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Winter is usually the most difficult time of the year for me for various reasons: the short days, less sunshine, more rain, anniversary of my son’s death, the façade of festivity highlighting all the reality of our imperfect world. But you do the best you can, right?

This year I am faced with an additional challenge of medication shortage. And I thought I was so clever.

Weight loss is challenging. Obesity is a multifactorial disease with aberrations in many hormones: insulin, glucagon, hunger and satiety hormones, thyroid hormones, leptin, adiponectin, dopamine, to name a few. All these mixed and messed up signals drive hunger and eating behaviors and it is not due to lack of will power as anyone who has ever tried to lose weight knows.

Along came GLP1 agonists. These medications increase the effect of one of the satiety hormones which in turns leads to slower stomach emptying time so people feel fuller with less food. They press the satiety brake in the brain and turn down the main hunger pathway in the brain. They help balance blood sugar which decreases sugar cravings. All this adds up to weight loss.

The medications have been life giving, hope restoring, miracles for a lot of my patients. Not because they help with weight loss but because they get to the root of the problem of insulin resistance and hunger/satiety hormone imbalance. The medicine slows the hungry gut, calms the hungry brain, balances the hungry blood, so a person can identify their hungry habits and have half a chance to stand up against a hungry society that pushes Frankenfood 24/7. Eat all you want all the time whenever you want whether you are hungry or not whether its good for you or not. That’s what the culture pushes.

And now these very expensive medications have been hijacked for various reasons (maybe by people who really don’t need them but can afford to pay for them out of pocket?) The demand is high. The supply is limited. So the manufacturers’ and insurance companies’ solution is to require a diagnosis of type 2 diabetes in order to get them covered by insurance. I understand this is trying to limit them for people who have DM2.

This is not solving the problem, however. The people who have been buying them for the wrong reasons (to lose the 5 pounds) will continue to buy them because they can afford them. Meanwhile, my patients and I are back to the drawing board, fighting with insurance companies for coverage with an endless back and forth with pharmacies.

My apologies to the pharmacist on the other end of the phone a few weeks ago. I felt exasperated to the point of rude honesty. “What do you mean semaglutide is not being covered with for insulin resistance anymore!!??!!” All in defense of my patients, of course. Convicted, I ended up calling him back to apologize. He was not the problem. My rudeness does not solve any problems either.

Recently a syndicated news show highlighted the ways obesity is a medical condition just like diabetes or hypertension or hypercholesterolemia and deserves coverage by insurance companies the same way they cover diabetes, hypertension, and hypercholesterolemia. If those latter conditions are not lifestyle related, I don’t know what is. And that’s the justification for non-coverage of obesity treatment and anti-obesity medications. It’s all lifestyle. So it’s all on the patient, exempt from insurance realm.  Even if you accept that logic, alcohol and tobacco and drug use/abuse all get covered. What about food?

Short sided is what it is. Unjust. What’s the old adage? Life is not fair.

Shoulder shrug. Big sigh right here. So now what?

That’s what I have been ruminating about lately and that’s what I am encouraged about, even in my frustration.

At Oregon Weight and Wellness, we teach how to eat in a way your brain can hear your satiety. We teach how to do what the medications do, bringing hormones back into balance.

Eat in a way your brain can hear your satiety.

Eat seated. At a table. Without distraction. Put your fork down. Breathe between bites. Eat with someone you love. Don’t try to solve the world’s problems. When you sit down for a meal, just eat. And pay attention. Eat what takes time and energy to digest. Like high quality protein from fish or beef or eggs. Protein takes time to digest so you feel fuller longer. Eat veggies with fiber. Fiber makes you feel full. Add a little natural fat. Fat with fiber. Like avocado, or walnuts, or pumpkin seeds.

Determine to be a person who values health. Then do what healthy people do. Eat whole foods, not in a hurry. Let your gut do the processing and tell your brain you are full.

It takes practice. It’s not easy. It takes stepping out of the current crazy culture. It often requires support. And with grace and time you will think and eat weigh different.  

You’ve been gone more than two weeks now.

Your dad must have been there to welcome you. Have you met my son, Sammy, yet? Or my cousin, Kevin? How long was  the line to meet QEII?

Have you found out that I tricked you into giving me the Wordle answer that one day? Or that I watched Downton Abbey before you? Or that I secretly liked my sour dough bakery better than your sour dough bakery? Or that I did not read every tweet or listen to every podcast you sent my way?

I can see your eyes roll mocking me for going to that Christian concert. Yes I cried when Casting Crowns sang Scars in Heaven. But those were hot, don’t rush me tears. Don’t rush me through this sadness. Through this anger. It will be some time before I can turn over in bed, ignoring the 3am haunts of unspoken words and unprayed prayers. Joy will come, I suppose, with the mourning.

Did you hear my tongue lashing as you lie there, paint still wet on your fingers, cold, silent in that sterile ER room roughly tidied of its crash cart shrapnel. With all the miracles of modern medicine, you were too stubborn or too anti-establishment to let them bring you back.  

And I can picture you showing up at the Pearly Gates and Saint Peter checking his book, scratching his head, confused. “You are not on my list today. You were not due here for quite some time. We will have to put in a rush order for your room.” I see you yanking the clip board out of his hand, scribbling your name at the top, shoving it back into his chest, grabbing a hammer and some nails and going to work. “I’ll do it. How hard can it be?”

How hard can it be? You said that often and conquered whatever you put your mind to.

How hard can it be? To build your own dental practice and then to make your patients your friends. How hard can it be to develop a non-profit dental ministry and relieve a little human suffering. Dream it, raise funds for it by selling the paintings you painted and quilts you quilted,. Then gather your friends and go.

How hard can it be? You’d visit a local artisan, observe him at his craft, then try your hand at it, like stuffing sausage, or making cheese, or pasta or sour dough bread. You’d get the hang of one thing, then move on to the next. Fermenting pickles, sour kraut, kombucha, always inviting friends to learn alongside you. See one, do one, teach one.

How hard can it be to refurbish a rundown printing press you uncovered on an overnight to Ashland. The deceased owner’s now aging son had housed the dinosaur for years in an old barn just as dusty and dilapidated as the printing press was.  Junk to him was treasure to you. All the attention to detail seemed exhausting to me, but you evidently enjoyed painstakingly setting the blocks, and the ink, then sending the same card through, one, two, and three time to recreate nostalgic remnants of the past.

But then you liked old things and old ways of doing things, preferring a reverent liturgy with hyms and head coverings over a contemporary church service, or an old-fashioned high tea with scones and lemon curd over a chic cocktail party. You preferred supporting local businesses over buying from box stores. And never on a Sunday.

For all your love of tradition, though, you broke the rules. Once you mastered conventional quilting, you made it your own with free style piecing and free hand quilting on your very own long arm.  I marveled how you could see strips of fabric at random angles, yielding uneven sized pieces, eventually sewing them together to create beautiful tapestries that told a story.  

We were friends for a reason. You to sharpen me as iron sharpens iron. “Faithful are the wounds of a friend,” comforts Solomon.  You called me out like no one else could. I did not always appreciate the curt execution of your exhortations, like when you ripped the mask off my face as we entered that estate sale late August last year. You walked right past the sign, head held high with a clear conscience, completely resolute in your truth. You could not abide with my seeming inconsistency.

 “Be brave” your note read arriving by snail mail, supporting my nonconformist practice of medicine in this crazy mixed up world at this crazy mixed up time.

You know I forgave you when you got me in trouble at the grocery store. You thought you were so clever, strolling in nonchalantly, knowing you were going to create a scene, then standing on your soap box to deaf ears. It was my license plate they took a picture of; it was I who was accused of stealing. The smug look on your face, like the grin of a Cheshire cat. You could be exasperating at times.

But your yes was yes, and your no was no. You were willing to stand up for what mattered and tell others why. I respected that about you. The way you defended the rights of the unborn and the mothers of the unborn. And the widows. That’s true religion says James.

I must correct you on one thing, though. You once called me a sycophant. First of all, I had to look up what sycophant meant. You were always throwing out fifty cent words, trying to best my vocabulary. But I was not. A sycophant. When I gave Kristen Kimball that glass of water to soothe her dry throat, it was out of compassion.  I knew she was overly fatigued from farming, family, and unwanted fame, and had just flown cross country to give the keynote address for the OSU small farms conference. I could tell she had a head cold and was not feeling well. Yes, I got my book signed. Yes, I talked to her longer than anybody else in line, but my heart was genuine. Hopefully, you know that now.

And what was my role in your life? To soften you, perhaps.  You surrounded yourself with friends who softened you with their gentle ways and their kind hearts. Jeanette and Peggy and Shon and Shannon. Your sisters. Even Steven. And I did see a softening over these last several years as you honored your mother by moving in with her and caring for her. Where you once were impatient with tardiness, you gave grace. Where you once were annoyed when things did not go your way, you were more at peace. I was almost shocked at how immediately contrite you were when I scolded your rude interruption of an office visit gone overtime. And I could see you slowly letting go of your deepest held hurts.

You were determined to give your mother her heart’s desire, which was to live in her home of fifty years, where the majority of her old memories resided because her aging brain could not easily create new ones. You gave your mom more and more of your time, more time than you gave your friends and siblings in the end. Time was your love language. And we knew it.

“Don’t hate me” you texted, begging off our annual Coburg trek. Of course, I didn’t hate you.  I knew you were tired. Weary of well-doing, perhaps, not able to see more fruitful service. I saw it in your slow pace when we walked from my office to Bush Park to the art fair late July. You had to stop three times to catch your breath. “Heartburn,” you feigned. I knew it wasn’t heart burn. For your sake, I will resist my catholic, self-effacing tendency to kick myself for not insisting one more time you go to the ER. The fact is, I didn’t.  For whatever reason. Respect. Futility. Distraction. It wasn’t because I didn’t care.

And I saw it in again in your face at breakfast on Labor Day. The fatigue. The food wasn’t great but that’s not what kept you down cast. I could see you were tired. Tired of contending. You always wanted more. More common sense from your country. More cohesion from your church. More commitment from your friends. More consideration from your family. You even wanted more cooperation from God. Maybe that’s why you barged in ahead of schedule. You believed in prayer, but you wanted God to do more, and you had to get right in His face.

I don’t remember our entire conversation at that belated birthday breakfast. I am racking my brain to remember. I know we talked mostly about how my home office was going. You thought I wore my dog shirt to counter the cat cards you sent me three days in a row. I don’t know if the conversation turned to you with your customary, “now let’s talk about Lisa” line. Did I even ask you about your how you were feeling, if you had any more episodes. I’d like to think I did. But I have to accept that maybe I didn’t.

All of life is a competition, you’d say. You beat me in fast Scrabble. You beat me in Settlers. You were stronger, more talented, more stalwart. You prayed more than I did, and you prayed for me more than I prayed for you. I know it. You were the better friend.  And you beat me going home.

You were not afraid to die, and you proved it. “Absent from the body, present with the Lord.” You believed it and so will l.

What I really want to know, though, is what was it like hearing Jesus say, “Well done. Well done good and faithful servant. Enter into the joy of your master!”

To live is Christ. To die is gain. You win, Lisa. You win.

.

School is back in session.  That reality set in hard yesterday morning on my way to work when I found myself coming to a screeching halt behind two other cars and glaring at the red stop sign sticking out the side of a yellow bus, flashing lights and all. I glanced at the clock realizing I had not left time for this slice of Norman Rockwell’s Americana.  Adjusting in my seat, I took a cleansing breath and melted into the familiar scene.

Grade school children lined up single file, climbing up the big bus steps and down the rows to find their seats. It was somewhat orderly, like ants at a picnic. A few young mothers stood safely at the roadside, waving enthusiastically as the bus lurched forward, hauling their children away, some of them presumably for their first day of school. One mom clutched her chest and blotted tears from her eyes with her shirt sleeve, maybe from the bittersweet reality that her child was growing up and moving on to the next stage of life, or maybe from guilty relief that summer was finally over. Or maybe from a little of both.

I remember taking the bus as a kid when we lived more than the obligatory mile away from school. Under a mile and you had to walk which we did when we lived on Vernon Avenue. Up hill, both ways, I tell my kids. But when we lived farther out on Eastbrook Drive, we rode the bus. My brothers and sisters and I attended St. Edward’s, a Catholic school located a few short blocks from Ashland Junior High for our grade school tenure. Apparently, St. Ed’s had an agreement with the public school that we parochial kids could ride their buses to the Junior High and walk the rest of the three blocks to our school.  We got out earlier than the Junior High kids and were always the first ones on the bus at the end of the school day. I usually sat in the second seat behind the driver, not wanting to appear too eager. And I saved a seat for Justine.

That’s all I knew about her. That her name was Justine. And that she was teased. A lot. She had short, dark, wavy hair. Her body odor was noticeable, even by me at the naïve age of eight, and she was heavier than the other kids her age. No one wanted to sit by Justine. So, she ordered me to save her a seat. She was not nice about it at all. I figured probably because she was teased so cruelly. Hurting people hurt people, I later learned.  I obliged her, dutifully placing my books and lunch pail next to me on the other half of the bench seat and then picking them up when I saw her climbing the bus steps.  What was it to me? Nobody seemed to want to sit up front anyway. We sat in silence most of the way home.

Admittedly, the vast majority of bus rides home are a positive experience for kids. It’s fun to sit in the back of the bus and goof off with friends, throw paper wads, eat the rest of your lunch, or get started on your homework right away so when you got home you could play. And I know that every negative comment does not cause lasting emotional trauma. Sticks and stones and words, however, can hurt. Deeply. I have no idea what happened to Justine, whether the school bus bullying went on to negatively impact her in adulthood.

I know a lot of Justines now though. I talk to people every day who were teased mercilessly as children because they carried extra weight, through no fault of their own. They were called Fatso or Porky or Tub-o-lard or worse. And by parents and grandparents even. They were passed over on the playground, never being chosen to be on a team. They were compared to their string bean siblings, as if they were in control of their own genetics or grocery shopping or the school lunch menu.

At Oregon Weight and Wellness, we screen for this kind of childhood trauma as well as other physical and emotional trauma. We know that childhood trauma correlates with adult obesity. Not to say that the damage is irreparable or people who experience trauma are hopeless.  But sometimes we must address that deep limbic woundedness to understand patterns of behavior, to get to the root of the barriers that sabotage people’s success time and time again. We try to make a change and it works for a time. Then something happens, and we find ourselves back to our tried-and-true coping mechanisms. Like turning to highly palatable foods not because we are physically hungry, but because we are lonely or tired or anxious or bored. The hurts can be so hidden and so deeply rooted, it seems like we don’t even want to succeed.

Recognizing our past traumas, giving space for them, perhaps reframing, and forgiving, can bring healing to those limbic memories so they no longer interrupt the progress of the present.

At OWW, people find hope and restore their health. We not only build a strong foundation on the lifestyle pillars of nutrition, activity, sleep, and community, we build the indispensable skills of resilience. And then those long forgotten but ever so painful bus rides truly become a thing of past.  

During the initial conceptualization phase of my start up business, I considered housing my office in my home. Several naysayers brought up reasons against: Location.Liability.Limitations. I stumbled upon my current office one day after a meeting with my CPA and that was that. I signed a lease at 1265 Waller Street in Salem.

These last two and a half years have been a blessing. The Waller Street office was a place of small but great beginnings. Now it seems it is time for a change. And the concept of home office these days is very much the norm, one of the silver linings from the recent past.

I have been talking about change for several months with patients as my sounding board. I made the final decision in May while visiting my cousin in Ohio.

Change talk sounds like this: Can I do it? Will it work? Is it worth it? Who is in charge? And Who is my support?

Is the change to a home office feasible? Will patients follow me? Do I have the time and energy and resources to convert our mother-in-law suite to a viable office? Will it be the overhead reducer I hope? When will the change take place? Is four months enough time to get everything in place? Who do I have to consult with for questions and counsel?

After thinking through these questions, I decided that even though I could not predict the future, I had enough confidence and motivation and support to move forward. Besides, my husband, who has always been my biggest advocate, would be doing the lion’s share of the work. #gokenny!

Then started the mission of breaking down the herculean task to small, manageable steps, taking one day at a time, one challenge at a time. First, tell people. Then design. Then choose colors. Then buy fixtures. Go through stuff I had accumulated at the office. Take only what is necessary home, a few things at time. Do one thing every day that will move me toward the September 1 goal.

It’s twenty-one days until Go Time. How am I doing?

If the dream I had last night is any indication, I am feeling very anxious. (I was sitting, naked, in the disorganized waiting room of my new clinic watching the first patient walk up the drive). But wait, maybe that is not just anxiety working itself out. Maybe that is foreshadowing that people will indeed show up, and that I am creating a vulnerable, honest, and safe place for my patients. OK, maybe I should keep my day job and not switch my career to dream interpretation, but I am choosing to think positive.

And seriously, we are 85% complete. Fresh paint. Done. ADA bathroom. Done. Ramp. Done. 75% equipment moved. Done. And, in the meantime, I have secured a Salem office location for most Wednesdays for people who are not able to come to Jefferson.

The goal is in sight. One day at a time. One tiny step at a time. Then there will be new goals to create and new dreams to be dreamt. Wait till I tell Kenny about phase 2!

Change starts with asking questions and talking it out. Can I do it? Will it work? Is it worth it? Who is in charge? Who is my support? This is a big part of what we do at Oregon Weight and Wellness when helping people envision better health. We give you the support and the knowhow you need to break that herculean task of weight loss, whether its twenty pounds or two hundred pounds, into manageble goals.

Give us a call to get your health vision started. 971-273-7143.

I was asked to give a talk to a group of church women attending a conference on Loving Yourself Well.

At first glance, the topic seemed somewhat selfish to me . I am supposed to talk about self-love? to a group of Christians? Aren’t we Christians taught to deny ourselves, pick up our cross, endure suffering, trials and tribulations of many kinds.

Then I thought about Mark 12 when “one of the teachers of the law came and asked Jesus, Of all the commandments, which is the most important? The most important one, answered Jesus, is Hear O Israel, the Lord our God the Lord is one. Love the Lord your God with all your heart and with all your soul and will all your mind and with all your strength. The second is this: Love your neighbor as yourself. There is no commandment greater than these.”

And it occured to me that we often gloss over the last part of the commandment. “as yourself. ”

Jesus did not say instead of yourself, not yourself, forget yourself, at the expense of yourself. He says love God. with every thing that is in you, both spiritual (heart and soul) and physical (mind and strength). And Love your neighbor…. AS YOURSELF.

We are commanded to love ourselves; but what does loving myself look like?
A spa day with my BFF? Perhaps.
Taking a vacation to Hawaii?Maybe.
Buying a new outfit? My personal favorite.

Occasionally pampering myself may be part of loving myself, but I noticed another verse that put “as yourself” in a more practical way,
In Ephesians 5:29, Paul is talking to husbands and wives. He says “husbands ought to love their wives as their own bodies. He who loves his wife loves himself. After all, no one ever hated his own body, but he FEEDS andCARES for it. Just as Christ does the church.” Another version of the bible says NOURISHES AND CHERISHES.
So part of loving myself is FEEDING AND CARING for myself. Nourishing and cherishing myself.
Maybe not the whole thing, but a part of it anyway.
How am I doing?
How are you doing with feeding and caring for yourself?

How did Jesus, feed and care, nourish and cherish his body?

To answer this, I looked at the beautiful story in John 4 about the woman at the well. You may know it well. It tells the story of how Jesus, in meeting a woman, breaks through so many barriers including polictical, religious, ethnic, cultural, and gender barriers to speak to her and love her into the Kingdom.

I posed my questions to this story and noticed a few things I had never noticed before: Fully human, Jesus had physical needs. He embraced his humanity and he met those needs in a way that nourished his physical body. Jesus kept himself healthy so that he could meet others’ needs.

1 – Jesus drank water. Jesus got thirsty and he went to the well to drink water. Not juice or pop or Starbucks mocha latte with an extra shot of espresso. Water.

Water is so important to the body over sixty percent of which is comprised of water. Water purifies our bodies. It protects our nervous system. It provides energy. Sugary beverages (even artificially sweet) do the exact opposite and toxify the body and hijack hormones to make us think we are hungry. They de-energize by causing a sugar spike and then a sugar crash. They intoxicate. Jesus cared for his body by drinking water.

2 – Jesus ate real food. “He sent his disciples to buy food.” I don’t hink they went to McDonald’s or In and Out or Chick Fil-A. Jesus ate real whole food, minimally processed, like fish and whole grain breads and cucumbers and leaks and figs and dates and olives. He ate foods that provided his body the nutrients he needed to be strong and stay healthy.

3 – Jesus walked. The journey from Judea to Galilee was forty miles. He did not Uber there. He walked. I don’t know how long it took him but he walked. Walking was so important to him, in another bible story, he walked on water. But he moved his body. A lot.

4 – Jesus rested. The bible says “wearied from his journey, he sat down.” Jesus took a break. He did not go 24/7 365. He took breaks. He respected and honored the fact that he had to reboot, restore, recharge. He rested.

And while tending to these physical needs, while feeding and caring for himself, he met the Samaritan woman and connected with her in a way that met her greatest need and broke through her biggest barrier, shame. He did not ingorne her. He saw her. He was patient with her. He was kind to her. He did not manipulate or judge or condemn her. He simply asked her for a drink of water.

Jesus loved his neighbor as he loved himself.

WWJD? Jesus would drink water, eat real food, walk, rest. He would keep himself physically healthy and mentally strong.

We need to do the same.

Loving yourself by nourishing and cherishing your body is not selfish. Embracing the fearful and wonderful way God created us, with physical needs, we can love ourselves well, motivated out of obedience to God , out of reverence to Christ, as our spiritual act of worship. Then we can truly love others.

Thanks to Oregon’s liquid sunshine all of April and May, it is June, and I am just getting my tomatoes planted. While we don’t have a huge garden, I do enjoy fresh home-grown vegetables.

You know that’s the SECOND tenet of OWW HAND Nutrition: Eat your vegetables.

I remember it by noting that when you hold up your index and middle finger to form the number two, it looks like the Roman numeral for five which is a V.

V stands for Vegetables. The first arm of the V represents 5 cups. The second arm of the V represents 5 colors.

I encourage people to eat at least five cups and five different colors of vegetables every day and at least. This is the target, I explain. I can hear my Aunt Mary Ann, and most of my patients, and myself 10 years ago. “Five cups of vegetables!!! That’s an awful lot!!”

I get it. Veggies have not been big part of the standard American diet in the last fifty years, except maybe for iceberg lettuce, hot house tomatoes, pickles, and onion perhaps.

But with a little forethought, 5 cups of veggies are not that difficult to prepare and eat. For example, this morning I spent five minutes prepping my lunch.  I grabbed 2 cups of greens from the spring mix container, grated ½ cup orange carrot, roughly chopped ½ cup of red bell pepper, ½ cup of zucchini, 1 cup of purple cabbage, on top of which I sprinkled ¼ cup walnuts, and drizzled lemon juice and a tablespoon of olive oil. Voila! In no time, I had a beautiful bowl of colorful bounty with 4 ½ cups and 5 colors just for lunch.

Why is eating a rainbow of colorful veggies so important?

Veggies give you a great big bang for your buck. And not only do they have the nutrients our cells need to function well, but they also have the fiber our colon needs to feed healthy gut bacteria, create precursors for neurotransmitters, keep things running smoothly, and actually decrease the number of calories absorbed.

To avoid pesticide residue, I use EWG’s Dirty Dozen and Clean Fifteen to guide my organic veggie purchasing when I am not able to go to a local farmer’s market or have run out of my home grown produce. Organic tends to be more nutrient rich, too. If the minerals aren’t in the soil, due to industrialized over farming and consequent artificial fertilization, then they cannot get into the plant

EWG’s 2022 Shopper’s Guide to Pesticides in Produce | Clean Fifteen

If you have insulin resistance you want most of your veggies to come from above the ground. Generally, above ground vegetables have less starch. Less starch lends to less breakdown to glucose, less rise in blood glucose, less release of  insulin, better blood sugar control,  and more digging into energy storage.

One more tidbit about veggies. Eat them first, not last like I did all my growing up years. Eating vegetables not only stimulates the stretch receptors in your stomach but stimulates the nutrient receptors as well, both of which signal your brain that you have the food you need, so you can stop eating.

Some of us don’t like veggies because they were served steamed, mushy, gushy, and basically dead when we were kids. Create a new experience. You don’t have to love all vegetables but determine to find some you like. Experiment with grilling, roasting, sautéing, raw. Toss some herbs and spices and healthy fats on them like walnuts, pumpkin seeds, avocado, olive oil, or grass-fed butter. If you don’t like broccoli, try broccolini. If you don’t like cauliflower, try cauliflower rice. Get creative. Make a goal. Incorporate one new vegetable or vegetable recipe every month.

Five cups. Five colors.  What do you have to lose?

My mom grew up with her three siblings in the house where their mother was born on Castialia Street in Bellevue, Ohio, the same town where her grandfather and great grandfather ran a successful furniture business on Main Street for more than half a century. Briehl roots run deep in Bellevue and a majority of the family tree has blossomed there.

Mom had been in the habit of visiting her sisters at least once a year. Circumstances beyond her control constrained her recent travel, Covid, of course, but also her husband’s medical conditions. After the second death in our family, however, she felt compelled to return. She was going to see her sisters, and nothing was going to get in her way.

The grand plan was for me to travel with her to Ohio while my siblings took care of details in Texas. None of us kids really wanted Mom traveling alone. Admittedly, she is in excellent health at the young age of 82 and I would not call her frail. But at 4’9” and 105lb sopping wet, she might get swallowed up in the masses of people moving through the DFW airport scurrying to their connecting flights.

Reality quickly set in when I saw the cost of air fare, that it was double the price since the last time I flew to Ohio, and add on top of that a side trip to Texas to pick her up? Yeah, it wasn’t going to happen.

We settled on visiting at the same time. I found reasonably priced tickets on a red eye to Detroit, which as it turned out, was closer to Tiffin, where my cousin, Jennifer, lives. She graciously picked me up at 0 dark 30 am. Bleary eyed and bushed, we joined Mom who had arrived safely the previous day and was already refreshed and relishing time with her sisters. There she sat on the couch giggling like a school girl. I should have known she would be fine.

We had a lovely time. Like a line from HMS Pinafore, I saw my three aunts, my remaining uncle, most of my cousins and most of my cousins’ kids. As it happens with people you love, we picked right up where we left off. We toured their new homes sharing in their future plans. We visited their old homes stepping into and cherishing the past. I closed my eyes and was ten years old again, snitching a second piece of Aunt Mary Ann’s Texas sheet cake which she brought to every Thanksgiving dinner. There was lots of laughter. And a few tears.

We visited the graveside with Aunt Flossie where the memorial stone for my Uncle Walt was newly set allowing the finality of death to sink in. I reflected upon life’s twists and turns that take us away from our family and place of origin and the twists and turns that bring us back.

We drove by Jennifer’s childhood home on Gunther Street where I had spent at least one week practically every summer in my grade school days with Jennifer and her brothers, Chris and Kevin. I remembered playing games in their basement, calling Time and Temp to see if it would be warm enough to ride our banana seat bikes to the local pool for a swim, running around with sparklers in her back yard, walking uptown to the Cherry Festival, and walking back home with lips stained and bellies aching from eating oodles of cherries, not to mention cotton candy and vinegar drenched French fries.

Those were the good old days. And these were the people I had broken bread with back then.

A few days prior to my Ohio departure, I chatted with my cousin about trip details. She inquired about any food allergies or sensitivities I had. Apparently, Mom told Aunt Joannie I was gluten free or did not eat bread. I chuckled. I guess I have become more high maintenance with my personal food rules. I own that. I called Aunt Joannie to put her mind at ease. “I will eat whatever you put in front of me.”

The food was delicious. (Shout out to PeeDee who hands down, grills the best deer steak you have ever tasted.) But being with family, that was the real treat. There is just something about sitting across the table sharing a meal with people you love and who know and love you, the extended family you grew up with and with whom you made memories.

I was asked to offer grace before one of our many meals together and found myself overcome with emotion. It is a wonder to hold the present and the past together in the same moment, giving space for joy and sorrow and gratitude and longing, feeling the loss of those who have gone before us and at the same time being so thankful for those who remain. All while sharing a meal.

I pondered the tempo of our meals. Nothing forced or rushed. All in due time. I found myself effortlessly putting my fork down and breathing. Why would I rush this? We had all the time in the world to spend this time together.

Breaking bread with the people you love. Life does not get better than that.

It had been two years since I had attended a live medical conference. When I found out the OMA conference was to be held in Atlanta, I was thrilled. I’d get to connect and network with other specialists in Obesity Medicine in person, something that energizes me and keeps me going. And I would be able to spend time with my son, Jacob, who lives and works in Atlanta. Getting to see him in his space would be a real treat.  

The conference proved extremely beneficial, providing up to date information from articulate speakers expounding on the latest research regarding obesity, plenty of review and reinforcement of what we at Oregon Weight and Wellness are already doing, encouragement that this is truly difficult work, that weight recurrence happens, that there is underlying physiology, that the work is necessary and worth it so stay the course, OWW.

I am always curious about what kind of food will be served at medical conferences. As customary, breakfast and lunch were served buffet style on platters with fancy cards written in cursive, eloquently describing their contents. Quinoa salad with radicchio, pine nuts, capers, and olives. Gluten-free, vegan lentils with farrow and lemon. All of the food was minimally processed, whole, real, heavy on the fresh vegetables and fruit and delicious. It was difficult to stay on my intermittent fasting regimen. Kudos to the caterers.

The beverages, however, left me incredulous. Of course, they had water, and coffee, and tea. But what do you suppose held the spotlight?

Coca cola.

Cans upon endless cans of ice-cold sparkling coke, diet coke, and sprite stood stacked on tables that flanked the four corners of the grand room. I wondered if this was a test. To see if even obesity medicine doctors who have the most understanding of the physiology of sugar addiction and pathway to insulin resistance and weight gain would fall prey to the seductively sweet taste of soda.

Then I figured out that Atlanta is Coca Cola capitol of the world. Anyway, that’s where Coke’s headquarters are. Two blocks from the hotel that hosted the conference was the Coke Museum where, at the end of the tour, you get to sample upwards of 34 different kinds of soda from all over the world.

No wonder.

So the answer is, Yes. Doctors drink soda. I found myself more than disappointed, I was disgusted, shaking my head, and wondering why, thinking that if I could rule the world for a day, I would wipe soda off the face of the earth.

Atlanta was in full bloom and gorgeous. The weather was perfect for walking outside. In addition to exploring fun restaurants and quaint neighborhoods which Jacob has discovered during his tenure in Atlanta, I had the pleasure of meeting several of his friends. I must say I was quite impressed. Every one of them, including Jacob, of course, was intelligent, accomplished and at the same time authentic and genuinely kind. Honestly, it gave me hope for our future.

Jacob’s buddy, Kieffer, said something I thought was quite profound. We were strolling through a redeveloped neighborhood when I made a comment about some carelessly discarded trash I  had to step over.

“People being people,” he said. I looked at him inquisitively. “People be people,” Jacob echoed.  Perhaps it was the way they said it that gave me pause. No condemnation. No criticism. No comparison.  Their tone left no questions. While they were not in the habit of throwing trash on the sidewalk, they did not consider themselves better or worse than the person who did.

People be people. It’s why doctors drink soda. It’s why I drank soda, up to 72 oz of diet coke a day, for several years, until I was ready to change. And, like a reformed smoker, I found myself quick to judge others who I think should know better. And leave it to a young person to expose my judgment and bias, even if unknowingly.

We talked about bias during the conference, more specifically bias against people who carry extra weight, even more specifically the bias against obesity that occurs in the medical field. Doctors got honest and vulnerable and stayed in a very challenging conversation. I wanted to believe that I am not biased in a way that hurts people. But I flunked this litmus test: When you are seated on a plane and the person walking down the aisle is carrying extra weight, what is your first thought?

Do I show the same compassion for people outside of my office as inside? Am I the same person? God knows I want to be. Jesus, help me to be.

Thank you, Jacob, for showing me a lovely time in Atlanta, and showing me a better way to people.