Thursday, August 4, 2016

Principles for being, conversation, San Francisco, destiny

Jean at Marcia's
Several of these photos were taken in Jean’s friend Marcia’s house in Berkeley.

Some of the more vicious FB posts about Hillary Clinton started me thinking about how we communicate and what responsibilities we might have in communicating. I looked up something I wrote in 1999 about ethics related to end-of-life care, especially the part about being honest. The fundamental moral or ethical principle is respect for people. Within this respect are these principles:
In Marcia's garden
  • Respect for autonomy – the right of self-determination.
  • Beneficence or benevolence – doing good, meeting needs; a moral obligation to practice mercy, kindness, compassion, and charity.
  • Nonmaleficence – doing no harm.
  • Veracity – truth-telling.
  • Confidentiality – respecting privileged information.
  • Fidelity – keeping promises.
  • Justice – treating fairly.

Of course these don’t apply only to end-of-life care; they are ultimately serious and high organizing principles for life and how we be together and within ourselves. (Thanks and a tip of the hat to Tom Beauchamp and James Childress.)

Conversation with Guy, the man who sells flowers on Noe:
It looks like I may be moving to Berkeley.
What about your son?
Well, I’m retired, so I’ll just commute – lunches in SF, Golden Gate, all that.
Marcia's bathroom
You’re lucky.

I know.


San Francisco

Several years ago my son-in-law recommended the Tales of The City series by Armistead Maupin. I think Charles thought that reading these books would help me better understand San Francisco, the city I’ve fallen in love with – especially gay San Francisco. That’s exactly what happened. I just finished the last book in the series – The Days of Anna Madrigal. What a soaring, beautiful book.

My apartment on Noe. Window by alarm is/was mine.
My apartment is very near David and Charles in Duboce Triangle, between the Castro and Lower Haight. Leslie and I lived here happily – most of the time. After she passed away (I almost wrote, died) I stayed. Like our home in Dallas, I’ve loved and been loved here, made love here, been happy here, mourned here – I’ve lived here.

This is the city David gave to Leslie – and she embraced it fully and was embraced by it. Leslie in the Haight! Market! Castro! Cole Valley! She’s on the bus, on the F-Line, she’s in the streets, she’s interacting!


To be born again.

We were studying Paul’s letter to the Romans (8:26-36) in Bible study (about groans too deep for words, searching the heart, predestiny – all that in ten verses!) and I was thinking about the
View from Jean's house - Mount Tam
day before when I spent several hours at a coffee shop with a young friend and was blown away by the fact that with open heart and well-acquainted with groans too deep for words, she’s walking tall into her destiny. It’s been a long road and she’s stayed true to the call. She and I have had some of the same visions. This was a very affirming time for me.

Friday, July 22, 2016

In the streets

Apartments in refugee neighborhood
Cambodian children - cold in the apartments
The way it worked was I would take clinical groups of community health nursing students into refugee communities. There were nearly always 8 students/group, so initially we had 4 teams of 2 students and me. Later as our reputation spread, we had volunteer and then paid translators and community health workers, like promotoras de salud. Still later in the process we developed clinics with medical (primary care, psychiatry, gynecology, pediatrics, etc.) and other services, which were integrated into the district health scene. But for now, I’ll describe the straight district health end of things.

We started in one apartment building (about 40 units), where a lot of refugees lived (as well as other poor people). We went door to door, finding health and related problems. On the first day, two of students helped deliver a baby – so we knew things were going to be interesting. Every time we’d find a problem, one of the student teams would stop to help the people solve the problem. Some problems were straightforward and readily solved, some took semesters to solve, and some were never completely solved. Often, one thing would lead to another and we’d work with the people over time. And Leslie was working with us (what an education for students that was!). It was never, ever about referral. It was always about helping the most underserved people be served – solving problems (pregnancy, primary care, depression, hunger, family violence, cancer, and on and on and on). 

In the day we sweat it out in the streets
of a runaway American dream

Community garden outreach
Agape Clinic waiting room
When we got through the first building, we left a team in that building to continue working through problems and went through the same process in the next building. Then we left another team in the second building and started working through the third. And so on. Over time, over semesters we had all the buildings covered in about an 8 block area (which was a lot). And we also had classes and other outreach (health screening, vaccinations, etc.) going on in schools, churches, and community gathering places; for awhile we were doing intake assessments for children who had been removed from their homes because of abuse; and we added the medical, etc. and expanded clinic hours.

Estevan Garcia, MD and Charles Kemp, FNP
Much of what we accomplished was through partnerships and cooperative relationships with community organizations, from grass-roots groups like the Association for Salvation of Cambodian Refugees to Parkland Memorial Hospital, Dallas County Health Department, National Council of Jewish Women, Dallas Police, and a number of foundations, churches, and religious organizations - and of course, the Agape Clinic.

We said we would take responsibility for this community and we did that. Far out vision, isn’t it. With dignity and justice for all in the real world. What an education for students it all was!

It lasted in one form or another for about 30 years and parts of it (East Dallas Health Center, Agape Clinic) continue through today
Refugee children on Carroll Street
and are seeing more patients now than ever before.

We didn't have a TV in the waiting room. Instead we had books - especially children's books and a children's play area. One of the books for adults was a regularly updated listing of sex offenders in the neighborhood.

Monday, July 18, 2016

Vancouver, Big Sur, the girl with far-away eyes, Anna Madrigal

Redwood from our bed. At night the stars!
If you’re downright disgusted
And life ain’t worth a dime
Find a girl with far-away eyes
Anna Madrigal at age 92: “Help me up, dear. Just for a second. While we still have the light.
It’s been another almost indescribable time.

David and Charles flew Jean and me to Vancouver, BC. We stayed in a boutique hotel, the Opus in Yaletown, two blocks from the harbor. It was my first time flying first class and first time in a hotel like the Opus.

We walked all over town, visited some of Jean’s colleagues on Granville Island (island like a tribal gathering place – my tribe), went to the brilliant anthropology museum, hung out in good times at the botanical garden, visited a great little market (Vancouver is a seriously friendly place), hung out at the New Amsterdam CafĂ©, had meals beyond belief (I’ve never had a tasting menu before – Ay Caramba!), Had a lovely birthday dinner for Jean, and had wonderful, wonderful times together. I am deeply grateful to David and Charles for this. What an incredible thing to do! What a beautiful time!
David Kemp and Charles Kemp at Hawksworth in Vancouver
Back to Bay Area, we spent the night in The City, then drove south toward Big Sur – driving along the highway listening to Astral Weeks, crying along the highway.

We stopped for Jean to say a prayer at Esalen where her husband’s ashes were placed six years ago.

In another time, in another place.
Big Sur

Then Jean and I met Steve and Susan, Andy and Marita, and Bob and Ann at a secret hollow space in Big Sur, where we slept two nights outside among the redwoods by a mountain stream, watched the shimmering light on the leaves, saw an incomparable sunset in good fellowship, had lovely meals in a clearing in the forest, hung out around an old table cross-cut from a huge redwood (it was cut long ago – the people who invited Jean are serious about preserving the wilderness), sat on a beautiful beach watching the sea otters, walked in the redwood forest, and became younger and more beautiful.
Golden land sunset over the beautiful Pacific

A woodland-nymph with far-away eyes
Lay me down
In silence easy
To be born again
To be born again
To be born again
In another world
In another world
In another time
Got a home on high
Ain't nothing but a stranger in this world
I'm nothing but a stranger in this world
I got a home on high
In another land
So far away
So far away
Way up in the heaven
Way up in the heaven
Way up in the heaven
Way up in the heaven
In another time
In another place
In another time
In another place
Way up in the heaven
Way up in the heaven
We are goin' up to heaven
We are goin' to heaven
In another time
In another place
In another time
In another place
In another face

(Van Morrison)

While we still have the light