Moving2Ecuador

I have been struggling with my teenage daughter. Whenever I get excessively angry, I have to remind myself that she is figuring out how to be independent and be her own person, and part of that is avoiding her family and her home and her life here. I remind myself to just let go and let her be, and then I get pulled in because she is not truly independent or prepared enough to be on her own. I am reminded that every generation bemoans the next. We remember being so capable as young people. Were we really so responsible? What if I have not prepared her well enough for the world? She is off to Italy and France for the summer and has found herself a job in San Remo and Nice. What a resourceful person she is! She has decided not to go to NYU next year and volunteer in Ecuador while we are there. On the surface that sounds like a wonderful idea, but I have all sorts of worries about her and her choices and her safety. But then I remind myself that I have no control over her life. I have giv...

So much has been happening in our house and with our plans to move that I have not been paying attention to Baltimore. Spring has come and gone and summer is here. It was a gorgeous sunny day. In my normal life I would never stay inside on a beautiful Saturday, but our lives are so not normal now; we are entirely geared toward moving to Ecuador and that takes precedence every moment. I was back in the office today, saying goodbye again and attacking my mountains of paperwork. Maya was at a skating party with many of her friends from school and from dance class. I was delighted that she tried to skate again. Two Christmases ago she had tried skating at an ice rink in Edmonton, and had fallen on her face. She came off the ice screaming with blood pouring out of her nose. She refused to skate after that, and insisted that she would not get on the ice today. But she did skate and she did enjoy it, and it was a good way to say goodbye to her friends. Moving to Ecuador is who we are now. It ...

Whew! I have worked ten hours daily for four days. That is too much for the type of work that I do, so I feel exhausted! Not that every moment has been agonizing. There have been several instances that my patients have been working to support me when I whine about how difficult the move is! Perhaps I am loosening up at the office, focusing on saying goodbye rather than doing what I ought to be doing, but perhaps saying goodbye is what I need to be doing, and it is saying goodbye that is most distressing. In fact, I have not been consistent at all. I start off the session trying to wrap things up and end up adding another session in another month. I am avoiding saying goodbye. I came home to children wanting food. I felt like a mother bird returning to her nest with her little birds. I cooked and got everything onto the table and then my oldest daughter picked over her food and ate almost nothing. I have to adjust to my college age daughter being home. She is fiercely independent and ha...

We may have a renter; a family came to look at the house for a second visit, and the house was clean and presentable today, so it my happen! We may have to be out by July 1! I wonder where we will live through July. It may be that I will have to close everything up earlier than planned. I ought to be more agitated about it; instead, I feel relieved. We will ramp up our moving date! Yeah! I look back and have to admit that it is only ten weeks or so that we have been organizing the house, and I have been gone for two weeks of that, so that reduces the torture to only about eight weeks. I have let it irritate and overwhelm me, but with the end in sight, I am looking forward to our move. I will check the airfares and try to focus more on closing at least one of the offices by th end of June. Eric will be teaching in Woods Hole for eight weeks, so Maya and I will be alone in Baltimore for several weeks, visiting Cape Cod on the weekends. Maya will be in a ballet camp and I will be in the o...

Time for a budget. Just for the next several weeks before we leave. Yikes! I have never actually made a budget. My brother-in-law pushed me about doing one and I had to admit that this is a new experience for me. Ordinarily I work and pay my bills and do not look past the next few days, the next trip, the next project, the next purchase. I live day to day, week to week, perhaps into the next month. So when Eric asked me to make a budget today, I felt hesitant but hastily listed as many items I could think of and when I got to the bottom of the page I was stunned. Clearly I am not prepared for this. I am accustomed to putting in the hours and covering the bills and making things work. Including private school and college for Tara, and ballet and violin lessons for Maya, and repairs on the car and trips to Canada and Rome and Belize and Ecuador. Now that I am winding down my practice and there is a finite end to my life as I know it, I am beset by limitations, which in turn create absolu...

I took a trip back to Rome tonight, and if it was only in my mind, it felt wonderfully real. For two hours and twenty minutes, I wandered the halls of the Vatican, descended into the crypt of St Peter's, screeched through the crowded streets, and rediscovered Bernini's statues in several churches throughout the city. It was quite a heady feeling to have wandered the same paths just two weeks ago. There was much publicity in Rome when I was there about 'Angels and Demons', since it opened that very week. Both the book and the movie were negatively reviewed, but just to see Rome was a treat. It was beautifully filmed and it felt as if I was running from the Pantheon to Santa Maria del Popolo to Piazza Navona to Castel Sant'Angelo. I am ready to see the film again if just for the views of Rome! Tara has been home but I have not seen her. She stayed for dinner tonight and came to the movie. I have discovered that the only way to keep her close by is to offer entertainme...

I read a harrowing book about early-onset Alzheimers Disease. It was horrifying and frightening. It was about a 50 year old professor at Harvard who very rapidly lost her cognitive function. I thought of my mother and then I convinced myself that I too was losing my memory and that I had only two or three years until I would lose my mind. I could not remember the word for a vespa. I thought of motoped and motorbike and motor..... and I could not figure out for hours and hours that the right word was 'moped', at least that is what I finally decided the word for it was. I started reading at the airport in Santa Ana and then throughout the flight to Atlanta and to Baltimore. I tried the trivia game on the console while I was reading and finishing the crossword puzzle and did not do particularly well, so I became more and more convinced that I was losing my mind. Multitasking has always been my forte! Of course, in truth, there is no indication that I am losing my cognition, at le...

I wandered around Balboa Island today. I walked past the house I once lived in and peered in through the front window and found it unchanged from 20 years ago. I wondered what my life would have been like had I stayed in southern California. I worked for Kaiser Permanente in Santa Ana as an outpatient psychiatrist. I lived in a cottage on a wonderful street called Heliotrope in Corona del Mar, a few steps from the beach. Tara had a nanny from England named Mia. I had traveled to Montreal for a meeting; I remember missing the shuttle that I had ordered to come to my house and take me to LAX, so I threw my bags in the car with Tara and raced to the airport through the traffic in record time, left the car at the airport and made it onto the plane hot and sweaty. I had a wonderful time in Montreal and met a psychiatrist and his wife from Salt Lake City. Through this contact I received an offer I could not refuse and decided to leave my corner of paradise to start a new life. I don't ...

More beautiful California. No big hikes today. My sister and brother-in-law brought me to Filola ( Fight, Love, Live), an estate built by the owner of a gold mine a century ago. I liked the house because although exquisitely designed and furnished, it felt like a home, it felt as if families had actually lived in it. The gardens were full of plants and flowers; everything grows well here. I was inspired. Will I have time to grow a garden in Quito? Ecuador is full of rose plantations, so I know that the conditions on the equator are excellent for growing things. Will gardening be one of my projects? I flew from the northern to the southern part of the state today. The plane followed the coastline with mountains viewable outside my window. It was remarkable that there was so much of the land that was unpopulated, in such contrast to the area around San Jose in the north and Santa Ana in the south. It was interesting to see such a concentration of humans at the two extremes and such em...

Friday May 22 It is super late and I am finally in bed after another long long hike up and down a mountain. I realize that I can walk for as long and as far as anyone, but I am not in the best shape and I could certainly feel the effort today. I was asking my legs and my heart to do far more than usual. The view was wonderful and the company of my sister and my niece delightful. My brother in law had many questions for me this evening. He asked about our budget while in Ecuador (do we have a budget?). He asked what we do if things go wrong, what sort of resources we have there, what we do if we have a medical emergency, if there is a political crisis or economic disaster, what we do if there is a natural disaster. I had no good answers for him and realize that I am going on blind faith, that I am expecting Eric to take care of everything and I am not questioning anything. We are moving to Ecuador without much planned. We are 'winging' it. I am not sure that is wise or prudent,...

California living. Sunshine, yoga, ocean vistas, good food, espresso, everybody feeling wonderful. I understand why people come from all over to move here. It is 0 degrees Celsius in Edmonton and it snowed this morning! I was very eager to leave Edmonton after residency to do work in Neuropsychiatry at UCSan Diego. I felt I had moved to paradise and it still feels that way! I slept well, I slept in, I took a yoga class, I ate Moroccan food, I hiked up in the hills over the valley with an imagined view of San Francisco in the far far distance. It was up and up and hill after hill and more hills. What a wonderful life my sister has in this beautiful place. Drinks, wine, steaks on the grill, conversation with delightful young people planning their lives and adventures. My niece and nephew are just starting their adult lives and there is so much good energy here. I feel that I am starting this new life of mine too. Leaving the past, being open to everything and anything that presents itse...

I took a course about yoga and psychiatry and it was awful. I could not meditate with the group and found the day painful and intolerable. The best parts were a walk through the city early this morning for espresso and a scone, and the hour for lunch walking around Market street trying to find the sunny side of the street to stay warm. San Francisco is as cold and fresh today as it was hot and heavy the first day I arrived. I am sorry that the course I took that held so much promise turned out to be a disappointment. Usually at this conference it is very inspiring to expose myself to all the new research in the field and I just wander to different talks and try to learn something by chance. This time I took two courses and missed most of the first one and gritted my teeth through the second. I am ready to leave the conference for this year, except that I purchased some 100 hours of online talks; I expect to review them and catch up with what I have missed, as if I had actually gone to...

The day started out cold and drizzly and uninviting. I woke up far too early and tried to sleep longer without success. I finally decided to get to the convention center and learn more about dementia. The problem is that after all these years of practicing, there is little that is new or something that I have not heard before. The field of psychiatry is advancing rapidly, but the basics are unchanged. I keep hoping I will learn something I have not heard before, but today was all about the usual information, nothing new, nothing that will change the way I practice psychiatry. Of course, I do not see much dementia in my practice anyway. I met my sisters as the sun was breaking through. Monica wanted to show us new and interesting architecture, and I was most impressed with the new UCSF buildings on the waterfront. I had not seen them before, so this was an entirely new part of San Francisco for me. We drove along the water to Golden Gate Park and to a wonderful sushi restaurant. I alwa...

Today was a more typical San Francisco day; cool, windy, overcast. A good day to devote myself to education. I have to try to focus my interest when I come to this massive conference. There are so many choices, so many different lectures, symposia, and courses. I decided to attend a symposium on a mental health program in Ayacucho, Peru, a city of 100,000 about ten hours by bus from Lima. There was no psychiatric care available to this community until a couple of psychiatrists from Yale volunteered their services in developing a program to provide mental health care. They are challenged by limited resources, and work with local nurses, psychiatrists from Lima who volunteer their time on the weekends, interns from the local university, and foreigners who contribute in various ways. There are significant difficulties communicating with the local population, most of whom speak Quechua and Spanish, and often the medical consultations include the family of the patient, the non-Spanish spea...

I think that on average I have slept only three hours nightly this week. and I wonder when it will catch up with me and prevent me from functioning.The alarm in my hotel room woke me up at 5 and once up I could no longer sleep so after a shower I put on the same clothes I had worn yesterday and headed for the airport. The sun was shining brightly and the famous 'Mall of America' spread out in all directions. I know this is a destination for travelers, but it feels as if I have seen enough and do not need to return as a tourist. Unfortunately my next flight is delayed and I will arrive in San Francisco too late to make it to the course that starts early this morning. Now I wish I had changed my flight so that I could watch Maya in her ballet today. I had organized this trip long before I knew her schedule and could have changed all my plans to work around her event. Instead, I made the decision that the CME's were important and that I had seen Maya dance countless times and ...

Whew! I am sitting in a very strange hotel. My flight to San Francisco was delayed on the runway for about five hours due to bad weather and I missed my connecting flight. Northwest put us up in the Ramada Inn next the the Mall of America. The hotel has  a native American Indian theme and all the meeting rooms have native names and the decor is supposed to reflect that. It is not particularly respectful, but perhaps I ought not to say that. It is simply bizarre. The positives are a great looking pool ( but I have no suitcase and no bathing suit and it is two am and I have to return to the airport in a few hours) and free internet! The positives about the flight were great seat companions, who kept me entertained for the hours and hours of waiting, and lots of legroom in the exit row. I set up four alarms to be sure to wake up in time, I will miss my first course at the meeting tomorrow, but I have all the reading material online if I can't sleep tonight. I will try to sleep.....

I have been in a nightmare mood all day. Going to Ecuador is about leaving everything and I did not realize that was so difficult. Saying goodbye over and over again is increasingly painful, I am not sure I can get through the day, and then I do and look forward to the same the next day and the next. Except that I am leaving again tomorrow for San Francisco for the American Psychiatric Association meeting to get as many hours of educational credits so as not to lose my license to practice medicine while I am away. I was looking forward to the trip because I will see my sisters and friends and of course some 20,000 or more psychiatrists, but perhaps because I have not adjusted to the time, I am struggling to fire up some enthusiasm. It is curious that I received an email from someone I knew in Salt Lake City, who is involved with a campaign against the Scientologists, who always have quite a presence at the APA and put alot of money and energy into disparaging psychiatry and offering a...

Dinner for a belated Mother's Day tonight at Petit Louis. This is a favourite nearby restaurant for the family to celebrate birthdays, anniversaries and significant events. Late during a difficult day at the office, I received an email form Eric alerting me to the evening reservation. I suffered at the office. The enormity of this move has hit me hard today. I am having second thoughts and wondering if this is really what I want to do. Perhaps I was too tired and jet-lagged to feel enthusiastic about Ecuador. I was at my office today and was horrified to find all my charts on the floor where I left them last week. My receptionist has decided not to file for me anymore. Whatever her reasons, I am full of sadness as I write up my discharge summaries and transfer the care of patients to my very capable colleagues.  Perhaps it was more difficult today because I have also decided that when I return I will not continue at this office. Having two offices is too complicated, and not having...

When I travel, I am forced to relax. I cannot go anywhere, I cannot do much, so I try to sleep, I read, I think. In my ordinary life,which starts in a few hours, there is no time to think or read or relax. Except that my life will no longer be ordinary. I will continue to wind down my practice during the next few weeks, make sure my house comes together, finalize all the details for Maya and her new school, help Tara with her plans, and organize our departure for Ecuador. I have been up for almost 24 hours, I am hoping Tara will meet me at the airport and that I can close my eyes in the car and wake up in my bed, except that I will have to wash clothes and organize myself for a full day tomorrow at the office. I have checked messages already , and because I have referred so many patients to my colleagues, I am not inundated as usual. It feels odd that my practice has a life of its own and appears to be moving forward without me. I once thought myself as indispensable. Tara was lost in...

Today was another glorious day in the sun. Rome is shining! I covered the same ground today that I did yesterday. Except that I took my time and entered every church and every courtyard and explored each ruin that I encountered. I found myself remembering places I had explored with Tara, with both Tara and Maya, with my sister Karen. I ended up missing my family and wishing that I could share this place with them. I am not sure I want to travel alone. It is much more fun to share the experience with others. I sat next to a missionary in the train from Frascati to Rome. He had lived in Grottaferrata for nine years and was moving to Munich. He had started a church in Rome and had lived in Quito many years ago where he had also started an evangelical church. He asked me about my spirituality and worked hard to convince me to look to Jesus for answers and salvation. I guess that is what he does for a living, but I was taken aback by his probing questions and his insistence. He told me that...

I have been wondering at the absolute beauty and splendor of this place. I am staying about 30 minutes out of Rome in a restored 16th century palazzo. There are frescos on the ceilings, perfectly proportioned rooms, and an endless view of Rome and the sea off the garden terrace. The town of Frascati is a kilometre away. I will take the train to Rome tomorrow without an agenda, but I will start with the forum and see where the day takes me. I return to the Pantheon always. The city is a museum, so I do not have to actually enter a building. With the warmth and the sunshine, most likely I will soak in the sun and stop off at the fountains to refill my water bottle. I will not take a map and see where my feet take me. I wrote that late last night. I slept soundly, woke up briefly at 6 AM and  then slept another three hours. Whenever away from home I find myself catching up on sleep; at home there is too much to do to sleep and I am lucky if I get four or five hours, consequently I am al...

I have arrived at my destination for the next three days. I feel peaceful at this moment with much activity happening around me. Eric dropped me off at Reagan International airport and hurried back to listen to Maya's concert and record it for me. Everything was so easy, it felt as if this was meant to be. I flew to Chicago and then boarded a plane to Rome. It was a free (frequent flyer) ticket so I was not fussy about the route. I slept across the Atlantic and woke up at Fiumicino. I found myself almost sleepwalking to the train station where the train was late, which is never a surprise here in Italy. This is a familiar place for me. Cappucino at the bar, throngs of travelers, poppies along the side of the tracks, pine trees, controlled chaos at the main train station, missing my train to Frascati, unable to resist a huge gelato for lunch. I wandered around Termini watching people of all sorts, listened to many languages but mostly Italian, walked out into the sunshine, and wande...

May 9, 2009 The journey is the destination. I am anxious as I am leaving. I say goodbye to Maya at her ballet class. Her hair is tightly wrapped into a bun and she has gelled all the wispy strands away, so I expect her to look severe, but her features are soft and I ask for a hug. She has been snuggling with me all night; I am not sure when she came into our bed to squeeze between Eric and I, but she is there in the morning. I am up early and am curious that I feel as good as I do. Eric drove home from Montreal yesterday, the Subaru packed tight with Tara's college life. I waited for his arrival and stayed up late with him. Tara remained in New York, finally enjoying herself with her friends and everything that New York has to offer. I wonder that she has been so unhappy for the two years that she has been there. Odd that now that she is leaving she can appreciate it. I talked to her today and she sounded content, perhaps because she met a nice boy yesterday. Maya was up...

I am about to do something outrageous, but exciting. Very unexpectedly, it became possible to embark on a three day journey that is absolutely wonderful. The details about how this came about are interesting but embarrassing, so I cannot reveal how this happened, for fear of exposing too much of myself and my defects. I will fly away tomorrow to a magical place and stay for a short few days to recharge and relax. I hope to return home renewed and ready to move forward. This is not the right time or the right circumstances, and I am as scared as I am anticipating this. The house needs more work, I am inundated with paperwork at both offices, and there are thousands of details to attend to. Eric will drive in tonight from Montreal after a detour through Manhattan to meet Tara an pick up her belongings from her dorm room. I hope he brings everything straight to the storage unit! I knew this was brewing a few days ago and I told my friend Emily who was entirely supportive and encouraging. ...

The house was almost perfect for a few hours during the night when we were sleeping, but has deteriorated moment be moment since we awoke. How do people keep their homes pristine for potential buyers while living in them? We had our first viewers today. I have no idea what they thought or if they were renters or buyers. I wonder if our real estate agent will chastise us for our mess. I have decided that will have to give our dog Elmer away soon. He seems depressed and I wonder if he knows that we are leaving. He stays in his crate all day except when we walk him. He could be with us in the evening but he would rather hide in his den. He has been unhappy since Pippi died and I wonder if he needs some Prozac. Or perhaps he is not getting the attention he needs. We have not loved him the way we loved Pippi; he was never as cute or as well behaved or as warm or as sweet as our former dog. I could not forgive him for chewing my antiques and ruining them. He does not chew anything anymore, ...

It is time to be positive and optimistic. The weather is being entirely uncooperative. It is cold, rainy and wet, but the grass is green and there are wonderful pink and fuschia coloured bushes flowering. Baltimore looks great to me, perhaps because we are leaving; ordinarily I find so much that is unattractive and uninviting in the city. I am reminded that these are the last several weeks that we will live here and I want to appreciate everything about it. The house is looking better and better and I like it more when it is crisp and clean. I wonder why we did not live this way these past years, and I remind myself that in our usual lives, we do not have the time to devote ourselves to organizing and cleaning; Eric and I have spent hours and hours on the house. Our first potential buyers/renters are coming tomorrow at 6 PM. I am less upset and more accepting about losing the house. I still feel that I may not return to Baltimore, but when I say that I sound silly and Eric isn't su...

We have our first house showing Thursday. Of course the house is not ready for any visitors yet; when I heard the news I was furious. I absolutely do not want ANYONE to buy my house and I am offended that things have gone so far. Eric texted me and then I heard from the real estate agent and I found myself getting more and more agitated until Eric informed me it was for a rental and I was somewhat relieved. I still want no one to see my house or live in my house or buy my house or even rent my house. I know I am unreasonable. But I realize again that my resistance to organizing and cleaning is not pure laziness; I do not want to give my house up. That aside, the house is close to being ready. Eric left for Montreal this morning for a conference and he sounds very happy driving through New Jersey and New York. He likes this meeting in the middle of nowhere with a bunch of scientists drinking beer and celebrating electric fish. And I am sure he is happy not to be home packing up boxes an...

I have been trying to ignore the swine-flu hysteria. But Maya and I are both feeling ill today, and I came home from work and driving Maya to violin and ballet classes and went straight to bed. Yesterday I took the train to and from New York and spent the afternoon in a packed theatre and a busy restaurant. I expressly chose the train as safer than the bus, and walked rather than taking the subway, but did not see New Yorkers wearing masks or altering their behavior to avoid illness. I have decided that this flu is like any other; we try to resist the flu by avoiding close contact with ill people and washing our hands. I usually travel to Mexico several times each year, but because of our plans for Ecuador, there has not been enough time for a visit to Tulum or San Miguel de Allende between now and our move, and I am feeling relieved that I do not have to make a decision to go or not to go. Listening to news on television or NPR is all about the swine flu, and my impression today is t...

The city is entirely different this week. It is raining and steamy and although the streets are full of New Yorkers walking in a hurry, the energy is less intense than it was last week. There are umbrellas out in force and the streets are full of puddles, and my feet are wet after a couple of blocks. I took the train early in the morning hoping that the three children sleeping upstairs would let Eric stay in bed a little longer; but I could not help but peek at them before I left and as I was watching them sleep, Marius opened his eyes and before I knew it, Maya was hugging me goodbye. I heard from Eric that they dragged him out of bed shortly after I left the house and demanded pancakes and waffles; they had agreed last night that before they ate the gingerbread house they had decorated the evening before, they would eat a healthy breakfast. They tore through the candied house and then tore through the rest of the house, leaving it in disarray. They were out of control, according to...