlantic and woke up at Fiumicino. I found myself almost sleepwalking to the train station where the train was late, which is never a surprise here in Italy. This is a familiar place for me. Cappucino at the bar, throngs of travelers, poppies along the side of the tracks, pine trees, controlled chaos at the main train station, missing my train to Frascati, unable to resist a huge gelato for lunch. I wandered around Termini watching people of all sorts, listened to many languages but mostly Italian, walked out into the sunshine, and wandered back to find my train. Much like the Harry Potter movies, the platform or 'binario 15' appeared to be nonexistent, until it materialized in between 14 and 16 far into the distance.

It is Mother's Day today. There are all sorts of reasons for this journey. This is a yearly pilgrimage for me. My sister Karen had a home in Tuscany for years. I brought Tara there when she was a few months old. She learned to crawl on the floor of Poggio Ventoso. We visited the hill towns near Montemassi and explored every Etruscan ruin in the vicinity. Florence and Siena were regular daytrips and the beach at Castiglione della Pescaia beckoned all summer. We came each summer and sometimes during hunting season in the fall,when the 'cacciatore' shot at everything that moved, but were looking for 'cinghiale' or wild boar. Poggio Ventoso was surrounded by olive groves, and the olive oil produced each year was tasty enough to drink alone. I would return home with a bottle each year, and use it sparingly to last me until my next visit. I came here with Tara and Maya to plan my wedding. We spent days on the patio or on the beach pouring over texts and choosing readings for the ceremony. Eric came with us that time, but did not participate in the planning. I think he had a conference to go to up north. I do not remember him being a part of my yearly sojourn in Italy. I wanted to show him this magical place and I think he 'got it' but I wonder if he understand how compelling it is for me. My sister and her husband Friedrich sold the place soon after that visit, and we have all shed many tears over the loss. Poggio Ventoso was not just a place, it held our hearts and our dreams and I find myself in tears as I write this now.

We usually flew to Rome and either rented a car or took the train to Grossetto. Sometimes we would fly into Milan or Munich and drive down, speeding through the Appenines in a tiny tiny Fiat. I remember how tired I would be after flying through the night, rarely sleeping because Tara would want to explore the plane and watch movies and she refused to sleep because it was all too exciting until we got into the car and on the way to Poggio Ventoso. Finally, exhausted, she would close her eyes and I would fight to stay awake for the two hours to Karen's place. I would stop at Talamone, or sometimes on the beach along the way. We passed a park with a collection of statues created by the artist Niki San Phalle, which were enchanting and fun for children, but Tara would often be asleep when we drove by and I would slow down and try to make out the colourful designs from the road and drive on.

When we came that summer before my wedding in 2001, the trip to Italy had been planned long before the wedding date was decided on. I had wanted to show Eric the place I loved most. We flew into Venice, stayed near St. Mark's Square, drove to Florence and Siena and settled at Karen's. I have made it back to Italy at least a few days each year, however it is unlikely I will return for a few years. Ecuador is far from Italy, and we will not have the means to visit for some time.

Meanwhile I will enjoy my three days. The sun is shining and Sunday brings everyone out on the streets. Once settled in my little palace hotel in Grottaferrata near Rome, I headed for Frascati for a few hours, wandering through all the tiny streets and visiting all the churches. Gradually the entire city emptied out into the main squares and walked and played and ate gelati. I suspect that people from the surrounding towns and perhaps even from Rome came to visit, the streets were so crowded. I had little energy earlier in the day, but now that it is late I am finding myself more and more awake, which is not good as far as adjusting to the time. I wanted space and time to think and reflect and make some decisions. I realize i did not have to go so far to do so, but now that I am here I plan to enjoy every moment and everything that Rome has to offer.

Oh yes, and every moment I am aware this is Mother's Day. I miss my daughters and wish they were here with me. I thought it would be fun to take a break from them for this special day, but now that I have stopped moving I miss them more.

The Journey is the Destination May 9

May 9, 2009

The journey is the destination.

I am anxious as I am leaving. I say goodbye to Maya at her ballet class. Her hair is tightly wrapped into a bun and she has gelled all the wispy strands away, so I expect her to look severe, but her features are soft and I ask for a hug. She has been snuggling with me all night; I am not sure when she came into our bed to squeeze between Eric and I, but she is there in the morning. I am up early and am curious that I feel as good as I do. Eric drove home from Montreal yesterday, the Subaru packed tight with Tara's college life. I waited for his arrival and stayed up late with him. Tara remained in New York, finally enjoying herself with her friends and everything that New York has to offer. I wonder that she has been so unhappy for the two years that she has been there. Odd that now that she is leaving she can appreciate it. I talked to her today and she sounded content, perhaps because she met a nice boy yesterday.

Maya was up early too. She wants to be ready for her ballet practice. she is so enthusiastic about her performance. She has a rehearsal almost daily these past weeks, and she does not want to miss any of it. She likes the discipline and the group dynamics and she likes being good at ballet. She had to maneuver between ballet and orchestra practice,being at both places at once. She performed in a concert today and I am anxiously awaiting a recording of her group. I have heard her orchestra play almost weekly and have been amazed at how wonderful they sound.

I have a difficult time leaving Maya and Eric. I wish we could all be on this particular adventure together, but Eric has no interest in traveling without a purpose, and he has much to accomplish before our move to Ecuador. We have had two home visits from potential buyers/renters and more planned for Sunday. The house continues to be a work in progress, and Eric has an endless list of tasks he is committed to. Not that I do not have an equally monstrous list, but I choose to take a break for a few days, perhaps not a choice really, I am in desperate need of breathing space.

I am so unaccustomed to being alone and quiet with my thoughts. That will be a challenge in Ecuador as well. Maya will be at school and Eric at the university and Tara volunteering, and I will have to find a way to be without working and accomplishing and giving and doing. I have worked almost daily as a psychiatrist for twenty-six years. Of course I take time off and travel and play and exercise and visit with friends and family, but all my activities are framed by my work and my patients, who welcome me after every weekend or time away. My work is an anchor and a tether and makes my life purposeful and directed. I imagine this is a concern for those to retire. How can I maintain purpose and direction without the profession that defines me? Of course I am also a wife and mother, and those roles are as significant as my role as a physician. When I first started telling people about what I would be doing in Ecuador, I would present a long list of activities and interests. I wanted to do something valuable and contribute during my year away. Lately, though, I have been curious about my need to convince others and myself that I will be doing something valuable and measurable. I could not just say that I was taking a year off to accompany my husband and child to Ecuador. As if by not working or pursuing a big project, I would lose my value. It will be interesting to see who I am when I am no longer 'Dr. Richter'...

Without my profession and without my income, I wonder who I am. Funny how we are defined by what we do and how much money we make. I think I will be fine, but perhaps I will be quite a different person when I return in a year.

This is the journey I am on. Learning about who I am now and who I will be in the coming months.

Friday, May 8, 2009

Secret Destinations

I am about to do something outrageous, but exciting. Very unexpectedly, it became possible to embark on a three day journey that is absolutely wonderful. The details about how this came about are interesting but embarrassing, so I cannot reveal how this happened, for fear of exposing too much of myself and my defects. I will fly away tomorrow to a magical place and stay for a short few days to recharge and relax. I hope to return home renewed and ready to move forward. This is not the right time or the right circumstances, and I am as scared as I am anticipating this. The house needs more work, I am inundated with paperwork at both offices, and there are thousands of details to attend to. Eric will drive in tonight from Montreal after a detour through Manhattan to meet Tara an pick up her belongings from her dorm room. I hope he brings everything straight to the storage unit!

I knew this was brewing a few days ago and I told my friend Emily who was entirely supportive and encouraging. Eric was skeptical but told me as long as I did not spend any money I could take a few days off. I moved all my Tuesday and Wednesday patients to ten hours days on Thursday and Friday. I had been anticipating another visit to my parents to possibly meet with my mother's doctor, but when this alternative possibility came up, I decided to indulge myself and 'go for it'. I told more details to my friends Daphne and Julien tonight. The story just seemed silly and bizarre, so I am feeling a bit uncomfortable. I can change my mind any moment, but I am not sure I want to. At this moment I am anticipating missing Eric and Tara and Maya. I wish I could be with them these four days. Maya has a concert tomorrow and I have been listening to her orchestra every Saturday and the music is wonderful. Eric to her 'Third Grade Idol' contest at school today. She played Haydn beautifully, and I was so proud. She had borrowed another child's violin at school a couple of weeks ago to audition as a finalist, and told me after the fact that she had made the first cut. I found out online that the finals were today; Maya was not expecting to see me, but a patient canceled and I was able to see her on stage. I have been so happy today to have both my daughters at home. Tara, Maya, and I cuddled together all night and Tara and I had a coffee together this morning. She has cut her hair short and lightened her hair color and looks great! I am looking forward to having my whole family together in Ecuador.

Tara was supportive when I told her. She would love to be with me, but it is too late to have her join me. Maya cried when I told her I would be away for Mother's Day, which made me cry too, but we decided to celebrate Mother's Day on Thursday night instead of Sunday.

So tomorrow morning I will wake up early to prepare Maya for her day. She sees her accompanist early in the morning and has ballet rehearsal all day. I teach a class and then take off for the airport and settle in for a circuitous route to my destination. I did not have many choices because I did not want to pay for my ticket. I will arrive Sunday morning in another world.

Thursday, May 7, 2009

Dog Days

The house was almost perfect for a few hours during the night when we were sleeping, but has deteriorated moment be moment since we awoke. How do people keep their homes pristine for potential buyers while living in them? We had our first viewers today. I have no idea what they thought or if they were renters or buyers. I wonder if our real estate agent will chastise us for our mess.

I have decided that will have to give our dog Elmer away soon. He seems depressed and I wonder if he knows that we are leaving. He stays in his crate all day except when we walk him. He could be with us in the evening but he would rather hide in his den. He has been unhappy since Pippi died and I wonder if he needs some Prozac. Or perhaps he is not getting the attention he needs. We have not loved him the way we loved Pippi; he was never as cute or as well behaved or as warm or as sweet as our former dog. I could not forgive him for chewing my antiques and ruining them. He does not chew anything anymore, so clearly it was only puppihood, but I could not understand that despite having chew toys galore, there was something special about my most valuable pieces of furniture. We crated him for much longer than expected. Pippi was trained in a week and entirely reliable from the first few weeks we had him. I took him to work and kept him under my desk in a crate and took him out hourly. He was my co-therapist, but after a while he became too much of a distraction. I am not sure what he did all day, but when Tara and I came home, we walked him. On weekends he would have long hikes in the hills around our house and he loved to swim in a nearby pond. He was so good and kind and warm and he knew it. Our second dog just could not compete. Elmer cried the first few nights that we had him and was scared to go up or down the stairs. When scared he would wet himself. I thought he may have been abused when younger. We crated him for toilet training and he did not 'get it' very quickly. It was the chewing that upset me. Clothes, toys, furniture, truly anything chewable was fair game. For a long while Pippi wa free to roam the house while Elmer was locked up. He chewed huge holes in the kitchen walls, which ended up being a great excuse to repair and repaint the kitchen, which was a significant improvement. Pippi was the alpha dog and dominated Elmer and it was clear to Elmer that he was second to Pippi in all things. I had to be careful for Maya's sake, because she was hurt if I said anyhting negative about Elmer. The one good thing about Elmer is that he can fetch, whihc Pippi never did. It is fun to throw things at Elmer and have him bring them back. Unfortunately Elmer was hit by a car two Septembers ago and spent the next year limping. He also got very fat and uglier. We have tried to restrict his food intake and he has slimmed down a little and is actually limping less, which looks better. He has a nice disposition and I have been unfair to him. We have friends who have agreed to take him. Maya worries that they will not want to give him back, but I am entirely comfortable with that. I do not love him. I saw the movie 'Marley and Me', which reminded me of Elmer.

Maybe he will be happier in a new home, with more children and more activity. He clearly sees that we are packing. Is he intelligent enough to know that we are moving soon and that he will be left behind? Pippi was always morose when he saw us packing our suitcases to move. He clearly knew what was going on all the time. I wa convinced at times that Pippi understood what we were saying. Pippi occupied a big place in our hearts and in our home and I still look fo rhim up the stairs when I come home. I do miss him still.

Tara came home today and we celebrated the end of the school year at a local restaurant which we once went to quite regularly. I ordered the same salad that I have always ordered and it was less than half the size it had been for years and years. I had not been at the restaurant for over a year; perhaps they are downsizing. My mother used to tell us to leave the table hungry, but I feel entirely deprived and still very hungry and dissatisfied. Tara and Maya were happy to share a huge chocolate mousse cake and ice cream. Tara is here for a day and tomorrow she will travel back to New York to meet Eric and load up the car with her belongings. She will be moving out of her dorm and everything will go into storage for the year that she is away. We will all be living out of suitcases for the next year.

Wednesday, May 6, 2009


It is time to be positive and optimistic. The weather is being entirely uncooperative. It is cold, rainy and wet, but the grass is green and there are wonderful pink and fuschia coloured bushes flowering. Baltimore looks great to me, perhaps because we are leaving; ordinarily I find so much that is unattractive and uninviting in the city. I am reminded that these are the last several weeks that we will live here and I want to appreciate everything about it. The house is looking better and better and I like it more when it is crisp and clean. I wonder why we did not live this way these past years, and I remind myself that in our usual lives, we do not have the time to devote ourselves to organizing and cleaning; Eric and I have spent hours and hours on the house. Our first potential buyers/renters are coming tomorrow at 6 PM. I am less upset and more accepting about losing the house. I still feel that I may not return to Baltimore, but when I say that I sound silly and Eric isn't sure what to say or do. I believe he can hear that it is an observation and not a threat.

Tara and I disagreed about her year in Ecuador. My instructions to her have been to find something of her own, to make her own arrangements, to find something that will interest her. She has decided to work on an organic farm and participate in yoga daily in a commune. My reaction was negative. I had hoped she would volunteer to help others, to move out of the inward focus and turn outward, to give to others to grow herself. She was offended that I expressed that I was not supportive of her plans and felt controlled and unsupported. I do have mixed feelings about her going to Ecuador. I do not want her to miss a year of shcool and not gain anything in the process. I realize also that I have no control over what she does and almost no influence.

So I repeat my serenity prayer and remind myslef to put aside the things I cannot change and of course recognize what I can and cannot change. I cannot tell Tara what to do and I must accept her choice and hope she finds what she wants and needs and lands on her feet.

Tara is frustrated when I tell her I do not know what I am doing during my year in Ecuador. Either I list a dozen potential projects or I say that I am taking care of Eric and Maya. Either way I am avoiding giving her an answer. I do not have a clue what I will do. Currently I am devoting my energy to packing up to go. Once I am out of here I will be free to do whatever I want to do . I am looking forward to being free.

Tuesday, May 5, 2009


We have our first house showing Thursday. Of course the house is not ready for any visitors yet; when I heard the news I was furious. I absolutely do not want ANYONE to buy my house and I am offended that things have gone so far. Eric texted me and then I heard from the real estate agent and I found myself getting more and more agitated until Eric informed me it was for a rental and I was somewhat relieved. I still want no one to see my house or live in my house or buy my house or even rent my house. I know I am unreasonable. But I realize again that my resistance to organizing and cleaning is not pure laziness; I do not want to give my house up. That aside, the house is close to being ready.

Eric left for Montreal this morning for a conference and he sounds very happy driving through New Jersey and New York. He likes this meeting in the middle of nowhere with a bunch of scientists drinking beer and celebrating electric fish. And I am sure he is happy not to be home packing up boxes and transferring our lives to the storage unit. We have been spending each evening, including Friday and Saturday nights, until 2 or 3 in the morning for weeks and weeks cleaning and packing up the house. I plan to make an escape next week; this is Eric's escape. A cleaning company is coming tomorrow night to add the final touches. I am sure the man was not joking but I laughed anyway when he said that our house would be easy to clean if it did not have so much stuff in it; this is after we have removed boxes and boxes of excess 'stuff'.

Anyway, it is almost over, this agonizing process of packing up our lives. I really believe the end is in sight. I wonder what life will be like when I can come home and relax, watch TV, read a book, hang out as a family, talk to friends and family, just be normal. I am not sure I know what that is like. I wonder if I will just take on another project and be obsessed with it and find that with more time I have no time or less time to live life and relax. Anyway I am looking forward to this wonderful future of ours when I do not have this endless list to attend to.

My next project is learning Spanish. I get by now, but I want to be fluent. And I want Maya to learn as much as she can before we fly off. So that is the next agenda. Lots and lots of Spanish videos and books and computer programs and more. We will no longer speak English in our home. It will be Spanish or nothing. What fun!

Monday, May 4, 2009


I have been trying to ignore the swine-flu hysteria. But Maya and I are both feeling ill today, and I came home from work and driving Maya to violin and ballet classes and went straight to bed. Yesterday I took the train to and from New York and spent the afternoon in a packed theatre and a busy restaurant. I expressly chose the train as safer than the bus, and walked rather than taking the subway, but did not see New Yorkers wearing masks or altering their behavior to avoid illness. I have decided that this flu is like any other; we try to resist the flu by avoiding close contact with ill people and washing our hands. I usually travel to Mexico several times each year, but because of our plans for Ecuador, there has not been enough time for a visit to Tulum or San Miguel de Allende between now and our move, and I am feeling relieved that I do not have to make a decision to go or not to go. Listening to news on television or NPR is all about the swine flu, and my impression today is that the illness may be abating. However I also heard that the flu would wane in North America for the summer but return as a stronger virus in the winter. The virus's behavior over the summer in the southern hemisphere will be predictive of its behavior next fall in the United States.

This reminds me of the book 'Culture Shock' which agitated me when I read it in January. One chapter outlines all the diseases that we would be exposed to during our year in Ecuador and the inadequate treatment for most of these illness. Chagas disease could be chronic and debilitating and there is no cure. Dengue fever is transmitted by mosquitoes and there is no vaccination for it and it can be fatal! Our GI systems do not adapt well to the tap water therefore we will be using bottled water to brush our teeth and of course to drink. It is likely we will have diarrhea several times during our stay. Hopefully there will be no cholera outbreak while we are in Quito. The hospitals are very variable in the quality of medical care. The medical care for the wealthy is very different from that dispensed to the poor and disadvantaged. Of course that is no different than the way it is in the United States. Except that I think we will be one of the poor and disadvantaged when we live in Ecuador. Will we have enough to eat? Eric assures me that nobody starves in Ecuador. Will we have access to good medical care if we need it? What do we do if there is an epidemic of some sort?

Eric has assigned a project that is entirely my responsibility; that is to pull together the best first aid kit I can find. The implication is that Eric and I will be attending to Maya and ourselves for basic medical care. We will bring lots of Cipro and anti-malarial meds, ibuprofen and aspirin and the like, bandage materials, epipens, etc. We will have to add Tamiflu to the mix now: the H1N1 virus may be busy this summer in the southern hemisphere. We will have access to medical care, at least we will while in Quito and less so in the jungle. It will be the more complicated medical procedures and protocols which will be less available to us. I am most concerned about huge natural disasters; earthquakes and volcanic eruptions. Quito is not the kind of place that seems ready to manage huge volumes of injured people. There is little we can do or prepare for in such a situation. I will just cross my fingers and hope that we will be lucky and not have to face such eventualities. I am working on my optimism.

Sunday, May 3, 2009

I Love New York!

The city is entirely different this week. It is raining and steamy and although the streets are full of New Yorkers walking in a hurry, the energy is less intense than it was last week. There are umbrellas out in force and the streets are full of puddles, and my feet are wet after a couple of blocks. I took the train early in the morning hoping that the three children sleeping upstairs would let Eric stay in bed a little longer; but I could not help but peek at them before I left and as I was watching them sleep, Marius opened his eyes and before I knew it, Maya was hugging me goodbye. I heard from Eric that they dragged him out of bed shortly after I left the house and demanded pancakes and waffles; they had agreed last night that before they ate the gingerbread house they had decorated the evening before, they would eat a healthy breakfast. They tore through the candied house and then tore through the rest of the house, leaving it in disarray. They were out of control, according to Eric.

Tara does not have exams at her studio. She is graded by her performance, and this weekend was her final play. It was not appropriate for children, so Maya, who usually sees all of Tara's plays, would not have understood or appreciated 'The Rimers of Eldritch' by Lanford Wilson. I am convinced that she would have missed the story and been confused and certainly disturbed by the violence. I was impressed with Tara's performance.

We then sloshed through the puddles to get to Times Square and TKTS and were lucky to get tickets to 'Waiting for Godot' for two hours of absurdist fare with Nathan Lane and John Goodman. The play has rave reviews and a great cast, but perhaps because it was a matinee and the actors had drunk too much last night, the energy was not good, and the play felt like just another rendering of Beckett's script, well-done but not unique or memorable. I was most concerned with drying out my very wet feet and lower pant legs and warming up. The rain relented a bit when we left the theatre. We arrived at the Pigalle bistrot for brunch but took too long to decide on our food so had to change our order to the dinner menu. We talked for the next four hours and did not leave the restaurant because it was simply too cold and wet and miserable outside and much toastier inside.

I was pushing Tara on her plans for next year. She still wants to come to Ecuador with us, but is less interested in the country and more focused on getting away from her life. That is not necessarily a bad thing, but I want her to have a plan for her year away. Of course, she asked me what my plans are, and since I was unable to give her any specifics, I was unable to maintain my argument. We are escaping our ordinary lives for far less ordinary ones.