The Five Stages of Health

In an earlier post, How Things Got Better, I talked about the process I went through to choose Boise, Idaho as a place that would help support my health. I thought I would write a few more posts this summer about my (mis)adventures dealing with health problems.

From the time I contracted Lyme Disease in 2009, to the time I moved to Boise in 2014, I struggled a lot with my health. The most difficult thing for me was not the pain, weakness, chills, or fever, but rather the sense of isolation I experienced. The Austin social scene was all about the moveable feast; by not being mobile or healthy, I missed out on the sense of community I’d come to rely on. I began to feel as if life was like a beautiful circle, and I’d been somehow cast outside of its bounds, into a shadowy nether realm. The only people who seemed to make the effort to reach out to me now were Netflix, Amazon, television advertisers, and mail order catalogues.

And a few very dear friends. Thank you.

All this is to say: there were two aspects to getting through this time; the emotional / spiritual, and the purely logistical. The emotional/spiritual was comprised of questions like, “If I used to have friends before illness stripped my talents away, and my friends don’t come see me anymore, did I ever really have friends in the first place?” ***

The logistical was more like this: “If I don’t get out of this house soon, I promise you I will lose what little grip on sanity I have left!”

The challenge I had with my illness was that my health was extremely variable, and I was too ill to drive safely in car-centered Texas. This led me to articulate the 5 Stages of Health:

#1: I am too weak to get out of bed.

#2: I am too weak to leave the house.

#3: I am feeling well enough to do something easy, as long as I have a way to get there and back.

#4: I am feeling well enough that I could do something energy-intensive, such as walking in a park, as long as I have a way to get there and back.

#5: I am strong enough both to do an activity, and to transport myself there and back.

So, as you can see, if you are at Stage #5, you are more or less independent. You may still have health problems, but they are not holding you back from mobility or activity. I was rarely in Stage #5.

On the other hand, if you’re at Stage #1 or #2, mobility isn’t even a problem because it’s not really an issue. If your head is split in two with a horrible migraine, you don’t really care whether, in theory, you’d be well enough to drive today.

The problem is when you’re at Stage #3 or #4 — well enough to engage in activity, but not well enough to be independent. Too often, when I lived in Texas, I would be stuck inside even when I was at a “4” level, because of a lack of appropriate transportation.

What do I mean by this? Well, a person with ok health but no car can plan to take a taxi to a special event. However, a person with extremely variable health may spend $20 for a taxi to an event, only to realize 20 minutes later that a dizzy spell is coming on and she has to get home right away. Maybe by now the taxis are all taken and she must wait, extremely sick, out in public, at the event.

Or maybe the taxi arrives promptly, and she goes home, having spent $40 to exhaust herself, and take a round trip straight back to her home, and not go to an event.

Because of this variability, and also the expense and inconvenience, the person with poor variable health really needs either a loved one who is willing to put her first — to drive her and take her home when she needs — or some form of transport that’s under her control. Otherwise, the fear of collapse while out in a public space is too great, and she stays home. Again.

This is particularly frustrating because healing from illness is a mental game as well as a physical one. If you spend all month being diligent and cautious, and finally have a day where you’re at Stage #4, you want to experience some positive reward for your efforts. If, however, the only reward is that you are merely well enough to feel even more keenly the bars of your prison, then there is almost no incentive towards getting better. In such a scenario, there are no repetitions of success when you improve, only repetitions of failure, and it can be extremely difficult to crawl one’s way towards a better life.

The wonderful thing about moving to a walkable city like Boise is that I finally get to build on my successes, rather than only suffer from them. I have things I can do when I can only walk 3 blocks, things I can do when I can walk 8, and even other places I can get to when I can walk a mile or more. As I’ve mentioned before, the dry climate is very supportive of my health, but so too is the knowledge that, if I can get just a little stronger, I can experience even more success. That in itself is an incredible incentive to work even harder at my recovery.

If I were to suggest a takeaway from this experience, it would be that if you or someone you know is struggling with something very hard — whether it’s recovery from an illness or learning a difficult subject in school — make sure that, for each measure of progress you gain, you also gain a commensurate reward. If you have to achieve perfection before you can even start living your life, you’re playing the wrong game.


*** It can lead to even deeper (and more confusing) trains of thought, such as,

“Aren’t all relationships, at their source, mere transactions?”

“Do we ever really ‘love’ anyone, or do we just love what they can do for us?”

“When even something as fundamental as someone’s personality can be changed in an instant by illness or accident, how can we promise to love someone ‘forever?'”

How to Be a Grownup: It Costs a Lot of Money to Look This Minimalist

I read them in the checkout line: organization porn. Magazines like Real Simple, which, like all good science fiction, show things that are beyond our mortal ken (in this case, spare, perfectly tidy children’s bedrooms).

The hot design trend is a “simple,” “minimalist,” Buddha-chic look. A look which says, “I only have a few items in my home, because I am detached and not crassly materialistic like you. Is it my fault that the few items I do have are exquisite? That’s only because God rewards deep spiritual devotion with equally deep Persian rugs.”

So, a few points about all this.

First of all, it’s great to de-clutter. A few years ago I got really into it, and my home looks a lot better for it. Getting rid of so much stuff helped me to get organized, which then gave me positive reinforcement to get even more organized. And that paved the way for me to be able to live in a lovely, small apartment – with my boyfriend – while also working from home. So, yay.

But, there are a few things I want to point out.

First of all, most of the people writing these design books live in New York City.  Only New Yorkers have to think, “Well, I bought this new pillow, so to make room, I’m going to have to throw out the cat.”

New York design is all about overcompensation. These folks live for years in cramped, cluttered quarters, so they spend their free time fantasizing about vast empty spaces filled with beautiful white nothingness.

But you, clever person in Iowa, have a spare bedroom, and you’re not even a millionaire! So live it up and get the second throw rug.

Second of all, I would like to point out that there is a hidden paradox to minimalism: living a beautiful uncluttered life can often take a great deal of money.

Let me explain. When you’re poor, you don’t just have, say, one clock radio — instead, you have the one where the alarm still works, the one that still gets FM on the low end of the dial, and the one that still plays CD’s (sometimes). You cobble together what you need out of half-broken things, and you keep weird crummy items around because they help you gerry-rig your broke-ass life (“No, you can’t throw that away, I use that to jiggle the radiator when the heat won’t come on!”).

Pretty soon, you end up with a lot of . . . stuff. Not stuff you’re proud of, just crap that you can’t afford to get rid of.

By contrast, when you’re rich, you can buy an item that really fits your purpose and needs. You can buy things that are well-made and built to last. And you can afford to maintain, repair, and replace things.

In the Victorian era, when the manufacture of dry goods was laborious and expensive, having lots of things was a sign of wealth — and that led to the fussy, over-decorated Victorian aesthetic.

In this day of planned obsolescence and Ikea, living without a lot of stuff has become, in a strange reverse-snobbery way, a sign of wealth.

It is the ‘white couch’ of life — simple, but hard to achieve without money.

Some Great Essays.

Every once in a while, I find an essay that really stays with me. Here are a few gems I’ve found over the  years.

In You’re a Good Man, Dr. Smurf — one of my favorite essays of all time — Martha Beck describes her intimidation as a Harvard student, surrounded by colleagues who appear brilliant and omniscient. Until, one day, in a very funny way, she realizes that everyone around her is totally and utterly bullshitting.

Rebecca Solnit’s essay Men Explain Things to Me is the essay that launched a thousand blog entries. She begins with a story of the time an older man patronizingly describes a book to her — her own book, as it happens. This essay inspired the term “mansplaining.”

In Does Gender Matter? Dr. Ben Barres describes the culture of the sciences from his unique vantage point as a transgender scientist: Shortly after I changed sex, a faculty member was heard to say “Ben Barres gave a great seminar today, but then his work is much better than his sister’s.”

If you like a long, richly-detailed essay, try  The Marriage Cure by Katherine Boo. It explores the theme of poverty, by following several women trying to make the best out of terrible situations. A moving essay that provides no easy answers, but plenty of questions.

And finally, a short essay called “Those Aren’t Fighting Words, Dear” — published in the Modern Love section of the New York Times of all places! — had a simple but profound effect on me. It’s about a middle-aged man who tries to solve his midlife crisis by breaking up his marriage, and how his wife’s verbal jujitsu enables them to get through his rough patch and stay together.

Now go ye forth, and Read!

How to Be a Grownup: Problem-Solving

(cross-posted on Applied Grace)


One of the most important principles of problem-solving is that changing the definition of the problem can help you come up with a solution. To illustrate this, I’m going to use a children’s story I read in grade school:

A hero goes to steal a valuable treasure from a king. The king is protective of his treasure, and keeps adding more and more locks to the door of his vault. But the hero is able to open the door and make a clean getaway. How? He takes the door off its hinges.

In other words, the hero re-frames the problem, reducing the problem down to its most basic components. He changes the problem from:

I need to find a way to unlock all of these locks


I need to find a way to open this door

By simplifying the definition of the problem, he removes assumptions that might have kept him from seeing a solution.

Here’s another example: a Brazilian mechanic, Alfredo Moser, came up with a way to light indoor spaces during the day. His town had frequent blackouts, so instead of relying on electric bulbs, he filled some plastic bottles with water and stuck them in the ceiling. Due to the refractory properties of water, each plastic bottle gave off the same amount of light as a 60-watt bulb.

So, when he re-framed the problem, he changed it from a hard-to-solve question:

How can our town get a more steady supply of electricity so that I can turn on my lights?


How can I have better light indoors?

. . . . .

What can we take from this? When problem-solving, it’s best to start by challenging your basic assumptions. Then re-define your problem away from “what you think you need” to “what you actually need.”

Here’s an example of how this might work in daily life, in a conversation about a problem with housing:

Person A: I need an apartment.

Person B: You need a place to live? Because you might be able to rent a room . . .

Person A: No, I can’t deal with roommates. I need to live alone.

Person B: So, you need a place to live, where you can live by yourself.

Person A: Yeah. The problem is, I can’t really afford the rent on a one-bedroom by myself, and this town doesn’t have any studios for rent.

Person B: Well, what about a house-sitting gig? I just saw an ad for a summer housesitter.

Person A: Hunh. I never thought of that.

Person B: You’d be able to live alone, and it would be rent free.

Person A: Yeah, that might work! And if I didn’t have to pay rent for the summer, I could save up enough for a security deposit for my own place in the fall!

So, by unpacking this situation, and separating out what the person thinks he needs (“an apartment”) from what he actually needs (“a place to live by myself”), a solution becomes apparent that addresses both short- and long-term needs.

“The Dip” by Seth Godin

I’ve been reading some books on marketing, business, and promotion.  Here’s my 5 minute summary of Seth Godin’s The Dip

  • We now live in a winner-take-all economy – in other words, the top search for a product, service, doctor in Google is going to have the lion’s share of the business. It’s no longer enough to be #4, you’ve got to be at the top of your market to succeed. (I think this is super depressing but it may also be true.)
  • The top of your market could be “The Best Pediatrician in Poughkeepsie” or “The Best Bagel Place in LA.” Know your market and be the best in that market.
  • “The Dip” = the long hard slog that weeds out the many from the few superstars. Examples of this could be: Organic Chemistry, Law School, a rigorous exercise program that gives you washboard abs – anything that is a barrier to excellence.
  • Looked at correctly, “The Dip” is your friend, because it weeds out the competition for you. If you’re willing to get through it – with creativity, etc. – it will protect your status when you get to the other side.
  • There is a difference between “The Dip” and dead-end, pointless, or diminishing-returns pursuits. Successful people know the difference. Successful people quit things that are pointless to continue, and double down on difficult activities that will eventually pan out. He gives examples to differentiate the two.

How to Be a Grownup: Getting Rid of Stuff

If my experiences growing up with two packrats have been useful in any way, it’s that I have learned, internalized, and then unlearned a whole bunch of excuses for holding onto crap.

If you’ve ever thought, “Hrmm, I appear to be living in squalor“. . . some of these excuse-busters may be useful.

1. But it’s an Heirloom! 

No, sweetie. An “heirloom” is something that is kept by several generations and cherished. You’ll know it’s an heirloom because you love it, you use it, and you want to show it off.

That horrible, heavy old piece of furniture? The one with the smell? The one that’s stuck in the basement because you don’t want it around? That’s called a “burden.” 

Keep the heirlooms. Lose the burdens.

2. Aunt Gladys gave this ugly thing to me, and now she’s dead! So I have to keep it forever!

No. No, you don’t.

Aunt Gladys probably gave you many things throughout your life. Really nice things like that sweet 16 necklace, and really forgettable things, like weird fruitcake tins. And then she died and you thought, “I can never get rid of these fruitcake tins because AUNT GLADYS DIED and if I get rid of them it’s like I’m Killing her Again! AAAUGGGHHH!!!”…then you hide the tins in a drawer and feel weird about them.

Did your Aunt love you? Do you think her last wish for you was, “I hope she keeps those fruitcake tins….Forever! May They Haunt Her Dreams! Bwah haha hah aha ha!” 

Probably not.

The trick is: “Keep the memories, Lose the stuff.” If you find it hard, you can take a picture to remember it by. You’ll never look at that picture again, of course, because you don’t want to.

3. But Invisible People Will Judge Me!

For years, I carted around loads of books I didn’t like and hadn’t read, because I was afraid some mysterious judge would pop out of the woodwork at any moment:

“You only kept the copies of that series that you like? How dare you break up the set!”

“You got rid of your Algebra II textbook?! But what if there’s an emergency, and you have to factor a polynomial?!?”**

“How can you possibly think of getting rid of your copy of Godel, Escher, Bach? Even though no one you know has ever made it through the whole thing, you just won’t be intellectual without a copy silently glaring at you from the bookcase!”

In short, I feared some friend, acquiantance, or family member would come and insult my book collection if I pared it down only to the books I truly loved and used. But after I pared it down, no one came over to my place to get on my case about getting rid of Coriolanus.***

Oh, and libraries have been invented. So that helps.  


** We all felt foolish during The Great Polynomial Apocalypse.

*** Or Titus Andronicus. That is one weird-ass play.

How to Be a Grownup: Miss Manners on Saying “No”

I’ve always loved Miss Manners, ever since college, when my friend Joel Derfner declared himself a fan.

“Really, Miss Manners?” I asked.

“No, you don’t understand,” he said. “She’s really quite witty, and she has excellent advice. For example, she says that if someone points out some flaw, like a hideous mole on your face, you should say, How very kind of you to notice. And if someone totally overshares with you, then you should say, How nice for you. Isn’t that great?!” 

I wasn’t sure about these methods, until a few weeks later when a classmate came up breathless to me in the dining hall:

“Guess What? I’M ON THE PILL!!” she announced — and very loudly, I might add.

Although flabbergasted by this announcement, I was still able to stammer out a response:

“How nice for you.”

Then I saw Miss Manners’ genius.

One of my absolute favorite pieces of Miss Manners’ writing is when she explains how to say “no.”

Here’s the text, excerpted from Miss Manners’ Guide to Excruciatingly Correct Behavior:

The ability to say no politely is an essential social skill. All that is really needed is the ability to repeat “No, thank you,” interspersed with such small politenesses as “I’m so sorry” and “You’re kind to ask” and “I wish you luck.”

Elaborating is what gets people into trouble. Excuses that are false are traps one sets for oneself, but even true excuses encourage the audacious to argue: “Can’t you do that another night?” “One little piece of cake isn’t going to kill you.” “But this helps more people.”

Yet most people can’t help blabbing on to soften  the “no,” which is apt to be so softened as to give way. So here is a small sample of supplementary sentences:

“I’m afraid I’m not taking on anything else right now.”

“Sorry, I never discuss my finances.”

“I’m sure it’s wonderful, but I’m not going to have any.”

“We never go to balls, but we’d love to see you privately.”

“I’m so sorry, but that’s not something I can help you with.”

“If you care to send me written material, I’ll get in touch if I find it interests me.”

“I didn’t realize what this involved, and I think I’d better bow out.”

And the ultimately correct, no-excuses refusal:

Dr. Peony Wilson

regrets that she is unable to accept

the exceedingly kind invitation of

Mr. and Mrs. Popinjay

for Saturday, the first of June

How to Be a Grownup with Money

Every once in a while, I read a book that enhances my “grown-up” skills. There are some skills I had down pat by the time I reached adulthood — for example, I was an excellent student — but there were many that were frankly mysterious to me, the lack of which caused me much pain during my 20’s. So, over the years, I’ve taken my “good student” skills and applied them to creating my own course, called How to Be a Grownup. (Of course, like every real course of study, the task is life-long…)

If you are familiar with my music or my writing, you’ll know that I have a strong interest in poverty, debt traps, and self-education around issues of money. So, the first title on my How to be a Grownup syllabus is the quirky and wonderful The Complete Tightwad Gazette, by Amy Dacyczyn. This book is part of what allowed me to pursue music for several years in Austin, living on a very-part-time income. It’s also part of what helped me to stay afloat as much as I did during the first two years I was struggling with Lyme Disease.

On the surface, this book is a household budgeting book, but it also has a number of fabulous essays on what I would call Tightwad Theory — the process and thinking behind how to make good decisions which are A) creative B) economical and C) fit into a long-range goal. Not only do I think everyone who runs a household should read this, I think everyone who runs a business should read it too.

One of the most useful concepts I learned from this book was calculating the “hourly rate” of tasks. We’re all familiar with an hourly wage for work done outside the home…this takes a similar concept and applies it to “unpaid” labor that saves you money.

For instance, if you live in an apartment building where it costs $2 to dry a load of laundry, every time you line-dry it instead, you will save $2. If line-drying one load of laundry takes 15 minutes, then you could do four loads in an hour — for an “hourly rate” of $8, tax-free.

By using this quick calculation, combined with other factors such as your enjoyment of certain tasks, you can decide if a certain frugal activity such as packing a lunch, rinsing out a ziploc bag, or changing your own oil is “worth it” according to your budget.

Once you are able to see tasks with this framework, you can apply it to many other areas of your life, including business. For example, if you’re planning a meeting, calculate the approximate hourly wage of all the meeting participants. If employees at your company are paid an average of $35 an hour including benefits, a meeting with 10 employees “costs” the company $350, so the meeting should be providing $350 of benefit to the company.

There are lots of other great recommendations, such as keeping a “price book” to track which items are cheapest at each of your local stores, and using her methods to calculate the true net value for a second income.

She also talks about the fundamental overlap between being ecologically responsible, and being frugal. In her words, “Economy and ecology are like two circles that overlap about 90%. The remaining 10% is the area where doing the right thing by the environment costs more.” She also gives great advice on skills such as goal-setting, long-range planning, childrearing, and being part of a couple that works well as a team.

Overall, this is a great book for anyone and everyone.