Sylvia's Journal

I am in Washington now, attending the annual gathering of professionals who in the field of international health. I left blue-skied and sunny Massachusetts yesterday morning to descend through layers of clouds and disturbed air that lasted all the way down to the runway at DC’s national airport. After the recent media reports about overtired and inexperienced pilots on regional airlines, I was happy to have boarded a national airline piloted by a chipper and bald-headed gentleman with many stripes on his uniform.

The taxi-driver who took me to the hotel had a serious tremor in his hand which frantically knocked now on the steering wheel, then on his thigh. I tried not to fixate on the hammering hand but it was hard. I wondered whether I should strike up a conversation, asking him ‘hey, what’s up with that hand?” but I did not. Instead I looked sideways to avoid seeing the shaking arm and hand and stared through rain-streaked windows, hoping I wasn’t witnessing the beginning of an epileptic seizure– it was the longest ride ever.

The annual Global Health Council is where I see friends and acquaintaines, onetime colleagues; some after one year, some after 15 or 20 years. It looks like a big conference but it is actually a small family – a dynamic one: coming in are the new graduates and MPH students, going (not exactly out) into retirement (or consulting) is the cohort about 10-15 years above me. I have accumulated enough friends, acquaintances and past colleagues that a quick traverse of the lobby is nearly impossible – but so much fun.

I attended a session organized by my colleagues and was pleased to see that the torch has been handed over to a confident and competent next generation of 30 somethings – all of them women. Kristen, who also belongs to that category, and I did our 3-hour session in the afternoon. It was well attended and a lot of fun to do – it was mostly experiential with a lot of moving around, small group inquiries that made the case of why we need to pay attention to people’s management and leadership skills. We were thanked afterwards about not lecturing tour audience. I’m glad they noticed. We might have been the only non-powerpointed event in the entire conference.

During the cocktail hour I served as an extra at a demo of our suite of virtual programs. We served wine and cheese which increased traffic substantially. An entire afternoon of standing left me in some pain – I am not entirely my old self despite what others see and what I tell them; the posterior tibial tendon/nerve mess at my right ankle, rarely problematic, was painfully apparent.

Dinner was a special reunion with Stephanie and Vince from Southern Africa who I had not seen in many years. Since there are no Japanese restaurants in Windhoek and it happens to be one of our favorite cuisines we ordered a large platter of sushi, sashimi and rolls and caught up for hours about kids, work and plans. After that I could not hold sleep at bay. I had, after all, been up since 3 AM.

Yesterday was a long day that ended at 9 PM at the Melrose hotel on Pennsylvania Avenue in Washington DC, in a 3 room suite. A bill that matched it in size was pushed under my doorway this morning.

When I travel I don’t get up at 4:30 AM so yesterday started slow and late. Axel cooked me breakfast, leaving me time to admire Lobster Cove, spectacular in its post snow-storm appearance. Everything was covered in frozen snow – the kind of white that looks blue in the sun. It made me want to pull out my watercolors – to catch the snow on tree trunks and branches, best painted by not painting it, as negative space. On some of the branches the wet snow had melted and then frozen again; ice crystals that sparkled in the sun like jewels. To complete it all a bright red cardinal settled down on a high branch, chirping as if there was no tomorrow. It was a fragile and tender nature poem – for now the sun was helping it come to life; soon it would kill it.

I dropped the car off at the Shell station near work to fix the slow leak in one of the tires. A little gremlin is piercing the outer wall of our tires. One month ago we replaced one tire and now this one on the opposite side has the same problem. We are puzzled by this and soon some 200 dollars poorer; but then, we know that the tires and the car are old and worn. The Korean mechanic circled the pinhole that he could do nothing about with yellow paint. He put the tire back on, it’s a slow leak after all, and did not charge me; he knows I will come back. My belief in the basic goodness of people is coming back, even if it is simply good customer service.

I travelled to Washington with Kristen on the 7 PM flight. These flights used to be full but now, like all others, they are only half full. We sat next to a discombobulated woman from the Commerce Department who panicked when she did not see her purse. When she found it (inside a larger purse) we all sighed and laughed. She was going home to DC and clearly in need of some R&R. She had taught businesses in Rhode Island about export rules and restrictions. When she discovered that we were ‘in international health,’ (in developing countries even) she blessed us for our good work and I kept my skeptic mouth shut, trying not to reveal how we are all tripping over each other in places like Afghanistan and Ethiopia, doing HIV/AIDS work. And that there is money in doing development – some people even derive a very good living from fighting poverty. That’s when shame takes over from pride. But I let her bless us nevertheless. As far as tax dollars go, I feel like I am spending them quite responsibly (we did not take an earlier flight to avoid an extra charge of 50 dollars and instead waited for 2 hours in the airport.)

We have been asked to do a 3 hour session to teach our peers about management and leadership of health programs. We have done a similar event about one year ago. Kristen will do more now and I will do less. We have no idea how many people will show up. There does not seem to be a registration process. We are prepared for one person, for 30 or anything in between. The event is part of our continuing crusade to have those who assign clinicians to run health facilities think about the management and leadership tasks that need to be done before things get messed up. It causes a lot of unnecessary stresses in people and systems. I know this first hand, as it happened in my own family. We have been doing these sorts of events for years and keep being surprised that this is not obvious to others that people need to learn how to manage and lead.

Yesterday was a short day, dominated by friends and dogs. It went by fast. Today we are flying back again.

After I posted my blog in the morning I told Axel he’d better call Larry. Larry is part of this small group of faithful readers who, when we see them do not require updates on our lives. In fact, they often know more than Axel knows, who is not a faithful reader. Larry would be aware of our presence in DC whether we call him or not. So we called and drove to see him and his wife Amy on the other side of the river, White House and Mall, in our macho car. We had lunch in their lovely house and were lucky to find daughter Elizabeth there as well. She had come over for the holidays with her man, all the way from Eugene (OR).

We went back to help Carol cook for a large crowd that included a number of surprises, more people than Chris was told would be there. He might have noticed that the potato salad and sausages would feed many more than the immediate family he was expecting. He caught on quickly when people started to stream in.
A third dog came to join the two pooches already there, now without sweaters since it remained balmy. In fact, people sat outside by around the sausage laden barbecue most of the evening , as if it was a cool summer evening.

I surprised myself by falling in love with Carol’s two ‘poo’ dogs, one a 5 pound maltezer-toy poodle cross (a ‘malte-poo ‘) and the other a slightly bigger cocker spaniel-toy poodle cross (a ‘cocka-poo’). Carol had written in their Christmas newsletter that Chris was smitten with the two dogs and now I understand how and why. They are the cutest creatures, with adorable faces who love to be held and petted. In fact I spent a good part of the evening with a sleepy little ‘poo’ draped over my legs, more cat-like than dog-like, but so much more affectionate than a cat. Carol washes her pooches often so they also smell nice.

We sung to and toasted the brand-new 60 year old and made the customary jokes about getting older and then we parted with promises of seeing each other soon.

I am woken up this morning by the street sounds of Washington that come in through my open balcony door. It is one of the hotel’s features that is listed under the rubrique ‘guestrooms’ on its website (door and windows that open). I am imagining that litigation about people having thrown themselves out of hotel windows has made such a feature rare in big chain hotels.

I made coffee in the small coffee maker (also advertised) and despite using only half of the recommended amount of water it comes out the color of tea. I enhanced the coffee sensation with a stick of instant coffee brought back from Holland; emergency rations that live permanently in my travel gear.

Yesterday morning we had a strategy breakfast with the MSH troops, rehearsing elevator speak messages and looking out for good partners and good people and then we swarmed into the various enormous ballrooms to do our good works. Kristen and I ran a three-hour workshop on leading for results. We had a full house, some 50 fifty people, and took them onto a journey mimicking the way we work with groups out in the field. We had people in the room from all over Africa, Nepal, Guyana and the Middle East with Americans in the minority. As it happened, we had many people from countries where we have teams on the ground. It was wonderful to make all these new connections. My big regret is that we did not get an attendance list so we can stay in touch. In the end many people rushed off to the various other activities programmed or lunch. It is a packed program and there is a huge social networking component to it that Facebook and LinkedIn could not compete with.

The opening session of the conference took place in Geneva and Washington at the same time; two gigantic screens connecting us with one another. This year is the 30th anniversary of the Alma Ata Declaration that focused attention of the public health community on primary health care, away from hospitals in the capital cities (tertiary care). In the past 30 years a whole new crop of public health professionals has grown up taking this for granted. The conference theme this year is Community Health and a stock taking of sorts. It was interesting to hear the giants from the field share their insights although I would have liked to hear them address the young professionals who will have to carry the torch. There was something slightly contradictory about the theme and the process: impressive talking heads, the experts, talking to a crowd that represented an enormous reservoir of expertise. Yet, by the very act of talking to them rather than listening and learning from them, the espoused message about empowerment was not practiced by these very well intentioned and expert advocates of Lao Tsu’s exhortation: ‘start where the people are.’ There was no way of knowing ‘where those in the audience were.’

I ran into Iain and his wife who is from Finland and whose name has so many vowels in such odd places that it took me years to get them in the right quantity and in the right place. Out of laziness most of us refer to her as RLKA. She pointed me to an exhibit about the treasures from Afghanistan at the National Gallery they had just returned from. It is a magnificent display of the various cultural streams that ran through Afghanistan (Bactria) at the time of Alexander the Great, before and after. I did not need much exhortation and played hookey from the conference; I felt I had put in enough hours for the day.

The exhibit was indeed magnificent. I was lucky to share the space with a small group that clearly consisted of insiders and hoverered around the edges to catch some of the stories that accompanied nearly every piece in the display. It made me realize how much of such exhibits is hidden from us ordinary visitors. There were stories of heroism about hiding treasures in vaults and smuggling them away from fanatic Taliban and there were stories about great stupidity, of not recognizing that, as the slogan at the door says ‘A nation stays alive when its culture stays alive.’

One particular piece caught my eye. It was a Greek inscription on a fragment of a funerary monument found at Ai Khanum in what is now Northern Afghanistan. It read: “as a child learn good manners; as a young man learn to control your passions; in middle age be just; in old age give good advice; then die, without regrets.” I learned that this came from a wandering Greek philosopher who was intrigued by eastern religions and had made it to Bactria in the 3rd century BC. The exhortation was one of several maxims for moral behavior said to have been presented to Apollo at his sancturay in Delphi by the 7 Sages of Ancient Greece. These sages knew something that is still current and relevant today and resonated stronlgy with me as I am now in this phase that is about giving good advice.

I met Larry in the Kogod courtyard of the National Portrait Gallery/Museum of Americann Folk Art that is housed in the restored Patent office. The restoration story itself is worth going there; the place beautiful in an eery sort of way.

We ended up in Adams Morgan in a restaurant where Amy met us and talked and talked and talked over elegantly served fish and soft shell crab dishes.

When I arrived back at the hotel my right foot was in bad shape from what I call ‘museumwalking’ and required a long soak in the bathtub. It was an early night for a change.

When I am on the road and staying in a hotel I always have a hard time going to bed because I watch TV in a way I don’t when I am home; mostly because these nights on the road there is an abundance of time. I went to bad too late and slept through my alarm. It’s rush hour now; none of this abundance left.

We biked into town yesterday morning for the various Memorial Day ceremonies that are acted out, each year in exactly the same way, in our small town. The only thing that was different this year was a woman among the 5 people that do the gun salute at each cemetery stop. I have difficulty seeing someone with a skirt and nylons shoot a gun; a sign of women’s liberation taken to its absurd extreme. I am also, every year in the same way, annoyed about oratory that glorifies war. As on cue I whisper my annoyance to Axel and every year he shushes me with the same look that separates Europe from America when it comes to war, especially those of the last 30 years. Axel is moved more than I am; none of these were ‘my’ wars; I missed WWII by 6 years and everything that followed were America’s wars, ordered by Presidents for reasons that have more to do with interests than ideals.

We biked back with our across-the-cove neighbor Bill. Back home we resumed our garden work. Axel rototilled, using both hands – the good and the bad – with tremendous dexterity and at some cost, as we discovered later when the muscles started to complain. We did get the tomatoes and basil into the ground; the beans placed around two poles; the lettuce and spinach seeds put in straight lines, the onions in a crooked line. I put the potatoes in using the entire back and claiming one third of the garden space. Finally I scattered flower seeds helter skelter in places that looked like they needed some color.

It was only with great difficult that I extracted myself at the end of the afternoon from all this garden work. Axel took me to the airport and Comair took me to Washington. After I had worked with my colleague Kristen on our workshop design and met a few friends I withdrew to my spacious corner room and watched TV. I caught the tail end of a dramatization of Bush’s stolen election in 2000 and then a documentary of soldiers who came back from Iraq as amputees and/or brain damaged and/or suffering from severe PTSD. It consisted of a series of interviews with very young people who escaped death by a hair but came home seriously damaged in a variety of ways. It was about the gory side of war rather than the glory I heard earlier this morning.