Monday, November 17, 2014


I took BART to San Francisco on Saturday - I was to meet a friend at the Civic Center at 5.30p.m.
I changed at MacArthur Station for the San Francisco train. It was crowded, but I did find a seat next to a window, and, as usual, began to read. The train got fuller as more people got on at the Oakland stations. Just after West Oakland I glanced up from my kindle and saw all the passengers looking at their different devices, cords of ear buds dangled around necks, the asian woman next to me was  engrossed in listening to something on her phone - no one made any eye contact with anyone else. Suddenly out of nowhere a woman stood up in the middle of the aisle - she had her back to us, but I saw she was wearing black pants, and a black hoodie and had a black backpack on. She was holding a sign which from our section could not be seen. I saw one woman who was holding her bike hand her some money. Then the woman turned our way - the cardboard sign read, "Broke and Hungry" "Please donate money for food tonight." She had on glasses and looked kind of squirrelly - all she did was hold up the sign, she was not hurting anyone. Suddenly a man came up behind her - he appeared to have   had a bit too much to drink, and looked rather unkempt. From behind her he said very loudly"hey, you are not allowed to do that, it is illegal." Everyone was now looking in their direction, devices forgotten. Then he said "get off the train" and she said "I can't, the doors are shut." He then grabbed her from behind and began to push her toward the back doors and he shouted, "Get off the fucking train." At this a number of young men got up and went after them. They all disappeared through the doors on to the next carriage. The woman next to me raised her eyebrows and shrugged, people turned in their direction, and the train continued until it reached Embarcadero. The doors opened and a crowd began to form near the doors of the carriage they had disappeared into. Our driver announced that we would be waiting for BART police to arrive and then he thanked the passengers who had held the suspect down and prevented him from getting away. After about 10 minutes a police man got on to our carriage and asked what had happened - we told him as best we could, and then he said 'but where is the victim - what does she look like?" Apparently during the fuss and commotion she had run away. Eventually we were on our way again, and everyone returned to their devices as if nothing had happened. The woman next to me raised her eyebrows and smiled, and I smiled back.

Friday, November 14, 2014


I have worked in Occupational Therapy, first in home health, from 1992, then in early intervention from 2002 to 2004 with Contra Costa County which was then disbanded and taken over by Contra Costa ARC. I have worked with them ever since.
I have met inspiring and wonderful families many of whom have battled against tremendous odds. I have fallen in love with the children, and their valiant families.
There are many drawbacks to working alone in the homes - for instance, isolation from one's peers. It really does take a village to raise a child and many times, the village is not available. I recommend physical therapists, feeding specialists, and speech therapists for the children with whom I work. It would be nice to talk with them and see how we can cooperate, but so often no-one seems to have the time, or there are privacy forms to fill in and sign before we can talk and it becomes daunting. Recently it feels that there is competition between the different service providers and collaboration becomes increasingly difficult, and is not in the best interest of the population we serve.
In the beginning we were often able to talk with the doctors and nurses, but now that almost never happens. It was helpful, because doctors only see a child for 10-20 minutes and we spend far more time with them and can observe what is happening. There was wonderful collaboration with public health nurses who made many referrals. Over the years there have been more and more budget cuts and restrictions. There was a time when I could see a child for up to three times a week, now we are restricted to one hour a week, or once every two weeks. Often the referrals are 34 - 35 months of age which means we maybe see them four times at the most - what on earth is accomplished?
I could go on and on about the deteriorating system, but I won't. To compound matters us home therapists have worked with a non existent supervisor who doesn't have any idea of the work we do.
I have valiantly battled on with all these stumbling blocks, setbacks, etc. Last year we were taken off salary and paid per child. Because of stringent eligibility requirements, referrals are far fewer and therefore the amount of children I see is dwindling.  Of course ever since last year's layoff I have been struggling with what next - to work privately, to work for a registry, then it hit me last week.
That is it, I am done. I am done working with frightfully incompetent colleagues, I am done with this work. I will not take on anymore referrals.  I now have four little ones whom I care for deeply and will continue to see until they age out or go to another program, and it is high time I move on to something different.
I have reached the end.