Getting Care As You Age

How to Get the Care You Need in Old Age.
Very useful guest post by Harry Cline.

Most Americans over the age of 65 will need long-term care at some point as they age. That could mean residing at a nursing home or seeking home care, both of which are among the wide variety of solutions available to meet the needs of the elderly. The problem is the costs, which can be frightening.

A private room in that aforementioned nursing home? That runs an average of over $8,000 a month, while a home health aide would set you back over $4,000. In some extreme cases, the total price of such support and services grows into the millions. Wow.

So, what’s a financially-responsible person to do in the face of such financial challenges? Plan. Here’s a breakdown on how to assess your basic needs and pay for care.

Do Your Research

The first step is learning what services are available. The most basic level is visits from friends and family or custodial care at home. There’s also adult day care, assisted living facilities and nursing homes. What you need depends on your level of health along with whether you suffer from a chronic condition and its severity.

Assess Your Health Risks

It’s tantamount to looking into the future. However, the likelihood of certain diseases can be gauged based on your lifestyle, current overall health and family history. If you have a parent, brother or sister with Alzheimer’s, for example, you are more likely to develop this form of dementia, and the same goes for some cardiovascular conditions.

Make Lifestyle Changes

The risk of falling ill can be reduced through exercise and a better diet. There’s no simple recommendation as far as what to eat, though Elders’ Helpers recommends nutrient-rich foods such as fruits, vegetables, legumes, beans and whole grains. As far as getting your body in motion, choose something you enjoy, whether it’s swimming, cycling or long walks on the beach.

Modify Your Home

This not only prevents injury, but allows you to stay there for longer and save money on costly assisted living and nursing homes. Some adjustments include installing railings on both sides of the stairs as well as automatic lighting to avoid nasty falls when you wake up in the middle of the night. You should also remove loose rugs and carpeting to enhance mobility and safety.

Now, we’ll move on to how to pay for all that. Bear in mind that the earlier you start, the better, and some options aren’t even available after retirement or a diagnosis with a severe medical condition.

Get the Right Insurance

Specifically, long-term care insurance. As implied by the name, it covers the cost of home care, assisted living and nursing homes, though the premiums can be high, averaging $2,700 a year, according to information cited by the AARP. That could be a worthwhile investment, though, if there’s a history of serious health conditions in your family.

Use Your Living Benefit

That means the living benefit rider in your life insurance, if you have one. If not, your insurer may be able to add one to your policy, in which case you would be able to draw from your death benefit to pay for medical expenses. Again, this could be a great option to have if you’re at high risk of chronic illness.

Put Money In Savings

Take this step before retirement with a health savings account. Both you and your employer make contributions, but the money stays with you when you’ve finished working. It’s tax-free when used for medical expenses, making it an attractive option along with high-deductible health plans.

Tap Into Your Property

You can do that via a home equity line of credit. This financial instrument allows you to withdraw money with your property serving as collateral, and offers a simpler alternative to a reverse mortgage, with lower associated costs. Both are common means of securing cash for long-term care, and which one’s right for you depends on your circumstances.

Planning for your care is not always easy, but you’ll breathe a sigh of relief when you’re done knowing that your future medical care is assured. Get started as soon as possible.

Image via Pixabay.

A Midwife’s Joys & Sorrows

Born for Life: A Midwife’s Story by Julie Watson.
Reviewed by Gabriel Constans.

Being that Call the Midwife, based on the memoirs of Jennifer Worth, is my favorite series on television, I was excited to discover this autobiography by New Zealand nurse-midwife Julie Watson. Born for Life is an intimate and honest portrait of the life Ms. Watson has led (so far), and her interest in nursing, which was inflamed when she first read about Florence Nightengale as a schoolgirl. The effects of birth, and having children, have an overwhelming impact on the author, in her own family, as well as her chosen profession.

Julie meets her future husband, Barry, at a young age (in 1968) and is married at 17. Four years later she has her first child (Kelvin). During the pregnancy she develops preeclampsia and must be on bedrest. “Preeclampsia is a condition that occur during pregnancy when a woman’s blood pressure rises sharply.” She first comes across the condition at work when it has devastating effects on a patient. “All these thoughts were going on in my mind. I never thought something like this could happen when having a baby. It never occurred to me that sometimes things can go wrong. Little did I know that preeclampsia was going to have a devastating effect on my own life that would impact me for years.” The impact she is referring to is the death of her second child, Shelley Anne Watson, who lived only a short time after her birth.

After having more children, and going back to school to become a licensed nurse, Ms. Watson had several other children (Angela Mary) and much later, another daughter (Elizabeth Jane). Not only does she have to deal with preeclampsia and bedrest once again, for both these pregnancies, but she also discovers that both her daughter’s have Albinism, which is a congenital disorder that results in the partial or complete absence of pigment in the skin, hair and eyes. It can also effect sight, which it does with her children.

The author speaks candidly about her periods of “depression, loneliness, and self-doubt”, which she struggled with after the death of Shelley Ann, and at other periods in her life. She describes the wonderful support she had (and has) from her spouse, family, and friends, and how they all came through to help, especially when she has a stroke in mid-life (from which she recovers). She also talks about starting to attend church, and the comfort prayer, and belief begins to give her. It is this faith that sustains her.

Though this review may sound as if this memoir is just about struggles, and sadness, Born for Life is anything but. Along with the writer’s personal ups and downs, she provides an abundance of details and tales, about different mothers, families, and situations in which she played a vital role in assisting in joyful and healthy deliveries. By far, the majority of this autobiography tells the stories of brave women giving birth, who are surrounded with caring and knowledgable midwives, such as Ms. Watson. It was an honor to read.

“I Demand My Rights.”

“I Demand My Rights.”

Kaia* was eleven years old when she was assaulted and raped on the way to school. A teacher took her to the hospital, but the police demanded bribes for even taking down a statement.

So Kaia did something incredibly brave. She sued the police for failing to protect her. What’s even more incredible is what happened next.

In Kenya where Kaia lives, a woman or girl is raped every 30 minutes. Police there routinely turn a blind eye, further isolating terrified young survivors and reinforcing the notion that rape is ok.

Kaia and ten other young survivors challenged that. On the day of the case, ignoring threats to their safety and a blockade from court security, they marched from their shelter to the courthouse, chanting “Haki yangu” — Kiswahili for “I demand my rights.” And then the judge issued his ruling: The girls had won!

The amazing advocates and human rights lawyers that worked with Kaia are ready to bring similar lawsuits against police forces across Africa and beyond, but they need funding to do it. We won’t process pledges until we reach our goal, but if just 30,000 of us pledge a small amount now, we can repeat this game-changing victory in other countries, remind police that rape is a crime, and take a powerful step forward against the global war on women:

Click to pledge what you can — we’ll process your contribution only if we hit our goal of 30,000 donors.

When Kaia’s story began, she looked set to become just another of the countless victims of child rape ignored by the police. But Kenyan child rights advocate Mercy Chidi and Canadian human rights lawyer Fiona Sampson joined forces to challenge this injustice in the courts.

The plan was hatched in Kenya by a group of colleagues from Canada, Kenya, Malawi and Ghana — it seemed like a long shot to sue the police force for failing to act, but they stuck with it and took risks… and made legal history. The work has just begun: like any win, it takes time, effort and money to make sure the ruling sticks, and to use it as a springboard to wipe out violence against women.

If we raise enough, here’s how we could turn a huge victory for Kenya into a win for countries across Africa and even the rest of the world:

* help fund more cases like this, across Africa and around the world
* use hard-hitting campaign strategies to make sure these groundbreaking judgments are enforced
* push for massive, effective public education campaigns that strike at the root of sexual violence and help erase it for good
respond to more campaign opportunities like this case — with super smart strategies that turn the tide in the war on women.

Click to pledge what you can to start this important work right away — we won’t process any contributions unless we hit our goal of 30,000 donors.

As citizens, we often appeal to political leaders and other officials to get serious about protecting women’s rights. It’s important to keep doing that, but when they fail to hear their consciences, we need to appeal to their interests, and take them to court. That sends a powerful message: not only that there are new consequences for their crimes, but that the era of unchallenged misogyny in the culture of our societies is coming to end.

With hope,

Ricken, Maria Paz, Emma, Oli, Nick, Allison, Luca and the rest of the Avaaz team

* Kaia is a pseudonym, but her story is real. She is not pictured here.

Curing Cancers In A Decade

From Technology Review
21 September, 2012

Oncology’s Moon Shot
by Susan Young

A large cancer research center in Texas announced today it will launch a “$3 billion fight” to reduce the death rates of eight cancers. The so-called Moon Shots program at the University of Texas MD Anderson Cancer Center will focus on forms of lung, prostate, ovarian, skin and blood cancers. According to the Houston Chronicle, the program follows a pledge last year by then-new MD Anderson president Ronald DePinho, who at the time said he wanted the hospital to develop a “bold and ambitious plan for curing several cancers.”

The Moon Shots program will include a focus on genomics to understand the genetic and molecular basis of cancers and to identify patient-specific treatments (for more information on these ideas, see “Cancer Genomics” and “Making Genomics Routine in Cancer Care”). “Humanity urgently needs bold action to defeat cancer. I believe that we have many of the tools we need to pick the fight of the 21st century. Let’s focus our energies on approaching cancer comprehensively and systematically, with the precision of an engineer, always asking … ‘What can we do to directly impact patients?'” said DePinho in a released statement.

Read complete story and other informative articles at Technology Review.

Stories From Syria

Dear Gabriel,

You have heard the stories on the news — Syrian cities are being besieged, and civilians are dying in droves at the hands of their own government. Just today, a U.S. journalist and a French photographer were killed while covering the violence in Homs. I want you to know that Amnesty International is on the Syrian border, collecting stories for the world to hear.

Amnesty’s Syria campaigner Maha talked with a group of women from the village of Tasil, including a young mother:

“One day before we left Tasil I was looking out from the window and saw security forces chasing a man in the farms near the village. They were shooting at him and I thought no doubt they would kill him. When I looked closely I realized that that man was actually my husband. Thank God he managed to escape.”

Maha heard that 8 deaths occurred in Tasil in one week — including a woman shot and killed while putting her laundry out on the roof.

Donate to help Amnesty shine a light on the abuses being committed in Syria and around the world.

Those arrested in Syria face unspeakable torture.

Neil, an Amnesty researcher, spoke with individuals from the city of Dera’a. Dozens have been killed in the last week, their homes looted.

Neil is hearing accounts of torture unlike anything he has seen in 9 years working on Syria at Amnesty International. A refugee named Abu Suhaib tells Neil what he’s truly scared of, “I’ve seen many beside me be shot and killed but I’m not afraid of dying. What I fear is being arrested.”

Neil talked to Jihad, a 34-year-old clothes shop worker arrested last December. Like others, he was subjected to extremely cramped conditions, electrocuted several times, and sometimes violently beaten. Also, like many, he had his religious beliefs denigrated by the security guards.

After refusing to recognize Syrian president Bashar al-Assad as his god, Jihad was kicked down two flights of stairs. Jihad unwrapped the bandage around his left hand and told Neil what happened next. “He then ordered that I be restrained in the crucifix position, and have a piece of dynamite the size of a pen tied to my left palm. ‘Boom’, it exploded and half my hand blew off. Blood flowed everywhere.”

Jihad was taken to a hospital from where he was able to escape and later find his way to Jordan. After he fled, the security forces gave his family a document stating that if captured he will be executed.

Neil and Maha continue to uncover accounts of violence and torture. How much blood do the people have to shed before the world helps?

Amnesty International is campaigning for governments to take action individually and through the United Nations to protect Syrians from their government’s brutality. We need your help.

Donate today to fund Amnesty’s work to expose human rights abuses — and push the world community to act!

Sanjeev Bery
Advocacy Director, Middle East North Africa
Amnesty International USA

Community Nutrition – Rwanda

The following blog is composed of excerpts from a progress report written by current WDI intern Sean Morris. It describes one of the many projects he is working on and some of what he has learned thus far, working with The Ihangane Project in rural Ruli Rwanda.

Community Nutrition – an update from the field.

CNW Program progress: I have assessed the community nutrition worker (CNW) program through direct observations of their work in the field, and through surveying large samples of CNWs from various health centers in the Ruli District Health System. My partner, Huriro Uwacu Theophila, is a biostatistics student at the National University of Rwanda. We have worked to produce surveys in Kinyarwanda for both CNWs, and participants in the malnutrition program. So far, we have surveyed two of the seven Ruli Hospital CNW networks, and I plan to schedule transportation to the remaining five CNW monthly meetings as they take place in July. The information gathered in these CNW surveys includes: each individual’s satisfaction with the program; identification of resources necessary to perform their work; description of the food security situation in their villages; an assessment of the knowledge required to perform their work; and their current outreach to people living with HIV. I will use the data from these surveys, along with the observations that I record in the field to see how far the CNW program has come in implementing the Rwandan community based nutrition protocols (CBNP), and to identify gaps in their effectiveness in combating malnutrition in their communities. After gaining a full understanding of the CNW program, I will work to determine cost-effective approaches to meet their material needs, and provide them with focused training and education opportunities related to nutrition. This survey has the potential to act as an on-going worker satisfaction and knowledge tool for the CNW program. Such a tool would allow the CNW network and its administrators to continually, and accurately improve the program, monitor the success of any recommendations that we implement this summer, and foster collaborative problem solving within the CNW groups. Improving the CNW program will advance the nutritional status of the villages in the Ruli catchment area, and will lead to reduced resource constraints, funding dependencies, and operating costs at the malnutrition center.

COMPLETE ARTICLE

His Mother’s Arms – Part 3

His Mother’s Arms. Excerpt from children’s story collection Solar Girl and Lunar Boy.

His Mother’s Arms – Part 3 (Conclusion)

When Jon and his mother made their return visit to the hospital, Jon let slip a comment about his mother’s headaches. The doctor, a young, auburn-haired woman, named Sally Shapiro, quickly questioned Clarisa. “When did she first have these headaches? What was their frequency and how long did they last? What was the pain like? Were there any stressful events in her life? Did anyone in her family history have similar ailments?” The last question unloaded the cart.

To her surprise, Clarisa found the attention comforting and was relieved to finally reveal her private world of apprehension and fear. She made an appointment with Dr. Choate for tests the following week. To her delighted and infinite surprise, the tests discovered nothing other than high blood pressure, which was successfully treated with medication and a change in diet.

Jon’s feet pushed hard on the rubber pedals of his new used bike. He broke free down the straightaway and didn’t let up rounding the corner towards home. His mother was in the front yard with Grace and little Mary playing in the flowerbed. Clarisa was planting spring bulbs and chatting away when she heard a holler.

“Hey, Mom! Look!” Jon yelled with delight. He felt like the sky had lifted him from gravity’s grip and pulled him, flying, up the driveway. He skidded to a stop and stood beaming like sunlight. His mother clapped her dirt-covered hands and ran to his side. She gave him a long hug, pulling his head to her tummy and exclaimed, “That was fantastic! You’ve gotten so good! Your father will be very proud.”

Unfastening the strap to his helmet, Jon unconsciously felt above his eyebrow, adjusted his wire-rimmed glasses and basked in his mother’s presence and praise.

THE END

Part 1
Part 2

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His Mother’s Arms – Part 2

Hist Mother’s Arms – Excerpt from Children’s short story collection Solar Girl and Lunar Boy.

Hist Mother’s Arms – Part 2

The nurse, Bea, washed Jon’s forehead with yellowish-brown betadine that ran behind his ear. Bea’s brown face was surrounded by straight, thick black hair. The rest of her body was covered in white. She kept smiling and repeating, “That’s a good boy.” Her soothing voice put him into a matriarchal trance, as name-calling, rocks and falling took an afternoon nap.

Grace stood close by, rocking Mary side to side, like mothers’ of young children do. She was trying to put on a good face and comfort Jon, but he could sense her aversion to looking at his wound.

A tall mustached man, in a hospital coat, suddenly loomed over Jon.

“This is Doctor Patrick,” voiced the nurse, in a hasty introduction.

“What have we here?” he questioned, without expecting anyone to answer. He took the pad off of Jon’s eyebrow.

“Don’t touch it!” Jon screamed with fright.

The doctor ignored his outburst and stated matter-of-factly, “Pretty good one there buddy.” Turning towards the nurse he said, “I’ll need a butterfly suture set.” The nurse already had it ready and placed it in his hand.

Jon eyed the doctor with the hair on his lip, as he opened the suture kit and seeming to speak to the plastic tray said, “Son, I’m going to give you a little poke. It will sting.” Nurse Bea handed Doctor Patrick a small syringe. “Then I’ll stitch you up so good you’ll never know what happened.”

Doctor Patrick moved closer. Jon could feel his height. He looked at the doctor’s black belt and buckle, when his white coat fell open, then felt a sharp sting. He started to cry.

“The next part won’t hurt,” the physician’s monologue continued.

“It’ll just feel like someone tugging on your eyebrow a bit.”

“Son,” Jon repeated to himself. It sounded like his father’s voice. He knew his dad would want him to “be tough” so he bit his lip, counted backwards and closed his eyes. He longed for his mother’s arms and cried out “Mama!”

“All done,” chuckled the tall, black-belted, mustached man. “You can open your eyes now.” As he put the tweezers back in the tray, Dr. Patrick turned to Grace, who had just opened her eyes and said, “You have a brave little guy here.” Jon wiped away the tears with his dirty sleeve.

Before Grace or Jon could say a word, the self-absorbed doctor had gone to the next bed and disappeared behind a sliding beige curtain. Bea looked at Grace. “He’ll need to come back in a few weeks to get those removed.” She gestured towards Jon’s forehead and smiled her bewitching smile.

“I’ll tell his mother,” Grace replied, then helped Jon off the gurney and held his trembling hand out to the car.

CONCLUSION TOMORROW

His Mother’s Arms – Part 1

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Ashita (Tomorrow) – Part 3

Excerpt from children’s story collection Solar Girl and Lunar Boy.

Ashita (Tomorrow) – Part 3 (Conclusion)

Whether it had been divine providence, coincidence or random luck, I’ll never know; but my faith in Buddha and the precepts were instantly restored. I attended the temple weekly and diligently started reciting my sutras. I even entertained the idea of becoming a nun, until a wonderfully romantic dream convinced me I’d never make it as a recluse.

Reverend Tsukiyama brought the application later that week, as well as some phone numbers of other families who had daughters in the program. Haha knew one or two and called them that evening. I walked into the kitchen as she was finishing her last call.
She hung up solemnly and said we’d talk about it in the morning.

“OK,” I replied, acting as if it didn’t concern me in the least. “I think I’ll call it a day. Goodnight Haha.”

I figured the sooner I went to bed, the earlier the sun would rise. I brushed my teeth, put on my nightclothes and snuggled in for the hopefully brief darkness, but the night crawled by like a sleepwalking sloth.

Sleep deprived and blurry eyed, I was waiting anxiously at the breakfast table when Haha, Chichi and Soba (grandmother) straggled into the kitchen.

“Well?” I exclaimed, almost lifting off my seat.

“Well what?” Haha replied.

“You know what!”

“Oh, that,” she said.

They sat and stared down at the table. Haha was the first to break. She glanced my way with a brilliant grin.

“I can! I can!” I jumped up and down and kissed them all. “You won’t be sorry! I’ll make you proud! Thank you. Thank you. I love you all!” I bowed so many times I thought I’d surely broken my back!

Chichi turned away and went outside without saying a word.

Haha and Soba were crying. “I’ll be all right. Don’t cry,” I said.

Chichi left for work without speaking to me.

That night Haha followed me to bed and sat on the side as I got under the covers.

“I’m sorry Hon, I didn’t mean to bring a cloud on your head.”

“What do you mean?”

“We weren’t crying because we were sad. Well, we are sad to see you go, but it’s more than that.”

“You don’t have to say anything,” I cautioned, feeling a bit uneasy.

She continued as if she hadn’t heard me. “Soba and I are happier for you than you’ll ever know. We’re so proud of you.” She smiled and started crying again.

“Haha.” I put my arms around her. “What’s wrong?”

She wiped her wet cheek on the sleeve of her silk kimono; the one Soba had given her back in the fifties. “Nothing’s wrong,” she sighed. “Everything’s right. You’re doing something Soba and I never had the chance to do.” Her eyes watered again. “I think we’re feeling a little sorry for ourselves. I didn’t want to be a nurse, but I did want to write and play music.” She paused, gently caressing the blanket with her callused fingers. “Who knows, I might have been pretty good at it too.”

“What stopped you?”

“It just wasn’t something women were ‘supposed to do’. Our duty was to home and family, but I can’t blame it all on that.” She looked away. “I was scared. I’d never lived apart from my family. I knew what to do at home. I’d seen it done all my life. It was safe. I did what was expected.”

I started feeling guilty. “If only we hadn’t come along,” I thought.

Seeming to have read my mind she quickly added, “It’s not your fault! I couldn’t imagine life without you. When you’re a mother you’ll know how much I love you. No, I don’t regret having children.” She smiled and shook her head. “It’s hard sometimes and tiring as hell . . .”

“Haha!” I exclaimed. I’d never heard her swear before.

“There’s something special about each and every one of you.” She stopped, as if she’d just realized something profound. “I wish I wasn’t such a scared-y-cat.”

“Well?” I asked.

“Well what?”

“Why don’t you do something about it?”

She blushed. “It’s too late for that.”

“Too late?!” I exclaimed. “Remember that poem you wrote a couple years ago about the farm?” She nodded bashfully. “It was great! Everyone said so. Why don’t you start writing again?”

“I wish there was time, between chores and kids I barely get any sleep as is,” she said justifiably.

“Make time,” I insisted. “Basho and Yutaka are old enough to help out. You could practice your music too.”

“You’re so sweet.” She gave me a big hug. “I’ll think about it.”

“I love you Haha.”

“And I you.” Our necks were damp with tears. “I miss you already,” she cried.

I sat back smiling. “I’m only going to be two hours away.”

“I know.” She laughed.

“Chichi acts like I stuck a knife in his back,” I said sadly, looking at the floor. “It’s not like I’m going to Europe or something.”

Haha brushed the hair from my forehead. “He’ll come around. You are like the rising sun to him. He can’t imagine not having you here.”

“You don’t understand,” I said, feeling my cheeks getting wet once again. “He had me promise . . . I promised that I’d never leave Hamatombetsu.” I hid my shame behind my hands.

“Yuki,” Haha whispered. “Yuki. Look at me.”

I looked through blurry eyes.

“He never told me about that and you know why?” Haha asked. I shook my head. “Because he knows it was a foolish thing to ask a little girl to promise. How old were you . . . nine, ten?”

I stopped crying. “I was nine. It was on our way back from visiting Shogi in Sapporo.”

Haha shook her head. “He had no right to have you make such a promise.” Haha looked out the window. “He knows you can’t hold on to joy or try to put it in a chicken pen. You have to find your own way Musume, with your own heart.” She held my hand. “I’ll speak with him. He only wants your happiness.”

In less than a month I was informed of my acceptance, but it wasn’t until my crying Chichi and I got in his old beat up truck, waved goodbye and drove down the familiar, pot-marked dirt road, that it seemed real.

Haha had been right. Chichi came back to me the morning after they’d given me their blessing to go. He told me they would visit as often as they could. He helped me pack, gave me what little money they had and said he’d always be my “Number one fan.”

I wondered if my prayers had helped push my wish to the top of the karmic pile or the Bodhisattva’s had just taken a nap and knocked it off by accident. Then again, perhaps Sapporo wasn’t the land of honey and happiness after all. I looked back at my shrinking family and sobbing friend Kiri, who were waving in the distance. Through my bittersweet tears I realized that my ashita had become imadoki (today).

THE END

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Ashita (Tomorrow) – Part 2

Excerpt from children’s story collection Solar Girl and Lunar Boy.

Ashita (Tomorrow) – Part 2

Now I was being pulled, like an obsessive magnet, towards Sapporo’s alluring illusion of happiness. I was infected with a virulent virus known as TRISSES (The Rice Is Sweeter Somewhere Else Syndrome).
I wasn’t sure how to make my break – work, elope, runaway or hijack a bus? My teenage desire contradicted all financial logic. Our family had no savings account, wealthy relatives or hidden cash to save me from the purgatory in which I wallowed. My parents had no inkling of my nightly anguish and I wasn’t about to let them in on the secret. If they discovered my desire to go to Sapporo, their fears about “that depraved city of immorality” would descend upon me like a swarm of locusts. I had never forgotten the promise I’d made my father and neither had he.

When times were tough, I’d always been harangued into attending the local temple and praying for understanding and humility. After awhile I discovered that the prayers and priests divination’s often coincided with the will of my parents, teachers, and other illustrious icons of the community, but I figured I might as well give it one last try.

On a sunny Saturday in July, I decided to attend temple on a personal quest. I was turning eighteen in two weeks and could see the tiny grains of sand falling through the hourglass at the speed of light.
I wasn’t the kind of girl to stay home and play house or get married. Having grown up with six younger siblings, I was certain I’d rather be tortured and hanged then ever marry and have children! I didn’t mind if other women want to live that life, but it wasn’t my cup of tea or so I thought at the time.

I entertained the thought, rather briefly, about being a teacher. There were a few teachers I admired, respected and even fell in love with. Mr. Sato was my favorite. He had the nicest smile and always complimented my papers. Simple comments like, “Nice work.” would send Kiri and I into spasms of joy and late night talks about how one of us would make Mr. Sato our boyfriend. The fact that he was married, with children and twenty years our senior, seemed irrelevant at the time. Why should that matter when he was “so nice and cute”?
With somewhat more mature reflection, I doubted I could stand in front of thirty pairs of beady little eyes to impart any semblance of knowledge or words of wisdom. I’d surely wilt on the spot from fright.

Then the thought of working as a nurse embedded its tentacles in my skimming mind. That was something I knew absolutely nothing about. What could be so hard about that, I reasoned, handing doctors instruments, putting on bandages and saving people’s lives? I didn’t know about the ugly stuff, the pictures you don’t see on television – people throwing up on your newly washed uniform; exhausted interns screaming obscenities at your “incompetence”; wiping the bottom of a smelly old drunk dying from liver disease.

Haha (Mother) couldn’t believe how anxious I was to go to temple that day. “What’s gotten into you? I’ve never seen you so fired up.”

“Nothing special, I just want to recite sutras and pray for Buddha’s compassion.”

She looked me up and down, smiling with a look that said, “Yeah, sure.”

We arrived ten minutes early, dressed in our finest attire. I didn’t even mind wearing the totally embarrassing dress Haha had made for me to wear on special occasions. She had hand-stitched it from some strange fabric my aunt had given her. She gave it to me on my sixteenth birthday. You could see the pride she had felt when she handed me the package and bowed. Internally I had moaned. “I wouldn’t be caught dead wearing that old-fashioned fake-flower monstrosity!” But all she heard was my dutiful reply, “Thank you Haha. It’s beautiful.”

I rushed inside and sat on the mat. The rest of my bewildered family soon caught up and joined me, looking around nervously, ill at ease to be sitting so close to the altars.

Reverend Tsukiyama recited his ancient incantations, the followers paraded there off key voices with theatrical vengeance and everyone responded with stifled coughs and yawns. Silently, I plunged the depths of my imagination and begged the Ancestors and Buddha’s to reward me for all my good karma. “Please, please!” I begged. “Take me away from these endless fields of wheat, barley and chickens and deliver me to the Pure Land – Sapporo!”

“Get up child,” Haha whispered. “Service is over.”

The priests were shuffling down the corridor towards the hall entrance.

“Over?” I said in shock. “It can’t be! Nothing happened!”

“What are you talking about?” She felt my head. “You feeling OK Musume (daughter)?”

“I’m fine,” I mumbled, as we formally bowed and headed out. Haha kept eyeing me like a suspicious inspector.

What went wrong? I’d done everything! I helped take care of my brothers and sisters, seldom argued with my parents and never even thought about sex or drugs – well, not about taking drugs anyway. I said my nightly prayers and didn’t even hit Sashi Mutsui when she called me a “stupid little pig”.

I was a good girl. Why was I being singled out for punishment? Who were these dead priests and Bodhisattvas anyway . . . the farmers of suffering . . . the divine bean keepers? “This one’s good. That one’s bad. You deserve pleasure. You deserve pain. And you, Yuki, you have to live in Hamatombetsu until you shrivel up and die!”

I swore I’d never set foot on temple grounds again. “You call this a temple?” I admonished, looking at the empty space between the high, engraved ceiling and polished floor. “If I’m going to be stuck here the rest of my life, I might as well jump into the funeral pyre now and let my ashes blow away with the wind!”

As we reached the entrance, Reverend Tsukiyama motioned our family aside. The Reverend was somewhat of a village icon. In his forty years of service he had initiated, married and/or buried almost everyone in town. He’d known me since I was a wailing little bundle of flesh. He was a creaky, robust, silver-haired representative of communal devotion and tradition. Seeing his face reminded me of the day he caught Kiri and I orange-handed, sort of speak, on these very grounds.

We had snuck into the temple courtyard one day after school, like teenage fruit-stealing ninjas and devoured some delicious temple persimmons. They had been hanging invitingly on the lowest branch when we’d first eyed them after service the previous week. We had gleefully conspired then and their to stop by, when we thought the reverend was out making house calls and help ourselves to one of our favorite treats. Everything had gone according to plan, until we’d turned to leave and Reverend Tsukiyama entered the courtyard.
What could we say? We had orange persimmon juice all over our hands and faces. At first, it looked like he was about to laugh, but then his face turned very stern and he admonished us severely, naming every hideous realm of suffering we would end up in if we continued our lives of crime. We hadn’t known that after we’d gone running home that it had taken every ounce of control he had to not break out laughing when he’d discovered our shocked, setting-sun colored faces.

“Yuki,” the Reverend whispered. “Have you thought about your future?”

“What?” I said, still in a belligerent, melancholy daze.

“Your future. Have you thought about your future?”

“My future? It’s all I think about.”

“Well,” he chuckled mischievously. “If you don’t want to be a teacher or politician, I heard about a hospital in Sapporo that trains young girls to be nurses” his eyes sparkled, “and it doesn’t cost a single yen.”

I was stunned. He smiled a rapturous grin, then put on his stern, fatherly face. “Of course, it’s not entirely free. There is a catch.” My eyes were as big as saucers. “Once you finish their two-year program you have to work at their hospital for another two years. They provide room and board.”

I felt like I’d just been hit in the head with a large rock. “I thought you knew about this,” he said. “I’ve been telling all the girls about it.” My mouth hung open like a hungry carp.

I managed a few syllables, “No. I never . . .”

“If your parents don’t mind,” he continued, “I’d be glad to stop by later this week with the application and phone num . . .”

My shouting drowned out the good reverend before he finished his sentence.

“Yes, yes, yes! How do I apply? When does it start?”

He didn’t have time to answer. I turned to Haha and Chichi and pleaded shamelessly, “Please, please say yes!” I was jumping up and down like a kid who wanted a sweetened dumpling.

They hesitated, then Haha anxiously asked, “You want to be a nurse?”

“Yes!” I shouted. “With all my heart.”

“You never mentioned this before.”

“I thought it was impossible.”

Chichi turned stoically towards my black-robed savior and stated calmly, “We’ll think about it Reverend. It’s most kind of you to consider Yuki worthy of such a program. You know you are always welcome in our home.”

“They’d think about it?!” I screamed in my head. The answer to my prayers had just been delivered like a divine telegram and all they could say was, “they’d think about it!” I took a deep breath, put on my best face and managed a feeble semblance of control. At least they were considering it. In my vocabulary, that was as good as a yes!

At that moment my little girls promise to my Chichi to never leave our village had been washed away in a flood of excitement, but he hadn’t forgotten. Caught up in the moment, I didn’t allow myself to see the pain and sense of betrayal that was boiling under my father’s skin.

CONTINUED TOMORROW

PART 1

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