Transitions OMG

Photo courtesy of J. Stahlhut, September 7, 2026, near Georgetown, Colorado

What changes move you today?

It’s leaf peeping season in the Rockies; I will go eagerly back to Summit County, CO next weekend for aspens and friends–can’t wait! Hoping to get lots of photos to use here in the coming weeks. This is my 799th post–let’s see what I can capture for #800!

This made me laugh while scrolling Facebook today:

Baaahahahahaaaa TRUTH ;P

Summer to fall, youth to maturity. The Fourth Turning. Everything changes. How do we meet it all? What choices do we make?

Hubs decided this summer that we will replace the carpet in the whole house. The kids dutifully cleared their rooms before going back to school–it looks so sad, like they’ve moved out. My mental load increases the closer we get to installation, as 90% of the stuff in the rest of the place is mine and I must now clear 20 years of living off the floor and out of the closets–big lift for packrat me. I know I will be happy when it’s over and the process has already illuminated so much, for better or worse. I am who I am, have been so forever, with remarkable consistency, o.m.g. But after this project I may likely reorganize and reset, decluttered and refocused. Looking forward to it (but I’ll complain about it in the meantime). Makes me think about other things that are the same and also changing–my favorite paradox.

What have you noticed about menopause lately? I bet you hear or see something about it a lot more often now than ever. I wrote my most focused piece on it two years ago this week, which I still share with patients, but I really need to update it, as the landscape around this life transition has itself shifted significantly even since then. It’s still great that women’s health gets so much more attention and discussion now, no question. We have also swung well into pathologizing the normal in a lot of spaces, where unqualified influencers make money by sowing fear and mistrust of legitimate medical science and doctors in women of all ages. It’s all part of a larger societal transition, no? Social media has given everyone equal access to express and sell anything on various public platforms with little if any accountability. Menopause is a vastly different social experience now compared to even five years ago, let alone a generation.

Speaking of which, how is Gen X menopause different from that of our mothers? For many of us it hits when our kids are about a decade younger than we were when our moms went through it. We had much better access to birth control, and many of us delayed childbirth while getting our careers off the ground. So while our moms’ menopause happened after we were off at college or beyond, we’re going through it with teens and kids still at home–a very different, and I would argue more difficult, scenario. We are also the largest generation of working moms, primary breadwinner moms, and executive moms. We will or have hit our professional pinnacle around middle age, many in male-dominated fields, right when our adolescent kids’ brains and behavior devolve into chaos and our own bodies stage the second most significant physiologic revolution of our lifetime. Oh and don’t forget that our parents are also in their seventh or eighth decades of life, another pivotal transition that we also attend.

So to my fellow perimenopausal sisters: Holy moly, we are HEROES! Not only are we living every day in our own involuntary bodily transitions, but we’re doing it in a period of social and generational transition that is more complex than any timeframe to date. If you’re reading this and you have a woman leader anywhere in your life (and believe me, you do, even if she doesn’t have a formal title or designation), just thank her now. She’s holding all kinds of shit together and probably making it look easy.

What other monumental transitions do you observe now? What transformations? As we move from summer to fall in the Northern Hemisphere, entering the season of harvest and impending equinox, how do we feel and what do we need?

Multiple coincident and intersecting transitions can feel like a maelstrom. Can we find a quiet and stable center within it? Can we cultivate that dynamic balance that allows us to move more fluidly, with less friction and drag through it? What serves as our rudder, that which reliably stabilizes us on our life course, despite the inevitable weather changes? I know what mine are, and writing this post helps me reidentify and reinforce them.

Everything changes. Some things remain the same. May we always maintain clarity about the paradox of both, and exercise our agency to transition ever toward our most aspirational selves in each phase of life.

The Languages We Speak

愛 Love, written by me in eyeliner brush pen on Daughter’s hand

“…the medial aspect of my proximal left anterior forearm…”
–Me, describing where I would place the tattoo of my matrilineal surnames to Daughter.

What languages do you speak?

I speak American English and Mandarin with a Taiwan 外省人 accent. I am fluent in both but only literate to an early primary school level in the latter. In a previous medical practice I had so many Spanish speaking patients who were willing to teach me, that by the time I left if the patient knew a little English and the problem was not too complicated, I could get through an entire clinic visit without an interpreter. I had a long chain of Post-It notes in my office of words and phrases they had taught me.

Son and Daughter grew up with internist and orthopaedic surgeon parents so they speak a little medicine. Daughter spent five weeks learning archeology and osteology this summer, so her fluency in anatomy has improved–hence my description above. It’s just the most efficient and accurate way to describe the body part. Quick tutorial:
–Closer to central mass of body is proximal, farther is distal.
–Orienting left/right, closer to center is medial, farther away is lateral. For the hands, anatomical position assumes palms facing forward (anterior), so pinky side is medial, thumb side is lateral.
–Front of body is anterior, back is posterior.
–Closer to the head is superior; closer to the feet is inferior.
–Ventral is belly side, dorsal is back side (so back of the hand is dorsal but weirdly, top of the foot is also dorsal–which those fluent in anatomy already know!).
–Rostral is toward the head, caudal is toward the sacrum (tail).

How fun to talk shop with my kid!

It got me thinking again how bonding it is to share jargon. Consider any profession. We can go anywhere in the world and assume we can work with anyone in our field simply because we all speak the language of our discipline. It’s a built-in connection that precedes our acquaintance, that bridges other language and culture barriers. How cool is that!?

It all made me wonder what other languages I speak.
Here is a partial list, in rough order of verbal fluency:
Medicine (especially internal medicine and orthopaedics)
Biology
Chemistry (organic more than others)
Exercise/fitness
Nutrition
Volleyball
Mahjong
Pens
Paper/stationery
Writing
Psychology
Romance
Bread/sourdough
Audiobooks
Pottery

I also speak Relationship. I am highly fluent and literate verbally. But this language calls for and forth our greatest capacity for nonverbal communication, no? Huh. I love that.

Wanna know what languages I do not speak? This was fun to list too:
Sports other than volleyball (though I did learn once how to spot a moving pick in basketball)
Makeup
Skincare
Music (though I appreciate it greatly)
Pop culture
Fashion (though Daughter has taught me much about classic designers)
Money/finance

Aside from a lighthearted and fun reflection on Sunday afternoon while procrastinating housecleaning, the intersecting concepts of language, communication, and connection just make me shake my head in awe and wonder. How many more languages could I learn in this lifetime? I am convinced this is how people stay young and live longer: lifelong stimulation and learning, connection with and integration of the novel and interesting that brings us closer to our fellow humans. It could be anything!

Aspire to global human polyglotism, my friends!

So Proud of MaBa

On their 51st wedding anniversary (watermelon ‘cake’ decorated by Daughter)

Who in your family immigrated? Which generation are you?

My parents will visit this week, in the narrow window during which they are not traveling elsewhere and both of my kids are home before going back to college. It will be harder to coordinate calendars hereafter, I realize–I have adult children! What a milestone! I knew it was coming, but it only hit me when Daughter got herself from Trim to Dublin to O’Hare to home all by herself, with luggage, all while I was asleep and at work. [vibrating astonished smiley emoji]

Son is about the age Ba was when he left Taiwan. He and Ma met in high school, in study group at church. They got engaged after he completed military service and undergrad, and she was partway through nursing school, and came to the United States for his graduate studies. They eventually landed in Evanston, Illinois for his PhD in civil engineering at Northwestern, and I was three when he graduated. We moved to Colorado when I was six, and they still live in the house where my sisters and I grew up.

What a different world it was in 1971. Imagine picking up and moving to the other side of the globe, to a country where you barely speak the language, where you have few if any people, and you can only connect with them through snail mail. No internet, no cable TV, analog everything. I suspect most readers of this blog lived and recall those times clearly. Still, remembering is also akin to distant imagining, because our current reality is so drastically different and we simply adapt to what is.

How brave my parents were to do all of that. How mutually trusting in each other, in their own ability to figure things out. And maybe also in the decency of their fellow humans? They recently told me a story of their friend who was stranded in Memphis on his way to grad school at Ole Miss, who was taken in by a stranger, fed and housed overnight, and delivered to the bus station the next morning, all without ever knowing his host’s name. A kind American man helping out a young Taiwanese student, with no expectation of anything in return. Can we imagine anything like that happening today?

What happens when we cannot solve everything ourselves? What if I were stranded somewhere in a foreign country, phone dead, language barrier tall and wide, plans all upended? What if the people I could find were also disconnected from the internet? I suspect we’d find our shared humanity pretty fast, as long as none of us were outright sadists or sociopaths. I imagine that though racism and other ills of humanity existed then just as they do now, MaBa found folks who showed kindness, generosity, and even curiosity. They made friends, connections, and a life.

55 years on, they can look back at a remarkably successful life in every way. Steady professions, completed degrees (Ma got her BSN from CU while I was in high school and ended her career as a clinical instructor for our local community college), three daughters married to amazing sons-in-law, three grandchildren, a wide and exuberant circle of friends, and a remarkably active retired lifestyle. This is the American Dream, no?

My sisters and I watched how hard they worked our whole lives. Our family practiced frugality in ways my friends could barely imagine. Sisters and I experienced both the generation and cultural gaps known by all immigrant parent/native born children families. I think we have all come to appreciate and admire how MaBa confidently instilled traditional Chinese values in us, while also fully embracing qualities of American culture that made us better in synergy. Our academic and extra-curricular standards were high, but only because we could meet them easily–expectations were set by our own potential, not in comparison to anyone else. Tigers my parents were not, by a long shot.

MaBa continue to serve as respected leaders of the Chinese community in the region. They are tribal elders now, and I get to 沾他们的光, ‘dip from their light’, in other words, benefit from their positive reputation. People respect me because they respect my parents. It’s a status I gain by their decades of engagement and contribution to helping Chinese people be seen and included in America.

Their story is so much deeper, richer, and more awesome than I can write on a random Sunday night. As I witness my own kids emerging into fully functional adulthood, it makes me reflect on all MaBa went through to get here today. Somehow my own journey through this life phase feels prosaic and unremarkable in comparison, maybe because my parents were always within reach? I could always call if I needed anything. They could always (and did) fly to my assistance in a crisis. They not only created a solid life for themselves; they laid the foundation for my, my sisters’, and our own kids’ advantages and successes. They have set a loving and selfless standard for ancestral legacy, one that I feel proud to uphold.

Thank you, MaBa, from the bottom of my heart. Can’t wait to see you both soon. And I will do better expressing my appreciation from now on. xo