Spring 2009

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Gender-Based Medicine

Women’sHealth

T h e A m e r i c a n M e d i c a l A s s o c i a t i o n A l l i a n c e

inside every issue3 From Our Alliance Family to Yours

19 Screen Out! News

22 Healthy Connections

24 Bulletin

25 Profi le: Harriet Hodgson

27 Network News

Spring 2009 Volume 69 Issue 2

4

OUR MISSIONThe mission of the American Medical Association Alliance, Inc., is to partner with physicians to promote the good health of America and to support the family of medicine. As the organization’s member magazine, Connections is committed to providing readers with the news and information most relevant to today’s medical families.

We welcome your suggestions, concerns and ideas. Please send all submissions to:

ConnectionsAMA Alliance515 N. State St., 9th FloorChicago, IL 60654Phone: 312.464.4470Fax: 312.464.5020E-mail: amaa@ama-assn.org

Executive Director Jo Posselt

Editor Rosetta Gervasi

Managing Editor Leia Vincent

Assistant Editors Kallie Norton Henry Tam

Contributing Writer Melissa Walthers

Advisory Board Sandi Frost – President Nancy Kyler – President-Elect Kathy Lariviere – Secretary Susan Todd – Treasurer Dianne Fenyk – Immediate

Past President

Design and Layout Anna Matras

Connections (ISSN 1088-7393) is published four times per year by the American Medical Association Alliance, Inc., 515 N. State St., 9th Floor, Chicago, IL 60654. The subscription price per year for members of the AMA Alliance is $3.50, included in annual membership dues. The subscription price for non-members is $7 in the United States and U.S. Possessions, $10 in all other countries. A single copy is $2.50. Printed in the U.S. Change of address may be made by sending old address (as it appears on your Connections) and new address with ZIP code number. Allow six weeks for changeover. POSTMASTER: Send address changes to Connections, American Medical Association Alliance, 515 N. State St., 9th Floor, Chicago, IL 60654.

The inclusion of an advertisement in this publication does not indicate endorsement by the AMA Alliance for products or services.

© Copyright 2009 by the American Medical Association Alliance, Inc.

on the cover4 Women’s Health:

Gender-Based Medicine

features10 The Sandwich Generation:

Caught in Between

14 Alliance Members Rally Support for

Medicine at Nation’s Capitol

16 Calling All Members: 86th Annual Meeting

17 Alliance Delegates Prepare to Consider

Bylaws Amendments

20 Meet the 2009–2010 Slate of Offi cers

26 Strategic Planning Process:

Past, Present and Future

10 17

Spring 2009 Connections 3

Throughout this past year, we have engaged in a strategic planning process that began last October in Chicago at our Leadership Development Conference with a brainstorming session with the state and county leaders in attendance. You, our loyal member, have planted the seeds for growth and renewal with your open and honest communication throughout this year. You told us what the Alliance means to you and what the AMAA can do to impact your life as part of a medical family.

Next year, President-elect Nancy Kyler and her leadership team will put into action a new strategic direction for the AMAA. We’re returning to the roots of our organiza-tion and ushering in a new era of member-focused service. We pledge to be there with resources and support for every Alliance member, regardless of what stage of life you are in during the continuum of medical practice. You’ll fi nd the information and networking opportunities you need to thrive, whether you’re just starting your journey as a physician couple with medical school stress-es, facing a medical practice issue that only fellow Alliance members can understand or enjoying a well-deserved retirement.

We’ve already taken our fi rst steps by partnering with the AMA and their new Physician Wellness Initiative. Coordinated programming for physicians and their spouses has been off ered this year at the National Advocacy Conference and at the AMA Interim Meeting. Both the AMA and the AMAA are aligned on the importance of

focusing on creating health and wellness in medical families. Achieving a work/life balance and stress reduction is crucial in today’s hurried and harried lifestyles.

Last June, in my inaugural address, I shared my fi rm belief that Alliance members who work together to support each other and improve the health of America are heroes, just as physicians are heroes…Alliance heroes of integrity, courage, character, faith and action. This year has shown me that I was absolutely correct in my assessment.

The Alliance is gaining visibility in America’s medical community as a resource for physi-cians and their families. Reach out to your friends and colleagues who will benefi t from Alliance resources, knowledge and social networking, and infect them with our Alliance “spring fever.” They will fi nd not only work/life balance options and ideas to use and to share, but opportunities for career enhancement and personal development, leadership skills, health promotion tools and a powerful voice in advocacy. Check the Alliance Web site for the latest services, blog topics and news. Take a moment to add your thoughts and ideas, and to add a friend to the Alliance list of heroes.

Sandi FrostPresidentsandi.frost@ama-assn.org

From Our

Alliance Family

to Yours

Spring is a time of rebirth and renewal! It’s a time to celebrate the exciting promise of new

growth that lies just ahead. We throw open our doors and windows to let invigorating fresh

air sweep into our homes. We catch “spring fever” and get the itch to start transforming our

surroundings and our lives to refl ect this renewed feeling of optimism and energy. Spring

has offi cially arrived for the AMA Alliance!

President’s Letter

Gender-Based MedicineWomen’s

Health

B� L��� V������

4 Spring 2009 Connections

“Both the general public and a vast majority of physicians think of ‘gynecology’ when the words ‘women’s health’ are mentioned,” said Donnica

Moore, M.D. Moore is the president of Sapphire Women’s Health Group and author of the new book Women’s Health For

Life. “We need to educate health Life. “We need to educate health Life.care professionals, as well as the public, about the diff erent questions that should be asked and answered when treating a woman.”

Founda� on of Women’s Health ResearchAccording to the director of the Offi ce of Women’s Health at the Centers for Disease Control and Prevention (CDC), Yvonne T. Green, RN, CNM, MSN, “In the past, pregnancy was one of the main women’s issues receiving attention. However, since the 1960s, many women have desired more information about their bodies and their health.” She went on to explain that the focus previously has been primarily on issues that aff ect women only. “Women’s health gained more

prominence in the 1990s and still remains important today,” said Green.

Moore agrees that for years the research of women’s health focused solely on those conditions that aff ected women exclusively. Until 1991, there were 13 institutes at the National Institutes of Health (NIH) and not one focused on general women’s health. In that year, the Offi ce of Research on Women’s Health was created, and the fi rst order of business was changing the defi nition. According to Moore, there was much discussion about how to defi ne it correctly, because the only explanations commonly used dictated how “diff erently” to treat women, therefore establishing men as the standard. The fi nal defi nition, which spoke to the true purpose of research of women’s health, was anything that aff ects the health and well-being of women.

Phyllis Greenberger, president of the Society for Women’s Health Research, a nonprofi t organiza-tion whose mission is to improve the health of all women

through research, education and advocacy, agrees with Moore. “In the

1990s our society was founded because women weren’t being included in clinical research studies,” said Greenberger. “In 1993 we were offi cially established and we put women’s health on the map. What people don’t realize is that sex diff erences exist for all conditions, and research is benefi cial to both genders to know the causes and correct treatment. We can’t know how to correctly treat a person, man or woman, unless we study both sexes and how diff erent condi-tions aff ect all.”

Life Stages of WomenAccording to Moore, one major diff erence between men and women is the fact that women use the medical system more throughout their life stages than men do. “Women spend a lot more time with physicians for [conditions] not related to diseases or disorders. We eff ectively can label our life stages by our medical [evolution], for example getting a period at puberty, needing contraception, pre-menstrual syndrome, pregnancy, menopause — these are all normal life events and transitions that we treat medically. There is no male counterpart for these changes,” said Moore.

Because there is no comparison to these life changes for men, these

Most people know what makes a man and woman diff erent, whether they use the

explana� on of reproduc� ve organs or X and Y chromosomes, the reasoning is pre� y clear-cut.

But the medical diff erences that exist between the two sexes have been somewhat blurred for

centuries. It is only in the last 20 years or so that there has been major eff orts put forward on

behalf of research and medical discoveries rela� ng to diseases, illnesses and symptoms and

how they aff ect each sex diff erently.

Spring 2009 Connections 5

Moore, M.D. Moore is the president of Sapphire Women’s Health Group and author of the new book Women’s Health For

6 Spring 2009 Connections

are parts of women’s health that are already clearly identifi ed and moder-ately understood. According to Moore, these life stages have been the study of women’s health in the past even dating back to the 1800s, and while these transitions are handled well by the gynecology specialty, they are always researching further to fi nd ways of improving.

What We Know…And Don’t Know“We can clearly see the diff erences that exist between conditions in men and women, but we don’t know why the diff erences exist,” said Greenberger. “Our new scientifi c membership organization is exploring biological sex diff erences, so we can answer this question. Once we know why the diff erences exist, we can know how to [recognize] the symptoms in men and women and treat appropriately.” According to Greenberger, some of the big questions include: why is cardio-vascular disease the top killer of women, why does depression aff ect more women, why do more women suff er from autoimmune disease, among many others. “Also, we know very little about the causes behind some of the conditions that only aff ect women — are they genetically linked or hormonal, or a combination of both,” noted Greenberger. “We need to know the underlying mechanism to properly understand and treat any and all conditions.”

According to Moore, there is so much new information that comes out every day, and on menopause every week. She cites the Women’s Health Initia-tive as leading the major long-term studies on women’s health today. “One of the biggest topics being researched right now is estrogen and the fi nding that it’s neither absolutely good or bad,” said Moore. “Changing levels of estrogen for whatever reason is an individual decision women need to make based on their own values, needs and risk factors.”

Two of the biggest diff erences in women and men have to do with the heart, said Moore. “Women are more likely to have a silent heart attack with no major symptoms like they see on TV, [such as] severe chest pains and cramping in the arm. Many women instead present with severe indigestion, upset stomach, sweating and nausea — symptoms [of a silent heart attack] that they might ignore as something non-serious.”

The other heart problem that can be less than obvious is symptoms of heart disease, the top killer of both men and women in the U.S. More then 10 times as many women die of heart disease every year than die of breast cancer. “I often talk to women and ask them about shortness of breath after walking up a fl ight of stairs and they look at me dumb-

founded and ask ‘Isn’t that normal?’ to which I reply ‘Absolutely not!’” said Moore. She insisted that women are not aware of the risk factors of heart disease, including high cholesterol, high level of triglycerides, belly fat and large waist size. “Women are less likely to be told by their physicians to get their cholesterol and triglyc-eride levels checked, which is very important to know how your body is functioning.”

New Knowledge on Women’s Health TopicsThe Society for Women’s Health Research’s Greenberger mentioned that the organization established a scientifi c membership society to initiate communication between professionals who study gender-based diff erences. According to the group’s Web site, www.ossdweb.org,

While the study of women’s health is very important as its own individual forum, both the Society for Women’s Health Research’s Greenberger and Sapphire Women�s Health Group�s Moore agree that having women’s health be its own specialty, like cardiology or gynecology for example, would be a move in the wrong direc� on. “We don’t want to segregate the en� re medical profession,” said Greenberger. “Physicians should be knowledgeable about both genders and the differences and similari� es between them which can then benefi t the health and well-being of both. Learning something new about how a condi� on should be treated in a woman can shed light on how it might also be treated in a man, [albeit] in a diff erent way.”

Moore believes that every medical specialty should become more educated about women’s health issues. While she knows that there is much to learn about women’s health and that it could very well have its own specialty, she believes it should fall under a diff erent, more neutral name. “Why call it women’s health when it will benefi t both genders?” asked Moore. “So that people can focus on gender-based diff erences instead of singling women out like they are the problem, the � tle should be switched to gender-based medicine to be� er refl ect the gravity of the fi ndings.”

New Medical Specialty

Women’s Health:

Spring 2009 Connections 7

the Organization for the Study of Sex Diff erences (OSSD) is a nonprof-it society that includes “basic and clinical scientists from various disciplines who share an interest in exploring sex/gender diff erences in all areas of biological, medical and behavioral science.” The hope is that new discoveries will be made by the sharing of information of similar-themed studies.

“The fi eld of women’s health is not that old and much still needs to be learned about how sex and gender impact the health, safety and quality of life of women at every stage of

life,” said the CDC’s Green. She went on to specify these recent public health examples of progress:

• The Women’s Health Initiative changed how we think about menopause and hormone therapy (NIH) — www.nhlbi.nih.gov/whi

• Inclusion of women in clinical trials is helping determine if there are signifi cant sex/gender diff er-ences of clinical or public health importance.

• Introduction of the HPV vaccine for the prevention of cervical cancer —

www.cdc.gov/std/hpv/STDFact-HPV-vaccine-young-women.htm

• The Sister Study is looking at environmental and genetic charac-teristics of women whose sisters had breast cancer (NIH) — www.nih.gov/news/health/mar2009/niehs-16.htm

• Recognition of symptoms for ovarian cancer which before were considered too vague or unspeci-fi ed — www.cdc.gov/cancer/ovarian/basic_info

“The fi eld of women’s health is not that old and much s� ll needs

to be learned about how sex and gender impact the health,

safety and quality of life of women at every stage of life.”

Choosing the Right PhysicianAccording to Moore, the number one question she gets asked from her female patients is: what kind of doctor should I be seeing? Her response: “It depends on what your problem or symptoms are.” In many medical insurance policies, there is a requirement that everyone have a primary care physician specifi ed who handles overall health and can collect information from any specialist a patient might see. But according to Moore, it is always better to have both a regular internist for general illnesses and a gynecologist. “If you have an internist who is comfortable with gynecological tests, then you can get it all done with the same person, but you run the risk of something possibly falling through the cracks,” she noted. “The follow-up procedures at gynecologists offi ces match that of the conditions treated there. But I stress that every woman needs to visit a gynecologist at least once a year.”

Moore spoke of a specifi c case that she heard about that shows how important having both an internist and a gynecologist really is. This woman went to her internist every year without fail. Her physician

asked the normal questions about her symptoms. She had developed a bad cough, but was not a smoker, and was treated for bronchitis with antibiotics. After that didn’t work and she came back with a more severe cough, they took X-rays and found a mass in her lungs, which they biopsied and found out she had cervical cancer. After talking with an oncologist, she went back to her internist and simply asked why he had never inquired about when her last pap smear was. She had not had one in fi ve years and since her internist hadn’t told her she needed to go, she was unaware of the importance of an annual check-up.

The word is now spreading worldwide more and more every day about the need for annual check-ups thanks to the new cervical cancer vaccine and the publicity around the recent death of British TV reality star Jade Goody (who died March 22, 2009 at age 27 of cervical cancer after fi nding out about her prognosis while in front of the cameras). Still, Moore feels it is very important for family practitio-ners and internists to ask questions and inform their female patients of the necessary annual check-ups in case they don’t already know.

The Proac� ve WomanInteraction with your physician is critically important. The more specifi c information you give him or her, the more accurate the diagnosis.

“We have learned from behavioral health studies that there is a discon-nect in eliciting information from both the patient and physician,” said Moore. “If the patient has a problem, the physician thinks that they should disclose that information. Vice versa, the patient thinks that the physician should ask, and if they don’t, the patient doesn’t tell. When it comes to female patients, the questions should be very specifi c to give them ‘permission’ to discuss very impor-tant topics that they might be too embarrassed to bring up without being prompted.”

Moore spoke specifi cally about simple things, like sleep for example. Women are twice as likely to suff er from insomnia, and yet most physicians don’t ask their patients how many hours of sleep they typically get a night. Also, women are six to seven times more likely to get migraines, said Moore, and again, it is not a typical question a physician asks the patient. Incontinence is another

Women’s Health Study

The purpose of this study is to evaluate the eff ects of vitamin E and low-dose aspirin in primary preven� on of cardiovas-cular disease and cancer in apparently healthy women. The study was intro-duced in October of 1999 and is ongoing. The trial is in Phase III of the study.

According to the Web site for the Women’s Health Study, this analysis was based on the fi ndings of another study. The Web site stated: “The results of the Physicians’ Health Study, a large-scale primary preven� on trial of aspirin in male physicians, have shown a decrease in myocardial infarc� on, a non-signifi -cant increase in cerebral vascular events, and no diff erence in overall

mortality. However, few studies have addressed the effi cacy of aspirin in vascular diseases in women, and it is possible that the risk to benefi t ra� o may be diff erent in women. Specifi cally, there have been no large primary preven� on trials in women, who are at risk of coronary heart disease, espe-cially a� er menopause.”

The trial was extended through March 2009, so results should be made available soon. For more informa� on and study results, visit the Women’s Health Study Web site at h� p://clinicaltrials.gov/ct2/show/study/NCT00000479

8 Spring 2009 Connections

major problem that very often is left undiagnosed because a patient is embarrassed to talk to anyone about it, including her physician. “There is so much misinformation, and as physi-cians, we need to be more aware of the heightened sensitivity on such topics,” said Moore. “The average woman lives four years with incontinence before talking about it because it is perceived as an ‘old woman’ problem. The truth is that one out of three women begin having symptoms of incontinence before the age of 35.” Moore’s message to women is that even if the doctor doesn’t ask, tell them everything that is going on.

The Alliance is very focused on this topic and the advancements it will bring to the future of medicine. Share the advantages of Alliance work on this very important initiative by asking a friend or col-league to join the Alliance. The Alliance will be providing resources and infor-mation throughout the year to Alliance members via the magazine, the Web site, E-Connection (if we have your e-mail) and E-Connection (if we have your e-mail) and E-Connectionthrough Alliance conferences in Chicago and around the country. To join, visit the Alliance Web site and click on the button to “Join Today Become A Member!”

For more information on women’s health and updates of ongoing studies on the topic, visit the Web sites for the Women’s Health Initiative (www.nhlbi.nih.gov/whi), Society for Women’s Health Research (www.womenshealthresearch.org) or the CDC’s Offi ce of Women’s Health (www.cdc.gov/Women/). For easy reference, the Alliance Web site lists all of our cited resources in its Strategic Partners and Useful Links section under the About portion (www.amaalliance.org/site/epage/68496_625.htm).

MAY

Women�s Health WeekThe 10th annual Na� onal Women’s Health Week kicked off on Mother’s Day, May 10, 2009 and was celebrated through May 16, 2009. Na� onal Women’s Checkup Day was Monday, May 11, 2009. The eight-week Women and Girls Moving Across the Na� on (WOMAN) Challenge, an online physical ac� vity program, runs from May 10–July 4, 2009.

Na� onal Women’s Health Week is a weeklong health observance coordinated by the U.S. Department of Health and Human Services’ Offi ce on Women’s Health (OWH). Na� onal Women’s Health Week empowers women to make their health a top priority. With the theme “It’s Your Time,” the na� onwide ini� a� ve encourages women to take simple steps for a longer, healthier and happier life. During Na� onal Women’s Health Week, communi� es, businesses, govern-ment, health organizations and other groups work together to educate women about steps they can take to improve their physical and mental health, and lower their risks of certain diseases. Important steps include:

• Ge� ng at least 2 ½ hours of moderate physical ac� vity, one hour and 15 minutes of vigorous physical ac� vity or a combina� on of both each week.

• Ea� ng a nutri� ous diet.

• Visi� ng a health care professional for regular checkups and preventa� ve screenings.

• Avoiding risky behaviors, like smoking and not wearing a seatbelt.

• Paying a� en� on to mental health, including ge� ng enough sleep and managing stress.

Source: U.S. Department of Health and Human Services’ Offi ce on Women’s Health

(www.4woman.gov/whw/index.cfm)

Spring 2009 Connections 9

The Sandwich Generation:

10 Spring 2009 Connections

By Henry Tam

The Sandwich Generation:

Y ou fi nally fi nd the missing shoe strategically hidden under your kid’s backpack as you rush him to school. After dropping him and his siblings off , you drive over to your mother’s place to check on her and pay some of her bills and get a little yard work done. Then you head to your local Alliance meeting to plan next weekend’s fundraiser. Back to school to pick up the kids and drive them to karate and soccer. You fi nally head home to have the kids help stuff fundraiser invitations and call the in-laws to check on them.

This is a typical day of life for a person caught in the “sandwich generation.”

People who care for their children and aging parents are part of the sandwich generation. The Pew Research Center, nonpartisan “fact tank” that provides information on the issues, attitudes and trends shaping America and the world, reports that nearly 10 million boomers are now raising kids or supporting an adult child while fi nancially supporting an aging parent. And just over one of every eight Americans aged 40 to 60 is raising both a both a bothchild and caring for a parent. These Americans fi nd themselves and caring for a parent. These Americans fi nd themselves andin the parental and supportive role for two generations of their families, their own children and their own parents.

Nurturing RolesHaving to care for children and aging parents has always been an issue Alliance families have faced. According to Loving Care: How do Alliance members cope with aging parents? which appeared in the May 2005 issue of AMA Alliance Today, “The tables turned for AMA Alliance Today, “The tables turned for AMA Alliance TodayMarcee Clafl in. For years she played the role of daughter while her parents cared and nurtured her into adulthood, but when their health began to decline, she assumed a new role — caregiver.” Today’s members are no exception.

Alliance member Mary Meyers of Houston was in the sandwich Alliance member Mary Meyers of Houston was in the sandwich position when she cared for her two daughters and father-in-law. Although her two daughters are grown now, she understands how Caught in Between

Spring 2009 Connections 11

People who care for

their children and aging

parents are part of the

sandwich genera� on.

12 Spring 2009 Connections

it feels to be part of the sandwich generation. “My kids were probably 4 and 6 when [my husband’s] father went into a nursing home and we went every day to check on him and see that things were going all right…but the kids would say ‘Oh, do we have to go to the nursing home?’” Meyers said. When Meyers’ father-in-law passed away, she started caring for her mother-in-law who moved to be within a mile of where they lived.

While the sandwich generation is generally thought of as providing support to aging parents and young children, the clear focus of the defi nition should be the key sup-portive role of the sandwiched person. Alliance member Susan Owen of Knoxville, Tenn., was thrown into the sandwich generation when her 23-year-old daughter suff ered traumatic brain injury in a tragic car accident nearly two and a half years ago. Owen cares for her daughter every day, taking her to therapy and occasionally provides weeklong respite care for her 85-year-old father-in-law. “I think when people think of the sandwich genera-tion, they think of [caring for] children who are young and healthy [as well as] the care of an elderly parent, but ours is so diff erent because Caroline was a junior in college when

she had her accident,” Owen said. Now, Owen cares for her daughter every day; taking it little by little, in hopes of helping her daughter recover walking and speech skills.

Taking on new responsibilities will seem overwhelming initially for the person in a sandwich situation, and even those around them. Owen said the biggest hurdle for her initially was just “time adjustment; leaving one life behind and picking another one up, and it certainly wasn’t a choice, but you deal with what you are given.” For Meyers, caring for her in-laws affected her children. “When we had [my husband’s] father in the nursing home, my children remember that as a not so fun time because our time was really divided. The time that they wanted to play or do something fun, we would have to go to the nursing home,” Meyers said.

CopingMeyers didn’t have to add a full-time job to her list of responsibilities, so she was able to manage the time crunch. “I tried to [visit my father-in-law] when [the girls] were in school. They were in early elementary school so I would do [most of the] running [then]. I’ve

Spring 2009 Connections 13

Being part of the sandwich genera� on

isn�t always a choice, but Meyers sug-

gests using it as an opportunity to teach.

been fortunate that [my husband’s] income has always allowed me to stay home with my kids and his parents, because I couldn’t have done it as much as I did if I worked full time.”

Even the older generation helped ease Meyers’ load at times, when she did take her daughters with her. “I took them to the nursing home to see [my husband’s] father all the time, and they happily went to see his mother, because she was a good grandmother. She liked to have them around and do things with them and they would spend the night,” she said.

Meyers was still able to juggle a lot when she was sand-wiched in. “When we were taking care of [my husband’s] father in the nursing home, I was president of the PTA, working for volunteer organizations and trying to get that done so that the family didn’t know that I wasn’t [busy] entirely,” she said.

Fostering Family Connec� onsBeing part of the sandwich generation isn̕t always a choice, but Meyers suggests using it as an opportunity to teach. “Use it as a teaching tool for your kids, to learn that the older generation is valuable and can’t be discarded because they have reached a time when they are not so much fun. I think it’s good for children to know that not everything is fun, that you still have to do it and it’s worthwhile in the long run. Some day you are going to think that I did this for my grandfather and I was there when he needed me,” she said. Responsibility can bring a lot of stress and can diff er from family to family. Owen noted the best advice given to her because her situation is really unique, “there is no concrete thing, so take a deep breath, pray a lot and have somebody you can talk to.”

While those in the sandwich generation may appear trapped with added responsibility over two generations of a family, it also shows the strong family ties that span generations. Instead of looking at the responsibilities as a burden, look at your responsibilities as a value system you are passing on from generation to generation. “I taught them as my mother taught me, because she had her mother-in-law close by her [when] we were young; it’s just what you do, you take care of them. She was wonder-ful to her mother-in-law, and when people say ‘you are so nice to take care of your mother-in-law, most people wouldn’t do that,’ well I say ‘you learn from the master, my mother did that when we were little.’ She made it important to us to take care of those older members of the family; go get grandma, bring her over for dinner every night.” She stresses the family values aspect of

being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope being part of the sandwich generation. “I can only hope that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody 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example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody that we are giving an example to our kids so somebody takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said. takes care of us,” Meyers said.

Owen now views her supportive role for her daughter’s Owen now views her supportive role for her daughter’s Owen now views her supportive role for her daughter’s current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from current life as a blessing; after her daughter woke up from a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care a lengthy coma. Owen stays positive about the partial care she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think she gives to her father-in-law as well. “I refuse to think negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. negatively about those grandparents whom we help care for. He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively He is not here full time, and we refuse to think negatively about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they about Caroline. If you let those thoughts creep in, they multiply, not only having a drain on yourself, [but that] multiply, not only having a drain on yourself, [but that] multiply, not only having a drain on yourself, [but that] multiply, not only having a drain on yourself, [but that] multiply, not only having a drain on yourself, [but that] multiply, not only having a drain on yourself, [but that] multiply, not only having a drain on yourself, [but that] multiply, not only having a drain on yourself, [but that] becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no becomes a mental drain.” Instead, Owen said, “there is no end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.” end to what [Caroline] can do.”

It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years It is no surprise that Meyers’ mother-in-law is 97 years old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile old. She is currently in independent living about a mile away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go away from where Meyers and her husband live. “We go over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get 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morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to over at night to get her to bed and go in the morning to get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from 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her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-get her up.” Meyers also recently returned from a four-

hour drive visiting her father. She isn’t currently in a sandwich situation, but will soon be sandwiched again since her daughter is moving back closer to Meyers and bringing along her new grandson and babysitting duties. “I guess in the long run, it’s worth it because I feel good about the time I have given to my elderly relatives.”

14 Spring 2009 Connections

Alliance members from 27 states gathered in Washington, D.C. for the 2009 AMA Alliance Capitol Conference, held in conjunction with the AMA’s National Advocacy Conference (NAC).

The Coalition-Building Skills Workshop was a key session of the Capitol Conference that discussed community and building relationships with organizations to promote local Alliances’ work on health promotion topics with Screen Out! Executive Vice President of Fenton Commu-nications William Hamilton and Screen Out! Coordinator Melissa Walthers, MPH, led the session. “It is always wonderful to reconnect with Alliance members from around the country and hear about their amazing work on the Screen Out! campaign,” Walthers said. “We are hoping that the session gave them some new tips and ideas on how to engage community organizations on gaining endorsements for the Screen Out! solutions to smoke-free movies.” Hamilton discussed and encouraged Alliance representation for Screen Out! He emphasized the identity of the Alliance and stressed looking for allies and forming a local coalition with health care providers, school offi cials, elected offi cials, parents organizations, community groups, youth organizations and church leaders.

The Fundraising for Medicine’s Future session included speaker Don Wilson, Ph.D., President of Don W. Wilson and Associates, Inc. and AMA Foundation Board Presi-dent Jean Howard. Howard spoke about the goals of the AMA Foundation and AMA Alliance partnership. “We

know we have a wonderful, grassroots army of fundraisers out there, and we want to continue this long-standing partnership…we want to build an AMA Alliance endow-ment fund within the Foundation; a permanent fund that will support the long term goals and objectives of this strong partnership,” Howard said.

Wilson spoke about enhancing local eff orts and national results in fundraising. “Just because you have a good cause, one of thousands out there, doesn’t mean money will automatically fi nd its way to you. You have to attract support the old-fashioned way — earn it…people will support you if you present them with a challenging project that is consistent with their interests. To succeed, you must explain exactly why you seek the funding, why your project is compelling, who will benefi t and why the money is needed now.” He concluded by stressing that “all members have to be active ambassadors and ‘friend-raisers’ in helping others connect the dots to see the value in what you are doing as an organization. It is not a time to retreat from public view and wait out the economic storm. You need to be out there nurturing face-to-face relationships with your key supporters and constituents.”

The Volunteers and Voices for Advocacy session, led by AMA Chair of the Council on Legislation John M. VanEtta, M.D., and Vice Chair David Hannan, M.D., covered the top advocacy issues the AMA is most involved in. Physician spouses learned about the focus of health care physician payment reform and the direction it should be

Alliance Members Rally Support for Medicine at Na� on’s Capitol

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Spring 2009 Connections 15

taking. Hannan stressed the Alliance partnership with the AMA as a key to infl uence direction. “We must continue to rally together with a unifi ed voice to advocate our message on payment and quality to Congress,” he said. “Our voice was heard in July 2008, and Congress enacted an 18-month fi x. We must continue to work together in this same manner.” He concluded by urging members to act on your physician’s behalf. “As the process develops in 2009 and proposals are considered, we all need to contact our members of Congress to advocate a unifi ed message that preserves Medicare access to quality care for our patients.”

The Alliance’s presence was also felt at NAC. A majority of Alliance members who attended the Capitol Conference also attended NAC, which included sessions on health system reform and a Capitol Hill briefi ng.

Alliance member and state Senator Susan Paddack was presented with one of the Dr. Nathan Davis Awards for Outstanding Government Service at NAC’s Dr. Nathan Davis Awards Dinner.

To view the session handouts, photo album and meet-ing schedule for the Capitol Conference, please visit www.amaalliance.org/site/epage/51775_625.htm. If you have any pictures you have taken at the Capitol Conference or NAC and would like to share them, please e-mail them to amaa@ama-assn.org.

Alliance Members Rally Support for Medicine at Na� on’s Capitol

Attention all AMA Alliance members! You are invited to join us in Chicago for the 86th Alliance Annual Meeting, June 13–15, 2009. The main event is the Alliance House of Delegates in action, deliberating the future direction of Alliance resources and services to members and policies that aff ect physicians and their families in their communities.

Chicago is a summer destination for families on vacation. Picnic in the park, stroll along the lakefront, shop, dine, visit the zoo, peruse world-famous museums, take in the art galleries, view city vistas from the tops of some of the world’s tallest buildings and soak up the cultural diversity of an international city. Take a trip to Chicago this summer with your family, and while you’re here, weigh in on the issues that aff ect the future of the family of medicine.

AMA Alliance President Sandi Frost will preside over the House actions. Meet the nominated candidates for the 2009–10 slate of offi cers on June 14, and learn more about the Alliance’s strategic future and how it relates to you, the member and your friends and colleagues in the medical family as future members. President-elect Nancy Kyler will be installed as the 87th president of the AMA Alliance on June 15.

The coveted Alliance Prestige Awards ceremony on June 13 will celebrate this year’s Health Awareness Promotion (HAP), Legislative Education and Awareness Promotion (LEAP) and Membership Development Project (MDP) awards.

For complete details, registration information and a link for hotel reservations, visit the Alliance Web site at www.amaalliance.org and click on the AMA Alliance Annual Meeting link on the Calendar page.

Calling All Members

16 Spring 2009 Connections

Spring 2009 Connections 17

The upcoming AMA Alliance Annual Meeting in June gives delegates representing the entire membership the opportunity to consider important bylaw amendments, elect and install new offi cers and directors, elect the Nominating Committee and consider the policies and resolutions that will determine the future of the Alliance.

When the House of Delegates (HOD) convenes in June, the delegates will deliberate on the following proposed amendments to the bylaws:

ARTICLE IV. MEMBERSHIPSec� on 1. Categories, Rights and PrivilegesAdding partner to membership categories: regular, associate, resident physician spouse and medical student spouse. Combining Section 2. rights and privileges with Section 1. categories.

ARTICLE VI. HOUSE OF DELEGATESSec� on 1. Responsibili� esUpdating and clarifying the responsi-bilities of the members of the House of Delegates.

Sec� on 3. Annual and Special SessionsProviding that the notice of time, place and purpose of the Annual Meeting, together, with the slate of nominees for all offi ces and positions to be fi lled be personally transmitted by mail or electronically.

Sec� on 6. QuorumUpdating and clarifying voting procedures in the House of Delegates.

Alliance Delegates Prepare to Consider Bylaws Amendments

ARTICLE VII. OFFICERSSec� on 1. Designa� ons Creating fl exibility by proposing an inclusive number of directors to meet the needs of the organization in carrying out its strategic plan and establishing the position of the executive director of the corporation as an offi cer.

Changing the number of directors for the Alliance to four to six and stipulating that the voting members of the group will be the president, the president-elect, the secretary, the treasurer, directors, and the immediate past president; plus the executive director, who shall serve ex-offi cio without privilege of a vote.

Sec� on 2. Elec� on and TermUpdating and clarifying language regarding elected and appointed offi cers’ election, term and election during an emergency.

Sec� on 3. Du� es of Elected Offi cersUpdating the job descriptions for the elected offi cers and the executive director.

ARTICLE VIII. NOMINATIONS, ELECTIONS, APPOINTMENTS Sec� on 1. Nomina� ng Commi� eeUpdating the language regarding eligibility to serve on the Nominating

Committee and the responsibilities of the committee, including confi -dentiality statement, and clarifi cation of meeting, quorum, vacancies and removal of committee member.

ARTICLE IX. BOARD OF DIRECTORSSec� on 1. Powers, Responsibili� es and Accountabili� esClearly defi ning the board’s authority, responsibilities and accountability and allowing notifi cation to board members of board meetings by electronic means.

Sec� on 2. Term of Offi ce and VacanciesCompiling and clarifying language regarding term of offi ce and vacancies.

Sec� on 3. Regular and Special Mee� ngsUpdating of language regarding regular and special meetings of the Board of Directors.

Sec� on 6. Removal Proposing new language to cover the issue of absences by designating that any board member who is absent from three (3) consecutive entire board meetings without prior notifi cation may be considered to have resigned, and upon approval by a majority of the members present and voting at any regular meeting of the Board of Directors, shall be notifi ed to this eff ect.

18 Spring 2009 Connections

ARTICLE X. EXECUTIVE COMMITTEESec� on 1. Composi� onProviding for the inclusion of the appointed offi cer as a member of the Executive Committee, to include the president, president-elect, secretary, treasurer, immediate past presidentand executive director, who shall serve ex-offi cio without privilege of a vote.

Sec� on 2. Responsibili� esUpdating the responsibilities of the Executive Committee to state that committee members may exercise the powers of the Board of Directors in the interim between board meet-ings, except that the Executive Committee shall not have the power to adopt the budget, or to take action which is contrary to or a substantial departure from, the direction estab-lished by the Board of Directors or the voting members of the AMA Alliance, or which represents a major change in the aff airs, business or policy of the AMA Alliance. Further, the Executive Committee will not take any action prohibited by federal or state statute. The Executive Committee shall submit reports in writing to the Board of Directors regarding all action taken.

Sec� on 4. Mee� ngsAdding new language regarding meetings of the Executive Committee.

ARTICLE XI. COMMITTEES Allowing the Board of Directors to use committees effi ciently and as needed by proposing to amend the committee structure regarding the establishment of committees, the

required number of members on committees and eligibility to serve as committee chair and members.

ARTICLE XVI. AMENDMENTS Reducing the Article to the following two sections:

Sec� on 1. MethodThe bylaws of the AMA Alliance shall be amended by a two-thirds (2/3) vote of those present and voting at any properly constituted regular annual or special meeting of the voting mem-bers of the corporation, provided the membership has been informed of the proposed change in writing at least 30 days prior to the date of said meeting.

Sec� on 2. RevisionThese bylaws may be revised only upon authorization by the House of Delegates. A summary of the proposed revision shall be distributed in the Call to the Annual Session sent to the membership at least 30 days prior to the session of the House of Delegates at which time action is to be taken.

ARTICLE XVII. DIRECTOR CONFLICTS OF INTERESTInserting a new Article on Director Confl icts of Interest.

ARTICLE XVIII. EMERGENCY CLAUSEAdding new language regarding operations during an emergency.

Please visit the Alliance Annual Mee� ng Web page under the Calendar tab to view a complete copy of the bylaws with language crossed out or added as proposed.

Background on Bylaw Amendment 1

Proposed Bylaw Amendment One, to add “partner” to four categories of Alliance member-ship, was considered by the HOD in 2007 and 2008. The proposed amendment was approved by a majority of delegates in 2008, but fell short of the two-thirds vote necessary to adopt a proposed bylaw amendment.

The Alliance Board of Directors unanimously supports adoption of this amendment, noting that the organization can do no less than lend its support to all AMA physicians. The board believes that this is the proper direction for the Alliance and the time is now to welcome those physician partners who share our goals of building healthy com-munities and fi ghting for the profession of medicine.

Spring 2009 Connections 19

Screen Out! News

AMAA Featured in US Weekly

The Screen Out! campaign is urging local and state Alliances to participate actively in campaign activities this spring and summer to help meet the American Legacy Foundation grant goals and continue making the Alliance voice heard by Hollywood. By continuing to put pressure on the six largest media companies, they will know that the Alliance will not rest until a policy solution is in place to protect kids from dangerous smoking imagery. Please visit www.screenout.org for up-to-date announcements, materials and

assistance in working on this campaign in your state and county Alliances.

Take Action this Summer Movie SeasonSummer movies highlight some of the biggest youth-rated blockbusters of the season and this year Screen Out! wants you to keep watch and make your voices heard. Here are some simple actions to

take during the summer movie season to help make the Alliance voice loud and clear that all future youth-rated movies should be smoke-free.

1. Tear out the six postcards in this issue of Connections. Sign, and send the postcards, free of charge with the postage-paid permit, to the AMAA offi ces to be forwarded on to the media companies urging them to stop promoting smoking to youth in their fi lms.

2. If you go to the movies and see a youth-rated fi lm that features smoking, write a letter to the media company who produced that fi lm urging them to stop. You can even submit a letter to your local movie reviewer asking them to highlight this issue when reviewing fi lms. Materials for this can be found at www.screenout.org.

3. When soliciting an organizational endorsement for the campaign, point out current youth-rated movies that feature smoking. Connecting people to the fi lms that promote smoking is sometimes the easiest way to get a message across. Here are some recent examples of youth-rated fi lms that featured smoking:

• He’s Just Not That Into You (PG-13)• The Curious Case of Benjamin Button (PG-13)• Australia (PG-13)

Scholarships to attend AMA Alliance Annual Meeting in ChicagoThe Screen Out! campaign is off ering fi ve $1,000 scholarships to AMA Alliance members to attend the AMA Alliance Annual Meeting in Chicago from June 13-15, 2009. All members who have shown exceptional participation and action on the Screen Out! campaign in their local communities are encouraged to apply. Applications are due by May 22, 2009. To download an application, please visit www.screenout.org or e-mail melissa.walthers@ama-assn.org.

Screen Out! News

May 31st, 2009 marks the day when we stand united to create a tobacco-free world through World No Tobacco Day. Support this day by promo� ng Screen Out! in your community through gathering pe� � ons, wri� ng a le� er to the editor or asking an organiza� on for their endorsement of smoke free movies!

Spring 2009 Connections

members to attend the AMA Alliance Annual Meeting in Chicago from June 13-15, 2009. All members who have shown exceptional participation and action on the

The March 15, 2009 issue of Us Weekly magazine men� oned the Weekly magazine men� oned the WeeklyAMA Alliance and our messages against the smoking imagery in the feature fi lm He’s Just Not That Into You in their “Feuds of the Week” sec� on. The � tle was “The AMAA vs. He’s Just Not That Into You" and He’s Just Not That Into You" and He’s Just Not That Into You"showed an image of the fi lm’s star and execu� ve producer Drew Barrymore. The ar� cle read:

The American Medical Associa� on Alliance is smoking mad at Warner Bros. over images of American Spirit cigare� es in He’s Just Not That Into You. “There is absolutely zero ar� s� c jus� fi ca� on for this,” Melissa Walthers of the AMAA told The New York Times February 25. “It doesn’t ma� er if the story line is nega� ve or not in terms of the impact on kids.” (Warner Bros. had no comment.)

This ar� cle followed the February 25, 2009 feature ar� cle in The New York Times. To read the en� re The New York Times ar� cle, visit h� p://www.ny� mes.com/2009/02/26/movies/26smok.html.

World No Tobacco Day

20 Spring 2009 Connections

President: Nancy KylerNancy Kyler of Staunton, Virginia, assumed the offi ce of president-elect of the American Medical Association Alliance in June 2008.

Kyler previously served as secretary, director for two terms, Legislation chair, a member of the Legislation Committee, as the Alliance representative to the American Medical Association’s Council on Legislation and as Committee Chair of the Legislative Education and Awareness Promotion (LEAP) Awards.

Kyler has served the Medical Society of Virginia Alliance and Rockingham County Medical Society Alliance in many positions, including president.

Meet the 2009–2010 Slate of Offi cersThe Nominating Committee met on Saturday, March 14, 2009 at the Marriott and on Sunday, March 15, 2009 at the Alliance Chicago headquarters.

Meet the nominated candidates for the 2009–10 slate of offi cers on June 14 at the Annual Meeting, and come witness as President-elect Nancy Kyler is installed as the 87th president of the AMA Alliance on June 15.

The slate of offi cers for 2009–10 is as follows:

President-elect: Susan Todd, TexasElected: Treasurer (2008-09); Director (2006-08), Nominating Committee Member (2004)

Appointed: Finance Committee Member (2006-07); Strategic Advancement Advisory Committee Member (2006-09); Bylaws Com-mittee Member (2007-08); Election

Committee Member (2005, 2006); Legislation Committee Member (2004-06); Membership Advisory Committee Member (2003-04)

State President: 2002-03

Secretary: Marilyn Kezirian, CaliforniaElected: Director (2003-06)

Appointed: Bylaws Committee Chair (2006-08); Strategic Advancement Task Force Member (2005-06); Finance Committee Member (2005-06); Integrated Marketing Communications

Advisory Committee Member (2002-03); HAP Awards Selection Committee Member (2002, 2004); Election Committee Member (2000, 2001); Health Promotion Committee Chair (2001-02); Bylaws Committee Member (2001-02, 2004-05); Membership Committee Member (1999-01)

State President: 1998-99

Treasurer: John Lovin, North Carolina Elected: Director (2006-09); Nominating Committee Member (1999)

Appointed: Finance Committee Member (2008-09); Bylaws Committee Member (2007-08); Finance Committee Member (2006-07); Integrated Marketing Communications Advisory Committee Chair (2004-06), Member (2003-04); Communications/Public Relations Task Force Member (2001-02); Health Promotion Committee Member (2000-01)

State President: 1998-99

Spring 2009 Connections 21

Director: Emma Borders, Louisiana Elected: Director (2007-09)

Appointed: Finance Committee Member (2008-09); Reference Committee on Organizational Aff airs Member (2008); HAP Awards Selection Committee Member (2007-08); Bylaws Committee Member (2007-08);

AMA Foundation Committee Member (2005-07); Election Committee (2005, 2006); Health Promotion Committee Member (2004-05)

State President: 2002-03

Director: Gail Kacich, Illinois Elected: Nominating Committee Member (2008)

Appointed: Integrated Marketing Communications Advisory Committee Chair (2008-09); Strategic Advance-ment Advisory Committee Member (2008-09); Membership AdvisoryCommittee Member (2007-08)

State President: 2006-07

Director: Dinah Goldenberg, North DakotaElected: Director (2008-09)

Appointed: Bylaws Committee Member (2008-09); AMA Founda-tion Committee Chair (2007-08); AMA Foundation Board Member (2007-09); Strategic Advancement Advisory Committee Member

(2006-08); Membership Awards Selection Committee Member (2007); Membership Advisory Committee Member (2006-07); Integrated Marketing Communica-tions Advisory Committee Member (2005-06)

State President: 2004-07

Director: Barbara Hanas, Iowa Elected: Director (2007-09); Nomi-nating Committee Member (2006)

Appointed: Bylaws Committee Member (2008-09); Reference Committee on Organizational Aff airs Member (2008); Finance Committee Member (2007-08); HAP Awards Selection Committee Member (2007);

Health Promotion Committee Chair (2006-07), Member (2005-06)

State President: 2004-05

Director: Pat Hyer, Texas Elected: Director (2008-09)

Appointed: Bylaws Committee Member (2008-09); Legislation Committee Chair (2007-08), Member (2006-07); AMA Council on Legislation Member (2007-08)

State President: 2005-06

Director: Jo Terry, Tennessee Elected: Director (2008-09); Nomi-nating Committee Member (2007)

Appointed: Health Promotion Committee Chair (2007-08), Member (2006-07); AMA Council on Violence and Abuse Member (2007-09)

State President: 2005-06

Director: Sarah Sanders, Indiana Elected: Nominating Committee Member (2007)

Appointed: Membership Advisory Committee Chair (2008-09), Member (2006-08); Strategic Advancement Advisory Committee Member (2006-08)

State President: 2004-05

Director: Sue Vegors, Tennessee Appointed: Health Promotion Committee Chair (2008-09); Legisla-tion Committee Member (2007-08)

State President: 2006-07

22 Spring 2009 Connections

Healthy Connections

This is the fi rst installment in our new feature Healthy Connections which is dedicated to wellness for physicians and medical families. We’ll provide you with stories and information about how to stay healthy — both physically and emotionally — statistics, the latest resources available, advice on work/life balance and updates on what the AMA is doing in this area. This issue, we’re presenting excerpts from “21st

Century Medical Families: Engaged, Enlightened and Empowered,” the popular presentation by Alliance President Sandi Frost.

During the presentation Frost commented on the nature of physi-cians married to non-physicians. She remarked, “Medical Marriages are increasingly squeezed for time with both partners in the work force.”

Putting even more strain on a marriage is the situation of physi-cians married to other physicians, and the unique challenges these marriages may encounter. Frost explained, “Both women and men in dual-doctor families diff er in their professional and family lives from other married physicians.”

One issue in many medical marriages is that long hours are viewed as “normal” and can result from the doctor’s personality and the culture of medicine.

Frost pointed out that main sources of confl ict tend to stem from time

and money. When dealing with time and money. When dealing with time conflicts, she recommended the conflicts, she recommended the spouse not take lateness personally. spouse not take lateness personally. To resolve fi nancial confl ict, it is best To resolve fi nancial confl ict, it is best to set clear fi nancial goals together.to set clear fi nancial goals together.

The types of stress medical families The types of stress medical families may encounter are broken out into may encounter are broken out into the following three categories by the following three categories by Wayne and Mary Sotile, the authors Wayne and Mary Sotile, the authors of The Medical Marriage:

1) The Anticipated and Unavoidable, 1) The Anticipated and Unavoidable, which account for 80 percent of the which account for 80 percent of the stresses medical families face each stresses medical families face each day: postponing gratifi cation until day: postponing gratifi cation until after training, long hours of work, after training, long hours of work, emotional toll from fear of making emotional toll from fear of making mistakes and daily exposure to pain mistakes and daily exposure to pain and suff ering.

2) The Unanticipated and Unavoid-2) The Unanticipated and Unavoid-able of which many pertain only to able of which many pertain only to 21st century medical families: six-century medical families: six-fi gure medical school debt, government fi gure medical school debt, government intrusion into practice, physician intrusion into practice, physician bashing in the media.

3) The Anticipated and Avoidable, but 3) The Anticipated and Avoidable, but not avoided are the toxic stresses that not avoided are the toxic stresses that fuel resentments and can potentially fuel resentments and can potentially do the most harm to medical mar-do the most harm to medical mar-riages: competitiveness, needing to riages: competitiveness, needing to control others, constantly rushing.control others, constantly rushing.

Strategies to maintain relationships Strategies to maintain relationships include: assessment, walking in the include: assessment, walking in the other person’s shoes; acceptance, this other person’s shoes; acceptance, this is our life, not a problem; anger is our life, not a problem; anger management, resentments are the management, resentments are the number one killer of relationships; number one killer of relationships; and action, work together as a and action, work together as a team.

Changing medical family demographics:

• Approximately 20 percent of male physicians are married to another physician

• Approximately half of female physicians are married to another physician– Decreasing percentage over the past 20 years

• Dual physician families will increase as number of women physicians increase

Work/Life balance checklist:

• Exercise regularly

• Eat right

• Surround yourself with people you like and respect

• Live in an area that suits your lifestyle

• Stay organized

• Confront your problems

Why the Alliance to build your ac� on team:

• Unique in volunteer opportuni� es to partner with our physician spouses to build be� er communi� es and have an impact on the future of medical care in our na� on

• Membership gives spouses access to a network of friendship and support in the medical community

• Spouses grow skills in leadership, communica� on and advocacy

Advantages of teamwork for Alliances and medical associa� ons:

• Joint projects strengthen both organiza� ons’ programs and goals

• For the medical society — the Alliance is its volunteer arm

• To the Alliance, the medical society is a resource, both for funding and medical exper� se

Spring 2009 Connections 23

Recently profi led state Senator Susan Paddack (Winter 2009 issue of Connections) was honored by the American Medical Association (AMA) with one of the 2009 Dr. Nathan Davis Awards for Outstanding Gov-ernment Service. Paddack accepted the honor at the Dr. Nathan Davis Awards gala held March 10, 2009 at the National Advocacy Conference. Joseph M. Heyman, chair of the AMA Board of Trustees said Paddack was honored for her dedication to removing barriers to health care access for the people of Oklahoma.

The AMA Alliance nominated Paddack for this award. It is recognized nationally as one of the most prestigious honors extended to elected offi cials and career government employees for outstanding endeavors that advance public health.

Paddack thanked her husband, the Alliance and the family of medicine during her acceptance speech. She credited her experience including the 2000-01 Alliance presidency: “During this span of time I received incred-ible training on legislative advocacy, health care policy discussions and public speaking, all which empowered me with the skill sets that enabled me to run for offi ce.” Paddack also encouraged everyone to, “take this leap of faith to run for offi ce, or to help others run because we need moremembers from our family of medicine to be a part of the solution.”

Paddack Wins AMA AwardA statement in the Winter 2009 issue story “New Online Resource Addresses Teen Drug and Alcohol Use” indicated that the Alliance’s Youth Alcohol Awareness Grant Program is an annual program, when in fact, the donation that funds it was a one-time gift to use in supporting work with under-age drinking.

Correc� on/Clarifi ca� on

Ready to Take Ac� on Against Childhood Obesity?According to the Centers for Disease Control and Prevention (CDC), data from the National Health and Nutrition Examination Survey (1976–1980 and 2003–2006) shows that the prevalence of obesity has increased: for children aged 2–5 years, prevalence increased from 5 percent to 12.4 percent; for those aged 6–11 years, prevalence increased from 6.5 percent to 17 percent; and for those aged 12–19 years, prevalence increased from 5 percent to 17.6 percent.

Look in the next issue for the launch of a new Alliance campaign with the CDC aimed at the serious public health problem of childhood obesity. The series will span across Alliance com-munication media, including Connec-tions, E-Connection, Leader’s Digest,the Web site www.amaalliance.org, the Alliance’s editorial service and the CDC Web site www.cdc.gov. Topics will include fast-food fads, the importance of drink choices for children, breast feeding and hospital practices, food labeling and legal issues. There will also be a spot on CDC’s Web site for sharing stories from the Alliance and your community.

Master of Ceremonies, Journalist Bill Kurtis; State Senator, Susan

Paddack; Chair of the AMA Board of Trustees, Joseph M. Heyman

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24 Spring 2009 Connections

Spring 2009 Connections 25

Harriet Hodgson has been a member of the Minnesota Medical Associa-tion Alliance for nearly 32 years. She was fi rst asked to join the Alliance by a friend, but decided the timing wasn’t quite right. About two years later she became an offi cial member. Harriet comments on her motivation for signing up, “I wanted to help others and belong to a network that understands medical families.”

Along with her activities with the Alliance, Hodgson created a presti-gious writing career, which started on a typewriter in her basement near the water heater. Since those humble beginnings, she has written 27 books and hundreds of Internet and print articles. Harriet’s love for the written word saw her through the most diffi cult experience of her life.

In February of 2007, her eldest daughter died from injuries she received in a car accident. Two days later, her father-in-law passed away from pneumonia. Eight weeks later, her brother died from a heart attack. And several months after that, another car accident took the life of Hodg-son’s former son-in-law, the father of her two grandchildren.

Within nine months, Harriet and her family experienced more loss and heartache than many people endure over a lifetime. These deaths left Harriet, her husband John and their twin grandchildren reeling with grief and disbelief. Harriet refl ects on the experience, “After my daughter’s

Harriet Hodgson: A Woman of Her Words

passing, I derived sympathy from the condolence cards I received from many Alliance members.”

In this trying time Harriet found her inner strength through writing. She kept a grief journal and literally wrote her way to recovery. “Four deaths in nine months brought me to my knees,” Hodgson says. “Since I’m a writer, I decided to write my way through grief. I spent a year on the book and realized I wasn’t only writing to recover, I was writing to survive.” Her writing became the foundation for her books, Writing to Recover, Writing to Recover Journaland the Writing to Recover Affi rma-tions Calendar.

In Writing to Recover, Harriet Writing to Recover, Harriet Writing to Recoverexplains, “Each of us recovers from loss in our own way, at our own pace, and on our own terms. Whether you’re grieving for one loss or many, I hope you sit down and write…Writing your way through grief helps you fi nd your way through grief. And that is a blessing.”

Hodgson’s passions extend beyond writing. She comments on a few social issues close to her heart, “I feel inner city neighborhoods should have fresh produce on hand so locals can eat a nutritious diet, and public bike paths and walking trails should be available so people can be physically active.”

Harriet believes it is crucial to take personal responsibility for one’s health. “I think it’s important to know how to get a natural ‘high’ from life, instead of using drugs and alcohol.” In keeping with her beliefs, Harriet served on the Mayo Clinic’s Action on Obesity Task Force for more than four years.

At the county level, Harriet has held the titles of secretary, newsletter

editor, president-elect and president of Zumbro Valley Medical Society Alliance. She has also served on the Minnesota Medical Association Communications Committee and was an ad hoc member of its Health Reform Task Force.

On the national level, Hodgson served on the IMC committee, the Nomination committee and the Coordinated School Health Council of Olmsted County, Minn. She also spoke at a North Central Conference in Minneapolis with co-presenter Becky Gonzalez-Campoy. Their talk focused on “Communications on a Shoestring.”

Today, Harriet is enjoying her role as a GRG (grandparent raising grand-children). She recently created a presentation entitled, “You, Too, Can Write to Recover.” She presented the lecture at an area church and has three more presentations planned in June. Harriet off ers her presentation to Alliances at no charge, but requests her traveling expenses be covered. For more information, including how to purchase her books, please visit www.harriethodgson.com.

This Member Profi le was written by Kallie Norton.

Member Profi le

“Since I’m a writer, I decided to write my way through grief. I spent a year on the book and realized I wasn’t only wri� ng to recover, I was wri� ng to survive.”

Harriet Hodgson — photo taken by her granddaughter

Haley Welby

Alert — Lockbox address changeThe AMA Founda� on has changed its lockbox address to 9050 Paysphere Circle, Chicago, IL 60674. Please make note of the change, as it may diff er from printed fundraising forms and materials currently s� ll in circula� on. We ask that you begin using the new address immediately. The old lockbox is no longer available and any dona� ons sent to that box will be returned to the sender.

The strategic planning process began last October in Chicago when the Alliance selected Paul Amundsen & Associates to facilitate the development of its 2009-2011 strategic plan. The Alliance’s chief planning objective was to focus its programs and services to meet the priority needs of today’s medical family.

The planning timeline from beginning to the near future includes:

• In October, the Alliance asked the board and committees what they thought about how the leaders can work together to make the organization stronger and to attract more members around the country so that the Alliance voice can be stronger for all physicians. The Alliance used this feedback with other research gathered to fuel an ongoing strategic planning dialogue from October through the end of February.

• During the weekend of March 7-8, the Alliance Board of Directors dedicated 15 hours of deliberation to what this means for the future of the Alliance and how it aff ects the objectives and strategies. They also discussed how the Alliance will use its limited resources for the greatest good, to reach members with service that helps them adapt to the unique pressures and stresses of life in a medical family.

• Between the March deliberation and April 20, the elements of the plan were drawn and debated by the Board of Directors so that they could meet the direction that has been agreed upon to follow as national leaders.

• The Alliance will begin disseminating the completed plan in May so that national leaders can discuss it when they come together in June at the Alliance Annual meeting in Chicago. Board members are expected to be represented at this important meeting, where the Alliance will look at all of the opportunities foreseen in the future for both members and the Alliance as an integral part of the family of medicine in America.

Alliance Strategic Planning Process:

Past, Present and Future

26 Spring 2009 Connections

www

Network NewsBringing Health Care to GuatemalaIn August 2008, Dr. Richard Hirata of the Baltimore County Medical Association Auxiliary (BCMAA) and several other volunteers from the Baltimore area traveled to Guatemala on a mission to provide medical attention to nearly 400 children and their caregivers. They arrived in Guatemala City on the afternoon of August 5, and were transported by bus to their camp in a rural village called Lemoa.

The mission was made possible with funds contributed by the BCMAA, which donated $500 to the cause, and medical supplies donated by GBMC HealthCare and other health-related organizations.

Dr. Hirata, nurses and allied health professionals constituted the medical team, which saw more than 350 patients in four diff erent communi-ties. They treated patients with various ailments including gastro esophageal refl ux disease, musculo-skeletal pain and lesion of the lower lip.

The medical team also encountered patients with parasites, headaches, hypertension and other common

maladies. Many of the conditions they treated resulted from insuffi cient primary care.

For Dr. Hirata, one of the most memorable parts of the trip, was his visit to the orphanage, Hogar del Niño, in Lemoa, where an American couple from Tennessee provided loving care to 16 children varying in age from infancy to 16 years old. The orphanage’s total fi nancial support comes from the Tennessee United Methodist Church.

Dr. Hirata provided physicals for all the children and medical care to several of the staff at the orphanage. Dr. Hirata refl ects on his experience, “It was spiritually gratifying to serve the people of Lemoa, but our work is not done. For many of these people, this is the only medical care they will ever receive.”

Dr. Hirata hopes there will soon be signifi cant improvement in the infrastructure of Guatemala so that water purifi cation and basic sanita-tion will be commonplace and its people will have access to suffi cient health care.

If you wish to join the BCMAA and help this cause, visit their Web site at www.medchi.org/BCMA/bcma.htm. The AMA Alliance off ers members the opportunity to support worthy causes such as this, go to the AMA Alliance homepage at www.amaalliance.org and click “Join Today Become a Member.”

If you are interested in learning how you can help the children of Hogar del Niño, please visit www.samaritanhands.org.

This edition of Network News was written by Kallie Norton.

Dr. Hirata on far left with other volunteers from the

Greater Baltimore area

The Alliance Web site www.amaalliance.org has been completely redesigned and reorganized. Have you visited lately?

Take a look!

Spring 2009 Connections 27wwwwwwwwwwwwwww

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Visit www.amaalliance.org and scroll down www.amaalliance.org and scroll down www.amaalliance.orgto the Hertz Gold Club button. AMA Alliance members can enroll to get their first year of Gold membership, free!

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