In May of 2017, I went to the northernmost parts of California on a mission of reconnaissance, scoping out communities in Mendocino, Humboldt, Del Norte, and Siskiyou counties. I am the Outreach Liaison for UCSF's Project ECHO, tasked with recruiting rural Primary Care Providers to become participants in ECHO, thereby building capacity to treat hepatitis C (HCV) in these counties, and 11 others over the next 3 years,
California driving is the best. It is vast and beautiful and all those miles provide a lot of thinking time. My mind takes me to all kinds of places. I think about the gratitude I feel for this gift of cure and the passion that's driving me to work toward development of an approach that will contribute to the eradication of a disease. The sheer splendor of the world class scenery in Northern California thrills me.
And then, I remember that time in 5th grade when I was denied writing a report about California.
Flashback to November of 1967.
I live in the city of Orange, California with my mom and brother, Jon. He's 11. I'm 9. My dad lives in Portsmouth, Virginia and is getting married in about 3 weeks. Quite unexpectedly, Mom dies. One week I live in Orange where it's warm and free, the next in Portsmouth where it's bitterly cold and no one goes outside. A month into this foreign arrangement, I'm in Miss Farrell's 5th grade class at John Tyler Elementary. She tells us each student will be assigned a state to write a report on. Thinking of writing about California brings the first good breath I've taken since the passing of my mother. My heart beats with such nostalgia, I think the others can hear it. Miss Farrell announces, alphabetically by last name,
"Danny Owen: Rhode Island."
"Mildred Potter: California"
"Jennifer Slepin: Virginia"
And my breath is gone again. I show my ass with as much anarchy as a 9 year old can. For days. Who is this Mildred Potter? And what does she care about California? I cry. I step on her lunch bag to flatten her sandwich. I accidentally/on purpose wiped a booger in her cubbie. I knocked her coat off the hook. I can't understand why she gets to do this project that so clearly should be mine. At the parent-teacher conference, they agree it is to my benefit to apologize to Mildred, and get to know about Virginia by writing a report.
"It'll be fun."
They joke and say, "Virginia is for Lovers."
I don't get it.
They don't get it.
With no heart or air, I commit to write about Virginia.
After spending 35 years on the east coast, most of that in Raleigh, North Carolina, I finally resigned myself to southern culture and even acquired a bit of it. Always, I quietly longed for the west. With my son now graduated from college, it was clear he was not returning to North Carolina so I decided it was time to return to San Francisco. I found a job with a large hospital system and moved in December of 2008. Just a month before I moved, my brother Jon died at the age of 53. Since the beginning of my life, he was my one and only constant. He was my compass. Handsome, fit, fearless, and wild- he took the world by storm, always seeking the edge and beyond. We were teens in the 70's and he fully embraced sex, drugs, & rock-n-roll. Alcohol and IV drugs were part of his life from his early teens and somewhere along the path, he became infected with HCV. His heavy drinking and IV drug use over a lifetime took their toll. At about age 42, he began to get sick from liver failure and over a 10 year period, I watched him decline from a strong, healthy man, into a mere shell of himself. Sick with end stage liver disease and addicted to oxycodone prescribed by two different physicians, the light was gone from his eyes. He was ineligible for a liver transplant. After he died, I was left with myself. No one else's disease and affairs to manage. Just mine.
For years and years, I skillfully hid from my diagnosis of HCV by caring for my brother. Moving to San Francisco and being removed from my infrastructure allowed me the severe mercy of coming to terms with my own diagnosis and my responsibility to take care of myself. It wasn't pretty. My therapist described the timing of my move and my brother's death as a "perfect storm". Sparing the details, I fell apart. That's what it took for me to awaken, embrace my life and choose whether to let it crush me or reinvent me. Falling apart is the easy part. It's the picking up the pieces and recreating oneself where the bravery comes in. Brene Brown says that vulnerability is the birthplace of innovation, joy, creativity, and change. She is correct. In order for me to do this outreach work in rural areas, I had to experience all of the highs and lows in order to develop the tools I now possess. I am uniquely prepared to understand HCV from the patient, family member, and provider perspective.
I love my state as much as I did when I was a child, As an adult, I appreciate it more.
And now, in the company of some highly respected professionals, I get to be in service to my fellow Californians by building healthcare infrastructure in rural areas. Now is the time for my book report on California. It will be the best report EVER.