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How extreme car dependency is driving Americans to unhappiness | US news | The Guardian

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The United States, with its enormous highways, sprawling suburbs and neglected public transport systems, is one of the most car-dependent countries in the world. But this arrangement of obligatory driving is making many Americans actively unhappy, new research has found.

The car is firmly entrenched as the default, and often only, mode of transport for the vast majority of Americans, with more than nine in 10 households having at least one vehicle and 87% of people using their cars daily. Last year, a record 290m vehicles were operated on US streets and highways.

However, this extreme car dependence is affecting Americans’ quality of life, with a new study finding there is a tipping point at which more driving leads to deeper unhappiness. It found that while having a car is better than not for overall life satisfaction, having to drive for more than 50% of the time for out-of-home activities is linked to a decrease in life satisfaction.

“Car dependency has a threshold effect – using a car just sometimes increases life satisfaction but if you have to drive much more than this people start reporting lower levels of happiness,” said Rababe Saadaoui, an urban planning expert at Arizona State University and lead author of the study. “Extreme car dependence comes at a cost, to the point that the downsides outweigh the benefits.”

The new research, conducted via a survey of a representative group of people across the US, analyzed people’s responses to questions about driving habits and life satisfaction and sought to find the link between the two via a statistical model that factored in other variables of general contentment, such as income, family situation, race and disability.

The results were “surprising”, Saadaoui said, and could be the result of a number of negative impacts of driving, such as the stress of continually navigating roads and traffic, the loss of physical activity from not walking anywhere, a reduced engagement with other people and the growing financial burden of owning and maintaining a vehicle.

“Some people drive a lot and feel fine with it but others feel a real burden,” she said. “The study doesn’t call for people to completely stop using cars but the solution could be in finding a balance. For many people driving isn’t a choice, so diversifying choices is important.”

Decades of national and state interventions have provided the US with an extensive system of highways, many of which cut deep into the heart of its cities, fracturing communities and bringing congestion and air pollution to nearby residents, particularly those of color.

Planning policies and mandatory car parking construction have encouraged suburban sprawl, strip malls with more space for cars than people and the erosion of shared “third places” where Americans can congregate. As a result, even very short journeys outside the house require a car, with half of all car trips being under three miles.

Most of the decisions driving this are made at a state level, although Joe Biden’s administration vowed to help rebuild public transit networks beleaguered by the Covid pandemic and to tear down certain divisive highways. However, the federal government has continued pouring far more money into building and expanding roads than in any alternatives to driving. Next year, more than $60bn in federal funding is planned for roads and bridges.

A small sliver of the American public actively chooses to live without a car because they are able to live in the few remaining walkable communities in the US, but for most of those without a car it is a forced deprivation due to poverty or disability.

Being without a car can itself be expensive and isolating, according to Anna Zivarts, who was born with a neurological condition that prevents her from driving. Zivarts, based in Seattle, is the author of the book When Driving Is Not an Option and advocates on behalf of those unable to drive.

“Seattle has a solid bus system but everyone who can afford a car has a car. I’m often the only parent going to any sort of event without a car. Everything is built around cars,” she said.

“We are just locked into a system of driving that is meant to be more enjoyable but isn’t. I walk five minutes with my kid to the school bus stop and yet other parents make that journey to the stop by car. Is this really how you want to spend your life?”

A long-term effort is required to make communities more walkable and bolster public transport and biking options, Zivarts said, but an immediate step would be simply to consider the existence of people without cars.

“We need to get the voices of those who can’t drive – disabled people, seniors, immigrants, poor folks – into the room because the people making decisions drive everywhere,” she said. “They don’t know what it’s like to have to spend two hours riding the bus.”

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sarcozona
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Fix half our mental and physical health problems with one weird trick - building for people instead of cars
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Google Help Workers Ratify Collective Contract With Accenture, First In Alphabet Workers Union-CWA History

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(Austin, Texas)—Today, Alphabet Workers Union-CWA members on the Google Help team secured a first collective contract with Google vendor Accenture, becoming the first group of AWU-CWA represented workers to bargain a collective contract and only the second group of Google office workers ever to do so.

We're proud to be one of the few tech contractors in the US to secure a collectively-bargained contract. Many large tech companies have moved away from directly employing workers to avoid providing the benefits and security that they deserve. We hope this contract demonstrates to all tech workers that it's possible to demand respect, fair treatment, and improve your working conditions,said Mike Batilla, Lead Writer and member of Alphabet Workers Union-CWA.

Reaching this contract sets a precedent for temporary, vendor, and contract workers in the tech industry, who too often receive the lowest wages and fewest protections of any tech workers, and whose numbers have been growing as the industry increasingly “vendorizes” its workforce. Now some of Alphabet’s most precarious workers have united to win meaningful protection against the further depression of their working conditions and security in an industry in flux. 

Notable provisions of the contract include:

  • Guaranteed fully remote work
  • Six weeks of severance in the event of layoffs
  • 30 day notice of layoffs
  • A prohibition on keystroke and mouse monitoring software

This group of subcontracted workers first organized to improve their working conditions in 2021 and afterward unionized with Alphabet Workers Union-CWA. On June 7, 2023, 118 Google Help workers voted overwhelmingly to form a union, but shortly thereafter Google laid off all but 40 of them. The 26 workers in the unit today persevered in the face of adversity and have won meaningful security for themselves and future coworkers. Accenture engaged with them at the bargaining table in good faith, and today AWU-CWA can announce a ratified contract that includes significant protections and improvements including guaranteed remote work, severance, just cause termination, and more. 

“Today’s victory underscores the importance of solidarity across the artificial barriers which corporations increasingly rely on to lower labor standards and reduce worker power. This contract is proof that full time and contract workers can unite to secure meaningful protections and improvements at work and that the wall-to-wall, premajority union model can be a force for change in our industry,” said Parul Koul, Software Engineer and President of Alphabet Workers Union-CWA.

These workers write, edit and publish updates to the Google Support site for new and existing Google products and features and create and publish materials for Google Support agents. 

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About Alphabet Workers Union-CWA

Alphabet Workers Union - CWA unites full-time employees, temporary employees, vendors, and contractors at Google and other Alphabet companies in the United States and Canada in collective action to ensure that our workplace is equitable and that Alphabet acts ethically. We are members of Communications Workers of America Local 9009 and currently represent over a thousand workers across Alphabet. Learn more at alphabetworkersunion.org or follow us at @AlphabetWorkers.

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sarcozona
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Hell yeah
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Social media fueling young men's body dysmorphic disorder

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sarcozona
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STAT readers on the biggest underdiscussed stories of 2024 | STAT

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When it comes to what’s happening in the life sciences, STAT readers are the experts. So earlier this month, I asked readers of the First Opinion newsletter to answer two questions: What story do you think went underdiscussed in 2024? What should we all be paying attention to in 2025?

Many responded, sharing thoughts about policies, the high cost of health care, and much more. Below, you can find a selection of answers.

As a semi-retired RN working as a private nurse advocate, I am concerned for the army of independent and agency caregivers who are in homes on the front line of health care. Mostly foreign born and underpaid, they are doing most all the heavy lifting at the bedside.

Though not entirely unrepresented, their needs should be more comprehensively addressed.

Sue Trupin

Our obsession with AI this year led to underdiscussion about how nothing we do in medicine, research and health care innovation — including digital health — is going to matter or improve outcomes and reduce costs if we don’t focus on building trust with people through humanism and better, more approachable, relatable communication.

Right after the election I was out in an underserved community, helping a gentleman insured by Medicaid. He told me he voted for Donald Trump because “even though he lies,” he trusted him more because he used simple, understandable language and didn’t talk down to people. I asked if he knew Trump and Republicans tried to eliminate the Affordable Care Act. Over the past 10 years, he’d heard nothing about it and is now concerned.

Who is talking about this communication disconnect that continues to erode trust in health care?

Ultimately, humans have to engage in their own well-being and willingly participate for anything to significantly change the trajectory we are on at scale — for example, unstable costs, increasing or stubbornly high chronic disease rates everywhere, and a largely unsupported aging population.

None of this change will happen without more emphasis on building connection and trust, as humans.

Lisa Fitzpatrick

One major underdiscussed issue this year was the Biden administration’s failure to enforce a 2023 U.S. District Court for the District of Columbia ruling that struck down a Trump-era rule allowing insurers to implement “copay accumulator” programs.

Copay accumulator programs permit insurers to exclude drug manufacturer copay assistance from being applied toward a patient’s deductible or out-of-pocket maximum — effectively, leaving patients on the hook for a bill that the manufacturer coupon should have partially or fully covered.

The Biden administration has repeatedly stated a commitment to prescription drug affordability, so the admin’s inaction on this issue is a glaring contradiction. And as a result, many Americans are left struggling to afford their medications.

There’s still time to issue a new rule or announce that insurers must require compliance with the court ruling before President-elect Trump takes office next January. The administration must take action.

Carl Schmid, executive director of the HIV + Hepatitis Policy Institute

2024 lacked an honest conversation about accountability for AI errors in health care, as vendors rushed to deploy immature models without transparency around their reliability or limitations. While HTI-2 may provide some guardrails for generative AI in 2025, we’re witnessing companies recklessly positioning AI chatbots between patients and clinicians without addressing fundamental questions about medical liability when these black box algorithms inevitably make mistakes. The industry’s obsession with AI’s potential has overshadowed critical discussions about who bears responsibility when AI systems — which can inexplicably change their outputs from one day to the next — contribute to patient harm.

Jay Anders, M.D., chief medical officer, Medicomp Systems

I think the long Covid crisis will be big in 2025. How will long COVID be addressed in the new administration, with the expected changes with HHS, NIH, FDA and CDC? There will need to be a new infusion of funding — but will it be caught in political warfare and will the new leadership be able to meet the moment that is needed for millions of Americans struggling? That’s a big worry on millions of minds right now considering the bipartisan divide with so much, especially this disease.

Billy Hanlon

The 2024 presidential election hinged on affordability and costs, but much of the discussion centered on the price of eggs, bread, and housing. The skyrocketing cost of health care and its impact on the overall economy did not receive nearly the attention it deserves in 2024, and yet it has a greater and more pervasive impact on employers, employees, and their families. With 150 million Americans relying on employer-sponsored insurance (ESI), the unsustainable cost of health care is baked into the price of nearly everything we buy, from cars and computers to groceries. These rising costs act as a hidden tax, ultimately affecting every corner of our economy.

If Congress and the new administration are serious about strengthening the economy, they must first and foremost address the broken commercial health care marketplace and its massive impact on the future of ESI. Continued attention is needed on health care pricing transparency for PBMs, health plans, and providers, as well as enforcing antitrust laws, improving data accessibility, investing in primary care, and transitioning the U.S. health system from fee-for-service to outcomes-based payment models. For ESI to remain viable, a functional and fair health care market is essential.

Elizabeth Mitchell, president and CEO, Purchaser Business Group on Health

In 2024, the AI hype obscured a critical reality: We’re building sophisticated algorithms on data that is often flawed, collected through outdated manual processes that place unnecessary burden on highly skilled clinicians. While the industry celebrated AI’s theoretical capabilities for prediction and analysis, it largely ignored how reliance on human data entry creates inconsistent, incomplete, and often inaccurate datasets.

The uncomfortable truth is that without widespread adoption of Internet of Things sensors and automated data collection systems, health care’s AI dreams are being built on a shaky foundation of unreliable data — yet few are willing to confront this truth. We must fundamentally rethink data collection in health care, leveraging ambient sensors, computer vision, and automated systems to capture clinical data in real time. Only by removing the documentation burden from clinicians and implementing intelligent automation at the point of care can we build the reliable, comprehensive datasets needed for AI to deliver on its promises in health care.

— Stephanie Lahr, M.D., president of Artisight

In 2024, chief information security officers (CISOs) in the health care sector faced an unprecedented cyber crisis. Stripped of the resources and leadership support needed to defend against relentless cyberattacks and prepare effective incident response plans, many were left holding the bag for their organizations’ cyber risks. The result? Burnout, staff turnover, and glaring security gaps that leave health care systems dangerously exposed.

As if that weren’t enough, health care CISOs are being personally thrown under the bus. Often excluded from Directors and Officers liability insurance, they face legal and financial risks simply for doing their jobs. For those in public organizations, new SEC regulations mandating cybersecurity attestations pile on even more pressure, forcing CISOs to shoulder personal accountability in an environment already fraught with danger.

The fallout of a hospital cyberattack is catastrophic — patient safety at risk, operations disrupted, and lawsuits looming over stolen data. It’s time for health care organizations to step up: Invest in robust cybersecurity resources, empower CISOs with leadership backing, and shield them from undue liability. Anything less is a gamble the industry can’t afford to take.

George Pappas, CEO, Intraprise Health

Clinical research is one of the few industries where the regulator (FDA) is actively pushing the industry to adopt new technology and approaches, not the other way around! We have seen the FDA release fairly strident guidance documents admonishing the industry for not adopting approaches like decentralized trials, remote monitoring, and risk-based monitoring. These approaches are also more cost-effective, and preferred by patients. So why are sponsors and clinical research organizations so reluctant to change?

Meri Beckwith, co-founder, Lindus Health

We didn’t talk enough this past year about the 9 million seniors who declined toward dementia unnecessarily. 2024 was a year of great advancement in technology needed to give consumers and patients greater control over their cognitive health. New digital cognitive assessments and blood-based biomarkers offer the promise of early detection and intervention, but these approaches need to be adopted quickly to help millions stave off dementia.

John Showalter, chief strategy officer, Linus Health

In the U.S., 1 in 5 people are living with a neuropsychiatric disorder, with an estimated $280 billion spent on neuropsychiatric services. This has been a big year for much needed innovation in the neuropsychiatric treatment landscape yet, despite a few notable approvals, the year has increasingly been marked by the immense challenges associated with treatment development in this space. This is true in the case of major depressive disorder, one of the most prevalent and complex neuropsychiatric conditions affecting an estimated 21 million adults in the U.S. However, these trial “failures” are not just setbacks, they are opportunities to uncover novel insights about patient subgroups and improve trial design. These moments of reflection bring us closer to understanding the intricate biology of depression and tailoring treatments to individual patient needs.

Even when topline results do not align with expectations, these outcomes should be recognized as valuable data points rather than dead ends. This perspective has the potential to fuel smarter, data-driven, and more personalized approaches to drug development. Failure isn’t final; it’s a chance to dig deeper and build on our learnings. Looking ahead, 2025 could be a transformational year for the neuropsych space.

Amit Etkin, M.D., Ph.D., CEO of Alto Neuroscience

It’s worth recognizing that the industry has made progress in digital health reimbursement over the past year. We have seen evidence that links digital health tools to improvements in patient outcomes, enhanced patient engagement, and extend access to care. These new developments have continued to fuel usage and growth. For example, the Centers for Medicare & Medicaid Services expanded coverage for remote therapeutic monitoring and digital mental health treatment devices, and updated coding for simplified billing and enhanced reimbursement. Patients are reaping the benefits of these expanded, patient-centric treatment options, often achieving better health outcomes that enable them to recover and thrive beyond the hospital setting.

I predict we will continue to see the growth of digital health in 2025, but for the industry to feel its full impact, we must make stronger strides as an industry to help patients navigate digital health options more easily. This will require collaboration across medtech, consumer tech, and private and public stakeholders to address challenges in regulatory and reimbursement pathways, particularly the gap between FDA clearance and reimbursement. My hope is that the standard of care, including access to the most cutting-edge tools and innovations, is accessible and available to all, regardless of financial situation, location, or otherwise.

Julia Strandberg, chief business leader, connected care and monitoring, Philips

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sarcozona
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Gaza’s Kamal Adwan Hospital director pleads for help before it’s ‘too late’ | Israel-Palestine conflict News | Al Jazeera

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The director of one of Gaza’s last partially functioning hospitals is appealing for help, saying Israeli forces have surrounded the medical facility.

Dr Hussam Abu Safia, director of Kamal Adwan Hospital in northern Gaza, on Monday urged the international community to act “before it is too late”, calling the situation “horrifying”.

He said obeying an Israeli order to empty the facility would be “next to impossible” because nearly 400 civilians remain inside, including babies who need oxygen and incubators.

“The bombing continues from all directions, affecting the building, the departments and the staff. This is a serious and extremely horrifying situation,” Abu Safia said.

Outside the hospital in Beit Lahiya, Israeli forces have placed what is thought to be explosives at the gates. Witnesses said an automated guided vehicle delivered boxes with the word “danger” written on them.

Al Jazeera’s Gaza correspondent Tareq Abu Azzoum said the Israeli military has deployed automated remote vehicles called “explosive robots” around the hospital.

“[The robots] are loaded with tonnes of explosives that can lead to the destruction of the neighbourhood,” Abu Azzoum said.

“We’ve seen videos released by some of the medical workers inside Kamal Adwan Hospital showing how the Israeli military has been using these in the vicinity of the hospital,” he added, saying it could be a sign that further escalation might take place in the coming days.

“The Israeli military is systematically trying to exert ultimate pressure on the medical teams by causing severe destruction to the surroundings [of the hospital],” Abu Azzoum said.

Abu Safia said: “The world must understand that our hospital is being targeted with the intent to kill and forcibly displace us,” adding that the Israeli bombing did not stop throughout Sunday night, destroying homes and surrounding buildings.

“We urge the international community to intervene quickly and stop this fierce assault on us to protect the healthcare system, the workers and the patients within it,” the hospital director said.

Since Monday morning, the hospital has been targeted with bombs in its courtyards and on its rooftop dropped by quadcopters, once again threatening the hospital’s fuel and oxygen supplies, he said.

“The situation remains extremely dangerous and requires urgent international intervention before it is too late,” the doctor said.

Abu Safia made a similar appeal on Sunday, accusing Israel of directly bombing the hospital’s intensive care unit.

More than 14 months of Israeli attacks have devastated Gaza and displaced almost all of its 2.3 million people. More than 45,000 people, mostly children and women, have been killed in the offensive.

Israel’s genocide against Palestinians started shortly after a Hamas-led incursion inside Israeli territory on October 7, 2023 killed nearly 1,100 people, according to Israeli officials, and about 250 others were taken captive.

Source: Al Jazeera and news agencies

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sarcozona
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The Winter I Left Home, and Learned How to Live Again | The Tyee

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[Editor’s note: ‘Upon a Midnight Clear’ is an essay collection edited by Vancouver author JJ Lee. The book features the work of regional authors sharing true stories of memorable holiday seasons. This essay, which appears in the book as ‘Advent,’ explores the potential that new places and experiences hold for us to get to know ourselves again.]

I wanted to experience Europe in the winter. I craved beauty. I needed clarity. And so, I decided to take a year off from work as a naturopathic doctor in Calgary. One of my former residency students had graduated and was willing to cover my practice. My daughter, Zoe, was four years old, and I wanted to spend time with her before she went to school.

In Calgary, I couldn’t tell why my life was falling apart. I was working so hard to be successful, to make enough money, to be a partner and a mom. I was exhausted.

My medical practice was growing, and I loved my patients, but I felt like it was always hard. I had moved my clinic twice but still worked with conflict as a co-worker. I had a great husband, but he was always gone to Europe, or China, or the United States for work, and with a new house and a young kid, we needed the money.

When you run your own practice, there are never days off, and I worried about my patients constantly. Despite working full time, I did the lion’s share of the parenting decision-making. I had gone back to work when Zoe was four months old as we couldn’t afford otherwise, and she had been either with a part-time nanny or at playschool since.

I had had a traumatic pregnancy, as my appendix burst after I gave birth and I became septic, and I had never recovered my health. I became angry, resentful of my husband and his freedom and his travel, and I hated being that person, but I didn’t understand why I had to sacrifice my job so that his could be more successful.

Slowly, I fell apart, pieces chipped away with each trip he took.

I began to have panic attacks, which could take days away from me. You know what they say, you can change your hair, your husband or your home, but not all at the same time. I’d had enough haircuts to know that I had to make a different choice.

Things couldn’t go on like they were, and so, I decided to change my home.

If Zoe and I left for a few months, it would give Jason a chance to work as much as he wanted in the busy season, and me a chance to see if I could find a way out of the crazy life I had somehow gotten myself into.

Suddenly, Madrid

This was before the days of Airbnb, and I searched around a sabbatical homes website for affordable, beautiful places to live in Europe that were empty in the winter. I found houses in France, Belgium and Spain, and I offered them one-third of the proposed rent in exchange for an easy and consistent tenant.

I got one enthusiastic reply. A woman in a small town in Spain would love to have us at her house, a restored convent, in exchange for watching out for damage in the rainy season and not making any demands.

And so, I found myself one night in November in a busy Madrid square hauling my luggage off of the bus from the airport with a giddy and goofy four-year-old trailing behind me.

I wandered around the square looking for the street where our hotel was located, as Zoe hopped from stone to stone. Evening lights exposed pockets of young adults in warm yellow for a moment before they moved on to their destinations. Daytime performers packed away equipment. Old men sat smoking on the fountain edges, faded in the dusk. I imagined their fingers stained tenaciously yellow.

My big black roller bag clip-clopped over the cobblestones as Zoe trustily plodded along behind me, pulling her own animal roller bag in one hand and holding her LeapFrog Leapster in the other.

I loved being able to spend time with her even though we were so tired, and she seemed to be born to travel. It was hard always being away from her at work.

I had a decision to make. I didn’t know if I wanted to make her proud that I worked hard and had a successful career or if I wanted to just be with her.

On a whim, alone

In the hotel, I put her to bed and looked out the window as the evening transactions were beginning in the busy street below. It was a foreign landscape for me, and I was here alone.

A creeping feeling of loneliness filled me. If Jason was going to be gone so much, I wanted to see if I could be more independent, but I was exhausted from travel-parenting, decision-making and the work of handing over my practice.

I couldn’t believe that I was allowed to be gone from work. I was going to try to live in a foreign country on a whim, alone. What had I just done? I had left my home and my partner to try to figure out how to live again.

Zoe and I recovered in Madrid for a few days. For some reason, I had thought that Spain would be like Mexico, vibrant and boisterous. I’d studied medicine in Phoenix, and had worked with and seen Mexican people as patients, so I spoke mostly medical Spanish.

But instead of extroversion, what I found in Spain was a deep pride, a reserve, a cautious kindness.

I took Zoe to the Prado museum where she drew pictures of The Garden of Earthly Delights and delighted the museum workers. We walked the stone streets and ate Spanish treats. Tradition seeped into me like molasses; there was old stonework and dark paintings, and beautifully dressed people engaged in serious chats. Sharing all this culture with a four-year-old is like sharing caviar with a monkey, but I hoped somehow that it would stay with her.

Southern Spain in the winter is like an inhale, a long slow deep breath in, a break, a respite.

I’ve never experienced Spain in the summer. I imagine it’s chaotic and hot, and beautiful of course, but the Spain I know is still and fresh and cold until you light the fire.

We took a train to Seville where we were going to stay until Christmas, inching our way into the south. Seville is the fourth-largest city and the capital of Andalusia. It was the capital of Muslim Spain and the launching point for Spanish colonization of other countries, as it sits on the River Guadalquivir, which leads directly to the Atlantic Ocean.

Due to the mixed occupation history, Seville has stunning architecture. It was the location of the filming for the kingdom of Dorne in Game of Thrones, and wandering around the city was like walking into history.

The Alcázar is a Moorish Renaissance palace that you enter through blue and green tiled hallways. You walk through a series of courtyards, and then into the lush and miraculous garden. It is one of the most beautiful places in the world.

The apartment we rented was a two-storey two-bedroom, filled with the kind of furniture you can only imagine exists: a chair that looked like a velvet red shoe, a black plastic chandelier, a table made of some kind of exotic wood heavily coated in resin and in an ’80s thought-bubble shape. Nothing fit together and yet everything fit in a certain garish style. The cold tile was suited to the hot summer days but not to our November escapades.

I looked over the French door balcony and watched young adults passing below me through the narrow street. Seville seemed to consist mostly of the young on their way to something.

The Christmas markets started early, wooden booths that filled the town squares. Now I understood what the “European markets” in Canada were trying to simulate.

Individual stalls sold Catholic wares, most of which I had no idea what their purpose was. There were also stalls of bread, chestnuts, wooden toys and nativity figurines. Nothing was cheap or plastic.

People flocked to the squares and we stood among them, fearlessly crushed in a type of communal joy resulting from the kind of human proximity that existed before COVID.

Christmas in Spain felt like a song

One Christmas fair took place under Las Setas, giant mushroom-like concrete structures that formed a canopy and held a restaurant you could walk up to. Camels spat at us from pens underneath the mushrooms and we waited our turn to have a chance at the Shrek bouncy castle. We bought braided bread and roasted chestnuts and wandered amongst the Roman statues and modern concrete.

Work stopped for the holiday season and so Jason met us in Seville close to Christmas Day. I waited anxiously in the vaulted train station as Zoe looked through toy shops. Relief flooded into me as he stepped off of the train. My experiment to be independent made me realize how much happier I was when he was around.

But if he wasn’t the problem, then I had to wonder if I was.

We celebrated in that apartment, cutting ornaments out of cardboard paper and stringing them up onto our paper tree with red ribbon. The gifts we found were well made and small, as when we returned to Calgary, we would still have to fit everything we had into the bags we came with.

With Jason back, everything was an adventure. I didn’t let myself think about why I left Calgary, focusing instead on the joy and movement of experiencing the holiday season in a different country.

The image I hold now of Christmas in Spain is quite different than back home with the green and red and mall shopping, and the furious drive to get gifts in time.

Spanish Christmas felt more like a song with a healthy dose of eating at cafés.

Even though it was fun, and Spain was beautiful, I was still exhausted. My goal for the trip wasn’t just to have an adventure. I had to figure out how to get my life back. If Jason wasn’t the problem, what was?

A part of me needed beauty

We made our way to Jimena de la Frontera on Jan. 4. The train south from Seville gave us a glimpse of low orchard trees in a rocky and rolling green landscape. Everything looked rich in the way that olive oil looks rich, satisfying and filled with nourishment.

I wanted to just lie down in those hills, rest between the trees like fallen leaves. Once we figured out how to make connections between two train stations miles apart, the trip was fast and efficient.

Jimena de la Frontera is one of the oldest towns in Europe. It lay small and beautiful on the side of a hill, white-walled and brown-roofed. The train platform was at the bottom, and the road wound up towards the square, which is the only flat spot in the town. In the square, metal multicoloured fold-out chairs sat by café openings and children played soccer, and somehow avoided losing their soccer ball down the slopes.

We walked up a slightly inclined cobbled street in the sun. There were no breaks between the houses, just slight differences in doors and balconies. We found out that the whole street used to be a convent, since lovingly separated by an architect into units.

Our house had a thick, arched, wooden door, and we entered a terracotta-tiled hall with a rich red carpet. On the main floor a kitchen, dining room, small living room with a fireplace, and a piano room surrounded a small courtyard that beckoned with plants, a table and chairs, and a cold pool. The second floor was an open space with high ceilings and thick wooden beams. Two bedrooms with gauze falling from the ceiling to cover the beds, and a bathroom with a claw-foot tub stood off to one side. A terrace opened into the courtyard.

I’m not sure what grace allowed us to be in this place but the part of me that needed beauty sang in response as we walked through the rooms. We woke the next day to the sounds of excitement in the streets outside. When we emerged from our house on the morning of Jan. 5, the town was restless with preparation.

In the square were more bouncy castles, this time SpongeBob-themed. Kids ran through the streets with sculptures made from strung-together cans; we followed as they converged into a noisy parade.

Musicians played flamenco guitar as they walked. Jason took some cans from a recycling bin, found some string and made a small sculpture that Zoe could drag through the streets alongside the can-toting children of Jimena.

We had awoken to a festival that celebrates Epiphany, the Three Kings Festival, La Fiesta de Los Reyes. The three kings were the Magi, the men who visited Jesus in the manger.

In southern Spain, this is when the kids get their holiday presents, which are left in their shoes (ostensibly by the three kings) the morning after the parade. It was deafening, and exciting. The next morning Zoe woke to find some hastily bought presents in her shoes, a second Christmas, a new tradition.

Andalusia, southern Spain, had welcomed us, and we were gratefully there. Jason and Zoe were having the vacation of their lives, but now that the holiday was over, I grew desperate to be alone.

I wanted days and days of solitude, I wanted not to think, not to take care of, not to consider. My deep need to please and help others meant that it was difficult to understand myself around other people.

I needed to be alone to figure out how I could again become the person I used to be, that spontaneous, sensitive, goofy person that loved adventure. The price of clarity is selfishness.

A rhythm of simplicity

And so when Jason left to go back to Canada, it was both a sadness and a relief. Zoe and I settled into a calmer living. I wanted to hire a babysitter for a few hours a day so that I could write, but my landlord explained to me that because we were staying for a while, we were considered residents, and so when school started Zoe was invited to join the other four-year-olds.

Children are very motivated to talk to other children, and her desire fuelled her learning. The teacher was kind, beautiful and tough, perfect for my exuberant child. Zoe glowed in the life that Spain was offering her, in a way that didn’t happen in Calgary.

Finally alone, I imploded as I turned my attention to my chosen deep dive, researching a novel on the Roman empire.

The days became a rhythm of simplicity. Wake, eat, walk my daughter to school down the hill along the stone roads in the misty morning. Wait with the other parents as the children are lined up and taken in. Shop in the street market or the store for bread, wine, cheese, fruit and vegetables. Work in the morning researching my book and then writing in the room with the umber walls and the tile floors. Gather my daughter and play or walk. Eat dinner, put her to bed. Make a fire in the big stone fireplace. Drink a glass of wine as the sun goes down.

I was in Spain, on sabbatical. I was lucky and on vacation. I had chosen this. This was part of the life I wanted to live.

But as I lived this beautiful existence, as my crazy Calgary life faded, as I spent more time alone, I could no longer distract myself from a deep uncertainty.

I wrote and I researched and I felt a calm that I had not felt in a long time. Because of this calm, a small thought began to surface, an unwelcome thought. The more time I spent alone, the more I could hear it. I ignored it at first. I made ratatouille. I took little trips. I played and walked with Zoe.

It wasn’t one large event that made me notice. It wasn’t the joy of Christmas in another country. It wasn’t the boisterous parade of Epiphany. It was instead the absence of events. It was the quality of the air after all the holidays had finished. It was a fire that I built myself in the stone fireplace. It was the richly woven red and blue rugs on the tile floors.

One evening, after I stoked the fire, as I looked into the courtyard and the fading light, I let myself say it.

I didn’t want to be a naturopathic doctor.

As I was finally alone, I could no longer lie to myself that I had not come to Spain because I was on vacation. I had come to Spain because I was a failure. I was a failure because, if Jason wasn’t the problem, then I was.

I had gone through eight years of post-secondary school, and I couldn’t hack the stress of the job. This wasn’t really a sabbatical year, it was me figuring out how I could possibly keep going doing what I was doing.

My sister once said that in our family we have to leave the country to get drunk for the first time. I imagine that this was the same thing. The shame of failure meant that I had to leave to admit it. The shame of failing was too great to do it in Canada.

I didn’t leave my work to a colleague because I had planned it.

The pressures of my job were causing me to lash out, to party too much and to blame Jason for my unhappiness. I was both driving myself at work and then driving myself socially to make up for the fact that work never became easy. But I kept pushing, staying in a toxic clinic until I had a breakdown, and ended up desperately casting around for a way to save face.

I wanted out.

But I had spent eight years getting my doctorate, and my identity was connected to this job. I wasn’t a quitter; if I left my work, then I was a failure.

A lesson in success and failure

You see, growing up, failure was something other people were allowed to do. My family felt the ache of judgment deeply. Any shame my father perceived was met by the answer of my ringing successes. I was family pride personified.

We were moving houses, again? I won a speech contest. My dad lost his business? I got better grades.

My mom was sick? I excelled in university.

Succeeding was my answer to our chaotic world.

My dad was white, my mom was Métis, and they both grew up poor and proud. They were hard-working and they made themselves independent. The burden of judgment was always on us though, and I knew my parents felt it. We were fierce in our defiance of what was expected of us.

I recently spoke to Marilyn Dumont, the great Canadian Métis poet, at a Métis women’s event in Alberta. She talked about that burden of judgment on Indigenous people, and said something like, “Growing up, that white gaze was always upon us. We wore our Sunday best every day because we had to, because we were watched more harshly than the other kids.”

We never talked about being Métis in my family, but there was always that sense of needing to prove something to the other families.

I look more white than my mother did; although I have her tanned skin, I have my dad’s blue eyes, which makes me look more Caucasian. My older sister mimics the whiteness of my dad’s line, she burns in the sun like white milk in a hot pan.

But no matter our skin, we still feel the burden of our ancestry. That need to make money. That need to prove ourselves. We never talked about our problems in public. We never told other people if we needed money.

We never relied on anyone. We were a team, and that was all that mattered.

I have friends who have no problem failing spectacularly, even humorously. They have a buoyancy to their failure that feels like a balloon in a festive crowd, drop and be bounced up again, over and over, held up by family privilege.

It’s easy to fail faster when you are allowed to do it over and over.

I had no contingency plan. My parents were gone; I had no backup other than my husband and four-year-old kid.

My decision to take a year off was looked down on by Facebook friends: how dare I stop work for a year? Even though I had worked since I was 14, even though I had worked through school, even though the entirety of our existence in Spain cost less than the price of just child care per month in Calgary, I was judged for dumping the costs of our lives onto my husband. I cancelled my Facebook account, preferring instead to live my shame in secrecy.

The town of Jimena is old, and the Andalusia area has a long history of diverse occupation. The woman down the street dug in her courtyard to build a pool.

The workers first found Islamic stones, and then underneath that they found a Roman road, and even deeper, they found an ancient milling stone belonging to some long-forgotten culture.

Each piece of land has been owned a thousand times. There is some comfort that, in such a place, we are just momentarily on the land, that the land lasts, and we are temporary.

In Canada, I always felt the need to create something new, something from nothing.

In Spain, I was allowed to just live and live lightly. Things did happen — the rains caused flooding in the house and all the carpets had to be taken out and dry cleaned, we had to move out for one week to accommodate a different booking, a neighbour brought us to some Roman ruins to help in the research for my book — but overall, it was a gentle waterfall of joy, one calm adventure after another.

I couldn’t imagine not doing the profession that I had spent eight years studying for, but slowly I began to envision different ways of living, a way of living the way you wanted to.

A woman in her 30s lived across the street from me. She was born in Britain and she spent most of her time in Africa working on a wildlife reserve. Her life was lived in no English-speaking countries. Her house was filled with air and plants. We sat on benches in the sun, calmly talking about choices. She had chosen a quiet life, a life filled with open spaces and physical work. A life different than what had been expected of her.

The truth came to me as we spoke. I had always tried to find a profession that would allow me to live the life I wanted. It never happened.

The profession never transitioned to something easy. I loved my patients, but it was always hard.

The last year had been especially hard.

A patient whom I loved had died of cancer. I was just treating her for side-effects of her medication, but we became close. She was resourceful and she fought and rallied and fought again, but she wasn’t yet 40 when she died. It rocked me.

In addition to this I hated asking patients for money. I hated that naturopathic medicine in Canada was so misunderstood and controversial. I hated that I didn’t have time to spend with Zoe as she got older.

But, as I spoke to my neighbour, I realized that things didn’t have to be hard. In the calm that came post-Epiphany, I had found my epiphany.

At the end of the winter, I returned to Calgary as the snow was melting. I asked the woman who was running my clinic if she wanted to buy the practice and she said yes.

La vida es buena, especially on days that include tapas.


Excerpted from ‘Upon a Midnight Clear,’ edited by JJ Lee. Copyright 2024 JJ Lee. Published by Tidewater Press. Excerpted by arrangement with the publisher. All rights reserved.

Happy holidays, readers. Our comment threads will be closed until Jan. 2 to give our moderators a much-deserved break. See you in 2025!  [Tyee]

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