The Doctor As Entrepreneur
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The Doctor As Entrepreneur

The Doctor As Entrepreneur

Medical technology is changing every day, advancing at an unprecedented rate. Inventions like contact lens that measure blood sugar, and other wearable technologies, are in the works. Within a decade, it’s likely that people will be able to assemble health information easily, without the need for finger pricks or trips to the doctor’s office.

Some weeks ago, author and medical technologist Robin Farmanfarmaian was a guest on my BlogTalkRadio show, Independent Artists & Thinkers. Farmanfarmaian, who works with silicon valley biotech and medical technology start-ups, talked about her book The Patient As CEO: How Technology Empowers the Healthcare Consumer. She commented on the speed of the medical technology revolution and how difficult it is for doctors to keep track of new developments. The patient, she advises, must see himself or herself as the head of a team of healthcare professionals who work together to help the patient achieve optimal health.

This revolution is occurring at the same time that managed health care is making it harder for physicians to make a good living at a profession for which they have studied and specialized for a decade or longer, while also undertaking huge student loans. Indeed, I worry about my stepdaughter in medical school. Will she be forced to see twenty-two patients per hour just to pay back her student loans? Will her options be limited by checklist medicine and by debt?

In the face of the medical technology revolution and ever more rigid and punitive insurance regulations, doctors do have their own ingenuity to fall back on. I was reminded of this recently when my friend dermatologist Debra Jaliman told me about new products that she herself developed, Sea Radiance skin care products.

Dr. Jaliman, a board-certified dermatologist and assistant professor at the Icahn School of Medicine at Mount Sinai, has been a resource for me for more than twenty years. She’s always on the cutting edge of dermatological products and techniques. I reviewed her book Skin Rules: Trade Secrets from a Top New York Dermatologist because I found it useful, informative, and well-written.

Cosmetic dermatology may not be in the same category as, say, paint-on ink that gauges blood pressure, but for women like me who care about looking their best, it matters. Life deals us all so many bad cards that when I can do something positive for myself, I seize the opportunity.

So I was intrigued when Dr. Jaliman announced her new cleanser that moisturizes as it cleanses and her new eye cream, both made from sea flora, organic flower essences, and advanced dermatological formulas. I wanted to know what the products could do for me. Thinking about my stepdaughter’s future in medicine, and about Farmanfarmaian’s appearance on my BlogTalkRadio show, I also wanted to know what had prompted Jaliman to develop them and how she had done so.

“I’ve been working with big companies for so many years, and I always had in mind that I’d create my own products,” Jaliman told me. She’s consulted with companies such as Johnson & Johnson, Proctor & Gamble, SKII, Lierac, and others, helping them develop products. “I don’t sign the standard non-compete clause, when I work with them.”

“But why these products, now?” I persisted.

“I listen to my patients. They want immediate results around their eyes,” Jaliman said. “And over the years in my practice, I hear the same complaints, especially from people with sensitive skin or adult acne. The usual cleansers dry them out or provoke redness; after many people wash their face, their skin feels tight and dry. My goal in developing gentle cleanser was to create a product that took off all the dirt and impurities but left the skin feeling hydrated.”

She also commented that patients would stand in her office and read labels, and some dismissed certain products because of their ingredients. So Jaliman sought out the purest ingredients–and a lab that would work with her to create the finest, most effective products.

“Not all labs wanted to do this because it’s incredibly difficult,” she admitted. “It was no easy goal. I made many different formulas.” She noted that her products have very low numbers on the Environmental Working Group‘s list. Her eye cream and cleanser are formulated without parabens, phthalates, sulfates, gluten, and synthetic dyes and fragrances.

She explained that while the big corporations have the advantage of big budgets for research and development and marketing and promotion, she has an advantage in immediacy of feedback. “I have thousands of patients that I could give the product to. They tested it for me and gave me honest feedback. We then changed the product many times over the course of the year and a half of development.”

Jaliman was a stickler for maintaining her products’ efficacy. Air inactivates antioxidants, so she sought out a high tech tube that wouldn’t allow air in for dispensing the eye cream. Before launching Sea Radiance, she had a beautiful and informational website built. The consummate marketer, she included the new products in a gift bag for stars at the Academy Awards.

She handed me samples so I could try them for myself. I felt so good about the purity of the products that I shared the cleanser with my 11 year old daughter. She left for school saying, “My face feels so good, mommy!” It’s a sentiment I’m happy to echo: my skin feels softer since using Sea Radiance cleanser, and my crow’s feet are smoother with the eye cream.

I’m also happy to see such positive, utilitarian results from Dr. Jaliman’s entrepreneurial efforts. The medical technology revolution doesn’t just benefit consumers–it also, with some responsiveness and inventiveness on their part, potentially benefits doctors.

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Let’s Just Say It Wasn’t Pretty by Diane Keaton, A Review
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Let’s Just Say It Wasn’t Pretty by Diane Keaton, A Review

Book by Diane Keaton, A Review

Today I slathered on several layers of Elta MD sunblock and even still, when I traipsed off to the beach, I wore a big brimmed hat. By the time I arrived at the long golden stretch of Cape Cod sand, I had wrapped my daughter’s long cotton bathing suit cover-up around my head and the hat, to prevent any errant rays of sun from reaching my face.

Not that the sun light wasn’t delicious, because it was: honeyed over and lavendered under, in that intoxicating Cape Cod way that delights painters. Pores all over my body opened to suck it in. But the sun light does things to skin, you see, crepey, wrinkly things that are to be avoided when you’re not a spring chicken anymore. And I am a 50 year old woman.

So it was with amusement and self-reflection and an understanding that has started to seep in with my alarming half-centennial mark that I read Let’s Just Say It Wasn’t Pretty by Diane Keaton. This book delves into matters of aging and having to redefine oneself as the temporal body decays around the immortal soul. That last bit, about the soul, that’s pure Traci Slatton, by the way, not Keaton.

It was surprising to me to read how critical Ms. Keaton is of her own looks. I’ve always found her beautiful. Extraordinary, really. It made me feel sort of tender toward her. I think of how critical I’ve always been of myself–looking in the mirror at my flaws instead of my grace notes–and I wasn’t a famous actress who was on display all the time.

Ms. Keaton’s reflections on, oh, eyes and hair and the polymorphous perversity embedded within the larger idea of beauty were interesting. The narrative was interwoven with memories and analysis of her family, her parents and her children, as if to know herself is always done in relationship with her loved ones. I expected more about her work, especially from a woman who never married.

There is some of that self-involvement which so many actresses, especially famous ones, seem to inhabit. It’s their all-encompassing ground of being just as fishes live in the sea. I could forgive it in this book because there’s such good reverie, and because Diane Keaton is a kind of pioneer. She holds a lamp and stands ahead of me on the scary but devoutly-to-be-desired road of getting older and older.

So yes, the book is good, not perfect, and worth reading.

 

LESSONS IN BECOMING MYSELF by Ellen Burstyn
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LESSONS IN BECOMING MYSELF by Ellen Burstyn

LESSONS IN BECOMING MYSELF by Ellen Burstyn

            This summer I will enjoy a birthday milestone: I am turning 50. It’s a big, rich age, but also, for a woman, one with certain questions attached. Our culture tends to marginalize older women, so how do I squeeze all the juice from the ripeness of these years? Who are my role models for vibrant, successful, creative, sexy women in the fullness of their decades?
            I was musing on this subject when I came across a mention of octogenarian actress Ellen Burstyn’s memoir. I admire Ms. Burstyn’s work, I think she’s beautiful, and I was intrigued enough to download the kindle version.
            This thoughtful, well-written book contained some answers. It’s often thus in my life: if I hold something lightly but clearly in my consciousness, it will materialize. There’s a magic and mystery to consciousness that affects everything around it. In fact, this is one of the liet motif’s of Burstyn’s book.
            I think we read memoirs and biographies with an eye toward the parallels with our own lives. We look for the similarities of background so can we be inspired with an expanded vision for our own future. We want to know what our own potential is, so we compare ourselves to those who’ve gone before. Burstyn is an actress and I am an author, but there was enough in common to cause me to pause and think deeply about where I’ve been, where I’m going, and who I’ve been and am going to be.
            For me, the first point of resonance was familial. I hold a deep empathy with Burstyn’s accounts of her mother. It wasn’t my mother who beat me, it was my father, but my mother was a cold-hearted person who dedicated herself to invalidating and dimunizing me at every turn. Anyone who’s experienced that knows the fullness of it.
            I understood exactly what Burstyn meant when she described herself as looking at her mother and thinking “I don’t want to be like that.” It’s a particular kind of bone-deep dislike, and a kind of grief that must be integrated, and ultimately transcended, in order to accept and to love oneself as a woman.
            My mother was a heavy smoker and I never looked at her without seeing her as surrounded by a cloud of poison.
            Oddly enough, my grandmother, who played poker and sewed quilts and had to live on the wagon after decades as a falling-down, black-out drunk alcoholic, was at least as heavy a smoker, but I never perceived her the same way. Perhaps that was because she offered me a deep love and kindness that sustained me.
            Her love was unstintingly returned. After all, love isn’t about perfectionism. In fact, the two are opposites, I think.
            But thankfulness and love are close kin. Indeed, I owe my grandmother a debt of gratitude. It was she who suggested that I wasn’t trapped by my family of origin. One day, when I was 6, my father beat me to the point that my tough old bird of a granny went into another room to cry. When the episode was over, I went to check on her.
            “When you grow up, you can leave these people far behind and never come back, Traci,” Granny said.
            I don’t remember this moment specifically. Granny told me about it shortly before she died. Everything in me ached with truth and remembrance, though I couldn’t pull up the file in my brain.
            Burstyn talks about leaving home on the day she was 18: “There was no force on earth that could have stopped me.” I get that. I headed out when I was 17, my acceptance from Yale in hand. Burstyn yearned to see the world, and that yearning still fills me all the way into my toenails.
            Burstyn had her beauty, pluck, and innate intelligence to rely on, while I had a talent for school work. She became a model and actress while I went to college and then to graduate school. I burned with the longing to write books. It’s that longing that has led me through my life.
            Burstyn made some interesting and regrettable choices for mates along the way, as I have. She writes about her third husband stalking her for years, threatening to kill her. My heart wrung with understanding. My former husband has pursued me via the legal system, suing me repeatedly, losing, and then hiring ever more expensive attorneys with ever fiercer reputations, until the last time in court, when he showed up with an entourage of attorneys said to be some of the meanest and costliest in the city.
            The judge dismissed his suit against me, but I wonder if my ex’s blood lust is assuaged. One therapist told me, “If he’d had a different background, he would have picked up a gun. Given where he comes from, he’s firing his lawyers at you.”
            Burstyn’s in-laws blamed her and her success and treated her badly, something else I well understand. I haven’t been as successful as Burstyn but there’s no question that my ex’s family lives in narcissistic distortion around the matter of our failed relationship.
            Burstyn has done a lot of meticulous work on herself and she’s able to ask herself the penetrating questions: what in me allowed me to marry this unbalanced man? How is he carrying my shadow?
            For me, there’s no question that the sneering condescension with which my ex treated me for the 20 years of our relationship, and the dozen years since it ended, was a replay of my mother’s contempt for me. His desire to annihilate me since we parted is a reiteration both of his pathological desire to control me, and of my rageful father’s intentions. The way my ex is treating me now is not different in kind from the way he always treated me—it is different by degree.
            I chose a man like that because of my own wounding. If I had healed myself earlier, I would not have made that choice. Repetition compulsion is a bitch.
            I have the sense that Burstyn was able to use her fear and sorrow over her ex-husband in her craft as an actress. As an author, I use my experiences in my own writing, so I’ve found a way to be grateful for almost everything I’ve been through. I am currently working on a novel set during WW2, and my former husband’s unbounded aggression toward me, and his absolute certainty that he is justified in it, has given me my prototype for the Nazi’s—in particular Josef Goebbels.
            Hannah Arendt has said that evil is banal, but I disagree. I think that evil feels itself to be justified in its actions. I do marvel at the way my former husband feels justified in his behavior.
            Artists mine their own lives for their creations. In this way, the suffering I’ve endured has given me ample material. Life deals everyone some shitty cards. The question is, how do we play those cards? How do we make our hand meaningful?
            The game isn’t about wallowing, it’s about redemption.
            I enjoyed reading about Burstyn’s evolution as an actor, her education by Lee Strasberg, and her integrity toward her craft. I can relate to that, as well. At Yale and at Columbia, I was taught by exceptional writers and thinkers. Then I had to go out and apply what I learned, and to work with it every single day. I will continue to work on my craft until the day they pry the keyboard out from under my stiff, lifeless fingers. I have a feeling that Burstyn will be plying and perfecting her path until she is literally unable to walk onstage. I admire that.
            Hard work, integrity, and gratitude aren’t the only paths to redemption. There’s also the exploration of consciousness. Burstyn writes movingly of her forays into the metaphysical realm. If you open yourself, the universe—or God, “the Force,” the spirit of all that is—will speak to you in direct, palpable, and wondrous ways.
            Burstyn’s film Resurrection arose from her inquiries into the numinous, and, similarly, I attended a healing school and spent 10 years as a hands-on healer, with a practice. I still have a daily practice of yoga and a nurturing spiritual life of prayer and meditation. Though, to be sure, I spend as much time arguing with God and yelling at God as I do praying.
            When I soften and relax into reverence, I can feel the sweet, loving, healing humor of the Divine—like the warmest smile imaginable, hugging my entire being.
            I liked what Burstyn had to say about the divine feminine, and about women owning both their sexuality and their spirituality. I’ve been thinking a lot about this concept lately. We are creatures of spirit inhabiting bodies of flesh, and we must honor both our flesh and our soul. Denying spirit, as scientific materialists have done, or denying flesh, as so many religions have done, can only lead to imbalance, distortion, and disease—on both the personal and transpersonal levels.
            It’s not our purity that will save us, it’s our richness.
            I affirm both my eros and my sanctity.
            A few notes that are more critical in nature. For one, it’s hard for me to understand Burstyn’s embrace of Islam, a religion so harshly patriarchal as to ruthlessly enslave women. She mentions Sufism as a way to explore the universal truths contained in all religions, but I couldn’t help but wonder if it was about her absent father. Did she gravitate toward male-deifying Islam as a way to fill her own “father” void?
            Then again, I chose Judaism, so some people will discount my question purely on the basis of the ancient schism between Judaism and Islam.
            My personal experience with Islam was taking Arabic at Yale. I was the only woman in the class, and the unspoken, underlying misogyny of the class was so intense that I rarely attended. I redeemed my grade only by doing an excellent final project: a translation from Scheherazade’s One Thousand and One Nights. With her infinite story-telling creativity, she is one of my beloved archetypes. Scheherazade was the reason I took the language—despite the contempt of my male classmates.
            Remember, I have a high tolerance for contempt, because of my childhood.
            Second, I was saddened to read of Burstyn’s regular use of recreational drugs. I suppose I stand practically alone of my generation in my stance that recreational drugs are bad, but I’ve seen lives destroyed by pot and other drugs. I do not share the current cultural embrace of marijuana. I think marijuana is destroying America and our future prosperity and success.
            In particular, I wish Hollywood didn’t insist that drugs are cool. Is Hollywood so lacking in imagination that it can’t find another way to show that characters are hip and independent than to show them smoking pot?
            Substance abuse just isn’t copacetic. Pot is not a success strategy, no matter how many movies and TV shows say otherwise.
            Burstyn writes of finally giving up her addictions, as she continued to deepen her schooling in becoming who she is.
            Third, Burstyn mentions that the current generation of actors doesn’t work as hard as her generation did. I have to say I agree with her. The young actors I know never talk about their craft. They talk about deserving to be rich and famous.
            This generation of American kids is, largely, an entitled lot. They think everything should be handed to them. It’s sad. This isn’t true of every kid, of course. My lovely step-daughter, who is headed to med school, works with admirable zeal and dedication far into the night. But entitlement, lack of personal responsibility, and disrespectfulness do seem, generally, to characterize American youth—as I see with my two beautiful, lovable older daughters, who are, despite my love for them, disappointments to me.
            I must bear some of the responsibility for their character flaws. I did the best I could as a mother, but it was difficult in the face of my ex-husband’s antics.
            Life will, sooner or later, deal them some harsh truths. This is inevitable. I’m curious to see how they’ll respond. I pray for them that they’ll give up their certainty of being better-than and entitled. I pray that they will open up into humility and wonder. I hope for them that their education in becoming themselves will draw them forth into what is larger than their own small, insistent egos.
            I hope for that for all of us.
            It has been a sad lesson in detachment for me to let them go explore their narcissism.
            So here I am, 49 and 9 months, trembling on the brink of 50, the mother of three daughters and a step-daughter, the author of 8 completed books with 2 more in the pipeline and several in the note-taking stage, a wife, an ex-wife, a mother, a daughter, a friend, a lover, a recovering healer, a dedicated yogi, an inveterate traveller, still burning to write books.
            Who am I becoming over the next three decades?
            What magic will consciousness wreak for me?
            What parts of myself will I meet again, as if for the first time?
            I don’t have the answers to these questions yet, but I’m grateful for Ellen Burstyn’s Lessons in Becoming Myself (New York: Riverhead Books, 2006), which is a kind of guidebook by a fellow traveller who is further along the journey.

My New HuffPo article: review of SKIN RULES by Debra Jaliman M.D.
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My New HuffPo article: review of SKIN RULES by Debra Jaliman M.D.

Check out my new review of the essential skin care book SKIN RULES Trade Secrets from a Top New York Dermatologist by Debra Jaliman M.D. Here’s the link.

This book is beautifully, concisely written and full of practical advice. Get the book–you’ll be glad you did!

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Review of Skin Rules: Trade Secrets from a Top New York Dermatologist by Debra Jaliman M.D.

When I was in my early twenties, my beloved Aunt Judy advised me, “A good skin and a good figure, that’s what a woman needs.”

We were conversing in the kitchen, preparing dinner together, so this bit of feminine wisdom was just a casual mention. But she was in her fifties and still boasted both qualities, so I took her words to heart. They sparked a lifelong commitment to taking excellent care of my complexion and my body. That same week, I undertook a meticulous habit of using sunblock every day.

A few years later, my first pregnancy wrecked my carefully tended complexion. I was enthralled by the wondrous, delicious creature who was my new daughter. I was equally determined to repair the damage done by pregnancy hormones. I had read that a pregnant woman produces more estrogen during the nine months she’s pregnant than a non-pregnant woman does in decades. My face, stippled with pimples and depressions, showed it.

A girlfriend with lovely skin recommended Dr. Debra Jaliman, and I took myself to her office on one of those precious days I had a babysitter. I waited anxiously in the exam room, wondering if the doctor would be able to help me. The door opened and in walked a gorgeous woman wearing a white lab coat over a leather mini-skirt — and a very pregnant belly. I could only applaud her feminine confidence. I knew immediately I’d come to the right place.

My first baby is now a graduating senior from college, and I’ve been Dr. Jaliman’s patient all these years. I have remained in her care for the same reason that I use the multiplication table: because it works.

It was with pleasure, as a happy dermatology patient with a complexion I like, that I requested a review copy of Dr. Jaliman’s book Skin Rules: Trade Secrets from a Top New York Dermatologist (St. Martin’s Press, March, 2012).

First, let me attest: almost the first order of business in Dr. Jaliman’s office is to ensure proper face-washing technique. After two decades, when I come in for an appointment, she still asks how I am washing my face, and what I am using for cleanser. So, as a long-time patient, let me assure the general reader that Skin Rules meticulously documents Dr. Jaliman’s actual advice. She practices what she preaches in this slim, smart volume.

The book itself is a pleasure to read. It’s concisely and elegantly written. There’s not a wasted word in this book, nor an infelicitous one. Every one of the 77 rules is spare, practical, and instantly understandable. The rules come with product recommendations at all price points; Dr. Jaliman does not expect that her readers are all millionaires with an endless supply of money for dermatological goodies, whether they be procedures or creams.

The tone of this book is as empathetic as it is pragmatic. Rule 42 gently advises, “Don’t Despair If You’re Over Thirty and Breaking Out — Nobody Needs to Know.” Rule 39 reminds us, “Acne Doesn’t Just Ruin Skin; It Can Ruin Self-Esteem, Too — Just Ask Any Teenager.” It’s important to remember how vulnerable people feel when they don’t look their best, how adolescents in particular suffer from that vulnerability, and how much self-esteem can be improved by simply clearing up acne. Some people would like to dismiss dermatology as purely cosmetic, but there’s a deeper level here. Our appearance is inextricably entwined with our feelings of self worth.

Sometimes a medical condition results in skin problems, and Dr. Jaliman notes that in several places. In rule 33, “Legs and Feet Need Extra Care,” she mentions having diagnosed hypothyroidism in patients by observing dry, cracked heels and referring the patients to an endocrinologist. The skin isn’t its own separate, isolated system. It’s integrated into the body as a whole, and often reflects underlying disease.

I’ve set this review within the context of my own feminine beauty regimen, but it’s a book for men, also. There’s advice on shaving, hair loss and tattoo removal.

With a title encompassing the word “secrets,” a reader hopes for the scoop on what’s hot and really works. The book doesn’t disappoint. Rule 61 “Freeze Fat, Don’t Suction It” discusses the latest cryolipolysis techniques, and the machines that really do freeze off the fat.

At the back of the book is a resource section that lists products, injectables and lasers. It’s probably worth it to buy the book just to have this well-researched list of products and procedures that actually work.

This is a gem of a book that I’ll keep handy on my book shelf — unless my second daughter, now seventeen and seeking out her own beauty tips, spirits it away so that I never see it again.

On Paul’s 80th Birthday
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On Paul’s 80th Birthday

Paul’s 80th Birthday

We went to the Cape for my friend Paul’s 80th celebration. This afforded the opportunity to play on Thumpertown Beach before attending his party. It was wonderful to see him looking so happy, and to reconnect with some of his lovely friends whom I have met along the way.

Eighty is a milestone, and Paul gave a speech that began somewhat morbidly. His is a life that has seen both devastating tragedy as well as brilliant accomplishments and victories. Fortunately, his speech morphed into a more humorous exposition. He was his irascible self, exactly the man we had come to know and care for. If his words weren’t exactly uplifting, seeing him be fully Paul, with his foibles and his lovableness, was an affirmation of the core of the human experience. We are here to be imperfect. And to be loved.
I also owe Paul a debt of gratitude for modeling for me what it means to be an author. I was born to be a writer, but until I got close to Paul, I didn’t have a clue to what that meant.
So in honor of Paul’s 80th, I post herewith a poem I wrote for him more than 20 years ago. I still consider him The Good Man.

THE GOOD MAN

for Paul

His face conceives of the sun, gilded by flycasting

For manifold days off the crooked finger of the Cape,

Often around the jettied mouth of the Pamet.

Along those teeming shoals lie blue barnacled oysters, buried

Littlenecks, razor clams, one shard of whose sweet sharp

Crescent slit open my foot in the ebb tide. He sat me down

In the bright ankle-deep water, then trudged off

Across a glittering gilt sandbar, an oasis sculpted out of the flux,

For a band-aid and antiseptic wipe. Two terns

Fed each other, even the greedy white gulls, his favorite

Harbingers of humanity, for once stood peacefully watching

The wind ruffle in from the Bay.

Back home in his tower

(He built it on the earnings of years raking muck up

To publicly expose the threatening unseen)

I showered first, while he watered the pink tomatoes,

Curly beets, tiny triangular hot peppers and fragrant basil,

All fertilized by fish mulch, before he washed off

The luminous sticky sand of the day’s

Adventure. It took him an unhurried hour, maybe longer,

To nurture his green creatures to his satisfaction,

This general succoring in the prosperity of time.

 

by Traci L. Slatton

The Prom
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The Prom

Last night my step-daughter and oldest daughter went to their prom.
There were the usual concerns in the breathless anticipatory hours: dress, shoes, hair, make-up. The day before, my daughter decided her original dress revealed too much, and texted me to ask if she could exchange it. Text is the medium of communication of choice these days, I’ve found, and become adept at it myself, for that reason.
“Course,” I texted back. “B comfortable n happy!”
So she found another one, at a different store: the perfect pink concoction. And last night a bunch of parents were invited to a pre-prom soiree hosted graciously by the parents of a young woman in a delicious gold-print gown.
Present was a group of about 12 kids, young adults, who stood with splendid, nervous grace while an assemblage of parents snapped thousands of pictures. With my usual thought to backups and redundant systems, I brought two cameras, in case a battery died. (One did!) We parents were in a poignant, jovial mood and joked with the kids about the Hollywood red carpet.
It wasn’t just my daughter’s sudden and shocking maturity that caused a lump in my throat. These are great kids, some of whom I’ve known since they were 4 years old. I remember one young man as a skinny little boy in leggings. Another young woman climbed the monkey bars in the park while her mother read the newspaper and I chased my oldest daughter, who was 6. Now they are all going to college in two months. They stood before us in their finery, which made them look even older than 17 and 18. Where did the time go?
And how does it redefine parents when their children leave?