Rachel Ritvo

— 5th — (1977) Jimmy Carter

I'm in my fourth year of medical school and still ambivalent. I'm hoping that after internship it will all be worthwhile. Steve and I have kept alive the spirit of the Jordans in several co-op homes until our recent move to D.C.

— 10th — (1982) Ronald Reagan

Three of the last five years have been spent juggling family commitments and career demands. After Emily's birth (she was delivered at home by a nurse-midwife) I continued part-time in a family practice residency in Fairfax, Virginia. With the help of Steven and a marvelous babysitter, Emily and I both did very well. In July, 1981, I passed my boards in family practice. By then I decided to continue training part-time as a child psychiatry fellow at Children's Hospital in D.C. I was also pregnant with Louis: He was born at home December, 1981. I find that making a 4-day / 25-hour work week has so far allowed me the family time I value and a stimulating experience at work. However, it leaves me constantly aware that I am making compromises both at home and at work. I hope I can keep it up with two preschoolers.

— 15th — (1987) Ronald Reagan

I am no longer amazed that I am an adult. We took the kids (Emily is now eight and Louis is five) to the local high school to see their neighborhood babysitters perform in a musical at which time I discovered that it is easier for me to imagine my kids as high schoolers than to remember my own high school experience. Along with this firm sense of adulthood comes the sobering realization, so long perceived but somehow denied, that the people running the world (governments, school systems, or whatever) are no wiser, nor more capable than we are. Somehow I remain a humanitarian and an optimist despite ten years in Washington, D.C., where it seems that everything that can go wrong will go wrong.

With Emily's birth eight years ago, I began to describe my medical career as "part-time." For a long time I compartmentalized my life, flicking the doctor switch to off when I left the hospital, resenting the intrusion of on-call nights and beepers. Very recently, I have begun to rankle at the very labeling of part and full time. I am a mother, a psychiatrist, and a homemaker. The skills and experience of each assists me no matter which is foremost at the moment. I am particularly reasserting my interest in homemaking as a rewarding, self-expressive, and necessary social endeavor. That may be an intellectualized way of saying that after nine years in one house it needn't look like we are camping out. Of course, having Louis progress beyond writing on the walls was an important development.

But if I strike the words part or full, what I am constantly up against is time! It seems I always have one eye on the clock and am racing around hunting for my car keys. I've become a list maker and reassure myself that I can look at last month's list and see that nearly every item is crossed off. My move toward synthesis coincides with my second year in psychoanalysis. I can't prove it's related but it rings true. Analysis is passe. It is the ultimate low-tech experience. Its time frame is definitely pre-Sputnik. But like motherhood, marriage, and medicine, I was destined for it since my childhood. I experience it, like these others, viscerally and intellectually with pleasure, pain, and ample satisfaction.

In June, I graduate from my third post-graduate training program. Board eligible in family practice, adult and child psychiatry, I will hang out my shingle near my home and try to confine my hours to school time and one evening a week. I am particularly hoping to work with children and adolescents with chronic illnesses, and with parents.

Steven and I never have and never will forget the Jordan's, those Motown parties, and yummy Sunday brunches. This time we are coming to the Reunion and hope other Jordan's folks will be there.

— 20th — (1992) George H. W. Bush

I find this five year "Report" more difficult to begin than in previous times when it seemed I was always starting something new: a career, a marriage, or a family. These past years are more striking for the unfolding of what was already begun. I have remained happily married. I now struggle to think how I pass the wisdom or good luck this represents to my children. Emily is in the seventh grade. I've overcome my regret at seeing the "childhood" years pass by and I am beginning to enjoy the opportunity to revisit the adolescent roller coaster. Louis is just ten so for a few years yet I can get adoration when I need it.

I started private practice in child psychiatry in 1987. With all the boards finally passed, I have now begun training as a psychoanalyst. I have found my personal analysis immensely beneficial. The study of psychoanalysis has also brought me closer to my father who is still very active in the profession. The newest thing in my life is our house. We have spent two years having it remodeled and now must furnish the bare rooms. Half of me finds the task fun, like playing house as a kid. I have enjoyed working with people who deal with the world visually and materially rather than just in words. The other half of me is appalled at the expense, the personal indulgence, and the consumption of resources. I bought the American dream even though I think it's not very realistic for the twenty-first century.

With older children and my career under way, I hope in the next five years to have more time for socializing, for social action, and for a reexamination of my Judaism.

— 25th — (1997) Bill Clinton

RECOLLECTING the past twenty-five years has the quality of remembering a dream. My postgraduate pre-med year the emotion is anxiety, the near panic of drowning as I struggle through organic chemistry. With MCATS in the 400s, med school applications seem absurd. There is comfort in living with Steven and our Samoyed, Neeka.

In the next scene I am in New Haven, at Yale med, so close to my parents that I fear I'll forget how to take care of myself. Woefully unprepared, I have no mental constructs for the vast quantities of information. I am standing in a closet with no hooks or hangers and the professors keep hurling in winter coats that are piling up around me. We keep the spirit of the 10rdans alive in two group homes as we split our time between New Haven and Amherst where Steve studies economics from an anti-capitalist viewpoint.

I am studying to take part one of the National Boards for the second time. The shame of failure fades as the basic science finally falls into place. I get out of New Haven. My life becomes a journey. Steve and I settle into Washington, DC, drawn there by Steve's interest in national policy from a labor perspective. After marrying we miss the ready-made sociability of roommates. Thanks to Chris Hitt and Strom Thurmond we find a boisterous, recently divorced mom and two girls to join us in homemaking.

I am a nervous clinical clerk, then an intern and a resident in family practice. On my twenty-seventh birthday tears well up. I realize this was the age that my mother and grandmother had their first children. I want a baby too. Our eight- and twelve-year-old roommates are shocked that Steve has not gotten me a birthday present. Not sure he is ready to be a father, he is very sure he would like me home more than fulltime residency training allows. The solution to the lack of a birthday present is obvious. I read Spiritual Midwifery. We choose homebirth. Emily arrives. Parenting brings new heights of ecstasy and depths of anxiety. Now I slow down the career path to half speed to allow for nursing, and for co-op nursery school.

My family practice training completed and my identity as a physician firm, I move on to child psychiatry and eventually to psychoanalysis. In 1981, pregnant with Louis, I share a fellowship stipend with Shirley whose children are just a few years older than mine. My partnership with Shirley will last through six years of training and nine years of private practice with no end in sight. Throughout the 1980s and early 1990s I feel that I am headed somewhere. I am on an expedition in my personal analysis from 1985 to 1994. Steve and I steer a course for the kids choosing public schools and a new neighborhood.

Now, in 1996, I find that I am no longer on a journey but am tending a magnificent garden. I move about in this garden, frequently surprised by what grows, but familiar with the garden plan. My professional life connects me with my community. I am acquainted with my Maryland legislators. On behalf of child psychiatry, I follow issues on health care in the state legislature, and comment on county policies that effect the lives of children: from Headstart cutbacks to alcohol sales policy. In a more secluded corner there is a little patch where I read all I can on how the brain creates the mind and on evolution. Next to that is a large place for psychoanalysis. Most gratifying is the flowering of intellectual collaboration with my father. In my private practice I avoid managed care. We have traveled with my parents and my brothers' families, a cavalcade of fifteen people whose ages span seventy years, journeying to the Caribbean, Alaska, France, Israel, Italy and Greece. This year Steven's mother moved to an apartment barely a mile from us. I feel the loss of Steve's father, who died suddenly in 1977, even more now that I have been a member of his family for twenty years.

Friends and community require constant attention so that the best of the past is not lost and new entrants are encouraged. Housekeeping is an undervalued necessity. In my garden there is a delightful little spot for our Jewish community with a study group to examine the weekly Torah portion. Will it ever sprout an adult Bat Mitzvah for me?

At the heart of the garden is my marriage to Steve. I hope we can live to see a fiftieth anniversary as did my mother and grandmother. Parenting has continued to surprise us. Teaching Emily to drive was the latest leap of faith. We are poised to send Emily to college and know that Louis' fledging is only a few years behind. I am uprooting and dividing the plants in my garden, and I hope to see both our marriage and our children's lives flourish.

— 30th — (2002) George W. Bush

Thirty years and my ambivalence regarding Harvard has not waned! Radcliffe College is no more. I, for one, doubt that feminist values have made much of a dent on Harvard, although I still keep on my coffee table the Harvard Magazine issue Nov./Dec. 1999, "Harvard's Womanless History: It's time to revise."

My private life is full of blessings. Emily graduated Phi Beta Kappa from Washington University with a double major in American culture studies and Spanish and is working for a year in New York before attending Yale Law School. nc. voting rights and a first amendment fight with the local school board when she was a senior in high school stimulated her interest in Constitutional law. Louis is a sophomore at the University of Pennsylvania majoring in the biological basis of behavior and doing research addicting rats to cocaine. Soon he can teach his folklore major, psychoanalyst, child psychiatrist mother neuroscience. Both my parents and Steven's mother are alive and quite well, so we have come to a point of harmony and mutual enjoyment spanning three generations. I have taken on a wheaten terrier, Chaz. I like to say I am lucky that my only problem child is a dog. I think Chaz is the animal model for ADHD. He is making a behaviorist of me. Behaviorism is an excellent dog psychology! I have a rose garden of a dozen or so bushes that sate my need to nurture. Steven and I find we enjoy each other as much as ever. Our empty nest allowed us to take a terrific journey to Australia last October. My private practice is very busy. Child psychiatry is never boring. All that said, it feels like America and the world are going to hell. I have been waiting for the implosion of the mental health system to hit bottom but it keeps on falling. Steve and I compete for whose team is losing ground faster, the psychoanalysts or the labor unions. Jesting aside, I see American business ethics and the demands of corporate America upon its workers as the single most sinister force threatening the stability of American families, and thus of America's children. I voted for Penny Pritzker for the Harvard Board of Overseers because in her letter to the Committee for Equality for Women at Harvard she observed that for women, "the impediments to success may be subtle, such as the pressures to be at one's desk when a child is ill." The market is our golden calf, the false god to which we bow down. We need to seek wisdom, not market forces, if we wish to find happiness and peace.

— 35th — (2007) George W. Bush

Midlife! I teach child psychiatry residents Erikson's "Eight Stages of Man." (Today would he say, "Eight Stages of Human Development"? Would the echoes of Shakespeare be lost?) Generativity vs. Stagnation, that is the stage this Thirty-fifth Reuruoner has entered. I am feeling the pinch of being the sandwich generation. I marvel at menopause. It is just as weird as puberty and pregnancy! And, although I try not to say it too often, I am waiting to be a grandparent. I feel deeply rooted in my marriage, admire my parents' sixtyfive-year marriage, and find most unwelcome Steve's initiation into the cardiac club with emergency angioplasty this summer.

Do I really want to talk about it? Writing about this moment in my life seems harder than for previous Report books. Compared to all the tragedies of the past few years (9/11, the Iraq war, the Katrina disaster) or even the private traumas of my patients' lives, my own burdens seem modest and yet they weigh me down. Since living in Jordan K, Steven and I have nearly always shared our home-with roommates, with our own children, and now with our parents. Living with a nonagenarian, joined for lengthy visits by two octogenarians, is the oddest household of all. Telling one's parent or parent-in-law when it is time to go to bed, or to shower, or to eat is an unexpected role reversal. Elder care, with the assistance of full-time, paid helpers, is not as hard as raising children, but not as hopeful, either. Death looms. Their decline makes the more minor degenerations of my own body seem trivial but still unwelcome. I am working at revising my daily routines to make time for the care and tending of my own body. Yoga and time on my exercise bicycle are necessary investments in health, not narcissistic indulgences.

On the bright side, our daughter, Emily, has moved back to Washington with a delightful fiancé. They are introducing us to the life (mental and physical) of lawyers. My mother planned my wedding and my daughter and son-in-law-to-be are planning theirs. I enjoy the excitement, and pitch in when asked. Continuing on the bright side, our son, Louis, is three years out of UPenn and living in Los Angeles. He works as an EMT and is midway through the grueling med school application process. Louis will be the fourth generation of doctors for my family, and I find that surprisingly gratifying. I am looking forward to getting an update on medical advances and a review of basics as he goes through med school.

I continue to grow in my profession. The gift of my father's good health and survival to age eightynine has provided an opportunity to share our professional interests. Teaching the use of play in child psychiatry is my latest solo adventure. I am continuing to champion psychotherapy, and remain active in the American Academy of Child and Adolescent Psychiatry. But I am also developing interests outside of child psychiatry and psychoanalysis. I work with neighbors in our town to raise awareness of our loss of urban trees and to encourage conservation of the town's canopy trees. Growing my own roses and dahlias and developing my garden have brought me into the rhythm of the seasons. I have also joined a neighborhood book club reading American biographies.

My changes come gradually, but I feel I am successfully avoiding stagnation. Steven is contemplating more radical changes. Retirement from the United Auto Workers is a possibility, but what would follow? That is a challenge.

— 40th — (2012) Barack Obama

"Life is bristling with thorns, and I know no other remedy than to cultivate one's garden." — Voltaire

How dare I quote Voltaire to Radcliffe-Harvard graduates? Someone amongst you has undoubtedly studied Voltaire and knows what he really meant. To me this quote is a fragment of my "cultural literacy" that came to mind as I pulled my thoughts together to compose this offering to our class communication. Literally, I cultivate a garden, a suburban half-acre that, thanks to global warming, is well advanced in the spring progression of blooms. Both lilacs and scarlet azaleas beckon from beyond my window. Figuratively, I see the decade of my sixties as the time to take up the responsibilities of the matriarch, to cultivate my human garden.

In my private garden, let me start happily with my sprouts. Two granddaughters: Aurora, who will be three in July, and her sister, Kalinda, born in December 2011. They live only forty minutes away, in Old Town Alexandria. After thirty years at work observing child development there is a keen joy in minutely observing the development of my granddaughters at weekly intervals. No thorns here. My saplings have grown into trees. My daughter, Emily, has grown into her profession as a Virginia public defender, and her husband, Andy, works for the antitrust division at the Department of Justice. It was striking when Aurora was about three months old and Emily and Andy stopped asking how to care for the baby and started instructing us on Aurora's routines, preferences, and their parental dos and don'ts. At Kalinda's birth they needed energy extenders and big sister distracters, but, steady in themselves as parents, they didn't need as intense an anchoring presence as they had the first time. Emily and Andy have mastered the art of deploying eager grandparents (a perfect set of four) as parent extenders. Our son, Louis, graduated from George Washington University Medical School and is a first-year resident in Harvard's psychiatry program at Longwood. My father, who died in 2008 at ninety-one (a thorn), did not quite live to see his love of psychoanalysis and psychiatry carried into the third generation, but as Louis and I discuss our work together my father returns to us, vital and inspiring. As I ponder the ways of matriarchs, of wise women, I think one key to success might be to find the ways to be present but not intrusive, to nurture my children as they build their careers and their families with timely suggestions, physical, emotional, and financial support as needed, but with a deep respect for their autonomy and personal priorities. Louis has a girlfriend I love having in the family. She is in my thoughts as I write, but it is not for me to say or know yet what will be.

Turning my gaze to the mature trees, I can report that Steven stays very busy in his retirement from the paid workforce. He is master chef, hands-on grandfather, and elder care administrator, as he and I manage in our home a team of three aides looking after my mother, who has advanced dementia and motor apraxia (also a thorn). Managing the passage from life, the exit, is so clearly the task of matriarchs. My mother's dementia has meant a steady passage to me of her duties as binder of the family, keeping her three children and seven grandchildren connected across continents and oceans. As a youngest sibling, this does not come naturally to me. I have to goad myself not to drift from the task.

I continue in private practice in my home office, still primarily seeing children and adolescents in long-term psychodynamic psychotherapy combined with medications. I teach the child psychiatry fellows at Children's National Medical Center the professional use of play. I supervise. I work on committees both at the Academy of Child and Adolescent Psychiatry and my local psychoanalytic organizations. I have done a bit more writing and editing. I watch the steady deterioration of mental health services in my own community and nationally. The loss of psychotherapeutic psychiatric hospitals is a terrifying reality when dealing with seriously troubled youth (a huge bed of thorns). I am ten years into studying Iyengar yoga and still feel I am a beginner. My wanderlust has diminished. I prefer to save my travel money to take the granddaughters to the beach in winter than to go trekking or on safari. My empty-nester dog, Chaz, died last Thanksgiving. I would love a puppy, perhaps a cavachon, to share with my granddaughters but hesitate to add another dependent to the household Steve manages when I am secluded with my patients.

I do feel blessed that the thorniest part of my garden is the front garden, the public sphere. I have been working to protect and sustain the street trees in my town. I feel despair and anger that my generation has failed to make the work-family balancing act easier for our daughters and sons. How can our nation claim to be a great democracy, a light to the nations, and not care to provide our children with the parental time that paid maternity leave would give? In my practice I see many children stressed by the long hours their parents must work. Thorny despair and anger flood me as I see progressive, humanist values eroding and inequalities of wealth and opportunity growing. The United States was born a chimera of conservative, slave-holding, paternalistic attitudes and liberal, progressive, egalitarian views. At both the crisis of the Civil War and the Great Depression the progressive, egalitarian impulse succeeded. I fear we will be the generation to disappoint that vision. Will we see abortion recriminalized? Will the bishops keep contraception from the women whom they employ in their secular endeavors?

But I am an optimist and believe in perseverance. I also believe that wisdom is the route to as much happiness as the inevitable, bristling thorns will allow. Thirty years in psychiatry, psychoanalysis and life have shown me the wisdom of love, of compassion, and of advocacy. These, I believe, are the values of matriarchs. (I am tempted to say my matrimony — why is matrimony so different in meaning from patrimony?) An eight-year-old with too clear a view of the nothingness of death insisted to me that life must therefore be meaningless. I told him he was too young to answer that question. It can take decades to answer that question. The question stayed in my head. I feel my own life is very meaningful. Is the meaning of life "life itself"? The meaning is in the daily doing and in the cycles of rebirth. I cultivate my garden.

— 45th — (2017) Donald Trump

Lately it occurs to me,

What a long, strange trip it's been.

That refrain started playing in my head during the six years that my mother lived with us as she slowly succumbed to micro-infarct dementia; she died in May 2014. I discovered that I have always been very close to my mother, so close I never thought about it until someone asked me. She lived long enough to hold two of her great-grandchildren. The very month she passed away, I learned that I have Parkinson's disease. (Statistically we should have about a dozen of us in the Class of '72.) It has taken me a while to find an approach to being a Parkie and to regain my sense of humor. It has taken even longer to find a neurologist I respect. With the help of the resources online at the Michael J. Fox Foundation, I have developed my own regimen: prioritize friends and family, Iyengar yoga, a personal trainer who specializes in Parkinson's, walking daily, and Zumba. I exercise like my life depends upon it — which I believe it does.

Barely one hundred days into the Trump presidency, and, already, "what a long, strange trip it's been." Everyone seems to worry about Trump, but I loathe Mitch McConnell, who is dividing us and changing the rules in ways that may permanently destroy America. I was not surprised by Hillary's defeat. I did not think this nation could follow the first black president with the first woman president. But I am heartbroken. I am a disciple of linguist George Lakoff, and I fear that progressives have lost the war of metaphors to Fox News.

The rest of my life is wonderful. Steve is retired and enjoying it so much that I am more and more encouraged to cut back my hours in my private practice, although I still teach and supervise at Children's Hospital. Our daughter and her family live within walking distance. We look after our granddaughters on Fridays, ending the day with a cozy Shabbat dinner. Our son and his family live in downtown DC. He is on the psychiatry faculty at Georgetown (third-generation psychiatrist, fourth-generation physician), so we can share our professional interests, just as I did with my own father. We babysit for his one-year-old son every Monday at our house.

I still cultivate my garden. The deer have decimated my roses and climate change is stressing my hydrangeas, nipping them in the bud two years in a row. But I have taken it as a challenge. I have turned to growing many varieties of Echinacea and a few other perennials. As I get older, my dogs get smaller. We now have a twelve-pound cavalier/poodle mix who goes with me on my ten thousand steps a day. I hit that goal on all but eight days in 2016.

— 50th — (2022) Rachel Ritvo

This could be the last time,

this could be the last time,

maybe the last time

I don’t know.

The Rolling Stones, 1965

I. My New Ambivalent Identity:

Existential angst, from knowing that you will one day die, is the price paid for the powerful knowledge that there is a future. It was never my angst. I saw it in others, but not myself until 2014, the year that I was diagnosed with Parkinson’s Disease and received my new, ambivalent identity as a “Parkie.”

Living in harmony with my body has become a challenge to be met with all the ego capacities I can muster. My father, who was born with a club foot, had a favorite Freudian aphorism “The ego is first and foremost a bodily ego” Coming to terms with our bodies is challenging. There was a period in my twenties when I naively thought my body, having reached adulthood, would now be the same forever. Then I had my first pregnancy and realized that my adult body might have as many stages of change as my child body. But I never anticipated my new, ambivalent identity as a “Parkie.”

At the same time as I was told I had Parkinson’s, my cousin Bill, just a year older than me, was told he had a brain tumor. We were comrades in battle with our bodies. But, within six months, it was clear that while my Parkinson’s was a life sentence; Bill’s brain tumor was a death sentence. I felt lucky!

Being a “Parkie” means maneuvering shifts in my social roles. As a “Parkie” I am expected to have a caregiver, a responsible person to get me through whatever I am no longer able to get through by myself. Is it not wonderful to be cared for? Yes, if not for the horror of infantilization and the fear of being left out of what the healthy are doing. “Parkie” ambivalence again. Lucky me, I have at hand the Caregiver-in-chief, our classmate and my husband of forty-five years, Steven Beckman. At this stage many people don’t even notice that I am a “Parkie.” Steve subtly picks up the slack as I do less and less. Steve must have his own ambivalence at becoming a “Parkie” caregiver but he is not one to show it. Who takes care of the caregiver?

I am angry with neurologists. When handing down my diagnosis, my first neurologist said “You are lucky. Of the three major degenerative diseases, MS, ALS, & PD you have PD, the least serious one. You are still in the early stages. Come back in 6 months.” 6 months! Suddenly I felt scared and alone with this new threat that just dropped into my life. “But, what do I need to know ?” I ask. “At this point” she says, dead pan, “the less you know the better.” WHAT!?! You just told a psychoanalyst “the less you know the better.” Of course, I told my family… but not my dying mother.

Friends asked me what I was going to do? The look of alarmed distress in the face of anyone to whom I gave the lame answer “I don’t know, I go back in 6 months” moved me to keep quiet about my new ambivalent identity. I shut myself in with my lonely and scared feelings. I was a signifier of helplessness in the face of human mortality.

Only the lonely,

Know the way I feel tonight

Only the lonely

Know this feeling’s not right…..”

Roy Orbison, 1960

Our classmates Elizabeth Fishel and Bob Houghteling, whose brother had suffered for decades with PD, pointed me toward the Michael J Fox Foundation where I found scads of information. I felt that as a physician I ought to find some sort of national expert or center of excellence to help me plan my treatment. A webinar on exercise to counteract the insidious loss of motor function so common to PD drew my attention. There was an expert in San Francisco where we were headed for my nephew’s wedding. I lined up a consultation. From my own work with children with neurodevelopmental atypicalities, I had witnessed the brain’s ability to find alternate pathways to various functions if the most common pathway was not working. I also knew the “use or lose” nature of neural cells. The consultant was inspiring and set me up with a specific exercise approach called PWR (Parkinson’s Wellness and Recovery) and a fitness instructor with 15 years of experience with “Parkies”. Bob, a 70 year old who had retired from doing HR at DOJ, was upbeat, knowledgeable and admiring of the flexibility, strength and balance that 14 years of Iyengar yoga hand given me. Despite hammertoes and bunions, I walk 10k steps daily, practice yoga 90 mins 3x week, and Zumba ad lib. I take pride in not looking very much like a “Parkie” although those who really know PD can tell. If I meet someone out walking and I am pretty sure they haven’t noticed my identity as a “Parkie” I may just let it drop… “I have Parkinson’s “ then I rattle off all my exercise accomplishments, offhandedly mentioning my 200 day or more 10k streak, my 20 years of yoga, my fun with Zumba and all those oldies. Just don’t complain. Stay upbeat.

Eventually I found an excellent neurologist, an expert on PD and exercise. She is a whiz with the meds and approves devotion to exercise but is not so much interested in what and how. I am still too healthy to be seen more than every six months. Can I still feel lonely? Yes, because the deficits in social cognition, poor conversational timing, the mild “Parkie” apathy, the moments of memory blanking out, an overall slowness or the sudden need to “get horizontal” do affect what I can do day to day. That’s when I fall back on a thought that I once despised when others offered it…. “It could be worse. Bill is dead.”

The Parkinson’s led to my setting a glide path to retirement. People would rather be told it was a desire to be with my grandchildren which certainly was an added motivation. Over roughly three years I wound down my private practice. It was the right decision. Once I closed the office, I did not renew my malpractice insurance thus shutting the door on any temptation to keep going with any form of patient care. I am glad I had the wisdom to give up my practice before I made any serious mistakes.

II. Legacy planned and unplanned

In January 2020 I closed my office and in mid-March the COVID-19 shut down came. The two have merged in my memory and experience. I’d became a recluse in our home with a ½ acre to garden, when, to my great delight, in April 2020, our son and daughter-in-law and their two boys, then 4 ½ and 1 ½ , asked to move in with us. They were teleworking and their DC townhouse was cramped, social distancing difficult in the city. They stayed until August. Our granddaughters live only a half-mile away from us so we had a lot of socializing in our garden.

My priority, as I marshal my energies for this last lap of life is to leave to my grandkids, Aurora, Kali, Sammy and Max, as a legacy, an understanding of our family history just as my grandmother had left to me, and whatever I can of the wisdom my mother shared with me on how to meet so many of life’s challenges. I hope to be remembered as a fun, reliable and loving Bubbie who adored each one of them individually for their own unique selves.

To my surprise I have another, more public, legacy. For twenty-five years I was an advocate for psychodynamic psychiatry at the American Academy of Child and Adolescent Psychiatry (AACAP). It has been a finger in the dike operation. One problem is the diminishing number of child and adolescent psychiatrists who can teach psychodynamics. My parents left a modest family charitable fund. It occurred to me that from that fund I could actually initiate a project of my own invention. I approached AACAP with a proposal for a Psychodynamic Faculty Initiative (PsyFI) to provide mentors for up to six junior or midcareer faculty per year. After four years it appears to be a success and it is likely that I can fund its future. I never expected to create a program that might take on a life of its own after I am gone. Tax me, I’m rich.

III. Feminism,

In 1972 I was proud to be a feminist and my friends, female and male, were too. I still am proud to be a feminist. But “feminist” became a slur? When? How?

I transitioned from latent feminism to conscious feminism while at Radcliffe. As a feminist I lay claim to being equal to men without having to suppress that which is essentially female. Women should not have to accept “mommy-track” disparagement or have the name of Radcliffe placed behind Harvard at our legacy institute. Women’s biology i.e. human biologyy, suits women to a different career trajectory than has been typical for men. A trajectory that accommodates the stages of motherhood and grand-motherhood. Children are the beneficiaries. Feminists, in my view, should resist pressure to make the male career trajectory the norm, rather we should insist on redesigning work and family life for the betterment of all. I am appalled that rather than redesigning work to facilitate women bearing babies during peak fertility in their late twenties we encourage them to bank their eggs for pregnancies in their late thirties.

I came to college with no particular plans for a career. Marrying and having children were a certainty for me. It occurred to me senior year that there would be no better time and place to find my husband. Taking my dating choices a bit more seriously I did find a husband that year. But what to do after graduation? I felt I would be letting down my mother, myself and all women if I did not choose a career.

Senior year I had an epiphany while traveling with my oldest brother. I saw from his behavior that I would be excluded from “the family business” and its conversations if I did not follow my father and brothers to medical school. After graduating in Folklore and Mythology and never having taken chemistry in high school or college, I somehow got into and out of medical school. I believed that women in the US were well on our way to achieving our feminist goals: equal pay, family leave and part-time work, as well as access to birth control and abortion if needed. I assumed we would achieve equal representation in elected office and in corporate boardrooms. I thought we did not need the ERA. If asked, I would have guessed that there would be a woman president before we returned to Cambridge for our 50th reunion.

Busy with life, I took my eye off the ball. I didn’t notice the Hyde Amendment in 1976. I falsely assumed that Reagan was an aberration in American politics. It was Anita Hill, the testimony she gave and the treatment she received that woke me up with a jolt. America had taken a hard right turn. Being called a feminist was nows a slur.

IV. Racism, Keynes, Climate Catastrophe

But you tell me over and over and over again my friend

Ah, you don't believe we're on the eve of destruction

Barry McGuire, 1965

Until the election of Donald Trump, I did not imagine that the counter-revolution to FDR’s New Deal and LBJ’s Great Society, might take us all the way back to the politics that led to the failure of Reconstruction.

Barack and Michelle Obama were AWESOME in the White House. Black Lives Matter, (“Say their names!” So many names!) as well as a new generation of African Americans speaking out eloquently and with facts in hand laid the relentless brutality of 400 years of American racism so vividly before my eyes that I could not deny the horror of it. I could not see it as past. How was I so blind for so long? I accept that while I do not believe in white supremacy I have benefited greatly from white privilege. (When did American Jews become white? It was in my lifetime, but when and how?) Abraham Joshua Heschel’s words helped me to understand that even if I am not guilty of creating this horrible system I have the responsibility to work for change and to repair the damage done.

Mitch McConnell exemplifies the opposite. He wields with glee the power of white racism. He makes my blood boil. The backlash to Obama was of hurricane force. I knew it was unlikely America was ready to go without a white man as president for any longer. Hillary Clinton had an exceedingly slim chance. She was loved as Secretary of State but not as a candidate for president. As Hillary’s campaign progressed I was intensely frustrated by the lack of excitement, even among progressives. There was minimal discussion of the coming centennial of women’s suffrage and little examination of the lingering sexism that undermined her. The drip, drip, drip of decades of lies undermined achieving the enthusiasm needed to win. So many held her accountable for her failures to be likeable ignoring the role of prejudice. I still don’t understand the editorial decisions at the NYT’s that led to obsessive coverage of the trivial email story, “Forget the damn emails.” And OMG look where that took us. Right to Comey and the October Surprise . My friends and family roll their eyes at my preoccupation with Comey, this one arrogant man on this one day in October changed history and so clearly for the worse!

I have turned to reading more history than day to day news. I am beginning to understand historically, sociologically and psychologically how we come to be where we are. What is less clear is how we can get back our democracy? How can we turn back the lies about how market forces will save us and reducing taxes on the rich will bring better jobs? Really!!

Why do so many people assume that personal finance and government finance are the same when it comes to carrying debt? Keynes demonstrated how government debt used to finance needed public goods can be done safely. Austerity sounds virtuous when in fact it is sadistic.. Historically, when the government has pumped money into the economy for much needed projects for the public good our economy improves.

Racism, anti-vax hysteria, American consumerism, environmental destruction, climate change denial, all these issues that a coalition on the right is forcing upon the majority of Americans due to a warp in our democracy devised to protect slavery all encourage a rejection of science and rationality in the interest of tribalism, authoritarianism and greed.

George Washington University