Nobody Said It Was Easy

Fixin' a Drink in the Morning

A few months ago, I had a few people* ask me if I was still writing.  I said that I hadn't been, but should resume as it was something I really enjoyed doing.  They all agreed and indicated that they enjoyed reading my posts.  So here we are, two months later, as most good intentions take time to come to fruition.  Indeed I had started this post nearly three weeks ago before promptly abandoning it for things that seemed more pressing.

The fact that I haven't written much, if anything, over these past two years can certainly speak to an evolving state of my mental psyche when it comes to parenting, and my role as a parent as my kids have gotten older - something that is more apparent now that we are into the summer months.  While we've weathered these past 2+ years arguably better than 99% of other families, this is certainly not to say that it hasn't been hard.  And at times really hard.

For me, writing has always tended to be a cathartic experience that has undoubtedly helped me process my own parenting experience.  During a time when that parenting experience was seemingly most intense, with schools closed and the world in lockdown, this medium was probably one of the more constructive ways to channel frustration and joy, but sadly fell by the wayside, as I neglected to make it a priority.  As for many parents, these past 2+ years have certainly not been filled with my finest parenting moments.  But they have certainly contained a great many experiences from which I can learn and progress as a parent.  And if someone besides myself enjoys reading about my observations of those experiences, all the better.  

So where to begin, or resume if you will.  I'll try not to cram 2+ years of material into one piece, but if you are familiar with the blog, you know that I'm seldom at loss for excessive words.  Much has certainly changed from my initial days as a stay at home parent.  Our oldest finished fifth grade this past year and graduated from elementary school, and brought us into the world of pre-teendom we were hoping to avoid.  Our youngest, who was the catalyst for my stay-at-home adventure, finished first grade and has embraced the role of an angst ridden seven year old boy, complete with an emo haircut and currently sporting a sleeve of temporary tattoos.  And there is of course our not-to-be-forgotten spirited middle child, who finished third grade and we have realized is much easier to parent when she is not in the presence of her siblings.

Insert obligatory pondering of how my kids got so old.

Summer has always brought a unique set of opportunities for me as a stay-at-home parent.  As they've gotten older, they've come to rely on my less, which makes me wonder what my own expectations of myself should be as a parent.  Indeed as I write this, our oldest is making herself breakfast, a skill we've tried to impart on all of our kids over the past year, our middle is reading (something she and her older sister would do for hours on end), and our youngest is stacking pennies.  Of course our kids will have a myriad of activities that they will need to be chauffeured to this summer, which at times makes me feel like an unpaid Uber driver.  Admittedly as someone who tends to thrive on task completion, I at times enjoy my services being called upon.

I am also keen though on allowing my kids a healthy(?) amount of unstructured time.  Literally unplugging all of the devices and leaving them to their own devices.  My guilt instincts at times kick in, and I try to get them to do something academically stimulating, like a page or two of a Brainquest workbook or read in Spanish.  But after mentioning my inconsistent attempts to avoid the summer slide with my kids to one of the teachers at their school, and getting a very discernable eye roll indicating that my efforts were probably over the top, it has become less of a priority.  We typically try and fail regularly at instituting some amount of chores for them to do.

A few weeks into the summer we celebrated Father's Day, and like a number of of other dads, my entertainment was watching our girls dance in their final dance competition of the season.  My present could have easily been realizing the fact that after that day they would be finished dancing, even if just for a week.  It was fun though to be able to watch them engage in an activity that they are passionate about and that challenges them.  Our son started dance this past spring, so in the years to come they will all be able to get in on the fun.

While Father's Day is a time to celebrate father figures and shower them with well intentioned, if not odd gifts^, it can also be a chance for those of us who are father figures to reflect on our roles.  For if you weren't in that role, whether biologically or otherwise, you'd really have no reason to celebrate Father's Day. 

As a father, and parent in general, one of the greatest compliments I've received is when people (mainly adults) tell me that that they enjoy being around our kids, or that they appreciate the way we are raising our kids.  Yes, typically this comes from close friends or family, but when it comes from people whose opinions I value, it tends to carry an extra amount of significance.  It makes me think that we are getting this parenting thing "right", at least occasionally, and while realizing that the word "right" is incredibly subjective.

Now I certainly know how our kids can be.  They can be vastly different at school or in other social settings (typically much better behaved and more enjoyable to be around) than they are at home (whiny, cranky, and at times incredibly disrespectful).  In fact, over the past two years, as I've spent some time substitute teaching, some of my more enjoyable interactions with my own kids have been at school.  I'd much rather have it be this way than the inverse, but it can be undeniably exhausting.  No matter how much patience I have (and I have a lot of patience), I can only direct expletives at my kids in my head so many times before they actually come out in audible form.  

So while I don't actively seek the approval of others in my parenting philosophy (or I wouldn't admit that I do), hearing those compliments can provide a certain level of validation.  Particularly so because I like to think that I put a lot of intentionality into my approach to parenting.  I've read an excessive amount of books, articles and blogs about how to make sense of this emotional rollercoaster of a world that is parenthood.  The fact that I've spent time, albeit irregularly, writing about my parenting experience shows how I have a tendency to grapple with the bigger questions of parenting and raising offspring.  I take this intentional approach to try and be a parent that I believe my kids deserve, as well as one that I can be proud of.

My wife has told me before that it isn't always easy to parent with me.  I can't disagree with her statement, as I know I'm not always easy to even be around.  I'm cynical and sarcastic, at times pretentious, and often unmoved by other's opinions of me.  While single parenting, especially full time single parenting, is a Herculean effort, co-parenting can be fraught with its own levels of frustration and resentment.  Spirited discussions and disagreements over parenting styles and passed judgements on parenting decisions are to be expected.  Finding a balance between constructive and critical is fickle.

There is a certain amount of irony in my wife's observation though, as obviously I wouldn't be a father, nor one that contemplated how best to raise his children, if it wasn't for her and the subsequent children that she birthed.  I take a great many cues from my wife when it comes to parenting, because she is, without doubt, one of the most amazing moms I know.  As much as she might disagree, she pushes me to be a better parent.  One that is more actively engaged with the child rearing responsibilities.  Coincidentally this probably provides more opportunity to frustrate and annoy her.  I have gotten better at recognizing certain scenarios where I do have to check-out of parenting, and have been told, both by my wife and kids that I am typically more fun when I do this.

It was Father's Day, so of course I wasn't going to say no to ice cream.

This past spring I was able to gain a small amount of redemption on a masochistic event that I planned on doing three years ago.  After getting snowed out of a 50 mile endurance run, I was able to complete the 34 mile version of it back in April.  I've done a few different long distance endurance events; a couple of marathons as well as training for the 50 mile that didn't happen and my most recent irrational distance decision.  To me, long distance running (or biking or hiking or anything else that takes a long time and requires a certain amount of physical and mental fortitude) and parenting draw a lot of similar parallels.  But in particular they are about playing the long game.  Putting in the work, and a lot of it, to hopefully realize some desirable outcome later on.  Maybe after 18 hours of nonstop plodding along or after 18 years of parenting.

  

Your biggest fans are the ones who will encourage
you in your most irrational pursuits. 

In utltrarunning, as in parenting, that desirable outcome can look different for everyone.  One person will finish first, while the rest of us just hope to finish at all.  Depending on the course and conditions, that experience can vary greatly.  And despite your best efforts to train and prepare, injuries can beset you or unforeseen circumstances can hamper your progress.  All this applies to parenting as well, as there are a great many things that are beyond our control when it comes to raising our kids.  Despite your best efforts and best intentions, your kids can still be jerks at times - even royals aren't immune.

As parents were often told not to try and compare our kids to other kids, or ourselves to other parents.  It's sage advice, but a challenge given our comparative culture.  But while races, and even endurance runs ultimately have a winner, author, and self-described masochist, Brendan Leonard is quick to point out that the vast majority of people engaging in the irrational activity of endurance running aren't competing against each other, but rather against themselves.  To push their limits and be a better person at the end of whatever goal they have set out to accomplish, even if they feel like complete shit afterward.  

This is the approach I think we should take in parenting.  To strive to be a better parent today than we were yesterday.  And use what we learn today to hopefully be a better parent (and person) tomorrow.  We won't always succeed in doing this, and at times it might seem as though we are running in circles, chasing our tails.  But that doesn't negate the need to put in the effort.  We might receive accolades and encouragement for our efforts along the way, like you often do from spectators and aid station workers in a marathon or other long distance running event.  Ultimately though it's up to us to take ownership of the effort we put in to keep moving forward.  We've got important things still left to do.                       

  

     

*Yes, one was my Mom

^The oddest gift I overhead was a Shitake Mushroom growing kit.

I've Been Having Dreams

Bounce With Me, Bounce With Me

Parenting is an adventure in calculated risk taking.  It's playing the long game - sacrificing in the short term for a life filled with memories in old age.  Making decisions as a parent is often times centered around evaluating risk, as we have a tendency, particularly when our kids are young, to be the gatekeepers to how much danger our children are exposed to.  We know we can't keep them in a bubble, but we can limit their exposure to certain risk - secondhand smoke, excessive sugar, chemical pollutants, etc.     

At the beginning of March 2020 we started dog watching.  It was something suggested to us by some friends who have a dog, and observed how much they would periodically pay for someone to watch their dog.  Our kids would love a dog, but my wife and I have zero interest in having a pet.  Dog watching seemed like a nice compromise as the kids could get their animal fix on occasion and earn a little money that we could put into their college funds for taking care of the dogs.  

If you got a pet after having kids, you can undoubtedly guess what has transpired with this arrangement.  My wife and I do most all of the "taking care" of these dogs - waking up earlier than normal to let the dogs out, taking the dogs for walks, cleaning up the dog poop (both inside and outside of the house), and dealing with the local police when a dog we are watching decides to bite a neighbor. The kids on the other hand reap the benefits.  Mostly financial, but they also get someone to pet and cuddle with when they are having a moment.  After watching about 30+ dogs over the past year, our kids no longer have a desire for a full time pet, so our strategy has worked in some sense.

The financial benefit of watching dogs is the benefit that our kids have become most acutely aware of.  Whenever my wife or I check our various financial accounts, which we do with regularity because we're such nerds, our middle child is mildly obsessed with checking their "Rover Account".  I doubt it will cover their entire higher education experience, but if we continue to book at our current rate (which I hope we don't) it might get close.  The claim could be staked that our kids are learning that hard work can pay off, both intrinsically and monetarily.  However, it seems like they are more understanding the notion that if they shirk their duties, mom and dad will pick up the slack, and they'll still make out like bandits. 

Along with a wanting a pet (before dog watching) our kids have pined regularly for a trampoline.  After much deliberation, we decided that they could use some of their dog watching money to purchase one.  We hoped that showing them how much would be deducted from their ever-growing bank account to purchase the trampoline might ultimately deter them from wanting one.  It did not.  After a few days of diligent internet research, my wife narrowed the options down to a couple she felt most comfortable with, and allowed the kids to decided which one they wanted.  Upon placing the order, that same middle child inquired daily if there were any updates on the product shipping and expected arrival dates.*

I had a trampoline when I was younger, so I wasn't completely against the idea.  My sister and I begged my mom relentlessly to get one, and offered no financial help toward the purchase in attempt to sweeten the deal.  She relented eventually, with her one stipulation being that as soon as someone got hurt on it, it was going back.  We had it less than a week before my cousin put his knee through his mouth, requiring stitches.  Miraculously it stayed up in our backyard, where it served as an accomplice in a variety of other minor injuries.  

We survived our inaugural season with the trampoline, with no major injuries to speak of - I realize that by saying that we are destined for a major injury very soon.  The trampoline has become a microcosm for well intentioned parenting.  The rule that you can only jump when an adult is present is broken multiple times a day, with near zero effort toward enforcement.  The rule of only one jumper at a time has been extended to a solid half dozen on certain occasions.  Flips and acrobatic tricks are at times encouraged, applauded and critiqued with expectations of improvement.  Considering how long it took to assemble, the threat of taking it down due to improper use is as thinly veiled as most all of my other threats.

Jumping on a trampoline, like life, can be inherently dangerous, but also inherently fun and exhilarating, and if nothing else, exhausting.  Most injuries sustained from jumping on a trampoline are often a result of colliding with another jumper.  We can get hurt in life by others, often times colliding with differing opinions, attitudes or expectations.  Before trampolines came with the ubiquitous nets surrounding the jumping space to prevent people from falling off, injuries were often sustained when jumpers were propelled from the trampoline and made audible contact with the ground.  People can even get hurt when jumping by themselves, as recommended, if they are engaging in acrobatics that are strongly discouraged but look awesome.  In life we can get hurt by taking on too much, even if we think we are capable of sticking the landing.

For all its inherent danger, there are a number of things I appreciate about the trampoline, beyond the numerous life metaphors it allows me to ponder.  I like that it keeps my kids active.  After the first day of using it, our kids were absolutely exhausted.  The trampoline entices them to be outside and physically active.  In reality, I'd rather have them sustain a broken bone from a trampoline than their brains turning to mush by sitting inside all day staring at a screen.  

I also appreciate how it seems to help them with their coordination and learning about the physical capabilities of their bodies.  Having spent a bit of time in various elementary classrooms this year, I am amazed at the number of times I have watched kids fall over for no apparent reason.  Sometimes while they've been sitting.  To some degree the trampoline helps to teach them about the limits of their own physical capabilities, something my 38 year old self doesn't always remember (especially when I use the trampoline).

Unfortunately, we didn't make it through 2021 without a broken bone, but this one was not attributable to the trampoline.  A few days before the end of the year, and one day before we were supposed to embark on a ski trip to Montana, our 7 year old took a tumble while skiing at our local hill and broke his collarbone.  It was an injury we didn't realize at the time - we brought him in two days later after we noticed some swelling in his shoulder.  It was also a reminder that injuries can happen in all sorts of places.  Given his propensity to spend as much time as he can in the terrain park throwing himself repeatedly off of any jump he can find, this fall happened somewhat benignly on the bunny hill when he caught on edge.  He even admitted he was probably going too fast.

It was a sobering moment as a parent - recognizing that an activity that you exposed your children to, and one that they'd seemingly taken to without much challenge was the cause of a potentially preventable injury.  But I also realize that my sister broke her arm as a young child just by jumping down the stairs (not being pushed by her younger brother, as she conveniently told my parents at the time).  I also have felt fortunate that to have learned that if your child is going to break a bone, the collarbone seems pretty minor.  Of course our Montana trip had to be postponed, for that and other reasons, and that ultimately lead to larger healthy related challenges that I'll expand on later.

We all have a certainly level of risk actualization, and this is developed based on our given experiences with certain types and amounts of risk.  Letting your kids engage in activities like jumping on a trampoline or downhill skiing might certainly increase their risks of breaking bones or other other maladies.  You can institute certain risk minimization strategies - helmets wearing, rule abiding (when convenient for you), and other measures of supervision - but you can't guarantee that trouble won't find them eventually.  If you are okay with excepting the potential consequences of those risks that you allow your kids to be exposed to, or even intentionally expose them to, then I think you are doing your job as a parent.

And of course we all make mistakes, as parents, as employees, as people in general.  Learning from those mistakes, to hopefully avoid repetition, is a sure fire sign of maturation in my view.  And it's a lesson that I hope to impart as much as possible on my own kids, so that they can understand how to learn from their own mistakes, and avoid similar mishaps in the future.  Admittedly, the amount of learning from their mistakes seems to have an inverse correlation to the number of times they behave in risky behavior and suffer significant consequences.  Or, in plain-speak, they could jump on the trampoline every day and never break a bone.  And then might make mistake after mistake and never learn their lesson.  But just as that one inadvertent fall that precipitates and ER trip, that one lesson learned from thousands of mistakes can have profound significance.     

              

   

*She also did this with the "Pop It" that my wife agreed to order her last week (using money from our daughter's bank account).

 

    

No, Not I, I Will Survive

We're Doing Nothin' From Christmas

I can say that we've officially wrapped up the holiday season in the Bruns household.  This is typically a stretch of time that starts the weekend before Thanksgiving by celebrating our eldest's birthday (and my wife's when I remember) and closes after we finally get around to scheduling a birthday party for our middle daughter.  Her birthday is on December 30th, which was over a month ago, but we're usually at least two-three weeks behind on the party scheduling.  We finally got around to it a week and a half ago, which I've come to view as the closing of our "holiday" season.  Obviously sprinkled into the mix are Thanksgiving itself and the Christmas and New Year festivities.  Oh, and our youngest's birthday on Christmas - can't forget about that one....

The two month stretch of parties and presents can be a whirlwind and certainly stress filled.  In effort to combat some of that (self induced) stress this year, we kind of de-committed ourselves from any Thanksgiving plans.  It was nice to have a day when we didn't get out of our jammies, and the leftover bacon-cheeseburger pizza was a welcome change of pace from the traditional turkey dinner.  But we also experienced a small bout of illness with one of our children, and some weather woes that turned one day of laziness into four.  By the end, I was certainly ready to come out of hibernation, and have our other family members do the same.

In the lead up to the Christmas festivities, and the various travel plans we had scheduled, we braced ourselves for what curveballs would potentially be thrown our way.  We had been healthy, but the flu had been wreaking havoc on our girls' school and dance studio, and we knew it would only be a matter of time.  And, as if on cue, when we transitioned into the winter break, and geared up for three Christmases, our oldest caught it.  The writing was clearly on the wall, as when I picked the girls up from school on their last day before break, our oldest inexplicably sat down in the middle of the school hallway and began sobbing uncontrollably.  It was time for a break, but who knew what that would entail.

It ultimately entailed her running a fever for a week - something we heard was commonplace by other kids getting this particular strain of the flu.  So we spent our waning days of Advent, the season of waiting, in waiting.  We waited for her to get better - which she did, until she got worse, and then better again, and then a little worse.  We waited for our other kids to get it - which our middle daughter eventually did, but not as bad and not as long.  My wife and I waited for us to get it - thankfully neither of us did, thought we constantly felt like we were just on the verge.  

We derived up scenarios in relation to our various holiday gatherings; if she is fever free by Saturday morning, we can go to a Christmas that afternoon, if she is fever free by Tuesday morning we can head out for that family Christmas later that day.  Neither of which happened.  In all we made it to one of the three family Christmas gatherings we were planning to attend, which, had we been playing baseball, would have been hall of fame stats.  Our plan to take advantage of a few unexpected days off my wife received around Christmas were dashed, and we settled for a makeshift Christmas celebration and excessive amounts of TV.  The week felt like equal parts stay-cation and house arrest.

At First I Was Afraid, I Was Petrified

I wrote the above four paragraphs at some point in January of 2020.  I completely forgot that I started a post, that obviously didn't get finished.  I figured I should try to write at least one in 2020, but of course that didn't happen either.  Given that I just realized that I actually did write something in 2020, I figured I should at least incorporate that into this one - if this one actually ever gets finished.

In re-reading those four paragraphs, it's interesting/comical/depressing the similarities between the 2019 Holiday Season and the 2020 Holiday Season, albeit for different, but also kind of similar reasons.  Thankfully, we were not battling flu-like symptoms this Holiday Season, but given the prevalence of the - insert scientific or derogatory name to your liking - flu, we kept a low profile as it seemed like the appropriate thing to do.  In effort not to play favorites or set precedents we could have a hard time rationalizing, we opted for the continuity of cancelling our Holiday plans across the board`. 

The first four paragraphs that date back to the pre-pandemic era clearly show that this wasn't the first time we'd had to make adjustments to our Holiday plans.  We've had other documented instances that have required calling audibles on what we thought would fun Holiday festivities.  It most certainly won't be the last.  With a widened breadth of parental experiences, more and more plausible scenarios have entered my purview of reasons you might need to make adjustments to your plans.  I've commented before that as a parent you will find yourself in situations you never thought plausible before you became a parent.  Needing to cancel Christmas for a global pandemic was likely not on many people's radar, prior to 2020 of course.  Dr. Michael Osterholm probably being the exception.

It's Fine, We're Fine

That's my stock answer when people ask me how things are going these days.  I think that has become a go-to response for many.  In reality, and I've voiced this aloud before, we are undoubtedly faring better than most.  Having been a stay-at-home parent for 5+ years when schools abruptly shut down last March, it didn't create the storm of chaos that it did for many two working parent families, or single parents who were also trying to work will "home school" their kids.  My wife kept her job, unlike millions who lost them, and transitioned to a mostly work from home arrangement, which created its own positive and negatives.  It added a certain amount of tension as we navigated the intimacy of everyone being home together all of the time (and unable to escape to warmer climates).  Ultimately though, our day to day stressors, like a need to upgrade the bandwith on our WiFi, were #uppermiddleclassfirstworldproblems.

At first the newness of the situation created opportunities.  We appreciated that the kids didn't have to get up before the sun to catch the bus for school.  I enjoyed the fact that most of my afternoons didn't become an uBer-ing of children to and from various activities.  We had virtual game nights and happy hours, did online drawing sessions with Mo Willems, and like many others, watched a lot of movies (the kids) and consumed a lot of alcohol (the adults).  We tried to keep our kids as engaged in school work as we felt reasonable, and when it became apparent that they would not be returning to school in the spring, I chalked it up to being an extra summer for them.

The transition to summer, and out of "trying to pretend to be home schooling" meant that we had nothing on our hands but time as all of our kid's summer activities were cancelled.  While enjoyable at first, the lack of structure had its drawbacks, and when our girls restarted dance class in July, I was ready to have some anchors in our day of things we were actually supposed to get to.  We were fortunate to be able to make a few in state adventures and temporarily leave behind the all-consuming-ness of the pandemic  The summer itself though felt like both the longest and shortest summer ever, having seemingly started in mid-March, but being devoid of most all the typical summer rituals.

Fall brought on a notion of taking things week by week, which was a juxtaposition to the summer when everyday seemed the same and no day seemed the same.  "Blursday" I believe it was coined.  We were excited and nervous for our kids to return to school, even if only part-time.  We never felt a strong desire that our kids either needed to be at school or at home, and my wife, the medical professional, would acknowledge that her personal opinion on what she thought was okay or not okay would vary at times by the minute.  Thank you social media.  

When school actually started, we found ourselves anxiously awaiting the Thursday announcement of the seven day rolling case averages for the four counties our school district was in to learn if our kids would get another week at school or if we'd (I'd) be back to full time "home schooling support".  I briefly came out of retirement and did a little bit of substitute teaching, as was my initial plan before the pandemic.  At times it was a nice change to be yelled at and ignored by children who were not my own.

Then, as expected (by the public health experts at least), the virus ramped up and everybody came back home and went back into quarantine mode.  Our kids' school actually had to go to a distance learning model two weeks prior to the rest of their district moving online due to a lack of teachers.  This meant our kids were home for two weeks, back at school for four days, before returning home until after the Winter/Holiday break.  We figured that would get extended at least a few weeks, which it ultimately did.  Since then though their planned return to in-person learning has actually been expediated with a decrease in cases in the state and optimism surrounding the vaccine rollout - even as deaths nationally hit an all time high.

As Long As I Know How To Love

While there seems to be light at the end of the tunnel, we're obviously still in the tunnel, or the woods, or as ultra-runners like to call it, the pain cave.  I'll admit, it seems like the attitude around things getting back to some version of normal, while still a ways off, has started to creep into me more and more.  My birthday last year fell on the first weekend after things went into full shutdown mode here in Minnesota.  I've used that as a marker for my perceived COVID year, and I will be interested to see where things are at come the middle of March.  I've suggested that everyone should have to experience at least one birthday under COVID, while recognizing that some people won't make it to their next birthday because of COVID.

Obviously we're all itching to get back to normal^, whatever that might look like.  In a way, I feel like my last 10 months under COVID have been a microcosm of my last six years as a stay at home parent.  There have been ups and downs, excitement and mundanity; and lots and lots of quality family time - both good quality and poor quality.  When I wrote a piece a (long) while ago about nearing the end of my tenure as a stay at home parent, I quipped about having earned a PhD in parenting, if such a thing existed.  Parenting during COVID feels a bit like my dissertation.  If we all make it out alive, I'll consider that a passing grade.

As challenging as this year has been, there have obviously been some positive things that I hope we take forward into a post-COVID world, if and when we every get there.  For all of the negativity that has blown up your social media feed over the past ten months, I'm sure there have been just as much positive clickbait as well.  Hopefully you were able to find at least some small amount of joy in 2020 - even if just in the little things.  The notion of hindsight being the same as the calendar year number of what has likely been one of the most memorable years for most of us seems a little too ironic. Yeah, I really do think.

When things started to shutdown in the spring, and that shutdown dragged on into summer, and then came back this winter, a common sentiment I heard was people indicating that they weren't going to survive.  Not knowing their own personal circumstances, I assumed this meant that if things continued on in a similar fashion for the foreseeable future they were ultimately going to lose it.  I realize that's very vague, but I think you get the picture I'm trying to paint (pick your protest turned riot from the last nine months maybe?) .  What I couldn't help but consider, was the want to survive versus the will to survive.  And I realize that if you are faced with circumstances completely beyond your control, like a  terminal disease or a lack of basic life necessities, you can't just will yourself to survive. But for many of these observations, that didn't seem to be the case they were trying to make*.

In a way, it seemed to me like we didn't want to survive.  That if the COVID world was what life was going to look like for, well maybe forever, we didn't want any part of it.  Can't drink at a bar, see a movie in a theater, visit my grandparent in a nursing home?  Not a world I want to live in.  I'd agree to a certain extent, but I think it is also worth recognizing that we historically haven't always been able to do those things.  Prohibition existed for almost four years in the 1920s, which ironically coincided with the opening of the first air-conditioned movie theater.  And while nursing homes have existed for centuries, many grandparents of previous generations never made it to an age where they would be in a nursing home.  Normal is always relative to what we know, and nearly all of us haven't known life in the midst of a pandemic.

It's also important to point out as a collective, we don't have the infrastructure that lends itself well to survival during these unprecedented times.  People have experienced the challenges that came along with a pandemic in the past - job loss, death and disease, social isolation, etc.  We just haven't had many, if any, times when we've experienced them en masse and at the same time.  And even while we've been experience the pandemic at the same time, we've certainly experienced it in varying levels of severity.  Take whatever metaphor you want to use, but if we're all in the same boat weathering the same storm in the same ocean, we all have different class tickets with different accommodations.  And in particular in the US, with the significant health, wealth, and educational disparities, as Mark Blyth has suggested, we have few good options for dealing with that storm.      

Parenting in general, and particularly during a pandemic, is all about dealing with the storm.  It requires adaptation, and lots of it.  You can't control your offspring, particularly the ones you still claim as dependents.  You can only coach them, hope they will make rational decisions, and prepare yourself to deal with the aftermath of the decisions they ultimately make.  And when you find yourself in those situations you never could have imagined before having children, or before experiencing a global pandemic, you are forced to react and address those challenges head on.  You do this because you love your kids, and ultimately you have no other choice.  They're relying on you even though you might feel utterly clueless and helpless.  Given the number of people with fully developed pre-frontal cortexes who continue to make suspect decisions, we can't expect those whose brains are still developing to fare too well on their own.

When I transitioned to be a stay at home parent over six years ago, it was in hope of getting to a better place.  That place was going to be different, and some aspects of it weren't necessarily going to "better" - like our financial place.  And that didn't mean that we were (or I was) in a bad place when I made that transition.  We just thought we could make some adjustments to our lives that might provide more of what we were looking for - more time together as a family and more flexibility; less stress in our daily lives and the opportunity to take a more direct approach in our kid's upbringing; and for my wife someone to make her lunch before she left for work each day.  We made adjustments and adapted to our new arrangement.  It wasn't always smooth sailing, but six years later we've developed a new normal.  And we're done with diapers.

Now, I realize that my decision to become a stay at home parent was a voluntary one, and a lot of parents have been forced to become stay at home parents over the past year, whether they wanted to or not.  But you may recall that our transition into parenthood wasn't something we put much forethought into.  Luckily we were in a place where adding offspring to our life required adjustments that we were both ready and prepared to make.  I've commented before that my perceived marker of when someone is ready for children is if they feel like they could be a stay at home parent, should the circumstances warrant it.  Again, I didn't have a pandemic in mind at the time.  

As we look to get back to normal, or to a "new normal", my hope is that we can actually get to a "better normal".  A "better normal" where we can take the appreciation for all of the things we've been missing this last year - time spent with family and friends, small businesses that add so much to our community, actual human contact - and better incorporate them into our daily consciousness.  A "better normal" where we can prioritize the care of those who need it most, while looking out for our most vulnerable, and recognize who really is "essential" in this society that we've created.  It will be tall order, as it will call us to reflect on all the ways we've chosen to overlook those things that seemingly matter most when we've not been concerned about losing them.  But it will also remind us of what we are capable of.  

2020 put us through the ringer, and sadly, not everyone made it out.  And many more will ultimately succumb to the linger effects of what it brought in 2021.  But for those of us who made it and continue to make it, we have the opportunity to take the things we learned, the challenges we faced and get to that better place.  That better normal.  We've got life to live and love to give.

 

`The exception to this being Easter.  I started working on this post back in January, and finally got around to finishing it in typical fashion.  

^This is purely anecdotal, but I seemed to notice that people who were most adamant about things getting back to "normal" also seemed to be those least likely to do the things that most experts agree will get us back to normal - wear a mask, social distance, avoid large gatherings, etc.  After spending a few months teaching elementary school kids, I also got the sense that these people, particularly those who openly defy regulations put in place to slow the spread/flatten the curve/limit the death, are probably the ones who had a hard time following directions when they were in school. 

*In our great state of Minnesota, a collective of individuals and business owners came up with a way of directing frustration at our Governor after he issued shut down orders that affected many businesses.  It took an oft-quoted line from the movie "The Sandlot" by Hamilton "Ham" Porter, and changed the line to "You're killing us Walz" - the last name of the Governor.  While certainly witty, it seemed a little off base, considering that people were actually dying of a pandemic the Governor was trying to address by ordering the closure of those businesses.  

     

   

Let's Hear It For the Girls

Dude Looks Like a Lady

We're closing in on the end of the year, the time when we typically reflect on the past twelve months and the year that was, taking stock of the highlights and the low-lights.  Personally, it's the time of year when I get consumed by assembling our yearly slideshow, a compilation of photos taken throughout the year set to some of my favorite tunes released this year.  The end result is usually a 10 minute video that our family will watch once, maybe twice.  This provides enough justification for me to spend too many late nights on it.

2019 was certainly a year for the books, and given the magnitude of what has transpired even over these last few months, and the general busyness of this time of year, one could be forgiven if they forgot that less than six months ago, the US Women's National Soccer Team won their second consecutive and fourth overall World Cup.  And win might be a meager term.  They broke multiple records during their World Cup title run, including;  most goals scored both in one match (13) and throughout the duration of the tournament (26), fewest goals allowed (3), most players to score in one game (7), and most goals scored by one player in a game (5).  They posted four shutouts and never trailed in any of their seven World Cup matches.  Yes, it was more of a domination.

The success of the Women's National Team was celebrated across the nation, and the globe, and having two girls involved in a youth summer soccer league, we even got caught up in the excitement.  We didn't watch every match, but we certainly followed it more closely than we do other women's sports - or men's for that matter.  Naturally though, there were plenty of critics of the team, with some negative commentary coming from surprising places, but not necessarily surprising people.  But as T. Swift says, "the haters gonna hate, hate, hate, hate, hate."

One thing that I seemed to notice, and other, more considerably talented purveyors of opinions have commented on, was that the Women's National Team was primarily being criticized for acting like men.  They won.  Indeed they "laid a smackdown" on their opponents, and they were unapologetic in their dominance.  They scored at will (in a field of play where every goal counts), and they celebrated each and every one of those goals as though it was the most monumental event since the last goal.  And this was, to some (mostly men), off putting, unprofessional, classless, even rude.  Despite one of the players being critiqued pointing out that sort of behavior is commonplace in men's games.  And in light of the fact that three months prior to the World Cup, the US Women's National Team filed a lawsuit against the governing body of the sport for gender discrimination.

Now, I know this will come across like my semi-regular exercise of "male bashing", but as the father of two young girls, and a son who I expect to show utmost respect to women, it's hard not to want to examine this quandary we tend to put women in, and ultimately girls who will grow up to be those women.  We deprive them of opportunities to succeed in ways comparable to boys, especially in sports and other areas deemed important to the masses - business, politics, etc.  And when we do give them rare opportunities to prove their mettle, we take offense when they act like men, despite that being the only precedent we've given them to measure success.

A few months after the Women's National team domination in the World Cup, author Ruth Whippman wrote an Op-Ed in the New York Times that suggested we encourage men to "lean out" instead of always encouraging women and girls to "lean in".  The notion predicates that men set the standard for behavior and what is worth attaining, without questioning if that is even beneficial for all of us as a society.  Whippman argues that the over-assertiveness of men can be directly linked to some of our more pressing social issues, and points out the oft-cited research that men tend to be overestimate their own capabilities.  Or as Whippman succinctly puts it, "women generally aren't failing to speak up; the problem is that men are refusing to pipe down."

Having read Whippmann's book America the Anxious, I've had the opportunity to appreciate her salient observations on parenting, and believe her argument has some merit.  Our encouragement of women and girls to be more like the men who have achieved success in business, sports and political life, and often in large part because they've "won the gender lottery"*, does a genuine disservice to both men and women, as well as those who do not identify with either gender or with multiple genders.  This is especially true when women find success and we criticize them for acting "unladylike".

I've often wondered what it would look like if women ran the world.  I've commented before that I am no stranger to being in the gender minority.  Most of my adolescence consisted of being raised by a mom and older sister.  All of my professional bosses have been women, and on more than one occasion I have been the sole male in my immediate work setting - including a five year stint at an all women's college.  It is a humbling experience, and one I think most guys would benefit from at least temporarily.  I'm not advocating that every working man seek out a female boss, just as I don't suggest that every dad (or mom) be a stay at home parent.  But having had these experiences I am acutely aware of what women are capable of.  Indeed men with accomplished women in our lives in some form, which essentially means all of us, know how invaluable those women are to not only ourselves, but society at large.  Is there really any coincidence that both Siri and Alexa are voiced by females?

So why do we continue to expect women to try and achieve success through the male lens?  Why does the male standard set the standard?  Why do we have the WNBA and the NBA, and not the MNBA^?  Why do female employees need to use legal recourse to make accommodations for situations that often get overlooked by male executives?  Wouldn't we benefit from having more male elementary school teachers to serve as educational role models for young boys? 

I realize these are all relatively rhetorical questions, but as I write this, while keeping an eye on one of our daughters at dance class, I can't help but ponder one more: What if, instead of spending most of our Sundays in the fall watching professional football, we watched professional ballet?  Yes, that seems like an absurd notion, but is it not equally absurd that our four year old son, who loves to dance at home (and actually has some pretty good moves), has already been socialized to think that dance is something that only girls do.  In attempt to encourage more boys to take classes, the studio our girls dance at actually offers half price classes for boys.  I mean, we could also watch professional women's soccer, as that seemed to draw a following this summer.

During one of the World Cup matches we happened to catch, I openly wondered how other countries found adequate female athletes to field squads.  We are likely well aware of the soccer craze in essentially every other country besides the US, but that typically is seen solely in terms of men's leagues.  We're also likely aware of the rising popularity of soccer as a youth sport in the US, especially among girls.  Most of our support of girls and women in sport exists at the participatory setting of youth sports, and then to a smaller degree at the collegiate and professional level.  But while the US has seemed to set the standard for women's athletic success, we have yet to have a female head of state, like a number of other countries competing in the Women's World cup, and women are still severely underrepresented in congress and at the executive level of Fortune 500 companies.

Having a female president or more female CEOS is certainly not a panacea for gender parity.  I would posit though that the 2016 Election was as much about Hillary Clinton's un-electability as a candidate as it was about the unrealistic expectations we place on women in the US - but that's another story.  Even the managing editor of Forbes had to admit that women "didn't stand much of a chance" when they released their 100 Most Innovative Leaders List earlier this year.  Given those contexts, it's not hard (for me at least) to understand why the Women's National Team felt the need to celebrate with such exuberance and grandiose.  Indeed the "antics" of the Women's National team might have seemed more noticeable considering they are only given the opportunity to showcase their talent at that level every four years.   

Do I think their actions and behavior were a little over the top?  Yeah, to a certain degree.  But I also believe the lack of support that we've given capable women, the way we've stacked the deck against them by making them play the man's game, and then criticized them when they've found a way to win anyway is equally, if not more, over the top.  So let them celebrate.  I also know that I'd much rather have my girls, and my son, look to the US Women's National team as role models, as opposed to those who criticized the way in which the team celebrated the success they've continual been told they don't deserve.

         

If any of them (yes, any of them) want to dye their hair pink, I'm cool with that.
Just as long as they take it easy on the F-Bombs (for now at least).

^The MNBA actually stands for the Mongolian Basketball Association, so there would probably be some licensing things to work out.

*Direct Quote from Dr. Tago Mharapara; used before and will undoubtedly use again

We're All In This Together

And We All Have No F#&%in' Clue What We're Doing

I recently passed the five year anniversary of my "retirement".  The anniversary seems like a good time to get nostalgic about the past five years, especially considering that I am likely ending my tenure within the next year as the Associate Vice President for Child Development at the Bruns Family Foundation.  I also realized that I had only written four posts so far this year, which equated to one per quarter.  If I wanted to continue to refer myself as a "writer"*, I figured I should at least try to hammer out two more, making my content a more respectable "bi-monthly" product.

Before I "retired", I spent sevens year working in higher ed - five at my most recent place of employment, and two at my first "real job".  In the world of higher ed, five years tends to be a notable, if not somewhat arbitrary, marker.  Colleges and universities (and high schools too I guess) typically hold class reunions every five years in effort to keep their alums connected to the institution and ultimately make sizable donations to the school to pay for a new building, or just offset the rising cost of higher education.  I actually have a reunion for my undergrad class coming up this coming summer.

One of the questions that colleges like to ask their alums (or at least the school I went to) is, if given the chance, would the alum choose that particular school again if they were a college bound kid^.  Obviously there is a healthy amount of subjectivity that goes into this question and ultimately the answer.  You would figure, given the magnitude of the decision, and the fact that the alum might still be making sizable student loan payments, that most would indicate that they would enroll in their alma mater if they had a chance to do it all over again.  And let's be honest, who wouldn't want to do college all over again.  College and university administrators love to champion these responses if they show the institution in a positive light from the perspective of their alumni (again, at least the school I went to).  It can be a powerful marketing tool for perspective students - "Come here because our alums loved it so much they would come back again if they could!"

In case you were wondering, and you probably aren't but I'm going to tell you anyway, if I had the chance to go back to college, I would pick my alma mater.  Yes, that underscores the confirmation basis narrative.  But it is not in attempt to validate what was ultimately a poor decision that set me back somewhere in the neighborhood of six figures.  I've written before how impactful my education experience was, especially my time in higher ed.  It was certainly an expensive endeavor, but one that I feel has paid off in dividends far beyond the actual sticker price of the school. 

This is not to say that if I had a chance to do it all over again I wouldn't do things a least a little bit different.  Maybe I would have picked a different major - English, maybe?  Then I could really call myself a writer.  I certainly look back on my four year experience in university and see mistakes that I made.  Like that time I drank an excessive amount of cheap vodka and passed out before 11pm.  It's those experiences that we learn from that help move us forward.  Maybe I would have spent more/less time in the Library - the actual one and/or the drinking establishment that went by that name.  We can always look back and say, "should've, could've, would've".  The visual acuity of hindsight is pretty undisputed.

So, it begs the question - for the content of this blog at least - five years later, if I had to choose to become a stay-at-home parent again, would I?  The answer is most certainly yes.  I've commented before on how when this "social experiment" is all said and done, there will likely be no part of me that regrets having had this opportunity to stay at home with my kids.  It's something I continue to believe is true, especially as I seem to be nearing the end of my tenure.  Sure there is a certain amount of confirmation bias in this response too.  You would be hard pressed to find many parents who would make the claim that they wasted the last five years of their life being the primary caregiver of their kids.  They are certainly out there, but they are a special breed.

This is not to say that if we were about to welcome a newborn into the world, something I am now physiologically incapable of assisting with, and I had the next five years ahead of me as a stay-at-home parent that I wouldn't do things a little different.  Above and beyond anything, being a stay-at-home parent has been a learning experience.  I've learned a lot about myself, and my kids, and my wife, and our familial relationship.  And sometimes the things I learn one day render themselves useless the following day, or the following hour.  I didn't have many expectations going into this gig, and I don't have many expectations coming out of it.  My main objective was primarily to keep the stress level low, and things relatively congenial in our day to day operations.  In that regard, I feel like I've mostly succeeded.  Again, the key is to set the bar pretty low.

The last few years have certainly been a rollercoaster of high highs and at times some pretty low lows.  But so far, no one has fallen off the ride and we haven't had any mechanical failures that weren't ultimately fixable.  Life, especially life with kids, can have a tendency to resemble an amusement park at times.  Equal parts exciting and fun, while also terrifying and exhausting.  And always more foods made solely from sugar than are reasonably necessary.  And usually insanely expensive.  Having had the opportunity to be at home with our kids, I feel like I've been better able to regulate what "life amusement park attractions" my kids have experienced.  I've also been able to pack bologna sandwiches - something my Mom always did when we made our occasional trips to Valleyfair.

If there is one thing in particular that I've learned from a "professional development" standpoint during my five year tenure as a stay-at-home parent, is that as parents we're all about the same level of clueless when it comes to trying to raise our kids.  If you prefer the Tom Cochrane "Life is a Highway" metaphor, it's like we're all trying to navigate the same road of family life.  But we have no idea exactly where we are going, how long that trip is going to take, and how often we will need to stop for bathroom breaks.  We're all traveling at different speeds but ultimately navigating the same general twists and turns (medical emergencies, financial ruin, teens in puberty) and mundane straightaways (sitting through another dance recital/soccer match/game of Guess Who).  And we're all driving different vehicles; some of us in Mazda Miatas, some in oversized SUVs, and the rest of us in Dodge Caravans.

One thing that I've noticed, as our society has become both more connected and simultaneously isolated at the same time, is this general attitude that we think we can figure things out on our own, and assume others can do the same.  When I see a vehicle pulled over on the side of the road, I often wonder if I should stop and offer assistance.  But then I assume that the driver probably has a cell phone and can just call someone they know for help, or a look up the number for a tow truck.  Plus I typically have one or more young passengers with me, and I have to consider the chances that the person pulled over might actually be a serial killer.  Safety first, right?

To a certain degree, I think this attitude has permeated other areas of our lives, and parenting in particular.  As a parent, it can be easy to look at other parents and believe that they have everything figured out, while you are subsequently hanging on by a thread.  By and large, we know that is likely a facade - the "social media being a window in the lives we want others to think we are living" phenomenon.  And even though we know that everyone has their own shit they are dealing with, when it looks like they are doing a good job of dealing with that shit, it makes us wonder why we can't handle our own shit with similar success (sorry for the profanity, Mom).

A few months ago, my wife and I took trip to Greece to celebrate our 10 year wedding anniversary - you may recall our actual anniversary was relatively tame.  We had a phenomenal week and a half enjoying the blue Mediterranean waters, an abundance of delicious Greek food and wine, and not having offspring to look after.  Given that this was our first international trip without kids, I found myself observing families occasionally, particularly during the time when we were actually traveling.  Watching these families travel with young children made me glad I was not doing the same.  But I also found myself taking note of how parents of different cultures navigate the "opportunities" that have a tendency to arise when children are thrust into rather inhospitable situations - air travel, city buses, etc.

What I took away from those observations was that at the end of the day, we're all trying to get to the same place.  Presumably to bed, in one piece, with the prospect of a tomorrow - and hopefully a better one.  Sure there are some best practices when it comes to life in general, and parenting in particular, but ultimately we choose our own adventure on how to get there.  Hopefully we all have the capacity and ability to make the decisions related to our own personal well being to live the life we ultimately want to, uncontrollable circumstances notwithstanding.  Or, in the parenting spectrum in particular, to again quote our old daycare provider, "You gotta do what you gotta do to be the parent you want to be."

I try to keep this perspective when I struggle to find fulfillment in day to day activities that can make me feel like a volunteer Uber driver or Instacart delivery person for my children.  I recently got together with a friend who just started his own stay-at-home tenure, and he quipped about his realization that lowering his standards was ultimately going to make him happier.  Happier with the things he felt he could accomplish as a parent, and happier with how he navigated the various curveballs that life threw at him.  But as Ruth Whippman suggests in her book, America the Anxious, part of keeping our sanity, especially as parents, may be recognizing that so much of our happiness depends on factors that are outside of our control.  When we are faced with those factors, we can't have high expectations, or any for that matter, and have little choice but to just "wing it".

There is safety in numbers though, and this is why we have each other.  The village that it takes to raise the next generation of the world's leaders or tech coders.  Those who are just getting into the business of procreation can certainly look to the elders who have been down that road before, for guidance on what and and most certainly what not to do, but would ultimately do it all over again if given the chance.  Of course we "elders" know quite well that the chance of us actually being in that situation ever again is incredibly slim.  As our kids have grown, and our oldest recently celebrated her ninth birthday, I know the time is coming sooner than later when I will get nostalgic for the days that were a whirlwind of mac and cheese, slime and dance class, when the main objective was just get through the day.

Having spent the last 5+ years at home with my kids, one could argue that I should be getting close to completing my PhD in parenting, if such a thing existed.  With dreaded fellowships and internships to naturally follow during my kids' adolescence.  At this point, I've probably already been approved for tenure whether I want it or not.  If there is one thing I could conceivably claim any sort of expertise in, it's being able to make it to the end of the day while keeping things interesting along the way.  But in the end, that's kind of all that matters.

     

                   

*I don't think I've actually ever told anyone I was a writer.  It's more of a pretend occupation I give myself.

^I think "emerging adult" is how that age cohort is referred to these days.

Doctor, Doctor, Give Me the News

On Why I Think Our Healthcare Costs So Much

A few weeks ago we made our final payment on the hospital bill from our son's visit to the local emergency room from May of 2018.  After a year of conversations with representatives from the hospital, other medical providers the hospital contracts with, our insurance company, and even our state's Attorney General office, we can finally put the matter behind us.  However, thinking about the entire experience continues to bring me unparalleled levels of frustration, and in my view indicative of why so many consider the healthcare system in the United States to be "broken".  And I wouldn't even consider our case to be particularly traumatic, especially given stories of what other people, and families, have had to go through in attempting to navigate the convoluted waters of medical billing.  

During my wife's benefit open enrollment in December of 2017, we decided to switch our health insurance to a high deductible plan with an attached health savings account.  We were done having kids (as previously discussed) and hadn't been to the doctor much in the past few years beyond our annual check-ups.  We figured what we might pay out of pocket for our few prescriptions and any unexpected doctor visits could be covered by the savings we would get from lower premiums and contributions to our HSA.  Of course we should have anticipated that making such a change would result in unanticipated trips to the doctor for a variety of things.  The most significant being a trip to the ER with our son.

I'll refrain from publicly calling out the health care organization whose medical facilities we typically use, but if you know where we live, you can likely connect the dots.  If you live in the same area, odds are high you utilize their services too, as we don't have many options, despite living in a metropolitan area of 200,000 people.  This is not to say that we've been dissatisfied with the service that we've received when seeing medical providers who practice under this particular organization.  We've always been impressed with the level of care the medical providers have given us, and particularly our children.  I've commented before that I'm tempted to write our children's pediatrician into our will.  Unfortunately, the experience of dealing with the financial side of providing that care has underscored how even our local health care organization contributes to the "broken" system so many people bemoan, while undermining the work of the dedicated professionals who actually provide care.

The whole reason our son ended up at the ER wasn't even a particularly exciting story.  He sustained a cut under his eye following a scooter injury.  And it wasn't even an epic fall, which one could have expected given how he had taken to flying around on that thing, given us mild panic attacks at times.  Instead, while he was attempting to turn around, his feet got tangled up in the scooter and he fell to the ground, with the end of the handlebar catching him right under the eye.  He was even wearing his helmet, since I'm not a completely negligent parent.

Initially, I even questioned if I should bring him in to get checked out.  He was awake and coherent.  The blood from the cut seemed to be stopping, and the sympathy cries from his older sister were actually louder than his own.  Like any good 21st century parent, I naturally hopped on WebMD to see what anonymous medical professionals from the internet suggested.  It seemed apparent that stitches would be a likely scenario if I took him in, but my research informed me that the main purpose of stitches was cosmetic.  Considering our new health insurance plan, and how much stitches might possibly cost, I pondered if it would really be worth it.  The more I read though, the more I feared the location of the cut might impact his vision.  A scar I could live with, compromising my son's vision because I was concerned about how much it might cost was something else.

So I opted to take him in^, his sobbing sister in tow.  But in effort to keep the cost of the trip as reasonable as possible, I decided to start with the pediatric walk-in clinic, which treated kids for a variety of things, minor lacerations included.  And when the pediatrician in the walk-in clinic recommended that we take him to the Emergency Room to be evaluated, I think he could sense my hesitation as he reiterated that they would be best able to look for damage to his eye sight, and that we should take him now - not tomorrow or whenever our next monthly contribution to our HSA was made.  

We would like to think that the potential cost of care would not make us reluctant to bring our kids in to be seen for illness or injury, but it certainly plays a factor.  There are countless stories of people forgoing care for themselves or their kids because of the anticipated costs of that care.  Even my wife, herself a medical provider who would do everything possible to ensure our kid's health and safety, including sacrificing her own well being (or more likely her husband's), rhetorically wondered aloud how much a trip to the ER was going to cost us.

Initially we thought we might come out "not bad".  One of the most frustrating things about health care in the US is that there is little transparency in the pricing.  Under a new rule from the Center for Medicare and Medicaid Services, hospitals are supposed to post their pricing online*, and as I've learned from our state Attorney General's Office, patients can request an estimate of what a procedure will cost before consenting to it.  Something to consider next time you are wheeled into the ER while bleeding profusely.  We anticipated that any trip to the ER would be expensive, especially given our high deductible, but when the doctor looked at our son, determined that he didn't need any further attention - no stitches or evals for potential head injury - and promptly discharged him, we figured it wouldn't be "as expensive".  Even though we really had no idea how much "expensive" and "not as expensive" would actually be.

We were about to find out though, as upon bringing our son back to the car, he threw up all over himself.  This sent my wife back into the ER with him to be readmitted (I had to head home with his sister to ensure his other sister wouldn't get off the bus from school to an empty house).  This time they suggested a CT Scan to check for possible head trauma.  Whether the doctor sensed any hesitation from my wife - based on the fact that CT scans emit some amounts of radiation or because they just sound expensive - he assured her that he would do the same for his own child.  Luckily the imaging came back negative, and when he was eventually discharged, we felt confident knowing that he would make a full recovery after being treated by competent and compassion providers.

Then the bills came.  I've read quite a bit about the current state of health care in the US, but I was still a little surprised when the first bill we got for our ER trip came not from the hospital, but an emergency physicians association.  When another bill came, again not from the hospital but from a regional radiology clinic, I realized that our local hospital, like many others throughout the US, contracts out a variety of its services.  Calls to the billing office at the hospital and these other entities, as well as our insurance, confirmed that this was the case.  When I pressed as to why the billing was done this way, each entity acknowledged that the process could be better streamlined, but indicated that billing in such a manner was "industry standard".

So when the bill from the hospital finally came, I was a little confused to see two charges for things that looked similar to what the other bills I had already; an emergency room charge and a radiology charge.  When I asked for a more detailed bill, I received one that now had three charges; two for emergency room fees (since he had been admitted twice) and one for the CT Scan.  When I informed a not-so-friendly patient financial services representative that I was having a hard time understanding our bill and didn't feel comfortable paying it, she told me to follow up with the medical records office - a process that takes 4-6 weeks to get medical records released.  When the records finally came, they provided an insightful, and at times humorous, narrative into the treatment our son received, but didn't shed any light on how that treatment translated into the charges on our bill.  Another not-so-friendly patient financial services representative (maybe it was the same one) made it clear that the bills we received from the hospital were the most detailed that they could send us, and we would have to decide if we felt the amount we were charged seemed reasonable.

While this process played out, I did some research.  I found out that the CT Scan they performed cost about 20% of the price the hospital negotiated with the insurance company - the cost we were being asked to pay in full because of the health plan we had, and because we had not hit our (astronomical) deductible.  I also found out that had we been uninsured, we would have been given a 40% discount on that price.  I also found out that it is considered insurance fraud, and subsequently illegal, to claim that you don't have insurance in effort to receive that discount.  And while the price comparison might not be exact, I also learned that a local imaging clinic would have charged us about 25% of what the hospital charged for the CT Scan, with the reading of that scan included.

Now, I know what you are thinking.  But there has to be a mark-up on a procedure, how else can they operate their facility.  Plus you went to the ER, the most expensive place to get care.  You can't really compare prices of a CT Scan at an ER with that of a scan at an imaging clinic.  Valid points.  But, given that there is no where else to compare your pricing, and only one ER in a 30 mile radius, that is where one would have to look to try to understand if they are being reasonably charged.  Couple this with the fact that the hospital is already charging an ER facility fee, and the doctor fees and radiology reading fees are billed separately, it doesn't seem like the procedure cost should be that much more expensive.  Yes, I would expect a mark-up, but a 5 time mark-up on a vulnerable audience, that seems, in the words of the medical director of the very ER we visited, "criminal".           

Now, I also know what you are thinking.  But that is the insurance plan you signed up for.  If you paid higher premiums, you'd have better coverage, and you wouldn't have to pay the full cost of the care.  Again, a valid point.  But this, in my view, is big part of why I think healthcare is so expensive in our country.  Even if I am not paying that amount out of pocket, I am paying for my insurance company to pay that amount for the procedure.  My insurance company can in turn, raise my premiums in subsequent years and reduce my benefits, as they typically do year after year, to cover the cost of this care.  If a procedure cost seems excessive to me, given what it costs a medical facility to do and given what you could potentially pay elsewhere, or what the facility would accept if you were uninsured (and presumably unable to pay full price or afford insurance), then I would hope it would seem excessive to my insurance company, who is supposed to be "negotiating in good faith" with medical providers on behalf of their customers.

What this boils down to is that once someone pays to much for healthcare, we all pay too much for healthcare.  Once an insurance company agrees to reimburse a certain amount for something, that sets the standard for what the procedure will cost, regardless of what insurance you do, or do not have.  And while we might paying varying out of pocket prices for that procedure, we all inevitably pay full price for that procedure.  Even when a facility offers a significant discount to someone who is uninsured, or is forced to accept a significantly lower reimbursement from Medicare or Medicaid, that cost is eventually dispersed amongst the remaining healthcare consumers, which is all of us.

I eventually paid the hospital bill.  But not all of it.  Taking the advice of one of those not-so-friendly Patient Financial Services Representatives, I made a payment of what I thought was reasonable, given the care our son received and the price of that care relative to its cost, and what seemed to me to be reasonable comparisons.  I agreed to pay what an uninsured patient would pay for the CT Scan -essentially the cash price, along with one of the ER Facility Fees#.  This came out to be about 60% of what our final bill was.  With my payment, I included a three page letter on why I believed that amount to be sufficient, and informed the hospital I would be happy to speak with someone if they did not agree with my explanation.  They processed my payment and I heard nothing from them, so I considered the matter closed.

Then I kept getting bills.  I followed up with them again.  Did they not see the letter?  Hard to assume given that my payment was wrapped up inside it.  A friendlier-than-the-last person I spoke with in Patient Financial Services indicated that there was no indication of them receiving the letter, and subsequently reading it.  So I sent it again (I should have been taking off money for postage by this point).  And then sent it again to someone in the Patient Advocacy Office, as well the Vice President for Billing, who might have read it (but it didn't seem like), but assured me that their billing procedures are accurate and I would continue to get bills until it ultimately went to collections.

Eventually I reached out to the Minnesota Attorney General's Office, a suggestion unknowingly made by someone in the hospitals Patient Advocacy Office (it was through that office, that I learned about the uninsured discount).  After a cordial, but relatively unproductive conversation, a representative from the AG's office contacted the hospital on my behalf, and we essentially repeated the negotiation process over the next few months, this time with him as an intermediary.  Eventually, the hospital offered to apply the self-insured discount for the remaining balance of the bill, bringing it down another 40%.  By this point I was ready to have the process behind us, and we paid the balance - no lengthy protest letters.

While this could be considered a (small) win for me personally, it likely won't provide any benefit to others who find themselves in a similar situation.  If the hospital is only willing to bill a (somewhat) more reasonable price when people challenge that price (rather extensively), it will have little effective on making health care billing more transparent and ultimately more affordable in my view.  I momentarily contemplated allowing the hospital to take me to collections, or maybe even sue me to collect the balance (as some hospitals have started to do to their own employees who can't pay their medical bills), but I knew the odds of any significant change coming about by my protests would be minimal (and likely much more costly on my end).  I also contemplated, despite all of my protests, just paying the full balance of the original bill as a kind of "reverse middle finger".

So to (finally) get to the point of my subheading, this is why I think healthcare in the US is so expensive.  Because it can be and we allow it to.  And the only way that we can push back against it is to be the problem customers who complain and challenge when bills seem excessive, which they typically always do.  This is not to say that providing healthcare isn't an expensive endeavor, or that we should expect life saving procedures to cost next to nothing.  But for a vast majority of our medical needs (and specifically needs as opposed to wants), we are beholden to what medical providers charge - and often times the people who are actually providing the physical care have little to no idea how much the services they are providing actually cost.  When we question charges, we assured that everything was billed correctly, which makes perfect sense, given that the people in that very office are the ones who determine what the cost will be.

I don't have a magic answer on how to make healthcare more affordable, or more effective, in this country.  And apparently no one else really does either, particularly the health care execs who are supposed to be the "experts".  But like a lot of things we gripe about, certain changes have to start with us.  As a whole, we don't do a very good job taking care of ourselves.  There is little coincidence that some of the top causes of death in the US are largely seen as preventable- heart diseases, certain cancers, diabetes, etc.  We have also created an environment that precipitates a decline in well being, while doing little to incentivize people to live healthier lifestyles.  As I mentioned in the midst of an intense, and somewhat alcohol fueled, discussion on healthcare this past weekend, no matter how healthy you try to be, your healthcare will always get more expensive.

But it is also up to us to push back on excessive charges and to demand transparency.  At times this might cause people to question our commitment to our health, or that of our loved ones.  However, there is a cost to the care that is provided, and just knowing that that care is going to be expensive, and possibly unaffordable, even with insurance, can lead to people rationing care for themselves or their loved ones as a consequence.  If it seems cold to inquire about the cost of a procedure for yourself or your child, and wonder about the necessity of that procedure, before it being done, than should we not be able to scrutinize those charges after we get them, at times months after the fact?  We shouldn't have to submit our excessive medical bills to media outlets in hopes that a public airing of those charges will result in a hospital drastically adjusting the bill.

Ultimately, I would like us to get to a point where people can get the care that they, or their loved ones need, without needing to worry about the financial consequences.  We should also allow medical professionals to provide the care that is necessary to help their patients without being concerned on how they will be compensated for that care.  We shouldn't live in a country where the number one reason people go bankrupt is related to a medical issue.  Nor should we live in a country where doctors commit suicide at double the rate of the rest of the public.  I believe that people would much rather be healthy, and would prefer avoiding receiving medical care as much as possible.  But this does not mean that they should avoid receiving it when they need it because they cannot afford it.

Does this sound like free health care for all, as one of my weekend conversation partners suggested?  Not necessarily.  We already spend so much per person on health care in the US that some argue we could cover the cost of care for most everyone, especially since a vast majority of those dollars are spent on a small number people.  Does that mean a more regulated system, that democratizes care across all Americans, regardless of their income levels?  Probably.  Does it mean health care rationing?  Possibly, but as we know, that already happens in our current system.  Does it sound expensive?  Absolutely, but so is our current system, and it certainly doesn't show any signs of getting better.

As parents we want our kids to be healthy.  We know we can't shield them from all pain, nor should we necessarily want to.  But when they get hurt, if it seems serious enough for them to be seen by a medical professional, we shouldn't feel hesitation because we are concerned about the cost.  When a trained medical professional suggests a certain type of treatment, we shouldn't have to contemplate what impact that might have on our finances.  Or when we see our health insurance premiums rise year after year, while our benefits dwindle, we shouldn't wonder how that might effect our ability to put food on the table. 

I don't have the answers, but I know those scenarios, which many of us have likely been in, are not the ones that we want.  Until those scenarios no longer exist, I will continue to advocate for more effective and affordable care for myself and my loved ones, and I will challenge and push back when I believe that is not the case.  I would encourage you to do the same.

I think his pride (what little a 4 y/o has) was hurt the more than anything else.
While he was very anti-selfie for the next few weeks, he was back on the scooter the next day.

Thanks for staying with it.  I know it got long.  I've read a lot (probably too much) about health care.  If you'd like to do the same, here are some additional resources I'd recommend. 

Catastrophic Care by David Goldhill 

An American Sickness by Elisabeth Rosenthal

If Our Bodies Could Talk by James Hamblin

Shots - Health News by NPR

VoxCare - Vox's Health Care Newsletter - Anything by Sarah Kliff (now with the NYT) or Ezra Klein is particularly insightful

Kaiser Family Foundation

               

^When you have a sick or injured child, "taking them in" tends to become shorthand for bringing them to be seen by a trained medical professional

*This came into effect at the start of 2019, so it wouldn't have helped us in May of 2018 for our particular visit.  I did find the information on hospitals website though, and the price list for procedures looks as though it was basically lifted from a medical coding textbook.  I challenged representatives in the Billing Office of the hospital to point out on the list what procedure our son had undergone.  I never got a response.

#The Emergency Physicians Association that provides the doctors for this particular ER had a policy of not billing for multiple ER visits in a given day.  This seemed to make sense to me, and I figured if the doctors the hospital contracted with did this, the actual hospital should do it to.   

Running Down a Dream

He's Going the Distance

If you are an occasional reader of this blog or know me personally, you may know that I am not one to shy away from masochism.  About three years ago, I wrote about how four years prior to that I was in the midst of training for a marathon.  It was my second foray into such stupidity as I had barely finished my first seven years prior to that, and promptly swore I would never attempt another.  Well, the seven year itch struck again, and this past fall I found myself clicking the submit button on an online registration for a 50 mile endurance run.  Yep, I figured if I'd already finished two marathons, albeit seven years apart, the next logical thing to do would be to attempt to run almost two full marathons in one sitting (or standing, or mostly death marching as they call it in the ultra world).

Attempting an ultramarathon had been on my list of things to do for a while.  I originally thought I could just jump into a 100 miler (arguably the standard distance when someone mumbles "ultra"), but sensibly figured a 50 would be a good place to start.   Recognizing that I am certainly not getting "Younger Next Year" (despite the title of the most recent book I read) and given that our youngest started a few mornings of preschool this past fall, giving me about five hours of "free" training time during the week, I figured there was no time like the present.  I had also watched/read some pretty inspiring documentaries/books (listed at the bottom), which confirmed that I was sufficiently crazy enough to drop a couple of Benjamins on a race entry and all subsequent supplies.

As an avid runner for the past 21+ years, I've come to appreciate the act of running for the role it plays in my life.  I wouldn't say I love running, but I love the way I feel after a good run.  I love how it challenges me but allows me a certain amount of release at the same time.  Running has become as beneficial for my emotional health as it has for my physical health.  While I haven't always actively trained for a particular run or race, I've also found it important to carve out some time to run a few days a week.  It makes me a better person.  I also love how running long distances allows me (questionable) justification to eat whatever I want with relative reckless abandon.

Naturally, training for an ultramarathon took an excessive amount of time.  The five hours of kidless time each week obviously wasn't going to be a sufficient amount of training time, no matter how many "Low Mileage Ultramarathon Training Plans" I Googled.  In reality, the training wasn't significantly different than training for a marathon, with the exception of what is commonly referred to as the "block run".  This usually means instead of doing your typical long run once a week like you would for marathon training, you do that long run, and then do it again (or as much as you can handle) the next day.  The premise of the training is that you should never run the full amount of your ultra, but you should get pretty close over the course of two days.  Training for a marathon, and especially an ultra, becomes essentially a part time job, and you start to wonder what other things you could have been doing with that time.

It can certainly be hard to justify taking that amount of time to engage in any particular pursuit, especially if you have a family that is feeling the brunt of your training.  I knew though that the training would be temporary, and the run itself would eventually come and go.  As a good friend, and decorated ultrarunner counseled me, you have to make sure your family is on board, because the training will take a lot out of you, and it will dictate a big chunk of your life.  My wife, as you all know, is amazing and selfless and tolerates most of my bullshit, and the kids seemed rather apathetic to the notion of dad running excessive distances.  They actually learned during my training that it probably worked to their advantage, as my need to try and get in a midweek run often meant some quality time for them with their favorite babysitter - the television.  I found turning on the TV for them if I was going to spend some time on the treadmill was significantly easier to justify than most of the other reasons I turn the TV on for them - all of which revolve around my laziness.

 So after six months of pounding the pavement, and the trails (and the occasional dreadmill), I was excitedly anticipating the run while also looking forward to the end of my training.  I wrapped up my training with the longest run/jog/walk I'd ever completed in my life, all on muddy and snow covered trails and a third of it in relatively terrifying darkness, and was ready for my taper - which included four kidless days with my wife in New Orleans for a friend's wedding.  As the run itself approach, I did my best to stay busy by preparing race logistics and marveled at how a few consecutive days of not running was actually diminishing the constant soreness in my legs.  It felt like I was actually get the bounce back in my step.  Just as I was as ready to become a dad I was was going get on November, 19, 2010, I was as ready as I was going to get for a 50 mile run.

And then the Minnesota winter scoffed at all of us, and especially the 900+ runners who signed up for one of the Zumbro runs.  Comparable to 2018, which resulted in the cancellation of the 17 mile run of the Zumbro, an April blizzard descended onto most of the state of Minnesota, and the race directors, after much consideration and deliberation, made the decision to cancel all three of the Zumbro races (100, 50 & 17) out of concern for the runners and volunteers.  Six months of training, 500+ miles of running, millions of calories burned (and probably more consumed), and no actual race to run.  Obviously I was disappointed, but given that the weather was the cause of the cancellation, and not my decision to pull out because of injury or anxiety, made it a little easier to take.  The race director detailed the thoughtful and difficult decision to cancel the run in a lengthy email explanation, and we still got the race shirts, which I wore for a week straight*.

Of course I didn't feel like the training went to waste.  One of my biggest fears about getting old is losing the ability to engage in the pursuits that I love, or ones that I mildly enjoy and know are good for me.  The most recent book I read, Younger Next Year, stresses the importance of engaging in physical activity nearly every day if you want to live a good long and health life.  The authors see the art of aging as choosing to grow, by being vigilant about your health through exercise and healthy eating, or decay.  We can't stop the fact that we will get older, but we can continue to do the things we enjoyed doing in our younger years if we commit to actively pursuing a healthy lifestyle.

My kids have certainly added some extra motivation for trying to remain physically capable.  As they've gotten older, it has been fun to engage in some of the various recreational activities I really enjoy doing, and watching them starting to "get it".  It makes me excited for the time in the not so distant future; when we can play catch in the backyard, hit the tennis ball or play some one on one hoops at the courts, follow each other through the trees on the double black diamonds, etc.  Secretly, I have a (like unattainable) goal to always be BFS (bigger, faster stronger) than our kids.  And not just for a sense of vanity - I've long given up on any pursuit toward six pack abs (to my wife's chagrin).  But more out of a desire to hopefully always be able to keep up with them, and maybe push them a little.  I will obviously always be their "old man", but I don't necessarily have to play like one - at least when it comes to being active.

I've also discussed in the past what I think is an important part of modeling healthy behaviors, and how I feel it is important for my kids to see me doing things that I enjoy and at times struggle with.  I hope this shows them a small amount of hard work and dedication to things that they are passionate about and find joy in doing is most certainly worthwhile.  If they gravitate toward being runners (and I hope they do), or any of the other leisure pursuits I really enjoy (of which there are many), that's great.  But I will let them find their own path.  Should they ever want to run a marathon and need a pacer, I want to be ready and up for the task, no matter my age.  Now that our four year old recently learned how to ride his bike without training wheels, I'm already plotting routes for our family cross country bike trip (pedal bike).

So that is why I at times put my own body through the ringer - to try and stay healthy so I can keep up with the kids and hopefully live a long life, while also trying to model some healthy behaviors of engaging in things that I love.  I recognize that it takes some time and commitment, and that might mean spending a little less time with them to engage in the things that bring me joy.  But I figure if I take the time now to stay healthy and happy, I will hopefully have more time with them in the future, and more quality time when I can actively be a part of their lives and share in the pursuits that bring them joy.

Will I attempt another ultramarathon?  Maybe.  Maybe not.  After my race was cancelled, I realized that after all of my training, I was pretty certain I could have completed 50 miles.  It might not have been pretty, and I likely wouldn't have finished in the arbitrary time goal that I set for myself.  But just knowing that I could have willed myself through it was an accomplishment enough - not to forget about the number of miles I logged over the six months, or the fact that I actually completed a couple of ultramarathons during my training^.  For now I've been taking a little running break.  Enjoying some additional quality time with the family, and tamping down a little bit on the kids' screen time (just a little).

I believe that whenever we try to better ourselves - whether through improving our physical health, mental or emotional health, or even our financial health - those attempts are never in vain, no matter if we reach our intended goal or not.  We always learn something along the way, and for those of us who are parents, things we can pass along to our kids - hard work, perseverance, band-aids over the nipples, etc.  For our kids to see us try, and either succeed, fail or not be able to complete our goal due to extenuating circumstances, and observe how we respond to that outcome can be a powerful motivator for them.  It may encourage them to try and make their dreams be more than just dreams.

Picture taken immediately following Isla and my first ever daughter-father run. 
It was 2 mile glow run of which she ran almost half (impressive for a 4 y/o).
We walked a bit and I piggybacked her occasionally

*It's not uncommon for me to wear shirts, or other clothes for a week at a time.

^Technically, an "ultra" is considered anything longer than 26.2 miles.  During my training, I did 30 and 34 mile runs/walks/jogs/death marches - neither were glamorous, but I was at least able to walk the following day.                   

Inspirational Readings/Viewings on Ultrarunning & Other Nonsense

Print

Born To Run - Christopher McDougall

Eat and Run - Scott Jurek

Ultramarathon Man - Dean Karnazes

Mindful Running - Mackenzie L. Havey

My Year of Running Dangerously - Tom Foreman

What Doesn't Kill Us - Scott Carney


Film

"The Barkley's Marathon - The Race That Eats It's Young"

"The Barkely's Marathon - Where Dreams Go to Die"

"How To Run 100 Miles"

"Breaking 2"

"The Rise of the Sufferfests"