About Me

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Because you want to know who I am.
It’s a basic human instinct. You want to know if I’m friend or foe, you want to size me up before you spend any of your limited attention on me.

Okay, so you want to know who I am.
So do I. Believe me, you won’t understand me until you’re as confused and surprised by my life as I am.

You have to understand that my life can unexpectedly take off in new directions. You’d think I’d keep my bags packed, but no, I’m always as surprised as everyone else. A life is the greatest work of art by the one living it, and I have never felt obliged to color within the lines.

I don’t recommend my career path to young people trying to figure out what to do with their lives. But for anyone on a path that’s crumbling under them, or on a straight path that’s pinching: Don’t be afraid to jump to a new road. It worked for me. Repeatedly.

Who am I? Dunno.
But if I tell you what I do, and where I’ve been, you can answer that question. (Note for the curious: That’s the operational definition of existentialism. We are what we do.) If you find the answer, don’t tell me. The questioning is way more interesting.

I know this is long. Feel free to skip around. I did.



  1. WRITER.
    1. Nonfiction.
      • The stakes are higher. We identify viscerally with the characters, because these people walked the earth and this happened to them.
      • You can’t make this stuff up. Paradoxically, the weirder the story, the more we believe it.
    2.  Nonfiction about what:  Health. Science. Public Health.
      • Someone has to explain what’s going on. Better it should be someone who actually knows.
      • Explaining, demystifying, and making accessible are some of the most therapeutic skills a doctor has.
      • A story must have dramatic structure, or it’s not a story. I also wrote a few plays.
  2. DOCTOR.
    1. Family Physician.
      • I joined a noble but failing revolution in modern medicine. Family physicians are trained to take care of the patient, not just her disease.
      • I loved being a family doctor, following people through their lives, facing life and death choices with them. Made me an old soul.
      • But. Family Medicine was founded by caring, self-sacrificing idealists with no business sense. Turns out, if you want to keep the lights on, you need more than wonderful lifesaving skills. You need to find a way to get paid for those skills. Otherwise it’s just a hobby.
    2. So I couldn’t live with the way the bean-counters made me practice.
      •  Explaining a diagnosis, and its treatment, is intrinsic to care. But I am not free to practice medicine that way. My job description ends with treatment.
      • Taking “extra” time to make sure my patient understands the treatment, agrees with it, and intends to follow it, is frowned on. Communication is not considered professional work, not paid for, and it just takes time and runs up the overhead.
      • So I fled the sinking ship of primary care.
      • Writing is my second chance at a meaningful life.
    • History is a way of figuring out how something works, how it got that way.
    • If something doesn’t work, you’ll never be able to fix it unless you know its history.
    • I write diagnostic history.
    • I’ve never heard of a gardener who lost her mind. It’s such a grounding, healing practice.
    • I grow food mostly. Many kinds of berries, pears, figs, and of course tomatoes.
    • Growing food is kind of like writing nonfiction. Chewy. Flowers, beauty is important, too, but not as important as nurturing.
    • I also grow fruit trees: pears, figs, plums, and others. I create fruit trees by grafting. It’s a cheap but magical hobby.


    1. CHICAGO
      1. Born there, 1954.
      2. My parents. Sam Karr & Clara Karr, respectively a journalist and a frustrated artist with an obsessive-compulsive’s gift for typography.
      3. Their parents, my grandparents. Jewish refugees who escaped from a shtetl near Kiev, called Pavoloch, to come to America.
      4. Political practically from birth. My parents knew democracy was high-maintenance, but worth the trouble. We participated, marched, wrote letters.
      5. Education.
        • Terrible soul-crushing inner-city Chicago schools that honored conformity and crushed ideas.
        • We were the only Jewish family, the only family that loved books, for miles around.
        • My parents kept us in the public schools, instead of moving to a private school that valued learning, because they were idealists.
      6. Cultural Adventures. Daddy never thought I was too young for art. He took me to small theatres on Chicago’s Lincoln Avenue, in the 1960s, before it was famous.
        • I saw Joe Orton’s “Entertaining Mr. Sloane.”
        • At Hull House I saw Anouilh’s “Antigone,” still one of my favorite plays. It was the 1960s, I knew which side of the barricades I was on, yet the play gave as much respect to Creon, the establishment guy, as to Antigone the radical.
        • Later, in high school, I saw “Warp,” and the original production of “Grease.” I used to take the #11 bus downtown for plays and concerts at the Auditorium Theater, like Stoppard’s “Rosencrantz and Guildenstern Are Dead” with Brian Murray. I saw it twice.
      1. The first suburb north of Chicago, where we moved in 1967 so I could start high school there (ETHS) instead of in Chicago.
        • A small city with a shining history – it was a stop on the Underground Railroad.
        • My freshman year, 1967, a major magazine named ETHS the best public high school in America.
      2. Thank god we moved! Evanston made me what I am: openly smart, and open to people. If we’d stayed in Chicago, I hate to think what I’d be today. Probably a bitter unhinged old crazy lady.
      3. Evanston also made me funny. It was like finding my tribe, people who cared about the world around them, people I could be myself with. I turned out to be funny, and I’m thrilled.
      4. I began to look for my Jewish self. Evanston was also my first experience of living around other Jews. I rebelled against my parents’ secularism and visited local synagogues.
    3. ROCHESTER, NEW YORK – College
      1. University of Rochester, in Rochester, New York. Because
        • They gave me a scholarship, which made it possible.
        • The U of R had a great Hillel, where I hoped to replace my emptiness and isolation with a sense of belonging as a Jew.
      2. Major?
        • I started as a major in psychology, because my bumpy transition from Chicago to Evanston, from isolation to acceptance, had been fascinating.
        • I found that my English classes were more interested in how the mind works than my psych classes were. I graduated as an English major.
      3. Summer after college. Scholarship from the English-Speaking Union to a 6-week Shakespeare seminar in Stratford-upon-Avon, England. Hitchhiked around northern Europe for another 6 weeks.
    4. BOSTON – So many turning points.
      1. Work. I hit the street with my English B.A. and found out what I could do with it. Clerical jobs. I had big, though indistinct, dreams, and I was terrified shuffling other people’s papers was all I’d ever do.
      2. Big corporations in Boston were so hungry for computer programmers, they would take bright young people off the street and train them. So I became a computer programmer. It was like being paid to play games. I knew I didn’t want a life of playing games, but it paid the rent and paid for assorted classes while I figured out what I did want to do with my life.
      3. I accidentally fell in love with mountains. I didn’t have to impress them. They didn’t care what I looked like, how I talked, or who I knew. At an uncertain time in my life, the mountains of New England kept me sane.
      4. Pre-med? Me?
        • One day I asked a doctor a question and she laughed at me. It made me angry. A week later I was still angry, and it occurred to me that if I was so pissed off that this doctor wasn’t taking care of people the way I thought a doctor should, that maybe this was what I cared about enough that I should do it.
        • It caught me off guard, without all the reasons why I wouldn’t want to be in a profession of, I thought, snooty rich old white men in white coats.
        • But I knew that medical schools then were looking for a different type of med student, someone who had a life and knew how to relate to people. Maybe someone like me.
        • I had a good example of the trend close by, in my boyfriend David Goldman, med student. We met in a mime class. He tells that story best. We’re still together, 30+ years on.
    5. SEATTLE – Medical School
      1. University of Washington School of Medicine.
      2. Why there?
        • Because there’s a polarity in American medicine, between high-technology specialty care for parts of the body, and relationship-based care for the whole person, called primary care.
        • Very roughly, East Coast medical culture prizes high-tech specialty care, and often denigrates relationship-based medicine.
        • Most West Coast medical schools respect primary care medicine and teach it well. And they have nothing against technology.
      1. Residency in Family Medicine at Oregon Health and Sciences University, OHSU.
      2. Being a Family Doctor.
        • Private practice in a semi-rural mill town, Oregon City.
        • Large HMO.
        • Urgent Care.
      3. Leaving Family Medicine for Journalism. Leaving one troubled profession for another.
      4. PSU – Portland State University, MFA in Nonfiction Writing.