Wow. Not a very positive start to a post, at all. Is it a difficult morning? Did I wake in pain, or feeling poorly? Am I sad, hurt, or angry? No, not really any of those things, and it is a lovely, simple morning.  I am thinking, almost happily, about yesterday’s challenges – well met, and behind me. What remains is mostly the recollection of a mostly lovely day.

A lovely summer afternoon in this city I love.

It isn’t a perfect picture; life itself isn’t about ‘perfect’ unless we choose to make it so. That’s rarely a good choice, in my experience.  I knew as I headed downtown for appointments at the VA that it was likely to be, like many experiences, less than perfect. It’s the VA. The news articles do not greatly exaggerate the issues, and may in fact present a rosier picture than exists in fact. Just saying.

First things first – any possible calm in the waiting room was entirely disrupted by loud administrators and ‘auditors’ of a variety of sorts. Business is business, work has to be done, and it isn’t all medicine…but when a disruptive crowd of noisy people fill up the waiting room of the Women’s Health Center, and some significant portion are rather disrespectful dudes with no apparent sense that people are waiting, and possibly not feeling well, its super annoying. Distracting, too, and as a veteran with a TBI, I’d like to be able to calmly focus on my appointment and my care needs. Yep – all about me, and every other patient there. Keep the freakin’ noise down!

It only gets better. Somehow, by mistake, although I specifically phoned and specifically scheduled an appointment with my primary care provider at her specific request, I was scheduled to see an entirely different doctor, who doesn’t know me, and has not had (or taken) an opportunity to actually review the entirety of my 20+ years of medical care for service connected injuries. She was personable enough, and educated, even fairly skilled on the VA computer system – a nice change of pace in recent years, to see doctors who can also navigate a windows OS – and I figured I’d relax and value what her perspective may have to offer. Seems fair.  My hopeful curiosity quickly fell behind my irritation.  She was quick to hand me the usual commonplace saccharine reassurances about menopause, not a glance at my records. I quickly and firmly objected to her suggestion that I may want to consider antidepressants for some of my menopause symptoms, and pointed her to the portion of my records that documents what a miserable failure that was – years ago.  She started to bring up atypical antipsychotics. I pointed her to that section of my records. Again. Again. Again. We finally get to a recommendation I hadn’t had offered before. She had piqued my interest – something that might ease the hot flashes? (They’re on/off nearly continuously these last few weeks, it’s very uncomfortable.)  No, I had no interest in spending even one moment in hospital purgatory (the pharmacy), yes mail the Rx to my home… and I made my escape.  While I waited for the bus to return me to downtown to connect with light rail, I read up on her suggestion… Um… wait, what? It’s associated with an increased risk of suicide. Not ‘a rare side effect’, nope, it has a white box warning label. Oh. Hell. No. Seriously? Why would a doctor recommend a drug with a high risk of suicide to a veteran with PTSD, and MST – who is also over 50? (Are the VA doctors unaware that veterans over 50 are, themselves, at increased risk of suicide?)

I walked away from the VA the way I often do – angry. To be fair, the state of women’s medicine isn’t fantastic, even in the civilian community.  Currently, the best medical test for menopause is… wait for it… No, seriously, that’s the test. Wait. 365 days, to be exact. Once one successfully completes 365 days of her adult life without bleeding from her vagina, it’s menopause! Very scientific, guys, very reliable… oh…what? You mean I might still have a period, or some spotting, or obvious hormone fluctuations after that? So… um… go medical precision? I think my irritation is understandable. The VA just pours salt in that wound by being more interested in Rx solutions than in practicing medicine and healing people, by rushing patient care in a very industrial and profit-oriented way (and still failing to actually be profitable), and being grossly understaffed in all roles just makes it very unlikely that anything will change – regardless who is at the top. The bottom line is still about the bottom line; no one really wants to pay the bill on all those broken people.  That shit is expensive.

It wasn’t unexpected. I headed for home, hopeful that I could just let it go and enjoy the evening.

Sometimes I have to take care of me.

The train was crowded. That’s a simple enough sentence. It doesn’t go nearly far enough. Wedged between a very large man who was drenched in sweat and smelled strongly of eau de unwashed humanity, and a very thin angular woman with children, strollers, and shopping bags, unable to move, pressed in on all sides to the point of being in very close contact – actually touching – I only managed one stop. I forced my way off the crowded train, gasping for breath, near tears, heart pounding – and still that residual anger. I was having a panic attack. Shit. I backed up against the building at the stop, in the shade, and closed my eyes. I took a deep breath and exhaled slowly, and another. The rush of commuters dissipated between trains. A handful of people were milling around, panhandling, chatting. My pounding heart and the rushing in my ears began to ease. A man approached me slowly, cautiously. “You okay, Sister?” He eyed me with wary sympathy. “Yes, thanks,” I replied. I made eye-contact. A homeless veteran? A veteran. Sometimes it is obvious. “I just couldn’t handle the crowd on the train, today.” He looked me over appraisingly, but without hostility or resentment, just that continued calm sympathy. “Yeah… you’re okay, though?” “Yes, thanks.” As he moved away, I contemplated his kindness. I wonder what he would have said or done if I hadn’t said I was okay? I wondered if his simple human kindness, consideration, and sympathy actually have more value than all the pills the VA has ever offered me. I sure felt better… I got on the next train and headed home.

Taking care of me still feels new.  A simple decision in favor of self-compassion, getting off an over-crowded train and waiting for the next one, really matters.  I ended up enjoying a lovely evening at home, as a byproduct of self-care.  Small changes. Good choices. So worth it.

Today is a new day, a fresh start, a different adventure. Today is a good day to be kind to strangers, and a good day to be kind to myself. Today is a good day to appreciate that we are each having our own experience, and we’re all in this together. Today is a good day to change the world.