Monday, July 9, 2018

We'll Always Have Paris

Chocolate almond and plain croissants
from Gontran Cherrier

We are in Paris again, after a few pleasant days in Lyon. We have been to Paris several times now and feel quite comfortable here. As Judy wrote, sometimes we like to travel to revisit places we love. San Francisco and Paris are at the top of that list. 

Here are some of the things that make travel in France special. 

  • The food, of course. It is the best anywhere. Italy comes close but can’t match French breads and pastries. The croissants in the photo are unbelievable!
  • The trains. They are fast, clean and comfortable. You can travel easily almost anywhere in the country. Lyon is about 300 miles from Paris. The trip took us 2 hours on the high speed TGV train. 
  • Paris is beautiful, filled with great sites and museums, and it is easy to get around. The Metro is crowded, but it is fast and efficient. There’s even an app to plan your route on the Metro. The crumbling systems in New York and Washington can’t compare. 
  • The French people. You’ve probably heard all the stores about rude or haughty French who refuse to speak English. (Of course Americans learn the languages of tourists in our country. Right?). But that’s the old France and it hasn’t been that way in a long time. The people we meet are friendly, helpful, and switch to English when our limited French proves insufficient. Paris is certainly a friendlier city for visitors than New York, Philadelphia or Boston. Or London, for that matter. There are unhelpful and rude people everywhere and it’s possible to have a bad experience anywhere but you can have an enjoyable time here. 
So here's what we did on this trip:  We had lunch at La Cambodge, an authentic Cambodian restaurant with very tasty food.  It was one of places targeted by terrorists on November 13, 2015. From there we went to the Galleries Lafayette, which was packed on a Sunday afternoon.  We did happen to hit one of the two periods of the year when there are sales.  We replenished our travel wardrobes (in lieu of sending laundry out).  Since we had a substantial lunch, we decided to just have something light from Pret a Manger, a chain that is ubiquitous in London, fairly easily found in Paris and other large French cities, and now shows up in DC, Boston, and NY.  What we like about it is that everything is organic and fresh, guaranteed because at the end of the day anything left is donated.  Judy's pretty addicted to both the hoisin duck wrap and the mango with lime.  Steve's a fan of the chicken and avocado sandwich.  

Later in the week we ate at La Fontaine de Mars, an old-fashioned bistro near the Eiffel Tower, famous for being a go-to place for the Obamas when they're in Paris.  Their duck confit and sole meunière are just amazing.  On our list for this trip was also a take-out window, the "boutique" part of Yam'tcha, where we got an assortment of bao (buns) of the day (duck, stilton cheese, onion confit, meat, and vegetarian) and steamed shrimp dumplings.  Judy was excited to see the chef and her husband and children, who she recognized from the "Chef's Table" series on Netflix.  We took the food to the Tuileries Garden next to the Louvre for a picnic. We also discovered that our hotel was literally around the corner from a lively neighborhood, Abbesses, and we enjoyed shopping and eating with the locals.  Sadly, our favorite eclair from our last trip is gone, but we did have some from Eclair du Genie, the runner-up in our search for the best eclair in Paris.

On our last day in Paris, we strolled through the Cimitiere de Montmartre (cemetery of Montmartre), which was the view we enjoyed from our hotel.  It's a wonderful, almost whimsical place, with little memorial houses and many statues.  Many famous artists, musicians, and writers are buried there, along with generations of families.  It's huge, and they have laminated maps you can use to locate the graves of famous people.  

In all, this was a very relaxed trip, with a lot of strolling through neighborhoods, traveling around Paris to find amazing food, and enjoying the gift of time that we now have.


So we hope to continue coming here from time to time, and perhaps even bringing grandkids when they are old enough. After all, our 3 year old granddaughter, Lucy,  can already say, “I want another croissant.”

Dementia Studies


The Bronte parsonage in Yorkshire

The impetus for our journey was an invitation from our old friend, Murna Downs, to give a couple of talks and meet with faculty and students in the Centre for Applied Dementia Studies at Bradford University. Bradford has long been a center for innovative work in dementia, and for the past several tears has offered a Ph.D. In Dementia Studies. The more we talked with Murna and her colleagues and students, and with two other friends, Linda Clare and Siobhan O’Dwyer who are researchers at Exeter University, the more it seemed that Dementia Studies was an idea that’s time had come. 

What became apparent in our discussions is how little progress there has been in care of persons with dementia and their families in both the UK and US and probably other places. Problems that were endemic and easy to fix, like making sure people with dementia aren’t overmedicated, have not been fixed. And it is still true that hospitals do on average a poor job of treating persons with dementia. Also still true is that when there are sudden changes in a dementia person’s functioning, doctors and nurses automatically assume it is due to the underlying dementia, but don’t look for possible treatable illnesses. And beyond that, despite notable exceptions, care facilities offer lackluster and sometimes cruel care.

These are problems that can be fixed but somehow it doesn’t happen. We don’t need to wait for an effective medication for dementia. We can make these problems better now. Over the years, Judy and I have visited wonderful programs and known health care providers who knew how to provide high quality care. They understood, for example how to talk to persons with dementia with respect, how to work around cognitive difficulties, and how to manage behavior problems. We have known excellent care facilities in The US and abroad. What is frustrating is how little progress there has been in implementing this practical knowledge widely. We have trained geriatricians, geropsychologists, geriatric social workers and nurses, but there simply are not enough people with training and not enough transfer of the knowledge from the truly good programs to the rest of the field.

So maybe we need Geriatric Studies to light a fire, to train bright and committed students who can advocate for better standards of care and to do the research that shows that good care is good for both patients and families and maybe even costs a little less. There has been a tremendous effort in the US and UK to increase research funding for basic biomedical work on dementia. Finding an effective treatment is a worthwhile goal, but in the meantime, we need to gather all the clinical wisdom that has accumulated in the stellar programs that have treated persons with dementia over the years. These are terrible diseases, yet we can reduce suffering with techniques that have been around for a long time and with new approaches. We can’t focus just on the biomedical aspects of dementia in research. Rather, There needs to be appropriate funding for people who have dementia now and their families, both in terms of implementation of what we know and expanding the knowledge base around care.

There is much work for Dementia Studies, and the bright and motivated students we met at Bradford University may be on the right track to begin making a difference.

Beyond the Bucket List

The Globe Theatre

Judy and I have begun travels in the UK and France. Our first stop is London. It’s a place we have been to many times and we are staying in Bloomsbury, which after several stays feels quite familiar and comfortable.  It is nice to be in a place like this. We know how to get around and don’t feel pressure to see the sites. We can move at a leisurely pace, going back to favorite spots and exploring new places and restaurants. A bucket list has it’s place, but so does returning to a city we enjoy. 

London has changed a lot since we first visited. I was first here in 1967 and Judy was here in the early 70s. England was fairly poor then, at least most ordinary people were. In B&B’s, you had to put a shilling into a heater to get some heat and hot water was at a premium. There was still rubble in places bombed during the war and many of the great buildings like Westminster Abbey were coated with a century of grime. The only relief from the drab food was an Italian restaurant, though they were usually not on the Europe on $5 a day list. 

Now London is a lively, exciting, international city, with, of course, a wonderful heritage. One major difference is how many people of different nationalities and races are here now. Just like closed minded people in the US, there are many people here who resent immigrants, but like the US, immigrants bring energy, intellect and innovation. We have eaten in two wonderful restaurants on this trip so far, one Asian Fusion, Wagamama, and the other Mediterranean, Moro. On all our recent visits, the hotel and restaurant staff have been international, mostly from other EU countries, but sometimes from further away. They have been cheerful and helpful.  And like in the US, immigrants have gone into many different professions and occupations. There’s bound to be a loss to the vitality and variety of London when the UK leaves the EU, just as there will be in the US as we close our doors to the world. 

Something we had not done on previous trips here was to attend a play at the Globe Theatre, the re-creation of the theatre where Shakespeare’s plays were first performed. Appropriately, we saw Hamlet. It was very special to see a play in that setting. This was a very contemporary Hamlet, with gender not taken into account in casting. Hamlet was played by a woman, as were some of the other male characters in the play. Ophelia was played by a man. Nonetheless, the play had the same power.  That’s what makes London fun for us, a mix of old and new. One piece of advice if you go to the Globe—the wooden seats are hard, even with the cushions you can rent when you buy tickets. 

On the rest of our journey, we will re-visit three places we have been before—Yorkshire to visit with friends Murna and Chris (and for me to give two talks), Exeter to visit our friend Linda, and Paris, where we plan to continue our search for the best croissants and eclairs. We will also travel to Lyon for the first time. It’s a mix of old and new. 

Friday, May 25, 2018

It’s Just on the Tip of My Tongue


See if you can name each of the characters and the actors who played them in this photo, or if you have a tip of the tongue experience with some of them.  We know a lot of time has gone by since that movie was made, but no hints from us.

Forty years ago (we still can't believe it can be that long), Steve designed a Memory Training study at the Andrus Older Adult Center, as a treatment for depression.  And Judy was a research assistant who taught the memory training classes to normal (as in non-demented) older adults.  One of the exercises was what is called Tip of the Tongue.  We came up with questions that could be answered by the name of a movie star or public figure from the 30s, 40s and 50s, since those would be most familiar to the participants in the study.  Questions like "Who was the star of High Noon" (answer:  Gary Cooper).  If they couldn't guess it but felt like they knew the answer, we'd ask them to guess what the name started with, how many syllables, etc.  

Judy's son Michael, who was 8 years old at the time, wanted to know what she did all day.  When she described the Memory Training classes, he thought about it for a bit, then said, "Well, I can see why older people would have more trouble remembering things than I do.  They have so many more memories in their brains that they have to look through for the answer."  From the mouths of babes.
 
Let’s admit it.  Tip of the tongue experiences, where we have the feeling we know a word or a name, but can’t recall it, are common and certainly seem more common than when we were younger.  A recent article by psychologist Katrien Segaert of the University of Birmingham in the UK and summarized in the NY Times suggested older people who had greater aerobic fitness had fewer tip of the tongue responses on a vocabulary test, though more than the 20-somethings who were the controls. 

The researchers ascribed the problems older people had in identifying words as difficulty connecting phonology, that is, the sound of the word, to its meaning.  And fitness is important for good cognitive functioning, so maybe it helps with that connection.  But what stood out to us was an observation the researchers made that suggested an alternate explanation.  Older adults in the study had larger vocabularies than did the 20-year old controls. When you have a larger vocabulary, you have more words to search through to come up with the one you want.  This may especially apply to words that you don’t use often.

The same thing is true about names.  How many names have you stored in memory over the years.  There are the people you know personally, as well as historical and public figures, movie and tv stars, authors, musicians, baseball players and so on. Some names will pop up quickly, and others take more time.  You may be thinking of a name and a day or two later it will come to you.  Studies done in the 1970s found that older people had more trouble retrieving names of political or entertainment figures, but had a larger pool of names they knew.  So again, part of the problem may be the size of the search.  More recent work suggests both aging and the size of the individual’s information pool play a role (Salthouse & Mandell, 2013). This work also found that tip of the tongue experiences are only minimally related related to decline in episodic memory, which is the most common type of loss in old age (Salthouse and Mandell, 2013).

If you get stuck trying to remember a word or a name, you can use the strategies we taught in our Memory Training study.  See what information you can recall about the word or name.  You can ask yourself, what is the first letter, what does the word or name sound like, how many syllables does it have, which syllable is accented.  Use this strategy and you will usually be able to remember the word or name.

Or you could just google it.

You might also consider what we learned from the Memory Training study. Older people were able to learn the strategies we taught, but said they were not likely to use them.  They told us the most valuable thing they learned was that with effort they could remember perfectly well. Getting that reassurance was sufficient.  


References:  

Salthouse, T. A., & Mandell, A. R. (2013).  Do age-related increases in Tip-of-the-Tongue experience signify episodic memory impairments. Psychological Sciences, 24, 2489-2497. 10.1177/0956797613495881

Link to the paper by Segaert and colleagues:  https://www.nature.com/articles/s41598-018-24972-1.pdf?origin=ppub


Sunday, May 20, 2018

Steve's Response to Sam's Question

Steve at Musee de L'Orangerie

I am following up on Judy’s answer to our grandson Sam’s question, “Why do we travel?”

Like Judy, my family did not travel much when I was young.  There was a trip to California when I was 4, which I mainly remember through photos, and again when I was 8, when we moved to LA, but we stayed only a few months, before moving back in Chicago.  When I was out of the house, my parents took some adventurous trips, including Europe, Israel and South America.  

Like Judy, I had a formative trip to Europe after college.  I took a cheap charter flight, and ventured out on a 3-month trek that started in London and ended up in Athens.  The dollar was strong, and I made $600 last the whole 3 months.  The sights, sounds and experiences were amazing. In London, I saw Lawrence Olivier (who was amazing!) on stage for a ticket that cost 45 cents at the exchange rate back then.  In Paris, I was in awe of the beauty of the city. Two friends and I shared a hotel room in the attic of a left bank hotel that was steps from the Seine.  Every morning, the owner, who was blind, carried breakfast up 5 flights to our attic room with fresh warm croissants, hot chocolate and wonderful coffee.  Each place I visited was poorer than the US, but rich in traditions and history.  So there wasn’t hot water in some of the hotels and hostels I stayed in.  But there was a vibrancy in daily life.  

For Judy and me, the trip we took to China in 1981 whet our appetite to travel more.  Several years later when the kids were older and we were financially better off, we were able to take advantage of the opportunities that began to arise through my work for us to travel abroad.

The most important opportunity was the connection I made to the Gerontology Institute in Jönköping, Sweden.  Boo Johansson and his family had come to State College for a few months in 1989—he and his wife Grazina were using some of the family leave time following the birth of their second daughter, Frida.  This was an eye-popping idea—paying parents to stay home with infants, and so we decided to visit Boo and Grazina in Sweden that summer.  With Matt, who was 7, in tow, we did a little Scandinavian tour, Denmark, Norway, and Sweden, spending time in Jönköping. Boo and his colleagues showed us around, including taking us to care facilities for older adults and telling us about social policies from parental leave to preparing immigrants for the workforce, to 5 weeks of paid vacation every year.  The Swedes clearly had a very different approach to wealth and welfare than the US, and I wanted to learn more about it.  

Over time, I learned a great deal about the Swedish care system, and even taught courses there where American students could see for themselves how Sweden handled health care and old age care. Like everywhere, there can be problems, but I still believe it would be better off to be old in Sweden than in the US.  

So Sam, part of the answer about why I travel is to learn about how people live in different places and how they do things.  There are many good things about this country, but we have a lot that we can learn from other places in the world, about their culture, their food, and how they manage things like health care.  It is perhaps clichéd to say this, but when we get to know people from different countries, we are less likely to have misunderstandings or conflict.   It also makes it more difficult to live with myths like we can’t afford universal health care or can’t pay a living wage, or can’t provide decent care for older people.  Or can’t give people 5 weeks of paid vacation a year!

Our travel has allowed us to feel comfortable and confident in other countries.  Many people say they want to travel when they retire, but it can be formidable at any age to manage the complexities of international travel when you are doing it for the first time.   So take time to travel when you are young, and then it will be easier and more fun when you are older.

Why We Like to Travel

The Seine

This week, while giving Sam and Lucy a ride home from school, Sam asked, "Grandma, why do you and Grandpa like to travel?"  I thought for a moment, then responded, "Because the world is full of different people and places and food, and we like to see what they're like."  A good six-year old's answer, but hardly the full story.  It made me think about myself at six, when I hadn't traveled at all, and probably preferred the familiar to the strange.  However, my parents gave me the gift of a first plane ride at age 7, from Oakland airport to Santa Rosa, where my grandparents lived at the time.  I remember being very excited and loving the thrill of flying, even then.

My family did not have the means to travel with a family of six, so our vacations were more of the driving and camping variety.  My next plane ride came when I was 24, when my (then) husband had an internship with IBM, and we flew from San Francisco to New York on one of the brand new 747s. So new that one of the crew accidentally activated the emergency chute before we took off, so we sat in the sun for several hours because nobody knew how to fold it up, and we had to wait for a new one.  My memory is that the flights that summer felt like a getaway for me.  I got to take a leave from my less than thrilling job (I was junior management in a department store), see places that I'd read about (New York City, Washington, D.C., Boston) and that I had longed to see.  We went to museums, ate varied and interesting food, and met new friends, so it felt like an extended vacation.  I was struck by the differences in architecture, the constant background noise level of cities, not to mention the absence of beautiful, fresh California produce.

My next adventure came about 3 years later, when my ex had the opportunity to do some work in Rotterdam.  We decided to take Michael, aged 18 months, and started in London, on to Rotterdam, then Paris, then Brugges, and then home.  Memories include the 14 hour flight from Los Angeles to London, where Michael was high as a kite on the Benadryl that was supposed to sedate him, and some very challenging hotel room situations with a small child, but mostly I was just thrilled to be in Europe, seeing the places I'd only read about in books.  We went to the changing of the guard at Buckingham Palace, Kensington Garden, Harrod's, the British Museum, went on a canal cruise in Amsterdam, the Eiffel Tower, Luxembourg Gardens, Versailles, another canal ride in Brugges, and so many other things I no longer remember.  My travel skills were still pretty rudimentary, so I brought way too much luggage, we were severely challenged in our map skills so got lost frequently, but our umbrella stroller saved our lives, and in all, it was again, a wonderful break in routine.

When Steve and I got married, travel became an integral part of our life, in part because his family is in Chicago, but once we moved to State College, my family was still back in California.  In fact, our honeymoon was a three week trip to China in 1981, right after they opened the country to the West, a fascinating (and delicious) journey.  Once in State College we initially relied on a jolly travel agent named "Brandy," but as the internet evolved, we became adept at finding our own itineraries.  Plus, Steve had several meetings a year in various parts of the country, and in time, all over the world.  He has definitely logged many more thousands of miles than I have (most of them to Sweden), I tagged along whenever I could.  We've made good friends all over the world, and will be visiting several of them in a few weeks in England and France.

The other thing that has been a driving force behind our travel has been my interest in cooking, and particularly in foreign cuisines.  When I was a child in the Bay Area, my parents would regularly take us to Chinatown in San Francisco, largely because my always frugal father would order for us at Nam Yuen, and be able to feed all six of us for under $20.  They also took us to Mexican restaurants in Oakland and Alameda, where the gold standard was to see someone hand-making tortillas in the kitchen.  Over the years, the restaurant scene has undergone many transformations, but the most obvious one is that there are a wide variety of very authentic ethnic restaurants in every city in the U.S.  When we moved to State College, there were not many ethnic restaurants, and certainly not the quality of food that we had enjoyed in Los Angeles.  So I started learning how to cook our favorite dishes.  That led to learning about ingredients, techniques, and equipment, and eventually to travel for cooking classes.  I've learned that food never tastes the same in the U.S. as it does in the country it originated from, where the ingredients and techniques have evolved over centuries.  So now, wherever we go we sample local specialties, we collect the ingredients we can take home, and then figure out how to source them if we can't find them in the U.S.

I would say that we are much better travelers now, but it has taken years.  We're better at dealing with jet-lag, better at not over-packing, better at having resources at hand so we don't get too lost, and better at selecting routes to travel.  What remains the same is the excitement that comes a few weeks before a trip.  We both love airports (although we will complain about the amenities at times), the excitement of getting on an airplane and leaving our regular life behind for a while, and then landing somewhere new or exciting.  Now we have places we like to visit in cities we've been to frequently (London, Paris, Copenhagen, Stockholm, Hong Kong, Florence, etc.) but I'm always collecting names of new food purveyors and restaurants to try as well.  When we get home, Steve will compile a photo book of the trip to remind us of what we saw and experienced.  And we come home with fresh eyes to look at our life at home, where the familiar can tend to fade into the background and not be appreciated.

So, Sam, that's the long answer to why we love to travel.  And we'll miss you terribly while we're away, but will be ever so excited to see you when we get back.



Thursday, May 10, 2018

What Do You Do All Day?

 PPG Place

Yesterday my six-year old grandson asked me this question:  "What do you do all day?"  My reflexive thought was "very little," which I think came from comparing my days now to how much I could accomplish back in the days when I was working, or comparing my days to his parents with their complicated schedules.  I didn't give him an answer then, but I will the next time I see him.

Every day this week, Steve and I have been to the gym for an hour every morning, walked to our local coffee shop in the afternoon to get some air and run errands, and after dinner, we have taken walks in the surrounding neighborhood admiring the stately and well-kept homes along with the ones that are struggling a bit.

Yesterday, after the gym, we went to our favorite bakery to buy a baguette for dinner and some treats for lunch, and then on to Whole Foods to buy food for the dinner we would be making for our grandkids and their parents.  We came home, and I immediately started cookies for dessert and preparing the meatballs since there wouldn't be much time later on.  We picked Sam up early so he could help me make pasta (he chose spaghetti), and then he played Yahtzee with Steve until dinner was ready.  His dad and sister joined us for dinner, and Mom showed up right at the end due to traffic.  Then we all went across the street to Sam's school for the Spring Choral, and watched Sam thoroughly enjoy singing with his classmates.  Lucy lasted through about half of it.

Today, after the gym, we went to check out the first Farmer's Market of the season at Market Square in downtown Pittsburgh.  We have started taking longer routes when we can, so we can see all of the different neighborhoods.  Many of the neighborhoods remind me of Oakland, California, when I was growing up, especially the architecture and the structure of the shopping districts at the heart of each neighborhood.  We parked near PPG center in downtown, with it's multi-spired super modern architecture, but across the street was the Benedum-Trees building, a historic landmark from 1908.  It's early in the Farmer's Market season, but there was a little produce, baked goods, local honeys, and some interesting looking Greek food we may try another day.  We chose a different route home, because in Pittsburgh streets meander and turn and you suddenly find yourself with yet another amazing view from a hilltop.  After a stop at Target (yes, we have to be practical sometimes), we went home to try out some of our goodies from the market, the "San Francisco Sour Dough" bread that was a little disappointing, and the apple strudel, which was not.

After living our lives in a "be as efficient as possible so you can accomplish as much as you can mode," it is not easy to switch gears and begin taking the time to look around at the scenery and appreciate it.  It is especially hard not to have a schedule, and to find a balance between busy-ness for it's own sake and really accomplishing something.  I'd say that each day I have several things that are on my agenda, but there is very little that simply must be done that day, so if something more inviting comes along, it's okay to postpone it until the next day.  There is time now to evaluate which things mean more, so a household chore will always lose to time with the grandkids.

So I think the answer I will give Sam is that when we were young like he is, we went to school, too.  And then we went to college, where we both went to classes and worked at jobs.  After college, we got jobs and then had children, and we worked just as much as his parents do.  Now that our children are grown, and we no longer have jobs to go to everyday, we finally have time to decide for ourselves how we want to spend our time.  And we feel very, very lucky to have the time to make dinner for he and his family, and to go to the program at his school.

Benedum-Trees Building