Thursday, November 27, 2008

I'm grateful for coffee

I'm also grateful for the rain we're finally getting this morning. Its been a while and we really need the moisture. I actually have quite a lot for which to be grateful. All the usual stuff; health, nice solid roof, happy healthy child, good friends, my dog and my family. I'm grateful, as always to be in the time and place that I'm living. Every day is a gift and I try very hard not to forget.

This is Wanda, expressing her gratitude by rolling in the sand at McAllister lake.

Tuesday, November 25, 2008

Thanksgiving, Families, and all that jazz

El Centro Family Health, my employer, has a dental clinic here in Las Vegas. Unfortunately we have a hard time keeping a dentist and our clinic is temporarily closed until a new torture specialist... I mean dentist can be lured to the banks of the Chicken River. Kudos to our management, though. Instead of laying off the staff until further notice, they are spreading the dental assistants and receptionist around to fill in at other clinics. Today, Theresa went with me to the La Loma clinic.

On our long ride to La Loma (which isn't in the middle of nowhere, but you can see it from the front steps) we spent some time getting to know each other. She asked me where I was from, if I traveled a lot, where my family lived. She has always lived in New Mexico, has only been to California, and her entire, enormous, extended family lives in Las Vegas.

My family is small, we gypsied around till we landed in New Mexico, and I've traveled a fair amount though not as much as I'd like and not as much as many of my friends. I'm considered a bit of an oddity up here, at least among my hispanic friends. I'm a single woman who left her family behind to live in a place where I knew not a soul. Of course, they expect white folks to be a little wierd like that.

I asked Theresa about her holiday plans. She said she has seventeen cousins who all live in town and the family gets together for each of their birthdays. Thats about 1.4 birthday parties a month, not counting the folks that married into the family and their kids. So Thanksgiving dinner is not such a big deal for them as it is for those of us who don't see our nuclear families regularly and may only see our cousins at biennial reunions, if we go.

Theresa is curious about the big wide world but has reservations about wandering out in it for too long. She thinks its because the extended family is a blessing and a curse. They love and support you so well that you don't really know if you can make it without them. And so sometimes you don't try.

I'm headed down to Albuquerque for Thanksgiving. Both my brothers will be there with their families. My sister-in-law's family will probably be there too. In my family, at least my father's branch of it, we're independent to the point that my brothers and I often don't see each other for months at a time (though my brother Josh lives 90 minutes away) and I'm not sure of the last time I spoke to my youngest brother Aaron. My father is staying in town for Thanksgiving for the first time since 2003 and that's just because their dog is dying and my father's health isn't stable. Otherwise they'd probably be in Mexico again, eating fish tacos instead of turkey.

We love each other very much but support is rather loose. There's definitely no pressure to stay put. In fact, my father and stepmother strongly suggested that I leave New Mexico after graduating from PA school. Maybe I will, later. For now, my debts are getting paid and I'm recovering from a lifetime of tough lessons.

Anyway, I was hoping for a strong ending to this post, but I'm sort of wandering and am not sure if I'm getting anywhere. So, au revoir... I've got to cut up the bread for the stuffing.

Sunday, November 23, 2008

A Girl's Best Freind

I've just finished watching Gentlemen Prefer Blondes. Its the movie with the iconic Marilyn Monroe number "Diamonds are a Girls Best Friend". Norma Jean did her best booty shake and breathy man-flattering but the real star was Jane Russel. Now that was a woman who could turn heads. While Marilyn turned her attention to any man who could give her a little hard currency, the equally curvy Jane made 'em work for it. A fella had to have more than half a brain to keep up with her and enough nerve to prove it. This was a woman who had the entire men's Olympic team doing a special workout for her benefit. You go, Jane!

Jane Russell as Dorothy Shaw in Gentlemen Prefer Blondes (1953).

Where the hell are these women now? Jane had brains and a body. Not some stick figure figure, either. She had hips and breasts and a teeny waist (helped, I'm sure, by a good foundation garment). Quick wits and a hot bod, she's my new heroine. These days we're all supposed to be thin as rails with big boobs and a flat tummy without the aid of a girdle. Thank god for Jennifer Lopez's ass. Of course we can't all have a personal trainer to work out with 2+ hours a day. We have things like jobs and budgets the preclude that sort of thing.

There's been talk about the affect Michelle Obama will have on feminism. Michelle is fabulous: brilliant, gorgeous, and utterly devoted to her family. An article on slate says that she embodies the ideas of feminism so well that she surpasses them. She's another heroine of mine. Jane should have had an effect on feminism too. She showed that a woman could be beautiful and smarter than everyone else in the room.

Saturday, November 22, 2008

Update on random stuff

There are a bunch of loose ends on the blog so lets tie them all up (or in knitting parlance, weave in the ends). I'm still not finished with the "snowdrift sweater" I'm stuck on the cabled section of the sleeves. But I have finished a pair of mittens and a hat for myself from the purple alpaca I bought at the Taos Sheep and Wool festival. I've nearly finished spinning the shetland fleece and I've started a pair of christmas mittens for one of my nephews/niece from some green and blue bulky yarn from my stash. Stash busting, so satisfying.

I've got 9 gallons of fruit wine fermenting in the guest bedroom. It has gotten to the point that in order to make more I'd either have to buy more 1 gallon glass fermenting jars or wait till I bottled what I've got going. Since a) I'm going to run out of room if I keep going like this and b) the holidays are coming and a gallon of wine is not really an appropriate gift for Katie (maybe when she's older) I decided to wait. Midwest Supplies sells some really great winemaking kits that I'm considering including a bordeaux and a malbec, but they require a 5 gallon bucket to start out and they make about 30 bottles of wine. I'd seriously have to reconfigure my storage space but how cool would that be!

This morning I'm heading out to help with the Thanksgiving Gallinas Cleanup in which folks go out and pick up the trash that's accumulated on the Riverwalk. Since I really enjoy that area and have seen some nice wildlife right in the middle of downtown I'm happy to help out. Also, I've been here almost six months and haven't taken many opportunities to get involved in much of anything besides work and really am feeling the need to be more sociable. In fact, I'd better get my breakfast together so I can get there on time.

Thursday, November 20, 2008

Belated weekend update

Somtimes it takes a few days to digest one really great day. Saturday morning Jon From The Office invited me to go to his brothers farm. "Dress dirty" he said. After I retrieved my mind from the gutter, I threw on a pair of old jeans and my fifty cent flea market sweater.

The drive east of Las Vegas never fails to amaze me. Jon, his two super-cute little girls, and I piled into the range rover and cruised out along the flat, empty mesa-top for fifteen or so minutes, turned onto a paved county road for a while longer. Red tail and Harris hawks wheeled overhead and perched in the pinon trees. Suddenly the terrain dropped in front of us. We wove along the side of a deep canyon. Amara, Jon's five year old, told me all about the dinosaurs that lived down there, and pointed out a boat on the canyon floor. All those years of racing up and down the I-25 corridor, trying to get to Denver before lunchtime and I had no idea this lay on the other side of the road.

Two or three ranch gates down the road and we were at Mark and Amy's place. It's a sixty acre island in a gigantic ranch. The Gallinas river (the little river that flows past my place) cuts through the middle of their land. When Mark bought the property, the house was four stone walls, more or less intact, and half a roof. He and his wife, family and freinds rebuilt the roof, stuccoed the outside, plastered the inside walls a cool sherbert green, installed plumbing and gas. Their electricity is solar with a back up generator. They have a few horses, a pack of silly dogs, and the clear blue sky overhead. That perfect, tourquois, endless, New Mexican sky.

Amy and Alisha (hope I spelled that right), Jon and Mark's mom, made bisquits and gravy. Jon gave me a tour of the greenhouse and showed me the edge of the mesa over the Gallinas edged with cottonwood trees and. We found a few arrowheads to add to my collection. It always surprises me to find these bits of work. So many pieces of someone's time, laying around for us to pick up as we will.

After stuffing ourselves on a good, old fashioned breakfast, we laid assault to the walls of the new section of the house. This was the reason I needed to "dress dirty"; we would be laying adobe bricks. Jon and Mark's parents mixed the mud morter, Amara and I were in charge of plopping the morter on the last course of bricks, and the boys laid and leveled the next course of bricks. Amy is in her first trimester with their first child. She sat under the portal and peeled the skins off the garlic bulbs they were preparing to plant. Amara and I had a system. I scooped up the mud and placed it on the bricks and Amara did a belly flop onto the mud to squash it into place. When we started, her coat was off-white. By the time she finally said "Uncle" she was stained the same red as the cliffs.

It was a wonderful lesson in staying present. Normally, I would have been all business. We have a goal and that goal must be reached, no matter what. No monkey business. Its some hold over from my german anscestors, most likely. Amara showed me that it wasn't an urgent situation. Her family had a nice snug stone house and this was an expansion of their love. I took a deep breath and we fell into a rhythm of scoop and squish, scoop and squish. A while later, Mark and Jon got out their guitars and played while the little ones napped.

I wanted to stay there, in that gorgeous afternoon, for as long as possible.

Wednesday, November 19, 2008

Lessons from too much time spent sitting

I'm going to get disciplined about this thing and start writing at least three times a week. It worked last week and possibly the week before. I can do routines and discipline... it just takes routines and discipline.

Today was desperately boring. Everyone from the main clinic had to sit in on a mandatory mediation. Apparently there are some pretty be troubles right here in River City. Fasten your seat belts, its going to be a bumpy ride. Actually not that bad. We at El Centro like to think of ourselves as a family. A big, squabbling, funny, dysfunctional family with messianic tendencies. And yes, I think we will save the world. At least our little bit of it. Today was all about getting to know your neighbor and talking about their strengths, the beauty of their character and the value of their experience. All of the times that you wished to grasp your neighbor firmly by the throat, rather like a rat terrier, and shake the life out of them- these instances were definately off the agenda.

On the whole, I think it was a great exercise. How often do we tell the people in our lives how much we value them? The most interesting person, I thought, was the janitor. He's a grizzled biker dude with a wisp of a goatee, multiple black and grey tattoos, and for riding his Harley he wears a headscarf that covers his face with a leering skull. He vibrates with energy and you can tell by looking at him that he's been in some unsavory situations. The clinic is also the cleanest its been since I got there. He has a smile and a good thing to say every afternoon. Today he had some really beautiful things to say about the importance of trust, respect, and open communication.

Damn, I did it again. I made assumptions about our biker dude before I knew a thing about him. Every time I do that I get a jolt and I'm ashamed of myself and my firmly middle-class assumptions about appearances and what they mean. You'd think I'd learn this little lesson by now. Thats why we're here I guess, to learn and relearn to love our fellow travelers.

Tuesday, November 18, 2008

Waxing Philosophical... Again

Its been a very intense few weeks with some very sick people coming through the office. Hopefully, I've done all the right things for them. Most of what we do in medicine is listen, at least it should be our main job. Sometimes all that can be done for a patient or for anyone is to listen. Close the chart and pay attention to what they are saying. There's time for writing notes later. That brief appointment may be the most important part of someone's day. It could change the course of their life.

People are not an accumulation of their symptoms, they are the best written novel you've ever had in your hands. Even more interesting: when they come to my exam room I become part of their story. All the elements are there; birth, love, disappointment, joy, struggle, fear, courage and death. What more could you want. Of course, you have to be willing to get your hands dirty.

But I like that kind of thing.

Friday, November 14, 2008

Friday Night at the Cinema

Wanda and I are watching movies tonight. Katharine Hepburn film "Long Day's Journey into Night" is playing on American Movie Classics. It's Ms Hepburn at her most vulnerable, most fragile but its a wonderful ensemble film. Her morphine addicted matriarch of a dysfunctional family was a risky role. I love her for that. Of course, at that point in her career she could afford the risk both financially and emotionally. Usually Hepburn played strong, smart women next to equally powerful leading men: Cary Grant, Spencer Tracy, Peter O'Toole, and even John Wayne. Under her characters' thick layer of confidence and brilliance was a deep desire to be loved.

We're waiting for the snow that's supposed to come tonight. Its awfully cold again but the sky doesn't have the right look. I think its bluffing again. Soon, I hope, we'll get something besides cold.

Thursday, November 13, 2008

Snake Oil and Hair Tonic

I'm all about prevention, personally and professionally. Prevention keeps bad things from happening. It's the fence that keeps the wolf from the door. It's the observant freind that picks the banana peel up off the floor before disaster strikes. It's seatbelts, vitamin C, and condoms. An ounce of it equals a pound of cure. But that depends on who pays for the study proving that the cure works.

Its all over the news today that giving Crestor, a statin drug that decreases low density lipids (bad cholesterol), to patients with no cardiovascular risk factors (in other words, no discernible reason why they should have a heart attack or stroke) in order to prevent heart attack or stroke. At first glance, this looks like great news. Think of all the lives we can save with just one little pill taken daily. Another great discovery brought to us by the pharmaceutical industry. Better living through chemistry.

What they don't tell you is that the study was funded by AstraZeneca pharmaceuticals. These are the kind folks that make Crestor, as well as drugs to treat high blood pressure, cancer, gastric reflux, pain, schizophrenia, asthma, and allergies. I prescribe their products every day to keep the wolf from my patients' doors. For the most part I think these are good and useful chemicals that help people function at a higher level than they would without these medications.

The NPR piece on Crestor today interviewed residents of Framingham, MA, the site of the longest running study on cardiovascular health ever. The good citizens of Framingham have been giving up their corpuscles to scientists for over 30 years for to help us all prevent early demise from heart disease. Through this epic bit of science we've learned that eating right and exercise can help us tremendously. We've learned that an aspirin a day keeps the cardio-thoracic surgeon away. And today we learned that Crestor will keep us from the monsters lurking under the stairs, waiting to snatch us in the light of day when we aren't looking.

Another missing detail in the NPR story was that the study was funded by AstraZeneca. They didn't let us know that the retail price of Crestor is $320.00 (costco pharmacy online) for 100 tabs (a three month supply). For a mere $32 dollars a day, lives are saved. Of course, crestor is approved by most insurance plan formularies, lists of drugs that insurance companies will cover.

I'm not saying that this isn't valuable information. We should be doing everything we can to prevent disease and disability. I want my family members, my freinds, and my patients to be vital and healthy for as long as possible. If this medication could really do the trick, I'd be handing it like a snoopy pez dispencer.

I'm a little tired of health care being run by Gordon Gecko. Maybe I'm a little bitter that the pharmaceutical industry no longer allows the sales staff to bring us free pens or take us out to lunch. I don't have a problem with the free market, but I have a problem with the free market practicing medicine.

Primun non nocere.

Monday, November 10, 2008

It's Monday morning, lets do a swan dive into controversy to get the blood moving. One of my clinic duties is to take care of patients at the local university student health. Most of the time this includes a lot of colds, sports physicals, pap smears and STD checks. Its generally pretty light duty. The patients are young and healthy and just don't involve the level of complexity that I see at the other clinics.

Since its been a couple of months since classes have started, the girls have started to come in for pregnancy tests. The last one (fortunately not pregnant) had only a vague idea how pregnancy happens. Most of our time together was spent discussing how the process actually works. She understood that sex=pregnancy/STD (good) but that's as far as her knowledge went. She didn't know what ovulation was, didn't know the timing of the menstrual cycle (she wasn't even late), and was not really sure how fertilization happens. This led to a great deal of fear and panic.

Eighteen year olds are allowed to vote on our elected officials and this year came out in massive numbers to elect the first multi-racial president. They are able to drive a car and most are expected to take drivers education classes in high school so that they are safe behind the wheel. They are able to join the military and/or be drafted, learn to carry a gun and kill someone before their frontal lobes are even finished developing. But we don't teach them about their bodies because, as a society, we think its "too dangerous" and leads them to increased sexual behaviour. That makes about as much sense as giving the keys to a sports car to a person who doesn't know the brake pedal from the gas and the turn signal lever is just there to make that rhythmic clicking sound.

According to the Journal of the American Medical socity (no citation, sorry), kids today are actually engaging in less risky behaviour than we did in the wicked 1980's when I was a teenager. They are waiting to have sex, using condoms more frequently and smoking and drinking less. The rate of teen pregnancy has actually gone down in the last ten years. However HIV and syphilis infections are actually going up. The places that are still having problems with teenage pregnancy and sexually transmitted diseases are where sexual education doesn't happen at all or where abstinence only (same thing) is taught.

Teaching kids about sex doesn't necessarily make them want to go out and fornicate like rabbits. If done correctly, it will make their hormone soaked brains think twice now that they know the potential consequences of unprotected sex. It leads to an understanding of how their bodies work which decreases fear. We're curious primates, fear only works as a short-term motivator. We are designed to have sex. Telling kids to wait has never worked all that well. Sure, in the past it kept the majority from bonking before they were married, or at least getting caught. But there were always a few daring souls who had their hands in the cookie jar.

Sexual education is like drivers ed. We don't really want these kids in a car. They are inexperienced, have short attention spans, and have more auto accidents than any other demographic. But if we can say "this is the seat belt, this is a stop sign, this is how you keep from getting hurt on this crazy road" its better for all of us.

Friday, November 7, 2008

Its 18 degrees this morning. That's pretty darn cold. I've got the woodstove cranked up but I'm not sure how fast its going to get warm in here. My house is a bit deceptive. I have giant floor to cathedral-ceiling windows with south-western exposure which are great for collecting sunshine but the house is primarily heated by a little woodstove on the first floor. So its been warm and snug when I get home from work even if it's getting dark way too early. I think I'm going to have to make a fire before bed and bank it up nicely so that I don't get frostbite in the morning. Its hard enough to get up when its dark without forcing myself from a nice warm bed into the cold air.

The weather has snuck up on us. Just four days ago, it was a balmy 40 degrees in the morning. Snow is forecast for this coming weekend. Snow. Yes, I know I've moved to a town in the foothills of the mountains. Yes, I live in the river valley. But I wasn't prepared for 18 degrees in New Mexico during the first week of November. This makes me a bit concerned about the temperatures in February, when its really winter. I'd better get some more sweaters.

Wednesday, November 5, 2008

Let me just say, one more time


Today there will be celebrating, maybe a little gloating, and a whole lotta joy. Its Christmas and Easter and New Years Eve all rolled into one. But its not just about Obama and his brilliance, it about us and our awakening as a nation.

Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it's the only thing that ever has. Margaret Mead

Tuesday, November 4, 2008

Chop Wood, Carry Water

Well, my freinds. We've finished an election year. We have done the thing that was declared impossible. As a nation, we aimed for something greater than ourselves. Something greater than Barack Obama. We moved beyond our fear into the unknown. That is called faith. Faith is greater than an affiliation with any group. Faith is the belief that beyond the trials of now, we can do better, we can create a world that transcends color, that transcends religion, that transcends our daily bread.

So will we wake up tomorrow and find that the sky is a different shade of blue, that our coffee is better, our lover more beautiful, our finances magically fixed? Most likely not. The hard work has just begun. We, as a nation, have signed up for a tough job. But the important thing is that we've signed up.

I don't know if President Obama will fix everything. I firmly doubt that he is the messiah. But I do think he is a leader. I do think his mind is one of the finest of our time and I think he has the stamina and the gifts to pull us through this time. As he said in his acceptance speech, its time for all of us to lay aside our cynicism, put our shoulders to the plow, and take responsibility for ourselves individually and as a whole. We are our brother's keeper.

One of the labors of Hercules was to clean the stable of King Augeus. The king kept a herd of gigantic horses there. Gigantic horses make... well, you know. Apparently the king had a difficult time keeping farm hands. The horses were ill tempered, had huge iron-clad hoves, and made a huge pile of manure on a daily basis. The mortality rate among the farm hands was more than the king's liability insurance could handle. Ergo, piles of shit higher than the towers of the palace. The king required that the cleanout occur in one day, and if completed, Hercules would receive 1/10 of the kingdom.

Rather than pick up a shovel, Hercules was able (by virtue of his divinity) to divert the flow of two swift rivers through the barn. Of course, this was a completely unexpected approach to problem solving. King Augeus did not want to pay for the unorthodox approach to barn maintenance and things did not end well for him.

The point is that a) we have a big pile of feces in front of us that needs cleaning and b) a shovel and wheelbarrow aren't going to do the trick. Barack Obama may not be Hercules, though. Maybe we are, collectively, Hercules. And by applying creativity and elbow grease, we can meet the labors before us.

Monday, November 3, 2008

A Monday by any other name is still a monday

Today I had two separate cases of the opposite of sibling rivalry. It was love and unselfishness and forgiveness of any childhood injury inflicted. I'm a fortunate soul to be witness. Let me preface the rest of this entry by saying that today was by far the worst Monday I have had in quite some time. It lived up to its reputation of being complicated, awful, and exasperating. It was a three martini sort of day, if I drank martini's. Which I don't because they are even more bitter than Mondays.

In the midst of the complicated patients who seemed to be on the verge of death or as I like to say "One foot in the grave, the other on a banana peel" and others who were fogged over by their psych meds, and even a couple of angry folks (because they were scheduled behind the lady with acute heart failure and they weren't at the front of the line), were a pair of sisters. I'd seen the "healthy" sister (let's call her Maria) for a heavy case of ear wax a few months ago. Today she was wheeling her older sister (let's call her Bernadette), age 74, in for follow up after being released from the hospital in Albuquerque. The Bernadette started out with a heart problem and come out with half her colon removed. Both were diabetic, but Bernadette had upped the ante by developing a tricky heart, scar tissue in her belly from previous surgeries which blocked her colon, and a host of other medical issues. Neither of them really understood the reason for the emergency surgery or why the Bernadette had diarrhea and I didn't either because I couldn't get ahold of her physician in Albuquerque until they were long gone.

What was really beautiful about this whole mess was that Maria was managing Bernadette's diabetes beautifully. Maria was changing Bernadette's diaper's, bathing her, making sure she got all the right medications, all the right food, and all the other things she needed. She took Berna to all her appointments, to the pharmacy, cooked and cleaned for her. It didn't matter any more what had happened in the hot days when their parents were alive, when they were young and pretty. The unconditional love was laid out like a table, full of food carefully prepared and presented. A gift that they may not have known was in them to give.

Another pair was a brother and sister. The sister was mentally disabled, probably from the seizure disorder and the polio and who knows why really. She was in the clinic for a pre-operative physical exam. She needed a new hip because the old one had rotted in it's socket. Don't really know why that happened either. Her brother brought her in to see me. I think he also took care of their elderly mother. He looked tired, washed out. But he answered all the questions and asked all the questions. He was gentle with his sister's inability to pay attention to the exam, reminded her to to stay in the present. It was his time and effort that would get her to the cardiology appointment I had to schedule and him who would take her for her surgery and interpretted my explanations about abnormal EKG's and abnormal kidney function. He was the one who steered her down the hall carefully as she veered from one thought to another. I felt like I was cutting down the last tree in their forest. Bad heart, bad kidney's; can't wait to see what the orthopedic surgeon says when he see's her labs.

But there he was, probably a role he's played all his life. Don't leave your sister alone, she's fragile. How long had he been taking her by the elbow, making sure she didn't careen into the walls? What had he given up to the altar of unconditional love and protection? How long will he last once his mother and his sister have slipped this earthly coil?

In this middle of all this mess of monday: the frustration, the diplomacy, the irascible nursing staff is this shining light of love and sacrifice. I hope I can find something like that in all my days here.

Sunday, November 2, 2008

Contemplation on the Human Animal and Solitude

Since I've moved to Las Vegas, my social and romantic situation has changed. Being the new kid means that I'm still working on creating a social millieu. I'm also not currently in a relationship. Having gone through marriage (rather like having gone through "the war"), long term relationships, graduate school with a cohort, raising my daughter, and living with my family of origin, this is the first time I've really been alone. Its a strange feeling.

On the one hand: I don't need to check in with a partner or a parent or get a babysitter if I decide I'd like to do something. I can play torch songs as loud and and frequently as I please. My wine making projects can hijack the spare bedroom and my wool can sit anywhere it wants. If I don't want to clean the kitchen/livingroom/bedroom, no one complains. I can make decisions on money, vacations, and everything else without consulting anyone. That's nice. It's an enviable amount of freedom.

On the other hand: It's sometimes lonely.

So, why does loneliness bother us, meaning me? I think it's because humans are mammals, specifically primates. All animals have social constructs. This is for the protection of the individual as well as the health of the herd or troupe or flock. The worst thing that can happen to an animal is to be separated from the group. It leaves them in a vulnerable position, open to starvation, illness and predation. In primate groups and horse herds, if a member misbehaves they are pushed to the fringes of the circle until they show that they are sorry for their behavior.

In Celtic society, there was no corporal punishment. Instead, offenders were exiled, usually to Scotland. Solo travel was greatly discouraged in most countries until the 19th century because of the dangers lurking behind every tree. These were very real dangers that included banditry, animal attack and sexual assault. Women who had been widowed and lived alone were targeted by their neighbors as witches. Individuals in abusive relationships will stay even to the point of death in order not to be alone. It has always been safer to live in the herd or to be coupled than to be alone.

The benefits of the herd are numerous. Sharing the food, the labor, the childrearing. We need laughter, music and storytelling. We help each other with building shelter, protect each other in times of danger and share our individual gifts to make life better and richer.

So, aside from the reproductive imperatives of coupling up with a mate to make more of ourselves we are also hardwired to need to be part of a group of some kind. The medical evidence shows that people with active social lives are healthier and live longer. Married men are healthier and live longer (married women not as much). If we could all find ways to keep these social needs met in a supportive way that doesn't lead to destructive behavior, it would lead to healthier, happier members and a happier, healthier world.