Primary care

Some of us may remember Marcus Welby, M.D., the TV show that highlighted the general practitioner who made house calls. I have vivid early childhood memories of my own family’s doctor, Dr. Gerry, coming to the house to tend to a sick family member. Years later I learned to make house calls, first as a medical student and then in my family medicine residency training. I can recall important moments visiting patients in their homes when I practiced in Lawrence, Massachusetts. My husband, also a family physician, recently mentioned a house call he made; this got me wondering why the thought of house calls provokes such strong and fond memories. I believe it is that they highlight the trust I had — first with my family doc, and then the trust I engendered with my patients.

Amid the flurry of misleading claims and disinformation about the Covid vaccine, we’re hearing recommendations to speak to one’s primary care provider for information we can trust about the Covid vaccine. A survey by the Larry A. Green Center revealed that people who were previously vaccine hesitant who then got vaccinated reported that receiving advice from their own doctor is what changed their mind. It makes sense that receiving advice tailored to one’s own health profile in one-on-one conversations provides a supportive and caring space to address questions and concerns in a way that results in increased confidence.

A robust primary care system is important for having better health as a country overall, and the essential elements of primary care are that it be comprehensive, continuous, accessible and coordinated. In other words, they’re always there for me when I need them, no matter what the complaint or concern, they can address most of my needs directly, and when additional help is needed they can connect me with who I need to see while keeping track of the various providers and recommendations to address my needs — all while supporting my ability to understand and take care of myself. These essential elements together contribute to building authentic relationship, and relationship is foundational to trust.

When people are talking about complex things like the Covid-19 virus and the pandemic we’re in, it’s important to have a trusting relationship with a health care provider with true expertise in medical science — whether an individual person or a practice — to help us sort through the noise presented to us by social media and politics. While house calls are less common today, trust is still at the center of the doctor-patient relationship. Your primary care provider stands ready to give it to you straight about the Covid-19 vaccine and is prepared to answer any questions you might have with your best interests at heart.

Localize our power

One of the more interesting changes that renewable energy will bring to New Hampshire is the localization of energy. As it is now, fuels are freighted (by truck or rail) into New Hampshire. For the power station in Bow, coal is shipped in by rail from out west. Most of our gasoline and gas is brought in by sea. What’s remarkable is that it all travels a good distance. Other than wood (and some nuclear power at Seabrook), New Hampshire doesn’t produce any of the material we burn to generate power. But that is changing and will likely change a lot in the next few decades. And we should do as much as we can to encourage and develop that.

Advances in technology are making it affordable and practical to generate power everywhere. From rooftop solar panels to larger solar farms to hydro power to wind turbines the next advances will mean that power won’t be generated at power stations as much as it will be generated everywhere, stored locally and fed back into the grid as homes, businesses, government and institutions need it. That’s a much safer, more economical and more environmentally friendly system than the ones we have now.

Going green shouldn’t be a Republican thing or Democratic thing. It’s a thing that makes us more independent, keeps money local, is safer and makes us all healthier.

Our local and state governments should be doing everything they can to help foster this new potential world of New Hampshire energy independence. How can we put rooftop solar panels in every home where it makes sense? How can we add solar panels to schools, warehouses, airports and former dumps? How can we turn roads into energy collectors? How can we harness the wind and power of the ocean to generate power? We should be supporting local projects like this even if they are just experiments now. Is every dam in New Hampshire collecting electricity? Is every parking garage generating electricity?

One of the biggest challenges with the lion’s share of renewable energy is that we just can’t turn it on or off like we can with traditional power plants. With solar we may have an abundance of power during the day but none at night. But what if an affordable way to store that energy was developed? A startup in Somerville, Mass., says they have developed an inexpensive way to store electricity in an iron battery. Commercial use of this technology may be 10 years away, but it represents hope and perhaps the future of what we could be able to achieve: real energy independence. And our state and local governments should be leading the way with projects of their own and incentives to help homes and businesses convert to renewable energy and experiment with ways to make it work. That seems like something everyone could get behind.

Why get vaccinated?

It seems that many conversations and topics are so controversial these days that we find ourselves avoiding them. Sadly, the topic of the Covid-19 vaccine has turned out to be one of them. If, however, we are going to end the pandemic, we need to have the conversation.

Recently, somebody who is not vaccinated made the argument to me that because I am vaccinated, I should not care whether or not he/she gets vaccinated. Here is why I care. The pandemic will not end until we reach herd immunity, and we will not reach herd immunity until enough of the population receives the vaccine. To assume that we will reach herd immunity by allowing the disease to progress organically throughout the country and world is a foolish and dangerous proposition, one that has already cost more than 600,000 lives in the United States alone.

By refusing a vaccine, people are at high risk of becoming infected with Covid-19, becoming hospitalized, impacting the health care system, and continuing to increase the spread of Covid-19 in our community, our state, and in the United States. When the spread becomes significant enough, the health care system becomes overwhelmed, creating issues for those affected with Covid-19 and impacting people with other illnesses as well. Additionally, if you become infected, you will likely infect others with the virus, if not my grandchildren who are too young to receive the vaccine, then possibly somebody else’s young children or grandchildren, or immunocompromised family member.

Science has provided us with a vaccine that can end the pandemic. These vaccines are safe, highly effective, and readily available at no cost to residents in the United States. The number of myths and pieces of misinformation spreading about these vaccines is mind-boggling. Rather than rely on social media for medical information, can we all commit to finding factual information before making a decision? A good place to start is a conversation with your physician.

Getting vaccinated is an individual choice, but it’s a choice that has a significant impact on those around you. Educate yourself first. Then make your decision.

If you delayed, it’s time

New Hampshire got off to a great start leading the nation in vaccination rates but now it’s falling behind just as it’s becoming even more important to be vaccinated with the spread of the delta variant.

The delta variant is two to three times more contagious than the original virus and is now the dominant strain of the virus being spread in America. Almost everyone getting infected and then being admitted to the hospital and dying is unvaccinated. That says a lot.

In New Hampshire almost 65 percent of the population — including Gov. Chris Sununu — has been vaccinated but that still is the lowest in New England.

Some may ask, why does it matter? Those who want the vaccine have gotten it. It matters because a fair number of people (younger children and certain people with medical conditions) can’t yet be vaccinated. The more of us that are vaccinated, the more protected those most vulnerable are. It also matters because as effective as the vaccines are, they aren’t 100 percent effective, meaning that even vaccinated people can get Covid and will get sick and die. Again, the more of us vaccinated the less the vaccine will be passed around and the less likely people will get sick.

Hesitancy is definitely understandable. Covid is a new virus and these vaccines were developed quickly. Most of the vaccines we take were developed over many years and have been proven safe by generations of use.

Though it’s tempting to Google vaccine questions, please talk to your health care provider. Ask them about the safety of the three Covid vaccines that you can get.

Folks also have questions about how to get vaccinated. There are more than 400 locations across the state to get vaccinated. All for free. The state even has a van that can come to you to give you a vaccine — for free. Just visit the state’s vaccine website (vaccines.nh.gov).

This is one of those times when we need everyone to get the vaccine so we can finally stamp out the virus. We can do this if we choose to do it. Many who have hesitated simply don’t see the need for them to get vaccinated. They are young and healthy.

I’d argue that we aren’t just doing this for ourselves. We’re doing it for each other. It’s an act of kindness. If you’ve delayed now is the time to get vaccinated for yourself, for your family, for your community.

Who will take their place?

By Jeff Rapsis

The recent loss of Meri Goyette is hard to put into words — but here goes.

For anyone who grew up or lived in Nashua since about the time of the Truman administration, Meri was as much a part of the city as the Main Street Bridge or City Hall or the Nashua High School marching band playing “Our Director” every time the Purple Panthers scored a touchdown.

Meri, who passed away last week at age 95, and her late husband Charlie (who we lost a few years ago) both played a huge role in making Nashua a better place for many, many years. And while it’s important to celebrate their accomplishments, it’s also worth asking: who among us will take their place?

The answer, of course, is no one — not exactly.

I don’t think anyone, for instance, will ever match Charlie’s record of delivering more than 10,000 Nashua area babies (me included!) during his decades as a local ob-gyn practitioner.

And Meri — well, we could devote this whole issue of the Hippo to listing the many projects and initiatives she spearheaded to make Nashua a better place, especially in the arts.

That’s another area I can attest to: My first drawing lessons took place in 1972 at the then-new Arts & Science Center on Court Street, which Meri helped champion and make a reality.

Much later, Meri was a big supporter of the Hippo, and never more so when we published a separate edition for Nashua for a few years early on. She practically adopted one of our writers, Seth Hoy, making it her business to invite him to all the receptions and gatherings she frequently hosted at her home.

For decades, she and Charlie were local ambassadors for making Nashua the best place it could possibly be. In terms of the classic movie It’s a Wonderful Life, they both helped Nashua trend more toward Bedford Falls than Pottersville.

And who can take their place? Truly, no one. But with the Goyettes now gone, it’s up to us to try — to channel our inner Meri and Charlie, and make our own efforts to make our own communities the best they can be. Keeping in mind their stellar example, we can all make a difference.

For all their interest in the arts, and in sculpture in particular, I think that’s one monument that the Goyettes would most appreciate.

Endless possibilities

Two activities that seemingly share little in common are the two that hold the most life lessons for me: golf and mountain biking.

Rarely do I walk away from these activities without new insights and appreciation of a multitude of issues. The top three that I work to fold into my life regularly are these:

• Trust your instincts

• Know your environment, and

• Focus on where you want to go.

There is much to be said about all of these and each will present itself differently on any given day. The unexpected thunderstorm on the golf course or a fallen tree on the middle of the trail teach me how to remain nimble while working to keep myself safe. Admittedly, I have a difficult time embracing any of these three thoughts on a given day but none more so than the last one.

I’ve been completely conditioned to think about all the spaces and places I don’t want to be. This fixation demands so much of my time and attention that I am not able to see the possibilities that lie in front of me.

When I’m trying to avoid the sand bunker on the golf course, I am not seeing the hundreds of yards of grass surrounding that one area. If I want to steer clear of a rock on the trail, I often miss the intricate carvings of the dirt that winds around it. In the end, I, unfortunately, usually end up going in the one place I did not want to go.

Conversely, when I have found those rare moments when I can focus on the where I want to go or be, it seems to just flow without my even realizing it. My body adapts with gentle encouragement and I achieve my goal with much less effort.

In a larger societal context, I know that I’m operating from the trance of fear in more ways than I wish to share. I know I’m in my healthiest space when I am seeing things from the space of possibility instead of the constriction of anxiety.

Take, for example, discussions around race. These no longer scare me because I see them as an opportunity to better fully understand this country and all who call it home. This took time to shift my perspective but I’m so grateful for all of those who lifted up my chin from the micro vision and helped me to see the bigger picture.

We need not be afraid of what isn’t when there is so much more to what could be.

Generous Listening

Much of what passes for public conversation these days could well be likened to a poker game where each player slaps down a card and the others try quickly to put down one of higher value. Whether the topic is immigration, gun control/rights, or abortion, the exchange soon becomes heated and the pace frantic. What is lost, quite simply, is listening.

For 25 years, there had been a space in our lives where that was not the pattern. Rather than shouting, blustering assertions, or insulting innuendos, NHPR’s The Exchange had been true to its name, a thoughtful, measured, and substantive exploration of issues and events among people with diverse and often deeply different views (NHPR discontinued the show last month).

Twenty-five years of The Exchange also brought us lighter fare about matters we didn’t know we didn’t know, such as the issues of pets along our hiking paths, developing alternatives to maple sugar syrups, and the curious doings of some of New Hampshire’s long-ago governors.

These conversations, in the truest sense of that term, were moderated by Laura Knoy, host of the program since its inception.

Whether interviewing a U.S. presidential candidate on a swing through our state or hosting a three-way exploration of substance abuse, Laura consistently modeled her program on what she herself values, generous listening. The term first used by Rachel Naomi Remen and later by Krista Tippett is “listening that is powered by curiosity.”

It is further suggested that this is “a virtue we can invite and nurture in ourselves to render it instinctive.” For anyone who had consistently tuned in to The Exchange each weekday morning, it would be clear that generous listening is instinctive with Laura.

And that is the point about what so many of us will miss. The program not only facilitated a statewide forum for the examination of issues critical to our community but also modeled behavior by which civil conversations even about profoundly contentious and divisive matters can take place.

At a time of such polarization, we need many more such exemplars of what our “better selves” could be to one another.

You can contact Steve Reno at stepreno@gmail.com.

Taste of Home

I love tacos, and when I first arrived in New Hampshire in 1993 as a medical student living in the Upper Valley, I realized I was a long way from Southern California and the tacos I’d grown up with when the only Mexican food source was a fast food chain franchise, where I was astounded to see the overhead menu displayed phonetic spelling for each of the food items: “boo-ree-toe”!

One day, my two Mexican-American classmates and I set out in search of Mexican food rumored to be available in a not too distant town in Vermont. It felt like a quest. Sadly, our too expensive (for our student budgets) meal was disappointing, and we resigned ourselves to living in a beautiful place with no gastronomic connection to home. We were excited when Shorty’s opened; the chips and salsa made it a favored site for celebrations!

Fast forward 28 years and I am thrilled to learn of Lalo’s Taqueria in Lebanon through “The Flavors of our Neighbors: At Lalo’s In Lebanon, The Taco Is King,” an NHPR story reported online July 2. A mouth-watering picture reveals authentic-looking tacos I can practically taste, light years from what I experienced in 1993, and sparks an urge for a road trip to catch lunch or dinner!

New Hampshire Public Radio is now running a wonderful limited weekly series, “The Flavors of Our Neighbors”/”Los Sabores de Nuestros Vecinos.” The Editor’s Note begins, “More than just a place to eat, local restaurants provide a taste of home for people through food and connections made with the folks who run them. This was never so evident as when the pandemic closed many of these gathering places, some for good … comprised of multimedia stories that highlight Latino restaurant owners, we learn how these entrepreneurs have not only weathered the pandemic but found ways to thrive and continue to provide a sense of community for their customers.”

In addition to stimulating our appetites, these stories evoke a connection to home, family, culture and community, for those of us with recent or remote roots in one of the many countries of Latin America. This is especially evident in the first story in the series, “The Flavors Of Our Neighbors: At Don Quijote, It’s Important To Feel At Home,” which highlighted restaurateur Sandra Almonte’s efforts “to make each person who walks through here feel as though they were stepping into their grandparents’ house.”

I am honored to be a member of the community-media partnership that collaboratively conceived of this project. We hope you will be inspired to check out “The Flavors Of Our Neighbors” and join us in creating community together over good food, as friends and neighbors in New Hampshire.

Foraging Memories

The elderberries are in full bloom. For my family they hold special significance as they remind us of my father-in law, who passed away almost four years ago.

My father-in-law loved his wild edibles. Every year at about this time he would drive along the country roads of Pickaway County in Ohio where he lived, keeping an eye out for elderberry flowers at the edges of woods and farmers’ fields. He’d carefully take mental note of their location so he could return later in the summer to forage for their magical berries. I’ve heard how he’d make elderberry wine with the berries — or how they’d get baked into one of his wife’s delicious pies. He also had many “adventures” getting stuck in ditches and battling poison ivy and always had colorful stories to share about his quest for those berries.

My husband has continued the elderberry passion, planting them on our property and harvesting them for all things elderberry. He also enjoys spotting them while driving around Manchester and New Hampshire, and talks excitedly about how they evoke memories, brighten up the drives and landscapes, and provide nectar and pollen for our local honey bees — another one of his passions, best left for another day’s column.

Most years, he and our daughter cook up a batch of elderberry syrup that is especially nice on yogurt and vanilla ice-cream. He has not yet forayed into making elderberry wine, but I suspect that is coming. The cooked berries regularly go into people’s smoothies and many live in the freezer for winter treats, once again reminding us of summer’s warmth and of fond times with my father-in-law. (Do note the tart berries can be toxic and should be cooked before eating!)

One of my less-favored consequences of working with elderberries are the inevitable purple-stained fingers that linger for days — and yet they, too, evoke “tasty” memories and trigger anticipation of the next elderberry treat that will be heartily enjoyed. (“Tasty” is a food adjective commonly and enthusiastically used by my husband’s family.)

I realize these little things we take for granted, such as flowers on the side of the road that we may not even notice most days, spark important and meaningful memories. What are the items or events that do the same for you? I hope we can all take time to appreciate and savor the little things that help bring meaning and sweetness to our life today.

My family and I are grateful for the generous gift of memories (and yummy treats) that the elderberries provide us today and every year. I wish the same for you and yours.

NH Gives (and gives)

On June 8 and June 9, the New Hampshire Center for Nonprofits hosted its annual NH Gives online fundraiser. According to its website, the event generated more than $3.8 million for the benefit of 584 nonprofits throughout New Hampshire. This amount represented a record amount raised for the event, and it included a $300,000 match by the New Hampshire Charitable Fund and an additional $700,000 in individual matches. As always, I am humbled by the generosity of our Granite Staters and inspired by the collaboration that made this event such a success.

I was proud to represent Fellowship Housing Opportunities on WMUR promoting NH Gives and grateful for the coverage of the important services that this nonprofit provides, safe and affordable housing for people living with long-term mental illness. According to the New Hampshire Center for Nonprofits, we are one of 6,547 charitable organizations providing services for New Hampshire. In a state that staunchly supports limited government and no state taxes, these nonprofits have an important role to play. They are frequently filling in the gaps where the state government lacks funding to provide services. Their services range from health and human services to the arts and theater and everything in between.

Most nonprofits in New Hampshire operate as small businesses with limited annual operating budgets. However, rather than deliver a profit, the goal of a nonprofit is to deliver on its mission. Many rely solely on grants, donations and fundraising to exist. New Hampshire Center for Nonprofits indicates that 15 percent of New Hampshire’s workforce is employed by a nonprofit. That means that with our state’s low unemployment rate, our nonprofits are also struggling for employees right now. It’s difficult for them to compete at the same wage level as the for-profit sector. Nonprofits rely on their mission to attract people. Volunteers also fill a vital role in the nonprofit sector, in day-to-day operations as well as at the board level.

Perhaps you will consider spending your time with one of the many nonprofits carrying out its mission throughout the Granite State? Whether you choose to volunteer for specific events, on a regular basis, or as a board member, or make a monetary donation, your contributions are important to their success. When New Hampshire nonprofits win, important work happens in our state.

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