December 4, 2016

Episode 2: History of Including Parents in Treatment - New Plates Podcast


Why have parents been kept out of treatment, and how has it changed? Host Laura Collins Lyster-Mensh as she asks experts from around the world why including parents during eating disorder treatment was once controversial. Also: eating disorder news, and Laura’s favorite word of the week, “anosognosia.” 

Details and show notes at: http://www.circummensam.com/new-plates-podcast.html


Check out this episode!

November 21, 2016

Have you heard the NEW PLATES podcast episode 1 yet? "Why Include Parents During Eating Disorders Treatment?"



"Why include parents during eating disorder treatment?"

Some might say "why not?" I took the opportunity recently to ask leaders in the field, parents, and advocates this question and you can hear those answers on episode 1 of the NEW PLATES podcast, now available on the Circum Mensam website as well as on most podcast apps.

Quoted in episode 1, in order of appearance:
  • Dr. Mark Warren, Chief Medical Officer at the Emily Program (phone interview)
  • Dr. Lauren Muhlheim, Psychologist and Director of Eating Disorder Therapy LA
  • Professor Janet Treasure, Kings College London, South London and Maudsley Hospital
  • Dr. Craig Johnson, Chief Science Officer at the Eating Recovery Center
  • Dr. Julie K O'Toole, Chief Medical Officer, Kartini Clinic (phone interview)
  • Dr. Lucene Wisniewski, PhD, FAED  is Chief Clinical Integrity Officer of The Emily Program
  • Dr. James Lock, Director, Stanford Child and Adolescent Eating Disorder Program
  • Dr. Sarah K. Ravin, Licensed Psychologist (phone interview)
  • Jenni Schaefer, the Well-known author and motivational speaker
  • Lisa Conn (phone interview)
  • Katie, parent of daughter diagnosed at ten and now 16, in solid recovery (phone interview)
  • Belinda Caldwell, Executive Director of FEAST and Carer Consultant Victorian Centre of Excellence in Eating Disorders (phone interview)
Mentioned:
Eating Disorders Recovery Podcast with Tabitha Farrar tabithafarrar.com
Eating Disorder Research Society
National Eating Disorders Association
Dr. Walter Kaye, UCSD

Circum Mensam is a consulting firm that assists professionals and clinics in working with families successfully and toward better outcomes for eating disorder patients. If your program, event, literature, or training could benefit from expertise on parent involvement, contact us today.

LISTEN NOW, FREE online: CLICK HERE.

You are welcome to contact me, Laura Collins Lyster-Mensh, MS at LM@circummensam.com, the host of NEW PLATES.

Add YOUR voice to the podcast by leaving voice messages at the site as well!

November 14, 2016

Back, but with a new hat...

I took a break from eating disorder advocacy, but you know what? I don't know how to quit you. With our last child graduating and starting college it was time to reassess and figure out what I wanted to do now that I'm free to work full-time. I finished some projects and tried a few new things, and discovered:

It turns out I've still got some work to do and, I hope, something to contribute. So I told a few friends, and they told some friends, and I now have a new company, Circum Mensam. That's Latin for "around the table" which is a bit of a theme with me. I believe getting families and clinicians working together is a powerful tool for both eating disorder recovery but also relapse prevention.

I have informally, and on a volunteer basis, been doing consulting for some time now. I have, to tell the truth, so many requests for information and to collaborate on projects that it has felt like a full-time job for a long time. I truly enjoy working with both professionals and parents to improve treatment for families. And, in the past few years, the interest in ways to involve parents in treatment for better results has grown faster than the supply. The voices of parents are being heard and it shows in the changing policies, media, and training.

But still, in 2016, most patients with eating disorders are getting treatment that is not inclusive or friendly to their families -- if they are getting treatment at all. And, those who want to better involve families too often find institutional, cultural, and training barriers. Even providers who offer Family-Based Treatment, the gold standard of family inclusive care, often find their work undermined by untrained or FBT-skeptical colleagues.

Involving families isn't only about FBT, or family therapy, and Family Week. Involving families means looking at everything from first phone contact to billing and communication between teams. Involving families means skill with family work but also a view of a family's needs and strengths in the bigger picture.

I'm ready to get back to work. I already have started and it's time now to publicly announce it, and ask my friends and allies in the eating disorder world to:

Subscribe to the new podcast, called New Plates, starting in November. It will be about family-centered treatment and ways for families and clinicians to work together to help patients get well. It will include the voices of families and clinicians and researchers and advocates. In fact, I hope you'll consider being a guest on the show!
If your practice or clinic treats eating disorders, schedule a phone call with me to discuss your program and how you engage and work with families. If you are a parent or family member with experiences to share: call me!

Pass my name on to any clinics or organizations who might be looking to add or improve their family work, or are troubleshooting issues involving training or website content.

And parents, allow me to help other families by learning from you. What's working and what's not? What would help your family better support your loved one? What policies or roadblocks do you wish were changed?

For more information on Circum Mensam, and my new work, visit the website at www.circummensam.com

To catch me up on what is happening with YOU, dear friends, change my email to LM@circummensam.com and update me!

January 10, 2016

Why you shouldn't listen to me about sex, but probably will anyway


If you needed a reason to wonder what on earth I am doing hosting a podcast about sex, this infographic should be a clue. 
  • I misspelled "benis."
  • The girl is shooting sperm back at the dude.
  • The sperm are the size of hamburgers.
  • It's sexist: why is "Boy" capitalized and not "girl?
  • You couldn't even catch the flu from this distance.
  • The girl has six limbs. Or two tails. 
I was probably seven years old at the time, but still. Some people have midlife crises: others start podcasts. Against all odds and good sense the first episode of Our Better Half is now available.


You can subscribe on iTunes
You can listen on the SoundCloud site
You can use the Stitcher app


December 22, 2015

Mistletoe, mischief, and coming OUT

This hasn't been a secret nor have I tried to keep quiet on it but for some reason saying it here on my blog makes it real: I'm working on an "easily amused" podcast series about SEX.

SEX after 50, which seems to shock people far more than just SEX. Why is it that the topic of sex over 50 makes people giggle and then confess?

Are we more shy about sex than younger people or are we more shy about seeming older?

Well, I'm over it. I feel like I closed my Our Bodies Our Selves in 1977 and then forgot to update myself since then. As an old married broad with children I've spent way more years making my kids roll their eyes than my parents.

But no, I'm not planning to start oversharing my own (quite happy*) sex life, except in passing. I'm interested in learning what I missed while I've been busy travelling the world and having kids and, as of this week, launching those kids into legal adulthood. There are vocabulary words I don't recognize, places on the Internet I didn't know about, even technologies that expand our sense of what sexuality is. There's a growing problem with sexually transmitted illnesses (they even changed the name!) among older folk, and ageism in healthcare is a problem. Many boomers are caring for even older parents and dealing with issues like sexual rights in nursing home care!

I have always considered myself positive, if prudish, about sex. I expected to remain a sexual being until I was dead. No one told me I was supposed to stop in the second half of life, so it came as a shock and annoyance when the giggles turned to snickering. Nope: not having it. There are sexual health and happiness issues attendant to getting older but the right to the pursuit of sexual happiness is not reserved for the young: what a waste!

So, tally ho. (sorry. everything sounds like a double entendre now...) Go see the site, go subscribe to the podcast which will be available on iTunes and Stitcher and all the usual podcast sites, as well as available to listen online or download from SoundCloud. Learn with me; laugh with me!

OUR BETTER HALF, the podcast: first episode early January 2016!

** Deliriously, gloriously, delightfully happy, for the record, and to make sure my husband reads my blog.

December 3, 2015

vote now for YOUR favorite film featuring lovers who are over 50 years old

Yes, Dorothy, there are films featuring lovers over 50. Not having 50 lovers, though that MAY be true.

Rankings will be announced in January on Our Better Half podcast.

Vote or add your own!

November 19, 2015

Transcript for AED F.E.A.S.T. Twitterchat last night now available!

If you missed it, and regrettably I did, you can read the transcript for last night's Twitterchat with the Academy For Eating Disorders on the topic of

The Road to Recovery: Caregivers as Partners in Treatment #AEDchat

with guests from F.E.A.S.T.

What a fantastic chat: inspiring and including some of the most important things parents and clinicians need to know when it comes to caregivers!

November 11, 2015

Getting naked for a good cause

No, I'm not stripping down! But I see a lot of it going on: supposedly empowering commercials featuring non-standard sizes of women in their underwear, for example. Activists stripping down in public and trusting strangers to hug or write on them. Daring to go bare.

I get the symbolism: stripping down to one's common, um, denominator is being metaphorically naked and real to the public.

But, really? Why is the standard for body confidence half-naked? Why is it appearance-based at all? Why, indeed, is it about others? For many, just standing in one's skin of a normal day is an act of boldness, alone in their room., fully dressed. It doesn't need to be in public, or shivering in the gaze of strangers.

This brings to mind an era when we were told we were "uptight" if we didn't want to embrace "free love."

I don't know that stripping down to one's skin is necessarily casting off one's self-consciousness. For some it is, and that is be applauded, but it shouldn't be the new standard of being real. I'm real in my clothes. I can be confident in my underwear without displaying my underthings. Confidence in one's body image need not be proved through how many layers we are ready to strip off. In fact, body confidence isn't about how we LOOK, anyway. It is not necessarily lack of self-confidence that keeps our drawers on, it is also social propriety and comfort and privacy.




November 10, 2015

Fragility as power: I need a fainting couch!

I am noticing all around me -- in politics and social issues and local groups and advocacy and support circles -- the power of fragility to become something very much like aggression.

Who knew fragility was so powerful!

Anywhere good people are trying to do good things the power of fragility is not just in getting personal sympathy: it's a darn good way to stop uncomfortable conversation. Polite, decent people do not force people to talk when they don't want to. Nice people don't respond to tears without sympathy. While we all stop to fan someone with the vapors progress is put on hold.

But fragility is not always from weakness. It can be wielded as a form of power as well.

The power of being offended, feeling unsafe, and having one's motives questioned only works when the other people are caring, decent people. And who, I ask you, are the ones out there trying to do good but the decent and the caring?

It is an uneven playing field when some in the mix use fragility as a weapon. Aggression is easier to spot. Meanness is easy to spot. But the power to withdraw isn't always an act of conscience. Again, like the Dreaded Drama Triangle mentioned recently, fragility can seem like merit and deservedness when it is really more a way to stop criticism and control the field of discussion.

Mutual respect means treating others not with delicacy but with an assumption of necessary confidence. Those feeling fragile need support and a seat to the side to rest: honored and cared for but not in charge of the conversation. If we are discussing tough topics we need to be in a strong space.

In other words, fragility can't be an excuse to stop the conversation toward progress. It does get exhausting and feels awful at times to be an advocate but, like aging, is not for sissies OR bullies.

November 9, 2015

Doing it right doesn't mean it will work

There's a particular brand of magical thinking out there among parents. We think that if we do it RIGHT then the results will be what we desire. As if we deserve the best when we try the hardest and, by corollary, if we do not get the best outcome we did not do it "right." This is at best laughable but also tragically cruel if you think about it. Just because you did it right doesn't mean the outcome is going to be glorious. That's as illogical as thinking that wearing a seat belt prevents accidents.

For parents facing really difficult caregiving I get it: we CARE A LOT about doing the right thing and we should. We need every ounce of hope and energy and the decisions we make do matter. But those decisions are not magic.

It saddens me to see parents for whom things have not been successful feeling as if they have failed. It's even worse to see parents feel criticized by other parents. Sure, parents do fail, but the outcome for our kids isn't the measure of our efforts or decisions. In the case of mental illness things do not always come out well. In fact this is why it is urgent that we get more research and do a better job applying what we do know -- because the bad outcomes are horrendous and we have to do what we CAN to increase the chance of success.We stumble along as best we can, all of us, making mistakes and doing our best -- all of us.

But when the illness or circumstances keep our loved ones from wellness too often all that hope and magical thinking can sound like criticism. This should not be. The outcome does not tell us anything about the family or the treatment providers or the health system and NOTHING about the patient's "wanting." We can all do everything perfectly: the patient and the family and the professionals and society AND IT CAN STILL GO WRONG. We can also make mistakes (we all do!) and still come out all right.

Let's not add to the pain and grief of families with judgement and second-guessing. Let's encourage fellow parents to do what they CAN and stop when they must. Let's accept no one does this perfectly anyway. Our job as a community of people who get it is to be supportive of one another and empower one another. That means honoring the choices of others. It means offering our own stories and the information that helped us but not requiring others to come to the same magic formula. Let's not judge effort by outcome, or do anything but hold up our fellow families. And, let's not fool ourselves into thinking that our successes make us better people or more than one anecdotal story.

Families whose loved ones remain ill or have permanently disengaged or have died need the support of the community as much as those just entering it. Their wisdom and experience are necessary and valuable, and their grief is not to be turned away from or made unwelcome. The reason that happens is fear, I believe, fear by association and fear of rejection. We, as a community, are stronger than that!

November 6, 2015

are you in the drama triangle?


The other day I had a EUREKA moment when I connected what I see in support environments with what happens in advocacy environments -- and in our little eating disorder parent advocacy world the two are often the same -- with the models represented in this diagram.

You can read about Karman's Drama Triangle and The Empowerment Dynamic here, and I hope you do. What I want to say to my fellow advocates is that progress in the field is best done outside the Drama Triangle, which is really an emotional trap. It's ego and being right and wanting to be a rescuer but it invariably ends up making us into persecutors or being seen as persecutors, and I think it creates more and more victims and it doesn't WORK.

The point of advocacy is progress for the field.

The Empowerment Dynamic represents the best of advocacy AND creating supportive peer environments for caregivers. It embodies the way, ideally, parents can make it about outcomes and to KEEP OUR PASSION. I see too many advocates and mentors burn out or become embittered, and only a few stay in the "Passion-Based Outcome-Focused" range. I see too many of us succumb to personal attacks or feeling unappreciated or disliked. These dynamics only serve to keep us divided and off track.

In fact, I think the Drama Triangle may have been invented by ED! And that makes sense, too, *duh* ,because it is anxiety-based. I'm seeing that the future of parent advocacy and of shared ED advocacy is in the top triangle, where the best parenting and the best peer support is to be found!

Thoughts?

October 15, 2015

Just because: Leonardo Sandoval, tap musician

Saw this young man perform in Richmond over the weekend and then attended his workshop: Leonardo Sandoval. So musical, so charming: he soars.

I have a new favorite tapper.

 

Two of my friends told me of grave medical problems today. I needed this.

F.E.A.S.T. event in DC coming up!

Have you registered yet?

Join other F.E.A.S.T. families at an event in Washington DC on October 27, right before the MOM March at the Capitol:

Caregiver Lunch & Learn Event
Speaker: Mark Warren






September 23, 2015

Why monitoring a child's weight and height DO matter

I applaud this article!

How Monitoring Your Child's Pediatric Growth Could Help Prevent An Eating Disorder by Dr. Lauren Muhlheim.

This is thorny: parents need to know that they can't tell by looking at someone whether they have an eating disorder. But you DO need to know your child's normal growth pattern.

It isn't that weight is the only symptom, but parents you do need to know your child's growth trajectory. You can not tell by looking if your child is failing to gain height or weight due to subtle restriction. That restriction could be from a number of reasons, as the article states, but it is not normal and may be an early sign of mental illness.

The best time to intervene is as soon as possible. For those predisposed to these deadly mental illnesses you may be able to intervene early enough to stop it in its tracks.

Believe me, you do not want to wait until you can see it. And this is not just anorexia nervosa, this is all eating disorders: restriction is the beginning of bulimic and binge eating patterns as well.

Monitoring growth isn't everything, but it is REALLY important!

September 18, 2015

Caring for an adult in the US with mental illness? Please participate in this NAMI survey!

It is hard to care for a child with mental illness. But for those supporting an adult child suffering from mental illness the task is exponentially more difficult: there are administrative and privacy and legal hassles, there is the wear and tear of chronicity, and the world is likely to be telling you to "let go."

Parents with adult patients in their care are stuck in a limbo of parenting without the rights of a parent, locked in perennial negotiation with an illness that is not likely to respond logically or in the person's best interests.

As a longtime mental health advocate I have seen the larger mental health world pretty much ignore eating disorders, and ED advocacy has until recently opted out of the larger mental health advocacy picture.

So, it is with enthusiasm and hope that I share this survey out of NAMI, a leading US mental health advocacy organization, looking for responses from US caregivers of adults.

If we want change, and we want to be considered in the mental health arena, we as families need to step up whereever we can to be counted and to be heard. This survey is one of those opportunities, and passed on to me by another wonderful parent advocate, Joan Riederer of the Erin Riederer Foundation.

September 16, 2015

new video describing the family experience of anorexia nervosa

There's a new video out there for parents facing an anorexia nervosa diagnosis:


I love seeing content being created by parents for parents. These parents have done a wonderful job describing their experience and what they have learned. It is a compassionate, respectful, and meaningful view of their daughters as well.

There is much here to learn from these parents that applies to ALL eating disorders, and of course to male patients as well. Although they are not addressing adult patients in the film I also see this as in principle a grounding view of all eating disorders.

Congratulations to Parents to Parents!

July 21, 2015

Women's Plaza of Honor



The other day a young woman I know deflected a compliment. A seasoned old woman, I admonished her, saying that not taking compliments is bad for self-esteem and leads to being dismissed in society.  Also, it insults the giver.

She expressed her instictive horror at appearing to brag or be conceited. She also didn't want to be seen as ungrateful. As we discussed this we realized that while we both feel uncomfortable with appearing braggy or full of ourselves we also recently had experiences with being passed over or not taken seriously -- or even SEEN -- because we waited for others to acknowledge our contribution.

Worse still, our ungracious deflecting was surely an insult to the giver and invalidates their opinion.

So then today I laughed because I was cleaning up files and updating my resume and came upon an honor, a compliment, really, that I myself didn't want to brag on and thereby have failed to fully acknowledge the gift of receiving it.

I felt funny about "bragging" so I accepted this honor privately and although I squealed with delight with my mom (it's not bragging when it's your mom), I took the modesty route and didn't make a big deal over it. But it is a big deal when someone acknowledges you and your work and while I fall over myself to do that for others I have never found a way to feel gracious doing it myself.

After all, we don't do this work for the fame or the money or to be loved. We do it because we are inspired to and want to help others, just as those who came before us and inspired and encouraged us.

I am HONORED and GRATEFUL and very pleased to have been nominated and accepted for a brick in the Women's Plaza of Honor at The University of Arizona by my friend and fellow advocate, Jennifer Aviles. Thank you for noticing and showing your appreciation for my advocacy. I can't tell you how thrilled and validated and happy it makes me. I am proud to be among other women so honored. 

Taking a bow, and blushing, and encouraging us all to take compliments with at least as much pride as modesty.




July 18, 2015

Read it? Review it today!

If you're a reader, then you need writers, and writers need YOU. We only need two things in life: to be read, and to be reviewed.

Post a review for a book you've recently read. It matters!

I'd love it to be one of mine, of course, but reviews only take a moment of your time, don't need to be works of literature themselves, and they keep the readers in charge of what happens to books.

on Amazon
on Goodreads
on LibraryThing

ps if you would like a review copy of any of my books, let me know!


July 16, 2015

F.E.A.S.T. Executive Director describes advocacy goals and approaches

Fantastic, must read blog post from Leah Dean at F.E.A.S.T. today. She says what many of us think and believe, expressed beautifully!

Same Brain: Different Operating System

On a personal note, I've been disturbed, myself, to see conflict inside the ED world of a kind I never thought I'd see. People with many of the same beliefs I have about evidence and science and parent involvement are forming their own groups and factions and running into many of the same obstacles and road blocks I know well. These informal groups are not always operating with the accountability and civility that I feel is so important. They are not always taking the time to understand the history or to know who has done or is doing what. Some individuals are making demands without having earned trust, confusing informal lists of people with accountable organizations, personalizing their critiques and making the issues into conflicts between people and not ideas, calling out organizations and individuals in the field instead of recognizing them as allies.

Also worrying is the resurgence of parent-led advocacy that repeats history by promoting ideas about parents and eating disorders that are not evidence-based and not parent empowering. Factions and fights and splitting are abundant. And people are confused.

I'm seeing people be exiled and shunned and pathologized. This is not the way I operate or recommend that others do either.

I know the temptation of throwing bombs. I've thrown some myself. They always land in my lap because I didn't recognize that change in the ED family comes through persuasion and trust, not being "right." I had a lot of "shoulds" in my head: people SHOULD understand, SHOULD behave differently, SHOULD have courage, SHOULD operate logically, and SHOULD trust me. Didn't work.

We are a family whether we like it or not. If you make an enemy in this world its a small room, and there's no room in here to stalk off and sulk. If we as an individual don't gain the trust of others we don't get very far and we often hurt our allies and the ideas we hold dear. You may be right, and you may not be the person you're accused of being but if the perception is there you aren't going to be effective until it is repaired. If you are associated with someone who has, rightly or wrongly, gotten a bad reputation or scared people, you carry that burden and have to fix that first. It "shouldn't" be that way, of course. People should do the "right" thing and they should believe the science as we know it. But, we're not there. And we're not going to get there as individuals or even as single groups.

The way forward, I find, is in accountable advocacy. F.E.A.S.T. started with just a handful of people, as Leah Dean describes so well, who built the scaffolding and accountability for the principles and beliefs we hold dear. It built a structure for present and future parent advocates and those who care about parents and science to do effective advocacy, to have a collective voice. An accountable voice. As individual members of F.E.A.S.T. each of us has a single voice but by supporting the organization's work we speak as a group.

You can be part of that voice, or you can distract from that voice.

Accountable advocacy is a team sport. It isn't as immediately satisfying as an angry tweet, or intimidating someone who disagrees with you. It isn't as visible, often: building relationships and real conversations are not showy. And it doesn't always feed your ego and make you well "liked" on Facebook.

Much of the very personalized infighting I see going on at the moment is about individuals, not ideas. I support F.E.A.S.T. because it keeps all our egos in check and is about more than any one of us or any informal group of us. But it also depends on the families it supports to support it through joining, volunteering, donating, and sharing it with others.

I don't want to hurt those in the field with whom I disagree. I want to persuade them, and learn alongside them, and succeed together in our common goal: better ED treatment. That doesn't mean not having or stating or pressing my points. It means doing so in a way that acknowledges our common goals and humanity. It means listening as much as talking. It means establishing trust, which can't be forced or demanded. Too small a room, and too fractured and embattled from the outside. We're a family and have to pull together and resolve our disagreements if we want to have a clear voice to the public and to policy makers and the media. We have disagreement and that's okay. Resolving them is what we need to do, not "win" or prove others wrong.

We're getting closer. Let's "keep going."

July 11, 2015

60 seconds of lovely

Cute cat videos are good, but I get my blissful moments this week by way of moments like this:
video

In the rare moments of sundown in Norwegian summer, gorgeous colors and peace.

July 5, 2015

The Norwegian art of slow

Writers live on coffee and resisting distraction.

Hubby is in charge of the coffee around here: he roasts and brews it.

Distractions, well, those are my problem.

This week I'm unable to tear myself from the live feed from a ship travelling south along the coast of Norway, a project called Sommerb├ąten 2015. In a few days the boat will pass right by my ancestral island, where the Lysters come from, but my fascination with this very "Slow TV" phenomenon from Norway is deeper than that.

It is "hynotic." One recent night I spent hours on the phone with my daughter, both of us watching it on our own devices, noting the scenery and the light, watching the landscape of coastal Norway pass by. My husband and I keep calling out highlights from various screens. Smaller boats come and accompany the boat for a while, then trail off. Families come down to the shore, in groups around bonfires or waving signs and flags.

There are long stretches, hours long, of the boat simply sitting on the dock and you are sitting there too, looking at people walking and biking by. Yesterday there were folks on horseback. The sounds of a boat at rest. Here's a highlight reel, below. #sommerb├ąten is the hashtag, should you care to follow along.



Occasionally, in Norwegian prime time, there are little concerts and interviews, but I'd just as soon skip that. When the boat is moving between ports someone's very eclectic playlist is alongside, from Norwegian rap to American country and everything in between.

I can't embed the feed, but you can visit the page here. If the current view gets too dull you can position it back in time and see highlights from the past week. If you're lucky you'll catch the very cleverly produced Mystery on the Summer Boat drama that is part of the show. Mostly, you experience the fjords and islands and birds, and families waving.

With nearly 23 hours of sunlight this time of year, Norway is an excellent place to offer a 24 hour live feed. There's something to see at all hours, even if it is only birds going by and a change in the rain.

As distractions go, however, it's not ideal. I can keep the screen up in the corner and it doesn't need my attention very much. It's ambiant and contemplative most of the time. Even the speaking, since I only know 25 words of Norwegian, isn't as diverting as it could be.

Better, though, than the very popular overnight fireplace cam experience they called National Firewood Night in 2013. That was way too short.

So, I keep drinking coffee, keep writing. But I have no doubt that this summer's writing will have a distinct sense of space, of sea and sky, of sweaters even in July, and people waving as we pass by.

June 23, 2015

Charlotte's Squee

(note: I wrote this while on my recent trip to Australia, but was unable at the time to post)

Squee. That's what she would say. That's what she IS saying, in my head. That's the price of having a dear dead friend with a terribly strong voice is that she still talks to you, even when what you want rather miserably much is for her to hear you because Charlotte would very much have wanted to follow me on my trip to Australia where we both have so many dear shared friends. 

Today at a picnic she was the one we toasted. Not because she is gone but because she is so very present. Not because we miss her so much as that she is with us. It's just annoyingly one-sided. We hear her loudly and clearly. She continues to hold us to account and not let us get too full of ourselves.

In short, Charlotte Bevan is still having a laugh at our expense and as a result we are still laughing at ourselves.

She would love that her friends met at Kings Park for a picnic and a Kookaburra swooped in to take a bit of bread. She would love that we sat and schemed for helping families over a good meal watching ducks and children around a pond. She would know or want to know every one of us around the circle, and because she was Charlotte everyone there knows her.

I suppose that won't always be true, but it will always be some part of any group of parents around the world into the future because she changed the world, whether people continue to know why or not. There was a terribly important person who personally helped countless people and the ripples of that will not end.

She's not alone. She was singular, our Charlotte, but not alone. I have known countless parents who have paid it forward over the past many years, and each has played a role. No one will remember them all but I have the honor to have known so many. It is times like this trip where it hits me the strongest. Someone approaches me a stranger but we are not, they simply reveal themselves as part of this web, this community over time. I have been a named person over time but I am really only that. This is a movement, a society of people who don't all know one another but their networks connect to one another and we are all part of that whole. Most have contributed and moved on, leaving a legacy without a name attached, and one significant one has permanently been taken, but it's bigger than any of us. What is it? It's a society of parents and patients and siblings and professionals who are moving the conversation forward. It is a cohort bringing new paradigms to life.

Charlotte you would be so proud. Charlotte we are proud on your behalf and in your name. Charlotte, I am in Australia visiting our friends. Charlotte you really are here.

June 15, 2015

Wombats, Platypi, and Kangaroos.... oh, and people, too!

OK, so the only wombat I saw was stuffed, the platypus was almost certainly a duck, but there were more kangaroos than I could count.

Friends are asking for my travelogue of Australia. I am finally awake and caught up on laundry enough to try!

The trip over: via Abu Dhabi. Desert after desert. I've never flown over such aridity. A moonscape. It was overwhelming and disorienting. It swallowed up the endless ocean before and made me less intimidated by the ocean to come.

Boarding flight for Perth spied two other women with blue hair. Good sign.

Arrived Perth pretty spry and giddily smug: my back didn't hurt at all. All credit to Dr. Charles Seal at Blue Ridge Orthopaedics and Julie Royal and the team at Innovative Physical Therapy. I went to them with the worst possible idea: despite chronic mind-altering back pain from a torn disk I would still like to sit for 48 hours round trip on planes and yank around heavy baggage and sleep in five different beds and be very busy all day for two weeks, okay? They all said "why not?" and helped me with the pharmaceutical and exercise and stretching regime to not just get through it but to return home BETTER than before. I was prepared to return to my home airport on a stretcher but instead was simply and appropriately confused by the time zones. My lifelong dream of going to Australia and the great generosity of my hosts could have been spoilt but instead were saved and I am so deeply grateful.

Arrived Perth to see my name on a sign held by the estimable Don Irvine, my host and sponsor who felt like an old friend already. From a stubborn insistence that since I was already going to be in the country I need to stop by and "meet parents" in West Australia, he waved away my feeble objections and created a day-long event for local parents! He embodies "no worries!" combined with "get 'er done."

I arrived in the afternoon to a Swedish massage, a gorgeous sunset over Scarborough Beach, room service dinner with a cold beer, and a view from the balcony that staggered my confused but happy mind. Such spoiling is not the norm in my life. Man, did I enjoy it!

Sang for my supper the next day, where I learned far more than I may have shared, at the Bridging the Gap: Collaboration with Clinicians and Carers" eating disorders forum put on by Bridges and F.E.A.S.T., with partnership from EDTEC, Centre for Clinical Interventions, the EDP at Princess Margaret Hospital, the Body Esteem Program, and the Hollywood Clinic, and sponsored by the Mental Health Commission. I mention all those partners because it usually takes almost two years to put on a conference, especially to build a coalition to do so. Don and his collaborators pulled it off in about three months for a very engaged, well-attended room full of Perth area parents. 

my first Australian sunset
I learned important facts about Australians that first day in the country. One: Australians are incredibly polite. I have been around the world and spoken to many audiences. I've never seen any other place where people are so generous to the speaker and fellow audience members. I did not see one glance at a cell phone. Not a single loud candy wrapper. No loud whispering. No coming in late or stepping out early. No fidgeting or self-important speeches in the form of a question. Talks started on time and ended on time everywhere I went.

Two: this politeness meant that if I wanted to see a roomful of completely silent slightly worried faces all I had to do was ask for general comments. 

Three: something I should have remembered knowing my Australian friends and colleagues already -- do not take large sips of anything you don't want to go up your nose when you laugh, which you will, often, because the Australian sense of humor is both dry and mischievously timed. I cannot tell you how often I had to wipe my eyes after a laughing fit. There is no mascara equal to this problem.

video
The next day, after another blissful night's sleep, I solved the mystery fruit (persimmon!) in the breakfast buffet with the help of Facebook friends around the world in real time and finally the kind kitchen crew at the Rendezvous Hotel. I walked the beach at dawn. Picked up some shells and stood enjoying the exuberant surfers and realized (this SHOCKED my Aussie friends) that I'd never actually watched surfing up close. Weird but true: I grew up around skiing not surfing, and somehow missed this essential people-watching experience. It's similar: compulsive controlled falling on H2O. But surfing does look like more fun. No sharks on ski slopes, however.

That morning some F.E.A.S.T. families put on a buffet picnic at King's Park, where I got a tour of flora and fauna and memorials and the view from above the city of Perth. At the end of my trip a young friend insisted I declare my favorite city in Australia. It was Perth. Sorry, Melbourne and Sydney, but really, Perth is gorgeous and she was my first.

My mom used to sing me a song with the line "Kookaburra sits in the old gum tree, merry merry king of the bush is he..." Well, I now know exactly what a gum tree is. And, I know why the kookaburra was so full of himself: he steals! Gordon, a F.E.A.S.T. dad and able MC for the Perth conference, was gesticulating with a piece of bread when an enormous dark bird swooped down to snatch the whole piece and fly off with it! Tell this story to an Australian and they know it all too well. Tell it to an American and we say "Kookaburras are birds?" Yes, and what a bird. I loved the magpies, though. The trill of magpies were my favorite sound of the trip.

The Kings Park picnic was my first experience of Australian kids curious to hear me speak American. I'm sure I was a disappointment, though, because I later realized they expected Marge Simpson. Sorry kiddies! My favorite comment about my American accent, however, came from a friend who declared it to be more pleasant than she thought it might be, almost, Canadian....  High praise. I managed not to say that most Americans assume all Australians -- male and female -- look, sound, and carry large knives like Crocodile Dundee. Who I think would be a good partner to Marge Simpson, really.

this is not a snake.
The park was my first chance to examine Australian nature, and now I make my confession. I flew over with the belief that there is A Eucalyptus tree, and A Kangaroo. Hey, I'm only 54. Now I can spend the second half of my life properly schooled with the knowledge that there are many types of both. 

On a stroll of the park I lost at least a year of my life to fright over a Kangaroo Paw plant, because when someone enthusiastically points behind me and shouts "Look!" I expect a python, not a plant. But it probably made my blue hair stand on end like Marge, so...

Picnic over it was to the airport for flight to Melbourne, after only 48 hours on the ground. Happily, some of the WA friends would be joining the At Home With Eating Disorders conference, too, so it was partly farewell and partly good-bye. Thank you, Don, and Perth friends, for the welcome and the tour and the cookies and the beautiful present and, of course, the Kookaburra.

I've never been flown around the world and taken care of as on this trip, but I again arrived into the arms and hosting of a new old friend, Belinda Caldwell, with baggage behind me and no idea of what was ahead. I'm surprisingly good at this princess-like oblivion, it turns out. I may have been meant for it, because I noticed that my iPhone only needs the letters "P-R" and it autofills "PRINCESS." Just saying. Belinda gave me an evening tour sweep of Melbourne and installed me at a guest house near her family home in Richmond. Rotherwood is, indeed, "elegant accommodation close too the heart of Melbourne," and to my surprise I was the only tenant. Way above my station, I went ahead and enjoyed the heck out of it: the art, the luxurious furniture, the lovely sounds of the neighborhood. It was like a Victorian poetess stepped out in 1885 and never came back, but her retinue keeps things in working order for her return. I got to know the local shops, had my flat whites outdoors, and managed not to get lost when out on my own.

Belinda, who aside from being busy on the conference committee was also my guide and chauffeur and friend throughout, drove us out to see the author, June Alexander, at the Geelong Clinic where she guides a diary-writing workshop for the eating disorder wing there. There I had my first taste of both Vegemite and Lamingtons. (Not in the same bite!) Vegemite struck me as thick gravy spread thin. Lamingtons were lovely and multi-layered. So were the diary-writers, whose questions and observations and insights were an ideal first stop in my tour of Australian clinics. I enjoyed learning about their work, their recovery program, and June's diary project. Then fish and chips on the water. Bliss. I admire and adore June, so having time with her and Belinda was one of those quieter moments of "wow. I'm here. we're here. amazing." I had a lot of those moments these past weeks.

Hit the wall that afternoon and slept for 11 hours waking up for the first time feeling really human. The indefatigable Belinda, juggling conference duties and navigation and multiple schedules and phone calls, got us to three clinics in dizzying speed. First we had a meeting at CEED, the Victorian Centre for Excellence in Eating Disorders, where she serves as a Carer Consultant, and we had our first of the many teas (coffee breaks, American friends). I am excited at the work she is doing there and the wonderful collaborative model I see. I have a vision now of what could be if care teams included not only families but had the involvement of a Carer Consultant just as teams have psychiatrist and dietician and therapist around the table. The respect that the CEED team has for the carer perspective, and for Belinda's particular skills, offered a view of what could be happening elsewhere. I'd like to see where this goes!

these are meerkats at the
live human child
exhibit. 
Then it was a run over to Royal Children's Hospital where we sat in on a meeting of the eating disorders team over a Gold Coin Tea. Although I was childishly anticipating the meerkat enclosure in the outpatient waiting room (Adorbs!) I was instead disarmed and moved by the ED team's professionalism and focus. 

One thing I want to observe about that visit that I found consistent among those clinics in Australia that offer Family-Based Maudsley Treatment is the unapologetic manner in which they talk about it. One of my pet peeves in our field is the "it doesn't work for everyone" and the "when I think it is appropriate" and "only for young compliant patients" wording that many use. None of which is necessary because no one thinks FBT is "for everyone" or always appropriate. It's refreshing to hear people say "I do FBT" just as any doctor would say "I prescribe penicillin" without having to explain when they don't. FBT should, at this point, simply be part of the toolbox for clinicians treating eating disorders. No one should be treating EDs without being able to offer or refer to FBT. Period. No apologies or provisos. It's a tool. It is a set of clinical skills and principles that inform treatment that doesn't fit neatly within the researched populations. It isn't "controversial" any more and doesn't need to be apologized for.

Not that FBT is widely offered in Australia but I have to comment on the confidence with which those who do are able to talk about it. We need more of that elsewhere.

Last clinic of the day was a CYMHS clinic. I'm going to confess that when I arrived there and when I first sat down to hear about the program I was quite clear in my mind that eating disorders are always best treated in eating disorder specialist services. If you had told me that I would, by the time I stood up again, have a basic belief altered, I would not have believed it, but I did. My prejudice on this topic is twofold, really, or was. I have not seen non-ED specialists do well with eating disorders. But I also think most ED specialists are not doing appropriate eating disorder care. My personal solution has been to focus on getting ED specialists up to speed on the science. I had not thought, and yes I'm sorry, that going directly to non-specialists was going to work. Well, I'm now seeing a new vista of possibilities. The fact is, most ED specialists are quite set in their way of viewing the disorders and treatment. Unteaching is hard. But non-specialist mental health providers have a lot going for them: larger practices and therefore experience, more resources, and a broader sense of mental health care. Modern mental health care, especially for children and adolescents, assumes family involvement. Modern mental health care is increasingly integrated with larger psychiatric and medical and community resources. Eating disorder care is often in small, roped off, closely guarded practices surrounding a visionary leader or philosophy or diagnosis rather than the larger picture of overall mental wellness. 

The fact is, if eating disorder patients were assumed to need full nourishment, family support, to have a condition that is not their or their family's fault, and that their care should be aimed at both full recovery and healthy family functioning then would we really need to have them in specialist clinics? 

The problem isn't just that patients are not getting ED care it is that they are not getting good ED care in the community. So, I sat down believing that non-ED-specialists shouldn't be treating EDs and stood up thinking that what we may need to do is get ED patients into the care that is readily and more widely available and already has most of the principles of care in place and needs only to be trained in the particularities of these particular mental illnesses. Suddenly the possibilities for treatment expand a great deal (not enough, or nearly enough, because mental health services are "thin" on the ground all over the world, but certainly far, far more than just ED specialists).

So that was my Big Moment of that day. Better than the meerkats. And that's saying something.

FOUR different ways.
I ended my evening over dinner and then Golden Gaytime ice cream bars with my friend Cate Sangster's three darling daughters. They did somersaults and handstands, literally, for me. The girls put on the friendship bracelets my son chose for them: friendships symbolically tied across the seas. Should he end up marrying any of them we'll consider this the first act of courtship.We all experienced our first Custard Apple and declared it unripe and/or unpalatable, but I was beyond tickled to have that "first" with them. Apparently my face when offered Four Different Ways to Have a Gay Time was memorable to their mother.  Thank you, Cate, for an unforgettable evening. Also, for explaining Australian rules football. And no, I still don't get it.

By my fifth night in Australia I was no longer making people laugh by trying to get in on the wrong side of the car. I was still alarming them by stepping into the wrong side of he road. Belinda ferried me over to my next accommodation: the venue hotel Bell City. Fantastic sparkly view of the city. On the way we stopped at the Butterfly Foundation offices to help stuff the delegate bags with goodies and brochures.

OK, so when I travel I have this extraordinary opportunity to meet people with whom I have had, often for many years or many years ago, significant relationships or connections. The F.E.A.S.T. dinner, held at a restaurant training school, was one of those experiences. I catch the eye of someone who is unfamiliar to me by sight, and often me to them, but then when introduced we both "recognize" the other. There's a rush and tumble to explain, then total recognition. THIS is Bronwen, HERE is Claire, YOU are Alison, is THIS really Martine? But it is much more than names and contacts. It's recognition. It is having an honored place in someone else's life, some email on a significant day, some way one of us helped the other, a shared joke, a shared friend, a revelation or moment of vulnerability. I am nourished by these moments. I doubt my "real" friends in my "real" life can possibly understand why meeting a "total stranger" could be so meaningful and so deeply important but it is. These moments are why people like me do what people like me do, quietly at keyboards, without asking for a response, without requiring an update. It is those moments when you lock eyes with someone with whom you have shared important connection even if only for a short while or at a great distance or simply by introducing another person or idea then forgotten. These moments are why we "pay it forward" as fellow advocates. For each of us there are countless such moments out there that, if you are as lucky as I am, you get to have. This trip had several for me. You know who you are.

I don't really remember the food that night. I do remember meeting people who made me feel I'd come home because we knew one another already. Also, Cate brought the dreaded and much discussed new Vegemite chocolate for me: a gift or a punishment I'm not sure. Which I shared. Dear Claire was the first and bravest among us. Others had to be coached through it, which THIS crowd knew a thing or two about doing!

Sleep. Have I ever enjoyed sleep so much as during and after this trip?

Thursday: Belinda and I gave a workshop for clinicians first thing in the morning if only because the dear woman had two MORE presentations to give later. Sleep? I don't think so. It went well, I think. I enjoy presentations to professionals. Every single clinician has the opportunity to change the course of many, many lives. With good information they can save patients and families. Almost all are eager to add to their knowledge and skills. They ask important questions. They add important observations for their colleagues. Especially happy that Nicki Wilson and Rod McClymont were there to amplify and exemplify the principles both Belinda and I have learned and were there to share.

Saw the other conference keynote, Carolyn Costin, in passing. She and I have a longtime conversation going on how our different points of view about ED and treatment intersect and how they are incongruent. She set me the challenge of taking notes on that for us to discuss after the events, which I did. Most people in the ED field, and most fields I'm sure, don't actually listen to or try to understand conflicting or contrasting views. Carolyn does, and I like to think I do. Wish more would. It's easy to rant to your fans, harder to have a respectful discussion with others, but really: where does progress come from?

Cheered throughout, and stifled sniffles along with the Around The Dinner Table parents beside me, through a very moving workshop on refeeding in the afternoon. The audience's questions were heartbreaking, though. Too many had never, despite many treatment environments, been given basic information on the role of nutrition and methods for dealing with resistance. Too few were familiar with basic concepts of modern treatment. But that was the beauty of the moment: watching eyes open and notebooks fill. Lightbulbs were going off and courageous people on the last fumes of hope were inspired. The three INCREDIBLE parents who told their stories in the context of the background given by Belinda and her colleague and co-presenter, Michelle Robertson, put the lie to many myths about ED and about parents being powerless. Parents are POWERFUL. Good treatment that involves parents and understands the role of nourishment in eating disorders is LIFESAVING.

I used to be shy, especially in crowds. Would avoid them and sit in corners with a book or notebook observing. This reticence is not a luxury I can afford as an activist, so I've become quite the social butterfly. I can march up to folks I don't know and start a conversation with anything breathing. I couldn't do it for myself but I learned to do it for A Cause. And eating disorders treatment is a Cause I believe in. So I met a lot of people at the social that evening. Lovely people. Then enjoyed drinks and dinner afterward so much. I was like a kid out of school. A princess with her slippers on.

fans at Bondi Beach ask for autographs.
(or, probably, fish and chips)
I was asked many times to sign my books, which were available. That's fun. I love talking about Charlotte, for one thing, so my blue hair streak and blue book gives me that opportunity and on this trip I was able to hear from so many people who knew and cared about and were grateful to her. She was toasted many times. My first book was also available, reissued with a new cover and foreword, and I was tickled to hear anecdotes about that one as well. 

Best story: a mum told me she was glad about the reissue because for years she wanted to lend her original copy out but just couldn't find it. One day her daughter confessed that she had torn it up page by page! Love this! 

I didn't have either of my newer books with me, because they have nothing to do with eating disorders, but it was fun to talk about them as well. After a long time of being only an ED parent advocate I'm finally "all of me."

Friday morning: my keynote presentation for At Home With Eating Disorders. My PowerPoint will be available from the conference committee soon but since it is mostly pictures and visual puns it may not make sense. I'm working on an audio narrated version. 

The conference featured an excellent combination of information on the science of EDs and lived experience by parents and families. I was struck by the enthusiastic questioning of one panelist, a recovered patient, and some of the later comments by parents that showed how keenly they needed to see examples of fully recovered people and their families. This is a tough one in our field, and one on which I have mixed feelings. On the one hand OF COURSE we all need to see the reality of recovery. We need to normalize that and fix our sights on it. On the other hand the burden on the recovered people can be overwhelming and there is an expectation that the recovery of one person has lessons for others. Recovery CAN mean insight and inspiration. But it can also happen without insight or answers for others. I worry about recovered patients being overwhelmed, having their experiences overanalyzed, and there is a risk that patients feel pressured to have answers. In my opinion the best thing that recovered people can do is get on with their normal lives, and their normality be the goal. They don't need to be heroes to be OUR HEROES. In this case the young woman who talked about her experiences with recovery was everything anyone could hope for: healthy and comfortable in her well-being, realistic about the struggle, positive about her family's involvement, engaged in a life that doesn't involve having an eating disorder. While the other panelists were fascinating and insightful this young lady captured the hopes and fascination of the parents -- especially parents who were searching for hope for their own still quite ill loved ones.

So, my bit done, I was free to enjoy the rest of the presentations and workshops, which I really did. I know most speakers come and do their bit and then leave, or go sightsee. I am really such a geek: I want to get the entire experience and I want to meet as many people as I can. I learn so much, even after a decade of attending ED events. If not about the science or techniques I still learn by listening to the questions and by watching how familiar speakers evolve over time, and of course to learn how to better do the job of advocate and public speaker.

At Home With Eating Disorders was rich with topics, with a real emphasis on the usable, practical, and science-based. This was the kind of event that will change parent's options and actions starting that day, not a lot of theoretical overview. There was some of the latter but I really felt the parents there -- and many were just starting or just starting over -- got true help and guidance from the podium and genuine friendships from their fellow delegates (attendees, for us USians).

I won't describe the specifics, but will recommend that you check out the PowerPoints and videos when available online. One thing about the parent community is we are all about sharing as much information as possible at lowest or no cost. This has been basic to F.E.A.S.T.'s ethos and this, the second AHWED conference, was a shining example.

A quick word on New Zealanders: there was a nice contingent there for the event, which made me glad. I'm largely tone deaf on the difference between Australian and New Zealand English, but I've improved, aided by the fact that they themselves often trade exaggerated examples of one another's ees and eyes. The banter is light-hearted but helpful to me in keeping track. I find that if I simply fix on one person's speech patterns as my example it helps. My favorite example for New Zealand is Nicki Wilson of ANZAED. Except she has the most lovely voice and manner and although I know she is unique (and someone I deeply admire) this regard gets extended to all those who are from New Zealand! Nicki and her daughter, Emma, gave a beautiful presentation near the end of the events that did me in, really. The two of them remind me so much of me and my daughter and they warm my heart.

The AHWED conference was a real success. Parents were welcomed, informed, empowered, and surrounded by new friends. Really. I'm not just being nice. I overheard many conversations about proposing projects and research and get-togethers. It was a dynamic event: part of an evolving ED parent community and joining the collaborative nature of ED advocacy. I am genuinely impressed, and left knowing that Australia and New Zealand have some important ideas and successes that the rest of the world can benefit and learn from. I'd like to see many things that are going on in both countries spread to others, as well as more widely inside those countries. I was refreshed and energized by the experience and really admiring of what is happening, and rapidly, in both countries.

My trip coincided with Australia's Reconciliation Week, and my friend Robyn sent me a gorgeous bit of music to share in the experience, Wiyathul, by Geoffrey Gurrumul Yunupingu.

For the last few days of my time in Australia my dear friend and host, Dr. Rod McClymont, got me out of the urban and into the landscape of New South Wales. Zounds. Although I also got two sweeping tours of Sydney, it was my time with his family up toward Bathurst that made me feel I was truly upside down and around the world. And what a tour! We Americans think an hour or two of car travel requires provisions and a heating pad. Not these Australians.

It was largely a matter of going up high to look down, and higher to look across, and down low to look up, sometimes involving lots of stairs. I have taken in epic sights all in a row, each as cool as the next. Between destinations kangaroos and wallabies and a few Lyrebirds just posed in front of the car for visual interest. on behest of some cosmic Tourist Bureau. We'd just be driving along and stop the car and walk over and Oy Vey the earth opens up and there's a postcard view and staggering experience, and no lines. It's quiet and the few human beings in sight wave. There's no trash. No tickets. Then down some switchbacks into a cave of your choice, followed by watching for the platypus. I have totally got to up my game on when my Aussie friends come to visit.

Australian children, or at least these parents' children, gambol like goats on the edge of precipices, kindly not laughing at the whimpering American lady whose vertigo was only kept in check by the casual conversation one must pursue when terrified because if she bolts into the bush she will be killed by her just that much deeper fear of snakes.

But here's the story my family keeps making me repeat:

On alighting into a cathedral-like canyon featuring an idyllic waterfall and fern-festooned walls, I took in the experience from a flat rock in the sun. It was cool, but the water colder. Being my clumsy self I should have known not to fuss with my sunglasses but I did and, crack, dropped them on the edge of the rock where they ever so slowly but too fast to catch fell into the icy pool. I made a weak cry of dismay, more for leaving debris in a pristine place than the loss of my sunnies, on which the 14-year old in our midst dove onto the rock and plunged, soaking to the shoulder and with half his face immersed, worked a few moments until he quietly retrieved my now far more precious possession. Astonished, I declared Felix my hero, to which he replied standing in the cold air wringing his shirt and jumper (sweater to us Yanks), that it was "no worse than a rugby game."

This, my friends, is Australian youth.

I think the kids, really -- and I met quite a few of my friends' kids -- were the finest part of my travels. I'm grateful to all those who paid for and organized and chauffeured and promoted the conference and all the other events around it but I'm particularly touched and grateful for the opportunity to meet so many of their children: young and adult, ED affected and not (one clever girl answered the inevitable looks of inquiry with "I'm the OTHER one"). When you spend time away from home at conferences you get to know folks pretty well and sometimes even meet their partners but so rarely their lovely, deliciously real children.

Better than wombats, which everyone told me have square poop (they do!), which I didn't see. Better than the Jenolan Caves platypus who is waiting until my next visit. To all the kids, my home is yours. No kangaroos or wombats and I'm no Marge Simpson but I'm sure I can find some very American experiences for you to carry home. I owe you that.

I owe a lot of you a lot. Thank you.