Tuesday, April 28, 2015

upset

In the children’s picture book Captain Small by Lois Lenski, a storm comes up as our ubiquitous hero (see also, Cowboy Small, The Little Farm, The Little Train, etc.) navigates his sailboat home. “Water washes over the bow. The boat heels and nearly upsets. But brave Captain Small brings it about and safely sails into the harbor.”

Upset. To turn upside down, to, as defined by my 1966 Reader’s Digest Great Encyclopedic Dictionary, “overturn, throw into confusion or disorder…” Even as an adjective: “1. Tipped or turned over. 2. Mentally or physically disturbed or ill. 3. Confused; disordered; messy.” Though it’s been diluted over time to mean mostly “unhappy” or “to make unhappy”, it was helpful for me to be reminded of the original and more full intention. A sailboat in rough seas, overturned.

I am not faring as well as Captain Small right now. Nor is the small town of Omak, which I left behind only two weeks ago, and for which, upon departure, I had words that may have left some people leaving unhappy. I would rather that they were upset.

Explanations, shorter sentences, plain English for God’s sake lad! Let me try:

A year ago, LL and hadn’t planned to leave Omak this year. We have a just-turned-3-year-old and (as of a couple days ago) a 10-month-old. Moving away from a familiar home, friends, work, the walk up Ross Canyon, the scooter ride to the market, is upsetting. Our boat has turned over. We are extremely lucky to have excellent flotation devices in the form of loved ones and some time. But we’re definitely swimming. We moved into a rental with a clothes washer that doesn’t drain, a dishwasher that doesn’t exist, and a ceiling we keep bonking our heads on. Disrupted sleep routines for our boys has translated into minimal sleep for us. Felix has announced that he’s moving back to Omak. My car battery’s dead, the back door handle fell off, and the dog ran away…oh wait, we don’t have a dog. It’s hard to keep track sometimes. I can’t say we would recommend a similar move to anyone with young ones.

At the same time, as our feet begin to find solid ground, we are reminded of all the things we’re grateful for. We’re an hour away from Nana and Papa. We’re two from my sister and her family. Previously both were five. We have an Asian (and yes, it is Asian, which really means more American than were it Thai, or Japanese, or Korean, but still!) bistro, within takeout range. Curbside recycling. For that matter, we have curbsides, and sidewalks, and even a bus line that takes us right downtown to the Asian bistro.

Most importantly, we have work that we are excited to begin. Though we loved the people we worked with, we ultimately felt unsafe in our hospital. A lack of vision, leadership, and collaboration added up to accidents waiting to happen—or already happening. In a remote and rural community, people can’t afford to not work together. Upon leaving Omak, LL and I submitted a letter to the editor of the local paper, who ran it as a guest column:
http://www.omakchronicle.com/news/2015/apr/15/do-you-think-your-hospital-safe/
(sorry you have to cut and paste!)

Our new jobs are also in a rural area. We think they will be an outstanding fit in terms of our colleagues, opportunities for personal development, the mission of the clinic, and so on. The first and fundamental requirement is that it feels safe here. A huge part of that feeling of safety is that there really seems to be, both in the healthcare community and at large, a spirit of working together for the common good.

To expound on this: America has some of the worst health outcomes on the planet, especially in light of our healthcare expenditures. This fact is not surprising when one also considers that we are one of the world’s most unequal countries in terms of wealth. Not just poverty, but inequality itself, is strongly linked to poor health. Our tax structure often serves to exacerbate these inequalities, especially in rural areas. For example, schools being funded by local property taxes creates better educational opportunities in areas that are already rich. Omak is not only poor, it is also rural, so there is not the buffer of nearby pockets of wealth that cities tend to have. As is the case for education, funding for public healthcare facilities is similarly bereft. In such a setting, what one long-time resident of the area called “the stark fist of poverty”, it is essential that people work together. This is what was lacking, and correcting it is, I believe, where opportunity lies. When things are getting by—when there are small errors in safety or quality of care but no big events—when there is perhaps imperfection but not crisis—such a situation can carry on. Now there is crisis. There is upset, and sometimes upset is what it takes to change.

That is why I hope anyone who reads our article in The Omak Chronicle, and might be unhappy, is also upset. At least a little bit. Maybe upset enough to ask questions. As we stated, our intention is not to make anyone feel bad. It’s to rock and perhaps help tip over a sinking ship, so that a better one can begin to be constructed.

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