Caring for Patients: Women’s History Month and International Women’s Day

March is Women’s History Month and the theme is “Celebrating Women of Character, Courage, and Commitment. “   March 8, was Internal Women’s Day.  The theme was “Inspiring Change.”  Many of my patients would say to me “Thank you taking such good care of me, but I worry about who takes care of you? “ I have thought about that over the years,

The answer to that question is not so easy to elucidate.  I started to reflect and I realized it is the women that I have in my life who care for me and inspire me. Not just one but all of them.  It started with my mother who has always had a sixth sense and always calls at just the right time.  She could look into my eyes and know I was not feeling well. Through high school, college and medical school she was my greatest supporter but also never stop reminding me that she “expected better from me.” That was because I was the oldest child. Not only was my mother there for me but all my aunts.  I had four mothers. The biggest supporter was my grandmother who always made me feel special.  However, she loved all of us the same.  This was evident when she handed out praise or discipline.

My sisters are great.  They have always thought I was the smart one.  However, I think my sister Kathy is the smartest.  She has fixed ripped seams, hemmed and sewn dresses, designed curtains and just been there with her laughter and positive outlook.  She recently finished her degree.  Her goal is to start a program to help students get prepared for college and the workforce. She never has a harsh word or thought for anyone.

In school, I had committed teachers who recognized I was a step ahead.  It started in first grade.  I recently saw my second grade teacher.  She was still so sweet and filled with prasie.  Until 5th grade, I went to a segregated school.  My sixth grade teacher could have ignored me but she made sure, that I was placed in the honors program for seventh and eighth grade. I was always an avid reader but that program expanded my skills.  Her support was instrumental in my success in high school.

It was my first HS English teacher that pushed me the most. She fearlessly challenged me to write better and read more.  This was despite taking all those math and science courses.  She forced me to put pen to paper and graded my work honestly. I dreaded but learned to rise to the challenge of that “red pen.”  My initial papers were hemorrhaging red ink.  My challenge was to decrease the amount of bleeding.

I had my host of friends in HS. They were there when I lost the race for Student Body President.  One of them became my roommate in college. It broke my heart when she left school to get married.  My next roommate was also wonderful.  When I go home, I still get together with several of my friends from college. We always went to parties together and our rule was “We came together, we leave together.” That kept us all safe.

My best friend from medical school is still my best friend.  She is an OB/GYN.  We have supported each other through many stormy times. She offered to whisk me away on the morning of my first wedding.  She knew what I would later learn; it was not what was right for me at that time. However, there were no hard feelings.

In residency I met my other long-time friend, she is a family physician.  She called me once a week.  For years, we met twice a year at medical conferences to catch-up.  She was an exercise fanatic and I stayed in shape so I could keep up with her.  She is ten years older and still looks great.  When her father died, I was in Maryland.  We could not get up for the funeral. So we all went to see “Having Our Say”, the remarkable play about the Delaney sisters, when I finally could get to see her and her mother.

My late friend who was a Cardiologist adopted me while I lived in Maryland.  We would make shopping trips to the Nordstrom for the Half-Yearly Sale. We would take a Friday off and have a blast.  She taught me about fine cooking and how to write a consultation.  After her help, I received praise from a doctor at Johns Hopkins when I referred a patient.  When he sent me a consultation note, he began by thanking me for the most thorough letter he had received in years.

All these great women were there for me. They are in my yoga class, my female col leagues, former residents and my new friends.  Most important over the past 30 years, it has been my husband who has been there and since we met, has had a positive approval rating from all these women.  He once said “he never worried where I was because he always knew I was in good company.”  He meant all my friends.

I want to thank all the wonderful and courageous women who have been and still are in my life.  They have taught me to be passionate, courageous, and serve others with humility and compassion.

Caring for Patients: Watching “Silver Linings Playbook”

I know you may think it is old news but I just saw “Silver Linings Playbook.”  It was beautifully acted by the entire cast.  Seeing the movie also highlighted the problems with our present mental health system.  Parents frustrated, loving, scared and in the end supportive.  Their son struggling with his illness, in denial but finally realizing he needs to take his medication and see his psychiatrist.  I loved the ending. Pat had a supportive psychiatrist and family.

Mental Health Care took a dramatic turn in the 80’s when Jimmy Carter was not re-elected and Ronald Reagan won.  This article in Salon Ronald Reagan’s shameful legacy: Violence, the homeless, mental illness “ is an enlightening piece about what happened after Reagan took office. Carter had signed the Mental Health Systems Act, which had proposed to continue the federal community mental health centers (CMHC).  When Reagan and the Republicans came into office in 1981, the bill was discarded and all the funds for the CMHC dried up. Also, we started to close down mental health hospitals.  This meant patients once hospitalized had no place to go. When I was in Maryland, many of my patients lived in the board and care facilities in the community.  These patients had been housed in the State Mental Hospital.  They each had a case manager who accompanied them to their appointments and monitored compliance with medication.  According to a report from the Treatment Advocacy Center (http://www.treatmentadvocacycenter.org/index.php), in 2005 there were 17 public psychiatric beds available per 100,000 population compared to 340 per 100,000 in 1955. This represents a 95 percent reduction of available beds from 1955 to 2005 and this explains why severely mentally ill patients have few treatment options.

My patients were part of this change in mental health care and were for me not a challenge to care for. I was responsible for treating their high blood pressure, diabetes, doing the pap smears and ordering the mammograms.  I was their primary care doctor.   I had the schizophrenic female who had her hat stuffed with aluminum foil to prevent the signals from the aliens.  She heard voices but the medications controlled them. One patient spent the day walking back and forth across the town bridge but he was picked up at nightfall.  They were never homeless.  When they had setbacks, they went back to the hospital.  They were never incarcerated except for a brief period of time and then sent back to the State Mental Hospital.  One patient caused a scene in the local bank and threatened the teller.  He did not have a gun, the local police picked him up and he was readmitted. Another patient had an altercation with her landlord; she then barricaded herself in her apartment.  The police were called because she was screaming.  The officer called me to confirm she was not a threat to herself or others.  The door was knocked in and she was off to the hospital.

For a period of time, I was the medical consultant for the adolescent inpatient mental health unit.  I managed their medical conditions which included thyroid disease, medication side effects and broken bones. These kids were placed there because their parents were unable to care for them at home.  These adolescents were diagnosed and placed in a treatment program. Treatment included medication, daily therapy and school. Education was important. They had been expelled from school because of disruptive behavior but they were smart kids. The staff became surrogate parents helping each child cope with being there. Some often stressed over having to leave what became for them a safe place.  Each child had a story but it was obvious their parents needed help.  It was difficult for me. We had a session on why hitting the wall with your hand was a bad idea after the Emergency Room doctors said I had to do something about the number of visits for “Boxer’s Fractures.” This fracture of the knuckles of the index and little finger happens when you punch a wall or a jaw.

I remember openly discussing the patients I referred to local psychologists, therapists and psychiatrists.  Now, they go into a black hole and I am told by the clinicians they cannot tell me anything and I have to ask the patient.  I do not get updates on medications or changes in status.  The patient has to tell me. So, I understand the frustration the families face.  I watched the 60 Minutes interview of Virginia State Senator Creigh Deeds.  It was heartbreaking for me to watch knowing what a shortage of providers and resource we have for those who have mental health issues.  I have had to treat my patients who parents like him stressed with high blood pressure and uncontrolled other medical conditions exacerbated by stress.

We have to agree that these patients have a chronic medical condition that needs the same intense monitoring and treatment as diabetes and hypertension to prevent complications.  We need to remove the stigma and start to provide integrative services that allow sharing of information and coordination of care between all the care providers.

The new model is Integrated Care. It integrates mental healthcare and general healthcare. This model especially includes family members who are the care givers. Mental Health providers are more concerned about privacy and are critical of this model.  I see no difference between caring for a patient with Alzheimer’s disease.  What would happen if we told the family we can’t discuss the case without the patient’s permission or we can’t force the patient to take medication that would treat high blood pressure, agitation or aggressive behavior?

We must have a serious shift in our care model. Emergency Rooms are not the place to get medications adjusted. Jails and prisons are not equipped to provide long-term care for these patients. Parents are not equipped and should not have to risk harm to prevent their loved ones from being homeless or killed because they are off their medications.  I speak as a family member with a relative with a chronic mental health condition. It is not easy for the parents who have to talk with police or monitor medications.

Black History Month: Time to Appoint an African-American Female to the US Supreme Court

Black History Month for me was always special.  At our  school we had special programs and even better was all the programs we had at church each year.  There were the plays, poetry readings and guest speakers. The concerts featuring special music show cased the talents of so many including my sister.

Growing up my heroes were Barbara Jordan and Shirley Chisholm. I was in high school and college when they took their places in the Democratic Party and changed it forever.  So I really think it is time to make history and appoint and African-American female to the Supreme Court. The first African-American female Supreme Court appointee will be a special person. I often think she would have to be an incarnation of these two great women. Each woman would so eloquently pass the scrutiny of this Congress. Could you imagine either one of them face to face with the members of Congress.

Barbara Jordon

1976 DNC Keynote Address

Barbara Jordan was a lawyer and an educator who rose through the ranks and to my memory gave one of the best keynote speeches ever heard at any political convention. I was in my first year of college and getting ready to vote in my first election.  We had hoped she would be the  first black female to be appointed to the Carter Administration as US Attorney General but that did not happen.  It was a dream “deferred.”  Nevertheless, she went on to greatness.

Shirley Chisolm

Announcing her bid for the Presidency

Shirley Chisholm was another  trailblazing woman.  She was not a lawyer but an educator.  A great teacher and advocate for equal education and employment opportunities.  She went on to have a historic political career.  She awed us all by having the courage and commitment to run for president in 1972.  I was still just in high school.  She was passionate about her campaign and each speech rallied our support.  We all felt empowered by her eloquence and determination to make a difference.  Another “dream deferred.”

Now, other heroic African-American women have made their way through the ranks by doing excellent work and making a difference. They are waiting for the chance to courageously step forward. It is the time for one of these African-American females to take a seat on the Supreme Court. Leah Ward Sears, former justice on the Georgia Supreme Court, wrote that the ideal Supreme Court Justice should have a strong character, be a visionary and be a patriotic American. There are African-American women who have the courage and the sense of justice that is needed.

This is a significant moment in time and  President Obama has the once in a lifetime opportunity to fulfill those dreams and hopes that Barbara Jordan referred to at the 1976 Democratic National Convention and Shirley Chisholm expressed when she had the courage to run for president.  More importantly, these are the dreams and hopes of all those little girls who were empowered by two courageous women and who now are inspiring the next generation. Many of them are now in the position to step into history and help bring more diversity to the decisions to be handed down in the next few years.

Caring for Patients: It’s medical not political

Thanks to the Affordable Care Act we now have coverage for contraception under all insurance plans. There are some exceptions. The rants of Mike Huckabee and other politicians were very upsetting. I did like Carly Fiorina’s take on the issue “Men should stop talking about women’s issues”. This really should be an issue discussed in the privacy of an examination room with a woman and her health care provider. Taking care of women has taught me some lessons. Women want reliable contraception with few side effects to prevent an unintended pregnancy and have the freedom to enjoy a sexual encounter with their partner. It has nothing to do with controlling our libido. It is about not worrying about a missed period. Another lesson I have learned is that caring men want their partners to have a reliable contraceptive with few side effects. They do not want their partner to have to suffer. They do recognize that they have to take responsibility and use a condom if they have to and feel very upset if they fail. Many of these of these offensive remarks sound like comments I have heard from abusive partners over the years.

The CDC website states that psychological/emotional abuse can “include, but is not limited to, humiliating the victim, controlling what the victim can and cannot do, withholding information from the victim, deliberately doing something to make the victim feel diminished or embarrassed, isolating the victim from friends and family, and denying the victim access to money or other basic resources. It is considered psychological/emotional violence when there has been prior physical or sexual violence or prior threat of physical or sexual violence”. If this sounds familiar, it should make you as upset as I am. If you go back and listen to every statement made by the outspoken politicians of late, you find elements of this definition in their statements.

For me, starting the pill after my son was born made residency much easier. My husband was a pharmaceutical company sales representative. The company launched its low dose oral contraceptive pill and I started taking it in 1987. After a few weeks of morning nausea, I was fine. I learned to stop my period even before it was common place with the new extended cycle pills. I would not have period during my hospital rotation months, during my vacation or on my weekends off. When I finished residency and started my private medical practice, I continued regulating my period. I also managed to save many honeymoons and vacations by using this method for my many female patients. I never had a period because I was too busy seeing patients or being on call. That was my freedom.

Now there are the new extended cycle pills that are being used by more women. Many women are not using them because of the higher insurance cost. The ACA will change that. The hormone dose in these oral contraceptive pills is even lower; one pill has only 10 micrograms if estrogen compared to 30 micrograms back when I started. Not only are the pills lower in dose, the new IUD’s are called Intrauterine Contraception (IUC’s). There are two types. The copper IUC which is non-hormonal which lasts for up to ten years and hormone containing IUC which is effective for five to seven years. paragardParagard http://www.paragard.com/default.aspx mirena   http://mirena-us.com/ I really love the new FemCap which is an improved version of the diaphragm and cervical cap. It is non-hormonal. cervical capfemcap FemCap   http://www.femcap.com/ Another blast from the past is the new and improved contraceptive sponge. Renamed “Today Sponge.” We all remember the Seinfeld episodes with Elaine hoarding her supply of the Sponge. This is an over-the-counter product and not covered by insurance. spongehttp://todaysponge.com/

Access to reliable and affordable contraception is our right and is medically necessary. The medical facts are being dismissed as we have to listen to the political rhetoric and the hysteria. Contraception decreases the risk of unintended pregnancy for women. Worldwide, women do not have this freedom. Contraception can reduce child-birth related deaths worldwide. In Nigeria, women are waiting in lines to obtain contraception. The facts are that using contraception is a safe option.

We made the decision together to have only one child to add to my husband’s two children. Every woman should have that freedom. It just takes a few clicks to be informed.

Caring for Patients: Women and Poverty

I read the latest Shriver Report A Woman’s Nation Pushes Back from the Brink.  The statistics were not surprising to me. We have made great strides in some areas but only for a small percentage of women.  All my life, I have known personally the plight of women in America.  For me, it started at age 5, when my parents were divorced.  My mother was proud, independent and refused child support if it meant having to share custody with my father.  Women had few rights at that time. From that moment in 1962 she was a single mother with three girls and no outside income.  I was the oldest. So she went to work. We were fortunate to have the support of her family.  We first lived with my grandparents and later moved to our own home in the “Projects” or subsidized housing.  In between, we  shared a house with my uncle.  He worked nights and my mother worked days. My mother worked two jobs at times and so we never qualified for  free rent, food stamps or medical care.  It was not easy for her to accept any handouts.  She once tried to stand in line for free Christmas gifts  on her only day off.  She was successful but would never waste another Thursday that way again   At times she was frustrated  over the need to have her brothers co-sign for any loans she made because she had the better credit and always paid her bills on time.

She is from a long line of strong women in her family that started with my great-great-grandmother. They have shaped the person and physician I would later become.  They are a loving and caring group of women. They have cared for all of us in one way or the other and been paid care-givers at times.  I know they all worked for less money than they deserved. I too have had to face pay inequity.

We did not get health insurance until my mother could pay for it. So we received care from the Community Health Center and the Dental Clinic at the University of Alabama in Birmingham. I did not know how far below the poverty level we were until I applied for financial aid to attend college in 1974 and later medical school in 1978.  My mother made sure we had the best of what we needed and much of what we wanted. However, she taught patience and gratitude. These lessons would later serve me well.  As we look at the plight of women, divorce is one that causes significant loss of income for women and children. If fathers are not supportive, there is no support for college. I did qualify for federal loans and repaid them once I started earning an income.

Judy_grad5       Judy_grad_Res

High School Graduation                            Graduation from Residency

When I started my practice in 1990, a large percentage of my patients were women who worked every day but made too much to get Medicaid and food stamps and, whose employers did not provide health coverage.  If they worked and had health insurance, they were providing coverage for the entire family because their spouses worked for employers who did not provide health insurance.  Like my mother, many of them were divorced. Their children received needed vaccines under the Vaccine for Children Program (VFC) and they could qualify for the Breast and Cervical Cancer Early Detection Program (free pap smears and mammograms).  However, sick care was an out-of-pocket expense.  Their children could get sick care from the Health Department Clinic.  The Affordable Care Act will change this for women and children.  However, the real solution as pointed out in the report is to raise the minimum wage and to have equality in pay for women.  Another key point in the Shriver Report is that to improve the plight of women will make significant gains for men and children. Women are the primary wage earners in a large number of families where there are children.

One of my favorite quotes from Dr. Martin Luther King:

“The curse of poverty has no justification in our age. It is socially as cruel and blind as the practice of cannibalism at the dawn of civilization… The time has come for us to civilize ourselves by the total, direct and immediate abolition of poverty”.

I am a physician and it is  difficult for me not to support the ACA.  As a child of a single mother who overcame all the odds and made it possible for me to go to college and medical school, I have to support measures to raise the minimum wage and ensure equity in wages.

As we celebrate the Dr. King Holiday tomorrow, let’s recommit to serve others .

Get a Flu Shot!!! It’s not too late

If I was in charge, the Flu shot would be mandatory for everyone. Influenza is preventable and over the years, I have heard so many excuses that a few years ago, I just started saying to patients” That is not true. There is no evidence for that.” Not to be disrespectful but to start a more informed dialog about the benefits of getting a vaccine for a vaccine preventable illness.
FluWidgetMed_English
So, it is not perfect each year. So some people get the Flu even if they had the shot. The cases are low and that is not a valid reason to skip the shot. This year the shot does contain the most prevalent strains of the virus. The Flu shot must be administered each year because of changes in the virus. Each year the CDC and the World Health Organization (WHO) closely monitor the strains of virus present to decide which ones should be included in the flu vaccine. This vaccine can’t give you the flu. However, flu vaccine, like other vaccines, can occasionally cause a reaction. Feeling some response to the shot is not unusual. The best time to get vaccinated is October or November. Children getting a flu shot for the first time will need two doses given 30 days apart. The flu shot is not approved for use in children less than 6 months old.

In residency, I got the flu shot to prevent the risk of my toddler and patients getting Influenza from me. I was caring for a lot of sick patients between my AIDS patients, the nursing home and the Newborn Nursery. When I entered private practice, I started to make sure my patients received a Flu shot. It was not until 1993 that Medicare actually covered the cost of the vaccine. Recommendations have changed over the years and now the basic recommendation is that everyone should get a Flu shot.

I only had Influenza once which I believe was 1992 or 1993 in March of all the worse times to get it. It was one of those years when we had a late start to Flu season. I was so sick that I had to cancel patients. I took one of the older antiviral medications on the market at the time but stopped it because of the side effects. After that experience, I get a shot in September and again in January. I was the boss and I was paying for it so I had that option. I have not had it since. Of course, now I just get one well-timed shot. When I was director of a Prenatal Clinic, we encouraged our pregnant patients, their children and spouses to get the vaccine. It really worked. I don’t recall having a case of Influenza in a pregnant patient while I was there. I am thrilled that hospitals and school systems are mandating it. But it is not in all states yet.

One year working as a medical director of a Nursing Home, we had a nation-wide vaccine shortage. The supply was late getting to our patients and we had an outbreak. I became aware of the risk of death that comes with contracting Influenza in a debilitated elderly population. The mortality rate is high. We lost a number of patients to pneumonia that year. We actually had a resident based in the facility to monitor the patients. The hospital was overwhelmed so we provided care in the facility. I think the outcome was better but we all felt the toll along with the families.

I now work with college students. We can’t make it mandatory but I can say that getting the vaccine prevents lost days from classes, missed examinations and can affect the final grade. The Flu can ruin a presentation or a project and without intervention can lead to a drop in a grade. Also, there is the risk of hospitalization for pneumonia and even death in this age group. For the first time gave out all of our vaccine and will reorder if the demand is there. It is my hope that parents encouraged their kids to get vaccinated during Winter Break.

My advice is get a Flu Shot if you haven’t gotten one already and insist that those in your extended circle get one.

Celebrating 30 years: Looking back on 2013 and ahead to 2014

Looking back 2013 was a year of celebrating 30 years.  The year started with spending time with my family in Birmingham the first week of January.  I caught up with two of my college friends and founding members of our chapter of Delta Sigma Theta on our Campus at the University of Montevallo.  Of course, I spent time with my family. I love driving to each aunt’s home and sitting and talking.

In March, I hosted the family Easter dinner at my home.  For years we traveled to Baltimore for dinner and church service. When we lived on the Eastern Shore, we had several dinners at the home of my friend Ann. This year we are hosting again.  The Baltimore family is traveling to NJ again.

In May, I attended the annual Society of Teachers of Family Medicine Meeting in Baltimore MD.  I had the honor of introducing the keynote speaker and moderating the Q&A session.  This year, I am doing the same but the meeting is in San Antonio.  May was my 30th Medical School Class Reunion.  I did not attend but it is hard to believe that I graduated from medical school in 1983. I feel like it was yesterday. Since graduation, I have spent 30 years as an MD.  I have practiced in New Jersey, Maryland and Tennessee.

June was a spectacular month. I started my blog and posted a short story I wrote. We traveled back to Birmingham for the first Annual Giddens Family Reunion. It was attended by over 200 members of my grandmother’s family.   Family_Reunion_Poster_new This year we will have another reunion in Birmingham and then start every two years.  We have a Facebook page.  It is used to announce birthdays and unfortunately update us on illness and loss.  My grandmother was from a large family.  We lost her brother (last surviving sibling) this year.  They were a remarkable group of people and we all hope to live up to the high standards they set for us.  The first is to keep getting together to celebrate our family.

In October, my stepdaughter was married in DC at the home of her new husband.  It was 30 years ago that I met my husband (her dad) and she and her brother became a part of my life.V__F250 We spent a lovely few days in DC during the government shutdown.  All the monuments and museums were closed so we walked around and took pictures. WP_20131005_016[1]

In December, we spent a few days in Ocean City Maryland.  It was 30 years of celebrating birthdays as a family. The weather was beautiful. WP_20131201_001[1]

I saw the Christmas Spectacular at Radio City Music Hall and waded through the crowds to see the Christmas tree at Rockefeller Center. We made it to Baltimore for Christmas Dinner and the drive down was delightful.  This year there was no snow or blinding-rain.

We have celebrated 30 New Year’s Eves together.  We spent a quiet evening at home and watched “Casablanca” and “Foyle’s War.”  We received greetings from friends and family on Facebook and by text message.

Here’s to 2014.  I am going to work very hard the first few months because of projects I need to complete but I do plan to spend time catching up with old friends. I do not make resolutions but if I chose a theme or a word, it would be “Gratitude.”

Happy New Year

Gumbo

I am going to make Gumbo New Year’s Eve. Instead of a Lenox Crystal Ball, in New Orleans they drop the Gumbo Pot.  The first time I made it was while we were living on the Eastern Shore.  I had what I thought was a great recipe in a cookbook titled “One of a Kind: Recipes from the Junior League of Mobile.”  It was a wedding gift.  I was making the Gumbo for our Mardi Gras Party at a colleague’s house. A group of us decided to bring Mardi Gras to us. Being the only true southerner, I volunteered to make the Gumbo.

I took my cookbook to my husband’s aunt, Tommie.  She was a New Orleans native and true Cajun ( her father was from Paris and her mother, African-American). She was known for her Gumbo recipe which she guarded like a state secret.  She took the book and crossed out (with great emotion) some of listed the ingredients and added no new ones.  I did not know that really good gumbo is simple.  She did not use crab meat, chicken or the gumbo file. It’s just good Andouille sausage and lots of shrimp.  The secret is the roux and the cooking time.  The best okra is frozen and do not cook it long.  Add the shrimp and do not over cook.  It only takes a few minutes if the gumbo is hot.

We always purchased  the shrimp in Baltimore at Lexington Market for years.  That meant, we always had an ice chest in the trunk and we have transported shrimp as far as Chattanooga, Tennessee.  I always tried to get the sausage there too.  One year, we almost did not find the sausage.   Well the Gumbo was the hit of that party and many more.  Over the years I have made it so many times and it never fails to impress. I have had to toss out a couple of bad batches of roux.

What is unfortunate is that our beloved aunt has Alzheimer’s.  I always made sure we talked for hours when we visited her in Baltimore. So I know a great deal of family secrets.  She lived two row houses down from my mother-in law.  The two of them were more like sisters than sisters-in-law. My mother-in-law passed first.  Tommie was heart-broken. We cleared the  house together. When she started showing signs of memory loss and became more difficult to manage: Roy and I would visit, take her to lunch at her favorite place, the “Cheese Cake Factory, and then to church.  We also would take her to the mall and to visit friends and relatives.  Roy had a calming effect on her.  He would drive and talk to her.  She had taken care of him when his mother was working. He always made her laugh.

I made the Gumbo a few years before we lost Tommie’s husband. It was the year Christmas Eve was on a Friday. When I told them I was making it, they all reminisced about Tommie’s Gumbo and told such sweet stories. Well, when I told them I was using her recipe they were in disbelief. They asked how I had been so lucky and I told them. That was a special pot of Gumbo and I was so proud to make it. It was downed with love. We had leftovers for Christmas dinner. They all said it was indeed her recipe. It was also the year after we lost our great hostess, Sylvia. She was the wife of Tommie’s son Jack. Jack is like my husband’s baby brother. Sylvia was the one who put together all the holiday dinners. So that pot of Gumbo was in honor of two great ladies.

I can’t help but speak of Tommie in the past tense.  That is what Alzheimer’s does.  It robs you of the person and leaves just the body. The woman I knew is not here but I did take her to lunch right before she had a turn for the worse. We had a great time..  We may have even gone to church.

New Year’s is a time of reflection. I always talk to friends and family.  I call my mother at midnight in Birmingham which is 1 am EST.  I will make collard greens and black-eyed peas and maybe even cornbread and remember my grandmother and other friends and relatives no longer here.  My New Year’s commitment is to catchup with old friends and colleagues.

Happy New Year!