April 07, 2016

(++++) GUIDES TO LIFE STAGES


Becoming Grandma: The Joys and Science of the New Grandparenting. By Lesley Stahl. Blue Rider Press. $27.

The COPD Solution: A Proven 10-Week Program for Living and Breathing Better with Chronic Lung Disease. By Dawn Lesley Fielding. Da Capo. $16.99.

     The biology of becoming a grandmother is quite clear. The psychology, as Lesley Stahl makes abundantly clear in Becoming Grandma, is not. In a few sentences, here is what it comes down to: “I thought about what it means to grow up. I decided it means that you watch time flow backward. First, when you raise your children, you relive your own childhood, going through (sometimes painfully) the various stages all over again. Then, as a grandparent, you relive your children’s lives. The process tends to soften the indignities of aging.” Yet this is only one element of what it means to be a grandmother, a state that Stahl discusses from her own perspective (she has two grandchildren) and many others – using the reportorial talents she has honed at 60 Minutes in the service of exploring a mundane-yet-exceptional time in a woman’s life. The book combines Stahl’s personal stories, including the difficult one of her mother’s death shortly after the birth of Stahl’s first grandchild, with the experiences of others and a certain amount of research. The latter takes such forms as: “The average cost of full-time day care varies across the country. In New York it’s $14,500 a year; in California, $11,628; in Alabama, $5,547. In most states high-quality child care is more expensive than college.” This information is not very useful, nor is it particularly accurate, since “high-quality” is indefinable (or at least undefined here), and an average for a state such as California surely does not reflect costs in the areas that Stahl herself most frequently haunts, such as San Francisco and the upscale areas around Los Angeles, where Stahl’s grandchildren live. Far more interesting in Becoming Grandma are the discussions of grandparental attitudes and worries with everyday people – not the ones with the celebrities whose comments Stahl sprinkles through the book, and who are presumably mostly concerned with their public images. For example, the other grandparents in Stahl’s own family are conservative Midwesterners, and a painful conversation between Stahl and her grandmother counterpart, Barbara, raises troubling-but-fascinating issues of resentment, competitiveness and financial inequality: “Financially, we can’t afford to go see them often in LA,” Barbara tells Stahl. “I understand that you can do that, and that hurts.” In fact, Stahl explains that one way she got to California often after the birth of her first grandchild was by figuring out how to work there: she arranged to do stories that required travel to Los Angeles. This makes for a slightly disingenuous comment: “I know that traveling across the country several times a year is something most people can’t afford. As it does with so many facets of life today, income inequality has a bearing on how we grandparent.” That may be true, but in Stahl’s case, where work inequality is her primary advantage, it is not entirely relevant, no matter how real Barbara’s pain is.

     There is hurt in modern grandparenting, often involving the use of grandchildren as weapons within family units, and Stahl explores this situation with sensitivity and empathy. But there is also considerable joy in being a grandparent today, and Stahl’s descriptions of the explosions of it are among the most affecting parts of her book. “Being a grandparent was my new identity. And I was fast becoming a stereotype. Whenever I passed a store that sold anything for babies, man, was I sucked in. ....I am so not alone. Grandparent spending on child-specific items has increased sevenfold in the last ten years. We’re out there buying baby food, equipment, clothing, tricycles, and toys. Our grandchildren melt our wallets!” This is an exaggeration at Stahl’s specific income level, but it makes a good point, one among many, about the ways in which having a grandchild changes one’s entire perspective on life – for some people. Stahl does note that many modern grandparents are uninvolved with their grandkids, more focused on themselves and going on with their own lives than they are on their children’s children; and she offers a few thoughts on why that may be so. Most of the book, though, is celebratory, because it reflects Stahl’s own bright and bubbly feelings about being a grandmother. This makes the forays into deeply troubling territory all the more effective, such as the story Stahl did about a grandmother whose grandchild killed his father – the grandmother’s son. The way Stahl recovers from the emotion generated by doing an interview about that tragedy – by visiting her own grandchild – makes a clear statement about grandparental love as a balance for life’s turmoil, if not a cure for it. Similarly, Stahl recounts the effect of being a grandfather on her husband, screenwriter Aaron Latham, who has Parkinson’s disease. Four months after the birth of the first grandchild, Latham’s condition improves markedly: he walks better and can even drive again, and facial tics caused by the medicine he has been taking for Parkinson’s disappear. Stahl writes, “We had trouble getting a straight explanation for why his symptoms had all but disappeared. …My own theory was that becoming a grandfather had healed him.” Indeed, “grandchildren can be curative in a profound way,” one doctor tells Stahl, and she does some research on the topic to back up the physician’s experience-based remark. Becoming Grandma is like that: personal, off-the-cuff at times, reportorial at others, pervaded always by Stahl’s own feelings about the “pivotal event” (as one of her colleagues called it) of a grandchild’s birth. The book’s flaws are largely ones of Stahl’s chosen profession: a bit too much name-dropping; a little more celebrity commentary than is necessary; a politically correct, predictable and not-very-revelatory foray into grandparenting in a family where someone opts for a gender change. Stahl is too polished and professional to be able to cast aside her own role as a journalist completely, but she is at her best when she comes across as most non-reportorial: not someone who researches wrongdoing for a living, not someone who travels constantly in search of the next major TV story, not someone who hobnobs with the rich and famous and politically connected, but simply a woman who has entered a new stage of life, found it marvelous and surprising, and wants to use her storytelling skills to inform others about the joy, wonder, occasional sadness and amazing amount of love she has discovered in her new role.

     If only all life stages were blessings, even mixed ones. Unfortunately, aging brings with it as many challenges as joys, and one increasingly troubling one is Chronic Obstructive Pulmonary Disease (COPD), which is actually a disease that combines two or more of three other diseases: asthma, chronic bronchitis, and emphysema. COPD has become the third leading cause of death worldwide, after heart disease and cancer; it affects more than 20 million Americans – 6.3% of the population. Tobacco use, air pollutants at home and work, and genetic predisposition are all implicated as COPD causes. The condition is most common in non-Hispanic whites and in women, primarily in people ages 65-74, and is associated with various lifestyle factors – not only current or former smoking but also being divorced, widowed or separated. Respiratory therapist and COPD educator Dawn Lesley Fielding argues in The COPD Solution that the condition need not force victims to change their lives dramatically and stop doing things they love, or even things that others who can breathe more easily take for granted. Fielding recommends a 10-step, 10-week plan that she says has “a 100 percent success rate [italics in the original] with those who followed the program” in her practice – a claim that is difficult to believe but that would be impressive even if only half true. The steps are not particularly revolutionary or even unusual, which makes it hard to believe that Fielding’s “100% successful” program is not the 100% standard for all COPD treatment for everyone everywhere in the U.S. and throughout the world. In simple terms, the steps are: 1) accept the diagnosis and seek support; 2) have oxygen therapy, plus treatment for sleep apnea if you have that condition; 3) reduce stress and take control of your breathing; 4) relax and conserve your energy; 5) use prescribed medicines as directed; 6) have your doctor refer you to a pulmonary rehabilitation program; 7) quit smoking (readers may be surprised that this is #7, not #1 or #2); 8) change your diet to increase antioxidant, fiber and fluid intake; 9) do yoga; and 10) maintain a strong social network – stay connected with family members, friends and work colleagues. Fielding’s tremendous enthusiasm for her program is uplifting: “Treating COPD has become my mission,” she writes, and she advocates her approach with evangelical fervor. And in truth, every element of her 10-step program is worthwhile, and every one of them can help people with COPD live better and more-fulfilling lives. But nothing in The COPD Solution is in fact a solution to the condition: there is no cure, and the book’s title is misleading to the extent that it implies there is one. Furthermore, Fielding’s certainty that she has the solution to COPD is delivered in such a way that if readers try what she recommends and do not get better despite the “100 percent success rate” of her approach, it is obviously the readers’ fault for somehow not doing things properly or correctly – a belief that, if internalized, will have significantly deleterious effects on a COPD sufferer’s self-image and psychological health, and may actually make the condition worse. The big problem with The COPD Solution is a lack of modesty: this would be a better book if it contained the same recommendations but stated forthrightly that some people, but not all, will benefit from Fielding’s 10-step approach, and that some people will find elements of the approach difficult or impossible to implement (for instance, Fielding’s dietary changes may conflict with dietary needs associated with other elements of a person’s health). There is a great deal that is good in this book, but if you have COPD, it is worth asking your doctor why Fielding’s 10-step program is not followed 100% of the time by 100% of health professionals dealing with this very serious condition. The discussion that ensues will likely be as valuable as anything in this book, if not more so. The reality is that there is no perfect, one-size-fits-all-100%-of-the-time approach to any serious medical condition, COPD included. The COPD Solution is a (+++) book because it overreaches, thus inviting disappointment in readers for whom the approach may not work as ideally as Fielding says it will; a more accurate title would have been “A” COPD Solution,  which is all that Fielding or any other person who deals with this condition can realistically promise.

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