Tuesday, February 26, 2002

Ricki Pollycove, M.D.

"Teacher Nurture in a Helping Profession: Self-Care and Balance While Caring for Others"

MS. LANE: Okay, folks. It's time to come in and sit down, please. Those of you on the left side of the room may want to move over more to the center or right side of the room, so you can see the screen. I think Ricki is going to be using that.

Just a few announcements. I did put two signup sheets out on the front table about people departing tomorrow, either for San Francisco into town or to the airport, and that really was to do a connection. I will not be your travel agent for this. But if you have a car or carpool and are departing early tomorrow morning, or at any time tomorrow and have room in your car for people going to either destination, would you please so indicate and put the time that you would like to depart, and then those who need a ride can check and hook up and see if you can make a connection.

As you also know, the Evans Transportation Company will get you to either place, but it might be nicer to carpool if you can. So that's what that's all about.

A reminder that today lunch is on your own. We do not provide lunch today. The reception tonight will be in the Fairway Deck. It is a cash bar again. I notice some of you came last night very formally and I hope you had a good time there. I hope more of you will come back before dinner, which is at 7:00. Dress for dinner is very informal. In fact, if you have your tights and your tutu with you, you may wear those.

I want to remind you that your evaluation forms are very, very useful for us. Do leave them on the front table as you leave, on the registration table, and I will collect them. It helps us formulate the program for next year.

The hotel had asked me to remind you that there are three ways of quick checkout if you don't want to go through the checkout desk. There is a card on the key card envelope that you got when you registered. You can fill that out and simply drop it in the box with your key. You may also check out on TV, or by the phone. So if you're in a hurry to leave, either this afternoon or tomorrow, you can do that expeditiously.

I'm now going to ask Harry McKay to introduce our next speaker.

MR. McKAY: Good morning. Like Joan Lonergan, I'm also a transplanted easterner, and so am delighted to be in another beautiful day in California. I hope you're all enjoying it, those of you who aren't from this state.

Our next speaker is a native Californian. Dr. Ricki Pollycove earned a B.A. in zoology and immunology and a master's degree in health sciences at the University of California Berkeley; and then an M.D. at the University of California San Francisco. She is certified by the American Board of Obstetrics and Gynecology, and holds medical licenses in both California and Arizona.

Dr. Pollycove has been in private practice in San Francisco since 1981 in the areas of obstetrics and gynecology, breast diseases, and integrative medicine, and she also serves on the clinical faculty at the University of California.

She holds memberships in numerous professional organizations and has served in many consulting capacities, including chairing the Breast Health Center Development Committee in San Francisco.

Recently she coauthored a book to be published this April entitled Mother Nurture: A Mother's Guide to Health in Body, Mind, and Intimate Relationships.

Ricki has been a colleague and a personal friend for many years, always bringing a perspective that I find to be stimulating and refreshing. My parents' generation equated medicine with sickness. My generation has experienced the dramatic shift in the medical field from sickness to wellness, and the evolution continues as we find ourselves embracing more and more the notion that all systems and all relationships are interconnected and that balance should be the ultimate goal. And I do mean the dynamic tension when I mention balance. Dr. Pollycove is indeed a pioneer on the journey to understanding and utilizing complimentary healing techniques. Please join me in welcoming Dr. Ricki Pollycove.

DR. POLLYCOVE: Well, it is really fun to be here being both exquisitely appreciative of yet another beautiful California day and also to follow such wonderful speakers that we've all enjoyed, and I feel that both Alan Jones and Lalita set me up perfectly for the remarks I want to make.

I want to also honor the pain of both my childhood growing up about 15 miles east at the same

period of time in Walnut Creek when Lalita was growing up in Castro Valley, and being a misfit as a child. But obviously, she was very successful, she did the scholastic thing and kept to herself. I think it is out of that discomfort and the wish to see a better day for others that I have been very hardworking in a more standard path on the outside, but I have appreciated that my inner path has been quite a divergence from the usual doctor.

Of course, I have a fan club of patients which, whenever my self-esteem and my zeal to work harder might sag, I just go into the office and it's like an infusion of enthusiasm. So I feel very blessed to have had probably my greatest gift being that from about age 8, I really knew what it was in this world that I wanted to do more than anything. And the curse of knowing your gift in this passionate way as a very young person is that you know the hurdles are enormous and you have people telling you, some of them shaking their finger at you, but all along the way, that that's just not going to happen. That's not possible.

And of course, when I was at Berkeley, the bombs were bursting in midair but they were tear gas

bombs. And being in college during the Vietnam War and really desperately not wanting to see soldiers going off to war, but also desperately not wanting to hurl bricks or rocks through Sproul Plaza and the windows of the administration building, I was again a misfit.

The court reporter, when I was coming in this morning, said to me, "Oh, I looked you up on the Internet and I saw that cookie story," and so I thought I would just tell you just how wild life is and how when you do follow your passion, you just never know what's going to happen.

When I was all of 19, I decided that to honor the Vietnam soldiers from America, I would send them cookies for Armed Forces Day. So not being acquainted with anybody in the armed services I called the Oakland Induction Center, got the name of a platoon and a major and addressed the cookies to them. And I went to my nutritional sciences department job where I worked for a Korean professor washing his glassware, and Dr. Chew told me that I had to vacuum pack my chocolate chip and oatmeal cookies or they would not arrive okay; they would be moldy.

So I went to enormous expense on my humble student budget, putting myself through school, mailed the cookies off with a note saying that as a student working against the war, I was sending these cookies to support them and let them know I wanted them to come home safely.

So about a week later I got a letter back from the platoon first major, Private Shamrock, and he said they had left my cookies in the jungle for the North Vietnamese because they figured, coming from Berkeley, they would be laced with LSD and marijuana.

Being about as straight then as I am now&emdash;I had about the same haircut, by the way. Anyway, I took the letter to the Daily Californian the student newspaper at Cal, and I said, "Look what they think of us. They accuse me in this note of being hand in glove with Hanoi." And I wasn't Hanoi Jane.

So that story got picked up by the Associated Press and the United Press and I had my 15 seconds of fame on the front page of pretty much every newspaper across the country. People sent me letters and my clipping from Chicago and Philadelphia, and New York, and it was really amazing. And I answered, and this, of course, was the days before anything but a typewriter, but I didn't type, so I handwrote over 350 letters to all these people. That was my point, was to reach out to the public. I returned money to people who gave me money to tell me to bake for their sons. Anyway, I could have seen the light, could have been Mrs. Fields right there. But I really wanted to go to medical school, so I let my little media career die down, and got back to work, and concentrated on the career that I really enjoy.

But you can evidently now find this article on the Internet. It was actually published in our local medical society journal in a hobby issue because I have actually continued to bake as a big hobby to this day.

I always envision my daughter sitting in the audience. She's 18, finishing high school, has had a fabulous private education, whereas mine was completely public. I had a rude shock. Paying for her first year of preschool was a larger price tag than I paid for my entire education including bachelor's, master's and an M.D. at state schools. However, times have changed, and I have raised her in San Francisco, and I really felt a passion for protecting the delicate aspects that she was endowed with as a child. I just couldn't imagine her thriving in a public school because I couldn't be at school every day, hands-on mom, because I was also a working professional. So I insulated her as she grew and strengthened from some of the really challenging aspects of being in a big city.

But if Leah were sitting here, I would be called to task to be standing here talking about balance on a day-to-day, hour-to-hour basis and especially having just written a book this past year. You know, anyone who's endeavored to write a book, working full-time, being a mother, is going to confess that that's not going to be the balanced time of your career.

But I see balance as something that we achieve in the wholeness of our lives, and I think that when you look at the definition of balance from a dictionary, it's the mental act of comparing or estimating two things, one against the other. It's an equality of weight, power, or advantage. It's equipoise. I think that's a beautiful word, that we would be poised in equanimity, and lastly, a bodily equilibrium. And I also see that as an equilibrium that's dynamic between joy and sorrow and work and play, and striving for something and being rewarded. And having a personal or a professional satisfaction. So these are all elements of balance.

And the personal growth opportunities that we all have come before us in life, it's often like, something goes by, Oh, that was a learning experience. I just thought it was hard. My question to Lalita was basically what happened to the spirits of those women that visited you, because when you have a paranormal phenomenon occurring on a regular basis, she was in a state of conscious perception that is not the normal thing she walked around with when she was at Sun Microsystems.

But what's so beautiful is that opportunity, and I see it as a vibratory openness that she held. She's clearly a gifted, wowie-zowie woman, but that's the voice inside her that, had she not been also gifted with this pain of her childhood and her need to know, she would not have received this other gift. I see these gifts as encircling all of us all the time. But she exemplifies so perfectly how we don't receive the gift unless we have cleared our slate in such a fashion that we're in that meditative mind-set that's not constantly interrupted.

I think it's in achieving that state that she then was able to directly receive these very intense spiritual experiences. They came out of that realm. And she said a few times during her talk that, "I don't really believe that stuff," and that's the beauty when you have a testimony from a woman like Lalita. I mean, she's totally straight. She brushes her teeth, she has a balanced meal over the course of a week. We can identify with her.

So I think that these are wonderful stories that inform us about ourselves as well. And I think I say this at least every day once to some woman in need of a little pat on the shoulder and support, that it is a very difficult challenge for each one of us to be a healthy self in an unhealthy world or an unhealthy community or an unhealthy culture.

And as a woman in this culture who was blessed with a good intellectual, scientific, organized, rational, deductive head, and also blessed with a very sentient, able-to-grieve-deeply, able-to-laugh-my-head-off kind of open, flexing emotional life, it has really been hard. I really think it's kind of a miracle, as all of us are miracles, but there's a certain amount of serendipity that you're just cursed with, you know? You just can't put up with that. It's just not you. It's too much of a lie.

And it's when we get into that space where we are seeing what our options are and rationally&emdash; and also with a dream and an imagination&emdash; comparing and contrasting the impact of one decision versus another that we can readjust. We can fine-tune, we can come to a new place in our own lives. It may not be as dramatic as what I call the cliff, you know, jumped-off-the-edge-into-a-new-life sort of story that Lalita gave us, but I think incremental change in the direction of your heart forces is probably the more natural thing for most of us.

I said to her after her talk, "Do you think that it's money and security that keeps people in their little cubbyhole, in their track?"

She said, "No, I don't think it's that. I just think it's fear of being so different."

And in my practice, I think the fear is very heavily infused with the fear of loss of security. I deal with this as a counseling gynecologist really every day on some level or other. But I think that there's the other aspect of this, which is the judging mind, that we wouldn't forgive ourselves if we made the wrong choice.

In 21 years of watching a group of women&emdash;and I probably have interacted intimately with about 5,000 women by now, so I think that's a pretty good data sample, plus I read a lot&emdash;but it's amazing. I have never seen someone with a job change or transition be a bad thing. It's always been a good thing. And of course, lately I have had a steady stream of dot-commers who have come in unemployed. I'm doing a lot of charity gynecology these days. But that's a very interesting opportunity for these women. They rode a wave, they experienced something that was mind-altering and crazy, and now they're in a readjustment phase, and it's a little bit like getting off the sailboat after a gale wind. They survived the heavy seas, but really as they get to the quiet place, they're glad and they're happy for this reorientation in terms of balance.

In my own career, I became very saddened in obstetrical care. I have these exalted

experiences delivering babies. This was the first era in which fathers would come in, and so I meet

him and her, and often I have taken care of the mom-to-be before she even married this man, so I had

a very deep relationship with her, and then with him, and then we'd have this magical baby and everything was just amazing.

And then what happens? Dad develops warts. His breath smells bad. He's not home on time. He's complaining that the house is dirty. It's like he totally falls from grace, and all the good juice goes to the baby. And I think, Wait a minute. To me, he kind of seems like the same wonderful guy that was coming into the office. So what's wrong here?

And it was really a communication disorder on the one hand. It was also the woman, the mother,

exhausted, depleted, not knowing how to ask for help. When you have been successful, when you have

worked in a career and you're humbled by the simple mammalian act of breast-feeding, it's a real shock,

you know. You can read in the book, you can prepare your nipples, all these things, hydrate, this, you

can this, you can that. But ultimately, you just have to let that little sucker suck. And I became

literally the nursemaid to a lot of aspects of the humbling experience of going from being a

professional woman, which really characterized my practice, to being a full mother, and it's a

learning by doing. It's a sentient complete abandonment to your hormonal crazies. It's so different than anything you ever studied in school. And even when I read about lactation, when it was my own baby, on the one hand it was so simple, and on the other hand, I realized, God, she's sucking for life, not for fun.

So anyway, over the years, I see some parallels in the intensity of involving yourself in a life-altering experience, the joy, the drain, the disappointment. But I also saw continuously the distractions of an overly materialistic culture where my heartfelt feeling was that these babies often were brought into this family as sort of the narcissistic bracelet in the wardrobe of this woman and this man. They had their BMW, paid down the mortgage, now it was time to add a kid. And I started to see very lonely children coming in, little toddlers biting their fingernails until they bled. That was so stirring.

So it's really out of that pain and frustration that I wrote a book outline in 1992, and the book will be out next month. But it's really to help put an end to the despair that women feel and to the lack of teamwork that just seems to be occurring right and left in families.

It's also about balance and it's a lot about how we nurture ourselves in the midst of all of the chaos that goes on around us. Over the years, many, many wonderful authors have infused my professional medical career with thoughts that help me pay attention. For example, Carol Gilligan's book that I read shortly after it came out, because Harry told me about it. I thought, Oh, that's interesting, "in a different voice."

And these books really do give a tremendous voice to women who would otherwise be either a professional who feels lonely or a mother who feels lonely, or a professional mother who feels lonely.

And similarly, I find that continuing to undergo an evaluation process to keep things in focus has given me a great gift. And I'll share with you why I got so smart, because I discovered that most of us are more like I am than I would care to believe, which is that it is the human condition to not ask for help early on. We ask for help when we're way down there and obviously in objective need of rescuing help.

What happened to me was, I was going along with this wonderful career and working on this,

working on that. My daughter was about two and a half, and I didn't pay attention to a sore throat I had had for months. I didn't see anybody about the fact that I had stopped sleeping. As an obstetrician, you don't get that much sleep. But even when I could have slept, I didn't sleep. Something was obviously churning inside of me. That was the fall of 1985.

By the spring, I was still not sleeping, and exhausted, and I was getting a sorer and sorer throat. Finally, one day, I was 105 degrees and I was comatose, and the next thing I knew, I was waking up in a hospital and I had viral encephalitis. Really, I'm about the only adult I know who has ever been that sick who doesn't have a seizure disorder and a few other life-altering events. Because I knew if I did have a seizure, that my career as an obstetrician would be over. I would probably never hold a scalpel again. I guess I wasn't going to be a gynecologist fully.

And the complete humbling experience of having in a sense lost everything professional,

maybe. I couldn't read. I couldn't write. I couldn't see straight. In fact, all I could see&emdash; which was very fascinating; it remains with me to this day&emdash;was auras. All I saw was these colors, like clouds of colors around people. I couldn't see them. I could recognize a voice. But that experience, of course, I didn't tell anybody, because I just wanted to get the heck out of that hospital, you know. I was going to be totally straight. I'm fine. I couldn't see you, but I explained to this voice I knew was my doctor that I was okay.

My husband took me home, and I spent the next several weeks just waiting, because western medicine really had nothing to offer me except to treat the pneumonia, because I had breathed so little, which is a classic side effect and complication. I'd gotten pretty bad pneumonia, very debilitated. So I had this opportunity for reflection.

So you know, I tell my patients this story in an abbreviated fashion because it looks so easy

how some people sort of swing into a room and they're just so together and they're happy&emdash;and I

am a happy person, thank heavens, but it's through enormous physical misery that I just had to figure

this out. I knew I wouldn't get a second chance to blow it. You know, you can only do that once. That

sick again, I don't think I would be writing a book.

So I really have been incessantly now on a path to keep these things in mind and to really ask questions and not buy into sort of the maelstrom of energy that surrounds medicine.

And of course, we have a lot of dark forces in health care today. I hope none of you have ever had an unpleasant exchange with your HMO, but these are very saddening events, and I feel such a loss of tenderness overall for patients and physicians and, you know, of course, consumers of health care, not providers of health care. And so one of the things that I have done, at the risk of offending colleagues, is to be a voice and write articles for the medical society journal, and to speak to the public, and to be on committees to deal with these health care problems.

But I do that not to point the finger or to judge others, but to really offer a healing voice and a voice of balance in our community, so that people do have a choice, and I basically distilled down our problem set to the following. I can see that most of the people who are trying to solve these problems are solving them in a very head realm. They're solving them using a style of knowing or epistemology which is really devoid of spirit. And of course, how does that happen? There was a study done at the American College of OB-GYN and there are about 2800 of us. And we, 65 percent of us, believe in God. Meaning 35 percent of people who deliver babies don't.

Now, how could that be? What bigger miracle could you have arrive in front of you all wet and squeally to tell you that there is a God? Because it isn't just DNA transcription and availability of protein moieties. It's a bigger thing than that. It comes out, it already has a personality. And you can see how some babies come out and they're just like crying to their fingertips and they're there. And other babies are kind of sleepy and they're not quite there yet. So there's a huge variation.

And it saddened me so much when this survey was presented to me like, "Isn't that great? Two-thirds of us believe in God." And I just felt sorry for the women and the families who have the obstetrician who's not honoring this absolutely precious event. It's just like nothing else. And I gave it up despite the high of doing obstetrics, and the moment of being there, but it's terrible for a single-mother lifestyle. So when my daughter turned ten, that was my gift to her, was to be home more. It's been a great gift and it's also allowed me to think a lot more. And, of course, thinking is dangerous, because you may just change what you're doing.

I think that Houston Smith, in his book Why Religion Matters is a wonderful articulator of how we got to this place of sort of soulless post-Copernican linear thinking where once we figured out that the earth revolved around the sun and we were not the center of the universe in a planetary sense, that actually was involved in shifting a lot of the consciousness and the way in which people knew what they knew.

And so we have really invested in science to save us. And there have been some very interesting articles discussing, can science save us? Now, I think even the most erudite scientists have agreed that science can save the scientists because they get the passion, the excitement, the spirit in their work. But science is not going to save the people, otherwise. It's much more of an energy of spirit realm, soul realm that saves people.

In Rick Tarnas' book Passion of the Western Mind, he described very beautifully the way in which we came to know what we think we know. I mean, that's a fascinating topic in itself, that I had not really thought about. When you're steeped in biochemistry in medical school and physiology of the gut and pathophysiology and hormones, we know so much. Your brain is so filled with what we know, and then you start to see what we don't know. And in western medicine we have this way when you fall off the shoulders of our bell-shaped curve, it's like we say, "Well, I'm sorry. We can't help you. You're not in the big group."

And we sort of shrug our shoulders and make a site referral or send people to a massage therapist. But I think that that's the testimony to the fact that there's a bigger picture of understanding that we need to go after.

Ultimately, my internist in 1986 apologetically referred me to an acupuncturist. I said, "Erica, whatever. I am still miserable." You actually get quite a lot of pain underneath your skull when that virus is healing, because there's so much inflammation. And it was amazing. Nothing touched the pain. So why take anything for pain? But acupuncture, within a day&emdash;oh, my gosh! It helped so much. And I was going twice a week and at least I wasn't racked with so much pain that I couldn't even see or be in light. That's a big problem when you have that trouble is light. Anything that flickers just drives you crazy.

So I thought, Well, I'm going to study this because this made a big difference in a rather short time and I have been miserable for weeks. And so it was then and it was really because of that illness that I started to appreciate how we have such hubris in the west that I had gone through the best medical school training and residency and yet I hadn't considered that these barefoot doctors from China had anything to teach me. And I really suffered inside of myself, feeling so sad. I mean, here I was in a city where I lived, there are acupuncturists about every five doors on Clement Street in San Francisco, and it was just so sad to me that all those people were over there and I had not ever even tried to read one of their journals, which are translated into English. It's very interesting.

So as I have evolved through, we've actually had acupuncture trials to turn breach babies and see if we can get them to become head down to deliver vaginally. We have done some pretty wild things. And actually, it helped a little bit, statistically.

But more importantly, I can see now that there's an attention to the energy of people which is where you as an individual live. It's your emotional state. It's your state of relaxation or nervous tension, and it's really in that energy plane that you will have your own greatest healing. You know, we can think and think and think about a problem, but it's the process of release of the problem that really reorients and balances your energy.

This, by the way, is one of my favorite cartoons, because I do think like an evolutionary biologist. I saw this and it cracked me up because this is the aspect of being a human being that is so incredibly precious, which is, what is it all about? It isn't just biology. It isn't just evolution. And basically, what I have come to discuss&emdash;and I came to this really to discuss it as a framework for menopause, where women face this biology which is finite and it's very challenging, because I do think we have evolved to enjoy a life span that, in fact, is somewhere between maybe 40 and 50 years. If you look at the life expectancy in 1800, 5 percent of women lived to be more than 50. So that means just shortly after the Revolutionary War, very few women, in fact, lived to experience the challenge of menopause.

Well, that's an astounding thought because what do we hear as sort of our battle cry? "I want a natural menopause." Well, I have come to be rather bold and blunt and I say, "You know what? I think the natural thing about menopause is to be dead already." So none of us check that box. That wasn't the one we wanted.

So now we're talking about something else. Now we're talking about over the next hundred years from 1800 to 1900, we had evolution of sanitation, we kind of cleaned up the water, we got a little bit of sewage going in our cities, we started to protect each other with a little more socialization and grouping that was more secure, and then by 1900, we had about half of women in 1900 living to be more than 49.

Now, the amazing thing is, with the advent of a little penicillin, some immunizations for smallpox, the conquest mostly of tuberculosis has been huge, so honestly, that's why we're here today, most of us. So I think when you drape this consciousness/scientific thinking/evolution that is really particular to human beings, it has given us this opportunity to hang around.

So what are we going to do with this boon? I say, "Hey, you have got a 35-year gift in the last hundred years, because now the average life expectancy is going to be 84 for a little girl born in 2000."

Now, what does that mean? That means half of the females born two years ago will live to be 84, and the other half will live to be more than 84. Now, that's a daunting perspective, if you, like I, make nursing home rounds. Because who's there now? We don't want to be her, because she doesn't look

particularly healthy, she's not functioning really well, and you say, "Ricki, you're not making rounds

everywhere else at 84, are you?" Well, you know, I would go to the grocery store in my sabbatical two

years in Arizona. In fact, that's what got me thinking this way. I saw all the motorized grocery carts, where in San Francisco we're really yuppified with our little baby attendants glued into the market basket where the small items area is. But in Arizona they have these market baskets which are geared to like a little mini-golf-cart setup so you with your infirmity&emdash;and it's mostly osteoporosis, hip fractures and not being able to walk&emdash;you can do your own marketing, and it is great. I think it's just absolutely wonderful.

But it was so shocking, growing up in San Francisco and working there, who lives in San Francisco is not the most disabled, because we've got hills. You know, you can't make it there. So I realized so much of our perspective is colored by these simple things, who the neighbors are.

I do find it really refreshing to have taken that big risk, which was my two-year sabbatical, which everyone told me I was so stupid to do because it was expensive, it was this, it was that. But it really got me thinking in a new direction.

It also got me thinking hugely about public health and that somebody has to risk it and get out there and get the word out, because you are really the first generation of adults to have a prevention opportunity to seek what we are calling healthy aging. This is a double-barreled challenge because pointed at us, on the one hand, is this youth cult. We want to age&emdash;well, I don't know if I want to age like Jane Fonda, but we want to age in a way that looks pretty vital and pretty fit and, you know, attractive.

And on the other hand, we want to be wise, and it isn't all about the body, and I'm sort of the bearer of grim news to my most beautiful patients. I say, "You know what? You will lose that little subcutaneous fluffiness. So no matter what expensive cream you buy or what plastic surgical injection of this and that you have, you're going to age and you're going to get crepe-y, sweetie, and if you're lucky, your smile wrinkles will overcome the frown type."

But that's the reality. So sort of a hard-hitting gynecologist, but I'm really trying to help my patients into this next stage of consciousness, which is self-nurture, the inside of me. I say, "You know what? After 40, a woman is responsible for her face." In fact, Abraham Lincoln says&emdash;at least, he's credited with this; historians here can tell me if I'm correct&emdash;but that he said that after 40 a man is responsible for his face.

Well, when you read that and you yourself are about 22, in college, that doesn't have such a big impact. But as I have observed people, which I do for a living very closely, it is fascinating to see how what we hold inside is reflecting on the outside, and one of the exquisite opportunities we've had here is we've seen people who are passionate about what they do. We see like Alan Jones, whom I have known for a long time. He actually asked me to serve on the Lay Academy Board just shortly after he arrived, as an outsider, you know, someone who wasn't encumbered by an Episcopal education. And they wanted someone to serve, like, how you talk to normal people. So I have met Alan, and I have watched his journey, and it's a wonderful thing. I mean, to study his face is such a fabulous experience. And I'm sure you share that with me.

But what do teachers look like as they age? What happens to the teachers that you work with? I presume most of you came from the teaching profession before you became the head of a school. I am sad to report that teachers are generally less healthy than the public. They are, not surprisingly, more stressed. They have more stress-related illnesses, chronic pain, obesity, depression, addiction, high blood pressure, and especially an addiction to alcohol.

And why would this be? Look, I got the thrill of being an obstetrician, but you get a thrill out of watching all these young minds and young lives grow up, right? Isn't that the joy of every day? Well, of course, if you got to have that thrill, the head of a school job would not weigh so heavily upon your heart.

But I think one of the huge problems when you are the leader and director of a large group is that you have to be better read than anybody, sort of. You have to be better informed. You want to be creative. You want to be very, very organized. And oh, yes, you want to be very social and available and cordial. And can you ever be those things enough?

And so what I find in a lot of my leaders that I take care of is they have this&emdash;do most of you remember Jiminy Cricket? You know, younger people today never heard of Jiminy Cricket, but that little ego thing that's perched on your shoulder that Jack Kornfield, in his wonderful book, A Path With Heart, calls a judging mind. That is the stable western diet. I think even more than wheat, we eat self-deprecatory remarks on a constant basis. I also say it's kind of like carrying your own carrot peeler, like you're just peeling a little bit of mean-spirited down on yourself. But that's the chatter that's constantly accompanying most of my very successful professionals that I take care of.

And if that's what you're feeding yourself, that is the antithesis of nurture and it doesn't lead to balance. It is like whipping the horse that's already tired and just asking it to run faster without a break or without even, you know, nicer oats to eat.

So I think where leaders of schools have their greatest opportunity for nurture and balance is really just a very simple task, and you can do it while you're driving, you can do it while you're waiting for someone to answer a phone, which is: Remember if you have already judged yourself negatively today. When did you do it? What was it about? And don't do it again, because it didn't help.

You know, we have such an imagination. In fact, that's what I said to Lalita. We had this little chat when she finished, and she was saying, "Well, my life isn't about balance," and I said, "Wait a minute. You talked about eating breakfast and exercising before you sat down to write."

So in my world view, she's so far ahead of the pack. But in her world view, she's so gifted with an imagination of what would be perfect, what would be balance, what would be nurture. She doesn't even give herself credit for what I consider the first three points. One is that she went to sleep the night before. She then exercised. You'll see by the end of this that's a biggie. And then the third thing is that she has an awareness of the diversity of nutritional input she's trying to achieve.

So if you look at your life cycle as something that informs you and helps you make a better choice and a better decision, then you get to arrive at the place of forgiveness, because you have never been this age before, so you have never been this smart. And so instantly you can just drop that whole sack on your back that so many of the psychologists call the shadow. I think that living with that shadow but allowing the part that you don't think is so great to just be&emdash;it's not done you in yet and maybe it's your friend. But that if you move forward without that noise of negative comments that you make to yourself that accompany you everywhere, you'll be amazed at how much more energy you have for the things that really do nurture you and help bring you balance.

The other aspect which I think is helpful to contemplate, because we are a group of women and men trying to work together in cooperative harmony within a school, within a family usually, certainly at this wonderful meeting, but that women have a very different visitation, this whole concept of just this absolutely unmistakeable, irrefutable change of our lives when we stop menstruating. This is a biggie, guys. In case you're not living with a woman and you have not been through it, we can buzz along for a long time without really thinking that old Cronus is working on us, as well. And it's amazing how we are encouraged to do that, because you just get a better cream and so those wrinkles are gone, and your vision is changing anyway so you're not going to see them as well.

But in fact, 30 to 40 percent of women, when they fill out surveys, say they are depressed. We just had National Depression Day last year for the first time.

Anyway, what we found was that we're not treating 30 to 40 percent of people for depression.

When I say "treating," I don't mean everybody has to go get Prozac, Paxil, Zoloft. I could list many more. But I'm talking about acknowledging that something is happening in this individual's life that leaves them feeling blue, at the very least.

A little discouraged, but this is really a huge national ill, and it's going to just get worse if people don't think about balance. The reality is, we've never had this much information about these physical changes and the definitude of options that are out there for us. And of course, what we say in the office is, "What are you looking forward to in the second half?" And my patients in major denial say, "The second half of what?"

And I say, "Well, you know, when I saw my 50th birthday last June, I know for sure I'm probably in the second half of my life, unless I'm going to be more than 102."

So I think this is really a critically important and orienting thought and discussion, and it helps us become patient for the process of awakening because it does take a long time. These are very sophisticated things that we are contemplating today. And at the same time, it gives us a little greater impetus to move forward in those what I call sentient directions, to the feeling state of awareness.

We do an exercise with some of our integrative health seminars, so I'm going to ask you, even though you didn't volunteer, could you please point to yourself? I'd like you all to point to yourself.

Okay. Well, you're like every other group I have ever been in front of, which is no one went like this (pointing to head) because no one is the self up here. Everybody was pretty close to their heart, and it's really a beautiful thing that this is my self. It isn't up here. So it allows us on this little kind of tickle node of humor to think, Well, wait a minute. If this isn't my self, how much time do I spend listening to my self?

And so that's another simple thing to remind yourself of where your most important feelings are, and where you really hold your deep beliefs. And I as a doctor have always thought it was interesting that we have gut instincts. "I just know it's true in my gut." And when you first see the intestines at surgery, they're pretty amazing. They're constantly on the move, by the way, even when you're sleeping. And they're pink. They're really quite pretty. And it occurred to me that, you know, that's where knowledge is, right in those pink wiggly things. But it's an amazing transition, just these little tiny, thumbnail cues.

The other thing that goes along with depression is sleep. Unfortunately, a huge number of people after age 50 have disordered or disrupted or unfulfilling sleep. Now, for me, had I been smarter or gone to a doctor, who would have been the most wonderful Marcus Welby, M.D., maybe someone would have said, "Look, Ricki, you need some therapy, because you are out of balance."

But I didn't. But sleep disorders are a huge premonitory sign that something is not right in the total balance of the individual. And sadly for women, they have come to accept sleep disorders for a whole variety of physiological reasons. "Oh, my hot flashes woke me up," whatever. But I still see an awful lot of hand-waving of the soul through the sleep because, of course, it is then that we're not in overdrive of this part of the self that's not listening to this part of the self.

So you know, I think for teachers in a nurturing profession, that's a tipoff for yourself. But if you have a colleague who says, "Oh, God I haven't had a good night's sleep in months. No, no, no, everything is fine at home." Something's not right. I mean, maybe their thyroid is abnormal. I don't know. But they really should get it checked out.

And on that score, I do think that the other thing that our culture does with sleep is, in fact, we medicate ourselves; of course, alcohol being the number-one free available drug. I mean, you have to pay for it, but you don't have to confess that you're having a problem to go get it.

So that's the other thing that I have all of my wellness balance-seeking patients do, is to really think about when you drink, how much you drink, and see how hard it is for you to drink nothing for a month.

Having had the most beautiful husband in the world who turned out to be, sadly and tragically, addicted to alcohol and narcotic pain pills&emdash;and he was a physician, so obviously that doesn't wash&emdash;and actually, that was what I was avoiding seeing when I chose sleep in terms of viral encephalitis and unconsciousness instead. I think how absolutely that piece of information could not fit into my rational universe. That was the father of my daughter. I had to acknowledge so much to see that. And so having seen that and worked with that&emdash;and now I'm happy to say he's the king of rehab; that's his new life career in medicine. He's a rehab doctor, and that's a beautiful thing. He has passion in his career.

His daughter has passion in her awareness about what it is like to be the child of an alcoholic and narcotic-addicted parent. And she teaches other kids and she's not ashamed. She's proud of her dad now, and he has accomplished a lot. But I think from my own learning, it was really probably the hidden ingredient that I just could not allow myself to see.

So from just a gratuitous advice point of view, definitely look more closely into the things that are troubling you, because it is there that you'll find the key and the solution. And it also opens your heart. We want our children to have courage. We want them to go forward into the world to be very inquisitive. You can do a little exercise. When a person brings a problem to you, whether it's a colleague, or especially a family member, notice what's happening with your abdominal muscles in the conversation. Of course, for a moment you'll be distracted, but allow yourself that. And notice the interplay as you kind of hold your stomach tighter and try and let go and then hold your stomach again. Your body does this involuntarily, because it is controlled by your spirit and your spirit is suffering.

This is a hard thing. So these are also cues that come to us, or you know, if you find yourself going like this (rubbing her neck) you know, something is stuck, energetically speaking, in this muscle. It's a very simple thing, but obviously, to figure it out and to be patient with the process and to take time to look at the cues&emdash; these are the challenges which face you.

I have given you a very short card for health care screening. I put basically everything you need to know on this one little four-by-six card. This is what I do in my office. I give people cards. Bladder infections, you know, preventing urinary tract infections, the point being that health care screening on a physical basis is kind of like a postage stamp. It's a very short thing. Check the blood pressure, check your weight, we calculate body mass index that shows you, how chubby am I? Am I in the danger zone? But I can tell you that this is about the most slender group of professionals I have ever lectured to, believe it or not.

Insurance covers different things if you're overweight to a certain degree. But I think that the ultimate aspect of food, of course, in the culture is that it's a nurturant in the moment. And so with a lot of my eating-disordered patients, which is about 98 percent of my practice&emdash;you know, the thin women are eating-disordered, too. They're just doing something different with their tension. They're not putting it in food. They may be exercising. Or they have had enough psychotherapy to see it for what it is and let it go.

But the point being that all of us can lose weight, but no one sustains their new body unless they are in touch with loving themselves. And so many health-promoting, health-supporting behaviors are like that. And truly, the old days of having the sticker on your mirror in the bathroom or the little funny magnet, "A moment on the lips, a lifetime on the hips" on your refrigerator didn't help. Plenty of Weight Watchers members have had all those stickers and little self-ridiculing derisive things in their day-to-day lives, but my encouragement is, have something that's meaningful to you.

This is a peach given to me by a woman I did some consulting for in health professions education in Arizona. It's actually made of stone. And it looks so yummy, you just want to eat it. But this is my paperweight on my desk. And it reminds me of her perspective of health and wellness and the life cycle. She teaches geriatrics and gerontology, and has a beautiful way of looking at the future from the elders that we have around us today, and then guiding your choices, and making different choices.

Having seen the women in the wheelchair, this is also about the size of the average heart of a woman. To see something really so tiny that has so much work to do relentlessly&emdash;I mean, the poor thing never gets a break. And it gives me a little heart esteem moment every day. I just thank it for ticking away. It flutters now and then, but&emdash; these are wonderful little reminders.

The other thing I have is a baby picture of myself. I have my very favorite, which is me in a little inner tube, sticking my little toes out because I was one year old.

I discovered that one of the best ways to get people to pay attention and do the right thing is if they have a little baby picture in their wallet. And so every time you get your credit card out or whatever, get your money, there's your little baby picture, usually smiling pretty adorably at you, and you are that same precious, vulnerable, tender little baby. Yeah, a little grown up, a little worn for wear perhaps on the outside, but the inner self, remarkably, is about the same.

I'm a great believer that the spirit really does come in, and that's your personality and your soul, and so it's a remarkable thing as an older adult, which I think we could all call ourselves pretty much that, to have that twinkling at you, because think of how you just bubble up when you have a picture of your grandchildren or your own children. They're just&emdash;oh, there's a beam of love. It's so cute, at my front office counter, as women are checking out, you can tell if they're mothers of children or mothers of dogs or cats by the picture in their wallet, because often they'll just have to share their pictures with me and my staff.

But I think that we should look adoringly, absolutely adoringly, at ourselves at least once a day. Because that little teeny self right there is now in this big grown-up body, but it needs to go to the playground. So what are you going to do? You know, it needs to recreate. What's fun for that little baby? You're going to put the healthy food in that baby's mouth. You're responsible for that baby.

It totally shifts your diet plan. Instead of this smashing, crashing, punishing diet, now you're going to think, Okay, what can I do to make this fun? You know, tolerable, good health, not a punishing thing. So if you follow that line of thought, you really will take exquisitely better care of yourself and you'll have fun doing it, too, because it's your little baby self that's basically running the show.

I wanted to read you a beautiful quote written by a remarkable woman named Ellen More, and she wrote a book titled Restoring the Balance: Women Physicians and the Profession of Medicine, 1850 to 1995. I don't think they're going to ever nab her for lifting anybody else's material, because she's quite an original thinker. She's down actually at the University of Texas, but she has a fellowship with the Radcliffe Institute for Advanced Studies.

She wrote&emdash;and I changed this around so it's not just physicians&emdash;but she wrote, "Women physicians have manifest a steadfast resistance to a one-dimensional conception of professionalism by pursuing a judicious balance of personal, community, and professional interests. Women have become experts at juggling the personal and professional aspects of their lives. They have had little choice, in actuality. We are attempting to solve the dilemma of difference. What may be changing, unacknowledged by most policymakers in the health profession, is the willingness of at least some men to participate in resolving the dilemma, to be more than a crowd of on-lookers. Certainly if women professionals are to achieve any sense of balance in their own lives, much less act as role models for their students and faculty, it is essential that we find ways to reconcile their professional skills and aspirations with their personal and social responsibilities to family and community. The only way to do that is to acknowledge that this is a shared problem and not theirs alone."

Balance requires constant reassessment, analysis, contemplation, time to think. It's life in the gray zone. It's not black or white. There are no simple answers. It does require knowing our individual beliefs and values and accepting that this is work. It's work on top of our work, but it's very joyful work, and that in striving for balance, you actually have a different energy that materializes that helps you accomplish the balance. It's the absence of awareness that this voice is there.

It's fascinating to me to have had Lalita speak before me, because these four spirits which inhabit her head, her space, wave fingers at her&emdash; I mean, can you imagine? That would be what we call living with ghosts, right? But when we read her book now, we can think so vividly about this woman who, to use a hip parlance, channeled these people into her life by clearing her slate and paying enormously exquisite attention.

I think what Karl Jung wrote over 70 years ago is just incredible. In his book, Modern Man in Search of a Soul, "During the past 30 years people from all civilized countries of the earth have

consulted me. I have treated many hundreds of patients. Among all my patients in the second half of life&emdash;that is to say, over 35 -- there has not been one whose problem in the last resort was not that of finding a religious outlook on life. It is safe to say that every one of them fell ill because he had lost that which the living religions of every age have given to their followers. And none of them has been really healed who did not regain his religious outlook. This, of course, has nothing to do with a particular creed or membership in a church."

Also, as most of you are aware, Jung himself basically had a pretty schizophrenic break for two years and was unavailable. He was in retreat in this beautiful little house on a lake in the forest. I mean, I'm not looking forward to that. I think I have already had my breakdown, so I can build up. But I do think that when we see very remarkable people like Pauley, who is the physicist credited with really doing the unified field of spirit and matter in terms of explaining it with physics and energetics. He was a patient of Jung's, and he was completely crazy for several years, and then basically reentered his normal state and was able to accomplish a lot more as he aged.

So there is a scary thing about opening up to your full potential. But I think that the best book you can find, if you have not read it, is Gary Zukav's book, The Seat of the Soul. He has a wonderful definition of true power which goes simply, "It is the correct alignment of the soul and the personality." And if you think about what that means, to have your soul and your personality correctly aligned, it is really a remarkable sense of calm that you have. Of course, that's like the pebble that drops in the pond. I could just see you all. Out from your desks will emanate these waves of harmonious light and energy, and everyone will come to your office and be healed. But the beauty is that when you imagine it, then it is possible. And it is in having these little tricks of your trade&emdash;you know, dispense with the carrot peeler and add a kind little pat to yourself. You know, carry your baby picture. Have something in front of you that reminds you on your own special level of centering honoring practice for your physical body as well as for your career and your family.

It's been a pleasure to share this with you this morning. Thank you.

MS. LEE: Well, that was fabulous, Ricki, and I think I can sum up what everyone is thinking by saying, consider another life change. Please come to Dallas and work for me.

Wendy, where are you?

DR. MOGEL: Here I am.

MS. LEE: Great. Why don't we start our conversation now, because that will give people a chance to ask you questions, as well. What I would really like the two of you to do is to help us all bring all these strands together. It's been wonderful because everybody seems to have given us a different perspective on balance, but they have all felt that what was important for us was exactly the same things. So with that, I'll turn it over to you.

DR. MOGEL: I just have to add one thing about the baby pictures, which is also to carry a baby picture of your spouse with you at all times.

DR. POLLYCOVE: It helps the forgiveness meditations.

DR. MOGEL: One thing I think that we've heard throughout the past two days is that some of

our challenges in some ways are simpler than we make them. So we want to solve the grand problems in our school of educating the children in the very best way possible. But if the school heads are not well-nourished, well-rested, and well-exercised, having an opportunity for play and silliness, then the teachers won't be. And if the parents aren't, then the children won't be, and then we undermine our grand project. So I think that Dr. Pollycove has said this so beautifully about how in the second half of our lives, we need to pay attention to things we think we may be finished with. And we have the vision of facing our mortality by trying to solve the great existential issues, when we simply may not be getting enough sleep at night.

DR. POLLYCOVE: Just as it's easier to think lofty thoughts with a full stomach, it's also easier after a full night's sleep.

DR. MOGEL: I also want do say one other thing about the ambition of the project of making the second half of our lives very fulfilling. Freud said that the object and the goal of psychoanalysis was the conversion of neurotic misery into ordinary unhappiness.

SPEAKER FROM THE FLOOR: It strikes me that you talked about a lot of things that we need to get in touch with, and you mentioned the heart. I think that part of what we have been given is our

ways to access the heart information or access the body information. Now, I happen to know a bit about this, because I work with people doing this. I have done imagery with people for a long time, and it really is accurate heart information. So people know how to not go in through their head only, but through your heart.

For instance, I'm sure everyone here who runs schools&emdash;I don't; my wife does&emdash;but secondhandedly, I know all these pieces, that when someone comes in and you deal with them with your heart and you know when you are, and it feels different when you deal with them from your heart rather than just intellectually, that there is healing that goes on. And part of it is to learn how to access your heart information, to learn how to begin a dialogue with your heart in order to get the answers about what is wrong with me. You can't figure it out from here. It just doesn't work. It's goes through here. You have to somehow find how to access that body information and that heart information, and I think finding some ways to do that or offering some ways to access that information is a vital piece.

DR. MOGEL: One thing that Dr. Pollycove said that fits right in here is how much we are interrupted. The example from yesterday was the wonderful example of the instant message from parents and whether or not we respond to it. The first place to find out what the heart is saying is to have time for reflection. And 150 e-mails a day makes that very difficult. Everyone does not have the secret ambition of being a writer or of being a creative person.

In my psychotherapy practice one of the things that struck me as very sad, over and over again, was adults who had wanted to be teachers, and they gave up that dream because their family or the culture around them had led them to believe that this was not a high enough status or a high enough paying profession.

So the time to access what your dream is may not be so different than what you're actually doing, but you need to cut off the interruption to do it.

The other part of really listening with the heart is listening to parents. If we listen in a nondefensive way, three-quarters of our work is done. If we can recognize that the belligerence is anxiety and teach that to our staff&emdash;the ones who often know how to do that very, very best at independent schools are the people who answer your telephone. And we all know we are very, very selective of who that will be. So we can take lessons from them about how to listen patiently.

DR. POLLYCOVE: I would add&emdash;this is a quickie for the immediate progress&emdash;the three-breath rule, which I basically made up for myself when I read How to Talk So Kids Will Listen and Listen So They'll Talk. Many, many years ago, I thought, Yeah. Let's just see. If I just breathe and I don't make it obvious, it's just a natural breath, through my nose, three times. That's about 15 seconds, really. Maybe ten seconds. But it seems like a very long pause. Well, guess what? It gives you time to check it out, to think.

So when you first do it, it feels so artificial and weird. It's like, Oh, I'm thinking about my three breaths now. But it takes you out of that sort of like throwing the ping-pong ball back and forth, back and forth, which is the intellectual ego kind of discussions we get into with the rational brain and we're really good at it, and then you slow it down, and you have now had a moment to notice if your abdomen got tight, and then you have a moment to reflect on how pained their expression was, and you have also been composing your response. It's amazing how quickly your mind works. So those three breaths give you the opportunity to very much change where the energy is, both within yourself and I think when you're responding to the parents.

DR. MOGEL: This is what the Gesell Institute talks about as the gift of time, that we want to give the children the time to grow up. We need to give ourselves time to think. A formula for parenting also has threes, which is one-third love, one-third discipline, and one-third sitting on your hands. So that breathing and the sitting on your hands, if you put it together, you're buying a lot of time.

MS. BOWERS: I think what leads many of us to the teaching profession is the desire to have

meaningful work in our lives, and then we go off in the direction of becoming administrators, and we

find ourselves finding meaning in that position, but also in large part because we deal with a lack of

wellness in others, you know, that the ministerial nature of our jobs these days does not leave us many

opportunities to deal with wellness. We find the issues that come to us in our people-to-people

relationships coming from people who are not balanced in their lives. How can we model that for the people that we need to both lead in our faculties, and serve in our parent/student bodies?

DR. MOGEL: I have a hunch, Reveta, that you have a partial answer to this question. Would you share some thoughts with us about what you do with your staff? This is not a trick, because I know the way that Reveta treats her staff and some of the very special privileges they have in her school.

MS. BOWERS: Well, let's see. Spontaneously, I think it's important that we celebrate being a community of educators. So we found that one of the ways we do that is to have breakfast together every Friday morning. Each grade level in the school takes turns hosting the breakfast for the rest of the faculty, so that eight teachers at a time will bring the breakfast to share with their peers. And it was something that would have been very easy for the school to do, but there's something about the selfless act of feeding and nurturing others, and celebrating the end of that week has been very significant.

I think one of the things that the board has done is to value the lifelong teaching and learning experience of educators by making available funds for professional development that allow teachers to go anywhere in the world they want to go to study, and to also experience some of the things that the entitled students that they must teach and guide and nurture and support every day experience in their own lives. I think it's very important that we not allow our teaching faculty to become our impoverished in our school communities. And I don't mean just in terms of compensation, but I think in terms of benefit and regard.

Then I'd say the last thing that I think helps to strike the balance is that the relationship that the school has tried to sustain over the years is one of mutual respect and admiration and partnership with parents, and signing some covenants that will guide both the behavior of the adults in the school environment on the professional side as well as on the parent side, and taking the time to comment on that when it breaks down and have some consequences for everyone who does not live those standards within the community of the school. I mean, I think those are the things that come to mind, but I sit here wanting to learn more because I think there's so much more we could all be doing in our institutions.

DR. MOGEL: Thank you so much. It reminds me of the Jewish principle that God is in the details. When Liza this morning talked about the 51 lunches, it's a detail, but it's significant. And it's so easy just to let it pass and not pay attention to what that waste means or the carelessness. With the parents and the parent partnership, so much has to do with consciousness-raising. With women's health in the second half of life, I'm sure what you're doing a great portion of your day is elevating awareness, and not treating severe illnesses.

DR. POLLYCOVE: I call it elevating the gaze, what we're looking at, what we're paying attention to.

DR. MOGEL: So we change our glasses a little bit and we wear a different lens to look at the problems, and what may look like a problem of management or governance in school could possibly be a problem of nutrition and exhaustion and faculty not getting to go on exciting enough vacations.

Thank you, Reveta.

SPEAKER FROM THE FLOOR: I wanted to make

an observation, if I may. I come from the business side. My wife, who is head of an upper school, comes from the world of education. And as I have enjoyed very much listening today, I think in my world the feedback that I get is very quick and that is from the world of business that I'm in. The feedback is very quick, and you either get it positively or you get it negatively.

I think in the world that all of you are in, the feedback oftentimes that you all get from parents who are upset, who want immediate action, the response you get is one of, Did I do the right thing? And I think that most of the time, if not the great majority of the time, the decisions that you all make are right and they are for the best interests, but so often the pressures are one of questioning whether or not what you did was the right thing. I think if you have confidence in that gut response, listening to your heart, you'll find that the great majority of the time what you do is for the best interests and very good and positive.

So I'd say, you know, listen to yourselves and have confidence in what you do, and don't listen to those elements that are constantly nitpicking you, and have confidence in what you do.

DR. MOGEL: Thank you.

DR. POLLYCOVE: Clearly this gentleman is doing more than standing as an on-looker at the sidelines.

DR. MOGEL: We don't have profit-and-loss statements for parenting or for our schools, and it is sometimes so much thornier than in business, where it's so very clear how you're doing. I think this is part of why we have begun to worship children's grades as a kind of idol, and replaced all kinds of larger spiritual and moral and social questions by this one grail of the children's grades. Certainly this is a message that has come through all of this conference, that we want to widen our view and not just look at the one bottom-line measure, how many 5s on the APs our students are getting.

MR. MANDEL: I think for me that raises an issue that hasn't quite been hit on the head, which is, so to speak, the extent to which we live in a world of ambiguity, and what that previous gentleman was alluding to in part was the extent to which we can't tell what the impact of our decisions are and what the ramifications will be. And there's a tremendous, I think, social avoidance, which you just alluded to when you talked about the grades, Wendy, of ambiguity and uncertainty and an unwillingness to live in that world.

When we see in science the constant revision of scientific theory and when we read on the front page of The New York Times that, yes, for now, officially, according to the U.S. government, mammograms are a good thing to prescribe, but we're not sure yet and we're not absolutely sure yet and we'll check back in about it, even the, quote, "hard sciences" which we hold up as the ideal to which we should be aspiring aren't sure, aren't right. They're just evolutionary attempts to get closer to the truth.

It seems in our society it's very hard to live lives in that state of uncertainty about the rightness of what we do, and unless we as leaders are confident of the journey and the capacity to make the best choices we can at this point about ourselves, our schools, our children, our faculties, and that's the best we can do. And that's good enough. Because that's the only best that anyone can do, we will always be left with a sense that perhaps we're failed.

DR. MOGEL: This is what Donald Winnicott, the British psychoanalyst, called good-enough mothering. We just need to be good enough school heads in the middle of the normal curve. We are not either highly gifted or disabled school heads, most likely.

DR. POLLYCOVE: That also speaks to the whole notion of perfectionism. I think we have had so many models in front of us, the perfect body, the perfect artwork, the perfect building, and so I think as a mere mortal, to hold ourselves to that perfection standard constantly&emdash;well, we may have a moment of perfect balance now and then, but it's in this striving that I think that sort of true love and the godliness comes manifest in your life. It's not in getting it perfect.

MR. McKAY: I would just like to hitchhike on what the gentleman said about the decisions we make. I have found a way of thinking about this, and I thought about it a long time before I began to

verbalize it to parents in conferences, and now I say it sometimes just in general meetings. Because

we hear so much from parents saying, "But I'm paying so much," and you know what the cost of the

education costs now. So I am right upfront now and begin to say things like, "Let me tell you what

you're paying for here. What you're paying for is our best efforts. That's it. You are paying for no guarantees on anything at the other end. And if you want," I say to parents, "to put this in your own mind in a way that makes sense, think about it this way." I head an elementary school and many times I'm talking to parents of kindergarten and first graders. And I say, "I'll guarantee you an education if you guarantee me right now in writing what kind of a teenager you're going to have at 18. Are you willing to do that?"

And of course, they're not, because they know that it's a game for them, too. It's a turkey shoot in a way. And I say, "You know, it's the same in education. We cannot guarantee anything except I'll guarantee you my best effort, I'll guarantee you the best efforts of my teachers, we will try to pull together the resources that we can at any given moment, and that's it. That is what you're paying for in this education." So I agree with what you're saying.

DR. MOGEL: And all we are asking from the children are their best efforts, as well.

SPEAKER FROM THE FLOOR: I think what we're all doing really is tending gardens, human

gardens. And we plant and we nurture and we need the soil and we put in some food and some water, but I'd just like to tell you that I think our best therapy as a parallel to the human garden is a real garden, because you have results that are fairly immediate in a real garden. Kneading the soil with your hands and cleaning up a garden and seeing those flowers bloom is something that tells you you have immediately done something. So I recommend real gardening, while you're at it.

DR. MOGEL: And I think it's time for all of us to be back outside, close to the real gardens. Thank you very much.