At the end of a too busy summer during which our family has had hardly a moment to slow down, we are finally on vacation on a houseboat in Philadelphia. Philly has lots to recommend it, water, bike paths, delicious food, great art, so much history. We started our trip in good tourist fashion with the Liberty Bell and the Constitution. We found ourselves reminded of what great and radical ideas this country was built on and one of the National Park Rangers put it well when he said that since the Constitution was signed, we’ve been trying to live up to the ideals it espouses. Philadelphia is also close to New York. A few days ago, we drove up to Liberty Island in New Jersey and took the ferry to Ellis Island and the Statue of Liberty. Ellis Island is my favorite New York attraction. The registry room with its literal and figurative echoes; the island’s proximity and distance from Manhattan’s sparkle and promise; the photographs and oral histories that are on display, all powerfully communicate the risk, hope, need, and strength that characterize immigrant experience.

Like many of you, I’ve been reading and watching the unfolding humanitarian crisis on our country’s southern border. My heart aches to think about mothers so desperate that sending their children with strangers, through desserts, hanging on trains, hiding in bushes, and crossing rivers is their only means to give their children a chance at life. What would have to be happening in my neighborhood, town, state, country to send my boys on such a journey? My boys can make each other crazy but my older son would lay down his life for his little brother. If they were forced to make such a journey, he would try his hardest to protect his younger brother but it would be a game of roulette and neither he nor I could influence the outcome. I’ve seen pictures of older siblings with their younger brothers and sisters making this crossing and I can’t help but compare… There but for the grace of God.

My heart breaks too for Americans who show no compassion. News stories about towns driving out child-filled buses and social media diatribes about false choices: taking care of our own versus taking care of “them.” Surely, this is not who these individuals are called to be. As a country, we’ve been here before. Three days ago, here in Philly, I walked past a memorial to Irish immigrants. Here’s how they were described at the time as quoted from the memorial:

Attitudes toward the Irish were typified by an English commentator who described the Irish immigrants as ‘more like tribes of squalid apes than human beings.’ A prominent Philadelphian wrote of the Irish that they had ‘revolting and vicious habits. Being of the lower order of mankind, they were repellent…

Hmmm…echoes, again.

Tomorrow, we head for Boston. Tea parties, midnight rides, stories of people from so many walks of life who risked it all to create something new. The founding fathers, brilliant as they were, didn’t get everything right the first time. The rights of many were sacrificed to get all of the colonies to sign on. But hearing all of the history again reminds me that we are a nation that is more than anything an idea and a dream. And each generation is charged with moving the idea of E Pluribus Unum – Out of Many, One – forward. Our founding fathers have left it to us to fulfill their great work. To lift the lamp…with liberty and justice for all.


Arcs of History

There are those that stick with you. A child, a family, a colleague, a moment. People and experiences that teach you something important about who you want to be as a professional and a person. For me one of those “stickers” I’ll call T. I’ve written about him before on this blog: a five year old with Chronic Granulomatous Disease (CGD) who I came to know during my second year internship at the NIH Clinical Center. He had been misdiagnosed repeatedly in his home country and by the time he came to the U.S. his genetically-transmitted disease that, like HIV, allowed opportunistic infections to take root, was far advanced and there was no cure, only experimental things to try.

This week I had occasion to talk with young social worker at the NIH. She works in the clinical center and was telling me about her work there. In passing, she told me about some research she was doing with a colleague to examine how young people with CGD moved from pediatric to adult care at the NIH. I had to stop her almost mid-sentence. “Young people with CGD moving from pediatric to adult care???” I asked. And then I told her about my experiences with CGD. “Now those children can be cured. They can have stem cell transplant. It’s not without risk and we still lose kids. But when it works, the disease is gone.” Even as I write this I have goose-bumps and tears. Joy and gratitude in knowing that the dogged persistence of physicians and scientists has produced a cure for something that was hopeless 25 years ago. And tears that the cure comes too late for a child and family who taught me so much and that I came to love.

During this trip, I stayed near Dupont Circle, a place I enjoyed when I lived in D.C. as a 20 something. Many a happy Saturday was spent wandering through the Mystery Bookshop where the owners would talk to you a bit and suggest a detective series just for you; perhaps having lunch at Café Splendid; and then a prowl through Melody Records. But it was a very different time. HIV was a death sentence. There were posters and signs focused on prevention -clean needles, condoms, testing. And although I had no comparison for what might have been, fear and grief were palpable. Fast forward to this last visit. There are still posters that promote HIV testing but there are also signs about marriage equality and other celebrations of long-term relationships. Although problems and prejudices remain, there has been progress and hope is manifest in what one sees walking through that neighborhood.

We are often focused on problems as we should be. There are so many and change does not happen if they are ignored or minimized. But there is progress too. Theodore Parker writing in the 1800’s said, “I do not pretend to understand the moral universe; the arc is a long one, my eye reaches but little ways; I cannot calculate the curve and complete the figure by the experience of sight; I can divine it by conscience. And from what I see I am sure it bends towards justice.”

Today, I take Parker’s words to heart. I cannot always see it. But for this moment I will stand in awe of scientific progress and social change even as I mourn those for whom it comes too late.


Living next to a college campus means that every spring I witness the aching sweetness that is college graduation. Listening to Pomp and Circumstance makes me tear up every time and the sight of young people taking pictures at campus landmarks never fails to make me smile. Chapel Hill is beautiful in the spring when each lovely morning seems more hopeful than the last. To leave when Carolina is at its best must be almost unbearable when you are 20 or 21 wondering what the next chapter will hold no matter how well defined and exciting your plans. When again will a graduate have the time or leisure to stay up all night talking, be encouraged to explore any subject you want, or be allowed to make mistakes with little consequence? Bittersweet.


Living next to a college campus means that every spring I witness the aching sweetness that is college graduation. Listening to Pomp and Circumstance makes me tear up every time and the sight of young people taking pictures at campus landmarks never fails to make me smile. Chapel Hill is beautiful in the spring when each lovely morning seems more hopeful than the last. To leave when Carolina is at its best must be almost unbearable when you are 20 or 21 wondering what the next chapter will hold no matter how well defined and exciting your plans. When again will a graduate have the time or leisure to stay up all night talking, be encouraged to explore any subject you want, or be allowed to make mistakes with little consequence? Bittersweet.

For many, graduation is the start of a time between times, perhaps grad school in the fall or a job hunt is on the horizon. Many of us avoid the in between because of the inherent discomfort – what comes next? Where will I be? How will I get from here to there? Will I like what’s next? Yet, long ago, a minister I know described sacred moments as “times between times,” times when you must take a risk, go outside of what you know, try something knowing you might fail or might wildly succeed. In between times are spaces where adventures happen and, for miy money, there is no better teacher.

A young friend I know is planning a trip across Asia with a friend. She’s asked for some advice about China travel and I’ve given her reading list…along with a few practical suggestions. I remember well the trip I took after my college graduation with my best friend from high school: the amazing freedom of no one except the other knowing where we were at any given moment, museums, and castles, and beaches, and bars… I loved all of it but my favorite part was the train. On the train I could go slow, savor the scenery, think about what we’d seen, the people we’d met, write in my journal or chat with some unlikely new friend. If I had it to do over again, I would have travelled like that for a year. As the song says, there’s such a lot of world to see.

At almost 50, I still love a good adventure and fortunately fate gives them to me on a fairly regular basis. For the fifth time, I’m off to China. I’ve been with students twice, by myself once, with my husband once, and now with two colleagues that I treasure. How lucky I am to be thrust out of the familiar into a place where I can’t read, can speak very little, where there is so much to learn, and where I now have friends. On a previous trip, a Chinese friend who is exactly one month older than me was talking about her high school graduation. In that moment, it hit me that as a 17 year old, standing on the stage at my graduation, I could never have guessed that somewhere on the other side of the earth a girl was graduating, standing on another stage, and we would grow up, work together and be friends. One of the best things about mid-life is to see how threads come together over time, how one adventure begets another – not all of them easy, not all of them what one would wish for, but they weave a one-of-a-kind fabric that has it’s own logic and pattern.

There is bitter and there is sweet. Happy graduation and happy travels.

“To live is so startling it leaves little time for anything else. ” Emily Dickinson

At the end of last week, I looked at my calendar and noticed that today would be one of those rare days in the middle of the academic term – a day with no meetings, no classes to teach, no conference calls – in other words a day to concentrate and move bigger projects forward.  Perhaps get that article that’s so close to ready to submit out the door, draft the new grant proposal, read for the new syllabus, etc. etc.  What bliss, the gift of found time.   Then I saw, to my horror, that it was a teacher workday. Not for my older son who, like his mother, likes nothing better than a day left to his own devices but instead a day off for my younger son who loves company and prefers his parents to all others.

January and February are the bane of parents’ lives.  Between honoring statesman, teacher workdays, snow days, and illness it’s almost impossible to do anything other than stay afloat work-wise.  Yet, my little boy was delighted.  “Mama, I will make a tent in your office.”  “Mama, where shall we go for our special lunch together?”  “Mama, are there snacks in your office?”  And so my illusion of productivity evaporated. I said the right things, “Yes, you can make a tent.  “Yes, we’ll have a special lunch.”  “It will be so much fun.”     All the while mourning my lost day…

Last night upon arriving home, an email to the whole School of Social Work came from our Dean saying that a colleague, barely older than I am, had died suddenly.  She is not someone I know well.  We chatted at meetings occasionally; we were Facebook friends; I sat by her last week at faculty meeting.  But there is no deep relationship between us like there is for others here.  So this news left me sad for those that will mourn her deeply and thoughtful rather than truly grief-stricken.  When recounting the news to my husband I articulated the obvious question – how exactly should we live knowing it could all end at any moment?  In his grounded, clear eyed way, he replied simply, “There is only one way to live your life” and left it at that.  I’ve found myself trying to fill in the second half of that sentence ever since.  “As if each day is your last…as if you have all the time in the world…doing what you love most…concentrating on what’s really important.”  The clichés are endless and not very helpful.

If I really knew what day would be my last day on earth, I know exactly what I’d do.  Having planned for it, telling family and friends how much they’ve meant to me etc., I’d head with my husband and kids to Cape Lookout.  We’d stay on our sailboat and see the morning’s unspeakably beautiful first light.  I’d drink coffee and hope that is was a day that schools of dolphins would surround the boat in silent greeting as they sometimes do.  We’d spend the day diving off the boat, finding shells and sea creatures on the shore, feeling the sand and sun, and watching the sun drop behind the dunes.  And then witness the stars appearance as the sky becomes a deeper and deeper blue…

But it’s February and there is no sailing to be done.  Just me, the tent, and its small inhabitant in my office.  It may be the last day but I pray it is not.   If it is, perhaps the best I can do is to make it a good day for others I meet along the way. From what I hear, my lost colleague was good at that:  an encourager, quick with a warm smile, a considerate listener.  And so to honor her and those I care for who mourn her deeply, just for today I’m going to really enjoy that special lunch; be grateful for the tent in my office; be patient with the 15 requests for a snack, water, to play games on my phone. I’ll take a minute to tell friends and family I love them; be encouraging and kind to others I come in contact with; hug my children; appreciate that man I so fortunately married; and hope that there is time to finish the paper, teach another class, write another grant, and find pleasure in all the other tasks, big and small, that add depth and dimension to our days.


It’s a Wonderful Life

It’s probably been 12 years since I sat in the cafeteria of UNC Hospitals and met a young psychiatry resident who would become a very important community collaborator and friend.  He was still in training but was the only Spanish-speaking psychiatry resident in the hospital at a time when North Carolina’s demographics were shifting rapidly and the state was struggling to catch up.  This young man from Arkansas identified a need and, even though he was not “prepared” to take on the task of developing an agency to serve new immigrant and Spanish-speaking families in need of mental health services, he did it any way.  Although it was a long time ago, I knew I was in the presence of something special and have been a cheerleader and occasional collaborator with El Futuro, the organization he founded ever since.  Over the years, I’ve watched former students join the effort becoming champions and leaders for these new North Carolinians.  We’ve started new programs together that have become some of the most meaningful efforts of my career thus far.

Last Friday, the organization held a retreat/planning session to think about how best to make decisions for the organization, and how to nurture and sustain the incredible people that work there.  These are tasks any organization must attend to but El Futuro is doing this in the face of a complicated and often hostile policy and payment environment.  In the midst of great food and fellowship, there was also great concern – concern that staff were seriously over-extended compromising their ability to be the clinicians they wanted to be.

Now, having followed this group for a long time, there have been lots of ups and downs.  Times when the director was not sure he could make the payroll, times when particular programs looked unsustainable, and grant applications that were due yesterday were flooding his and others’ desks.  But today was different.  Today there was real fear, fear that because of draconian policies by payment entities, services provided to individuals without social security numbers would have to be cut. (Here’s a link with more information on this issue.   How could such a choice square with a long-standing mission that provided services to everyone in this population with or without documentation?  What would it mean to the integrity of everyone involved to change that mission and serve only documented clients?  (There is a complaint in the Office of Civil Rights about these policies that is awaiting a ruling on this point.  Depending on the outcome, the payment entity may be required to pay.  The other alternative is that other payment entities may take up the same policy as this one if they are clear they can get away with it.)

At first, my impulse was to minimize and cheerlead.  This organization has been existence for nine years against all odds.  Surely it can weather the current storms.  Then I listened some more and moved into problem-solving mode.  Let’s contact so and so, partner with this group, tell the organization’s story in a new way, mobilize faith communities, etc.  All good things to do and I will contribute to doing  them in any way I can.  But eventually, I quit avoiding and confronted the very real discouragement and worry that was in the room and on my friend’s face.  This is a different storm and it will take big efforts from all of us that care about this population to get through it.  But it will also take courage and faith, a belief in things unseen.

Like many people, my favorite Christmas movie is It’s a Wonderful Life.  George Bailey who works tirelessly for the people of the community he loves becomes discouraged in the face of evil and loses his faith that anything he has done makes a difference.  Through mystical means he is given a chance to know all that he has done by seeing briefly what the world would be like without him.  The analogy is obvious: What would this community be like without El Futuro?  Three clinics providing evidence-based bicultural/bilingual mental health services would not exist.  Multiple schools would not have bicultural/bilingual on-site services provided to their new immigrant or children of immigrant kids.  There are mothers, fathers, grandparents, aunts, and uncles, people who work two and three jobs in our communities, who would remain depressed, ridden with anxiety, burdened by post-traumatic stress, and addicted because there was not an agency that could provide services that would help them.  (El Futuro’s success rates are quite impressive.) UNC’s and Duke’s emergency room and crisis services would be over-burdened causing other patients not to get the quality of care that they need.   Teachers can teach all children more easily when children in need are having those needs met.  To quote Clarence Odd Body, Angel Second Class, “Strange isn’t it, how every life affects another…”  Not to mention the classic scene when there’s a run on the bank and George has to explain how a community only functions well when it recognizes its interdependence and the consequences of giving that up. The story of course doesn’t end with George having a realization and feeling better.  It ends with friends pitching in and coming to his aid.  So if you’re looking for a worthy cause this holiday season, if you want to do something that will, in the spirit of the season, ‘welcome in the stranger,’ then check out the good work of El Futuro and throw some money in George Bailey’s basket.