The Senate BCRA Bill Part 2: How Could It Affect Care in Walla Walla?


The sudden announcement that Adventist General Hospital was closing sent a shock wave through Walla Walla recently. An unwelcome reminder of the precariousness of our healthcare system and how vulnerable we are when systems fail. Walla Walla General Hospital was hardly what you could call a failure, having served eastern Washingtonians since 1899, which is why it can rattle to the core when pillars of the community like this fall. After 118 years, two world wars, the great depression, and a fluctuating local economy, even Walla Walla General could buckle and fold in the wake of an upside-down economy. What’s happening in Walla Walla’s healthcare industry may be only the precursor to what’s in store under the GOP health plan, should it pass. Which is why it’s so important to understand what’s at risk.

Rather than recap a full explanation of each part of the bill, especially as it begins to morph ever so slightly over the upcoming days and weeks, here’s a look at how losing the Affordable Care Act and major cuts to Medicaid could affect healthcare in Walla Walla and the surrounding eastern Washington counties, which groups are most at risk and what might need to prepare ourselves for in the upcoming years.

Benefits of Medicaid Expansion in Washington Since 2014:

  • 790,000 Washingtonians Received Coverage Under ACA & Medicaid or Medicaid Expansion:
    • 600,000 New Low-Income & Working-Class Washington Residents
    • 190,000 New Enrollees Through Washington State Health Plan Finder
  • 20,000 People Received Cancer Treatment
  • 30,000 People Previously without Coverage Treated for Substance Abuse & Mental/Behavioral Disorders
  • Uninsured Rates Dropped by 58%
  • 51,000 New Jobs Created in the Health Care & Services Industry in Washington State

The impact of Medicaid Expansion Cuts In Washington State:

  • Approximately 600,000 lower income people currently covered under Medicaid expansion stand to lose coverage, 80% of whom are working families.
  • Due to the age-based addition to subsidy requirements (rather than income-based alone) under the Senate BCRA bill, approximately 100,000 people, mostly seniors will be forced to drop individual market health insurance plans due to lack of affordability.
  • It will cost Washington State $351 million biannually to reinstate and fund former state programs currently covered under ACA.

Impact On Healthcare in Walla Walla Under BCRA:

  • 30% of people are covered under Medicaid in Walla Walla, 12.5-15.2% under Medicaid expansion.
  • 76% of low-income children are covered by Medicaid programs, including special education and speech pathology programs for kids with disabilities.


  • In Washington State, approximately 24,000 veterans and their spouses stand to lose Medicaid coverage under the current Senate health care
  • The Walla Walla VA’s new Medicaid/Care-Certified Veteran’s Home services 10 counties, 50,000 Veterans, and 20,000 seniors over 65.
  • Many of these veterans and their spouses are low-income and subsidized under Medicaid.
  • 64% of all nursing home residents use Medicaid

Healthcare/Social Service Jobs:

  • Approximately 51,000 jobs created by Medicaid expansion in Washington state are at risk under the new Senate Healthcare bill.
  • The 2nd Largest Industry in Walla Walla is Healthcare & Social Services in the private sector.
  • In 2016, healthcare and social services made up about 16.1% of local jobs.  That’s roughly 3362 jobs in health care alone.
  • Walla Walla General/Adventist Health services closures put 439 full or part time health care professionals out of work, approximately 1/3 of what St. Mary’s/ Providence Healthcare currently employs (1,153 employees).
  • Only around 50 Health Care-related job postings are listed through Providence currently, leaving many already out of work or underemployed.

Although precise statistic is hard to gauge, with statewide cuts to ACA/Medicaid expansion jobs, 80% less funding for Walla Walla’s Planned Parenthood services, Adventist Health/ general hospital closures, and an already existing shortage of primary care providers, the local workforce and patient resources for Walla Walla could be severely impacted.

These shortages would mean far fewer services available than in previous years and in addition to paying more for less health coverage, access to primary care would be even harder to find. And if you get sick, become disabled or grow old, have a baby, are a low-income worker, or underemployed, there may be little to no affordable or adequate access to care available at all.

There are more unpleasant surprises lurking in the Senate BCRA bill as well. These are just the highlights for those of us here in the easternmost part of Washington State. If you or someone you know will be negatively impacted by this health care bill, please call your congressional district representative (CD5), Republican Cathy McMorris Rodgers, and Washington state senators Maria Cantwell and Patty Murray today and tell them to vote No on this bill. Whatever problems may exist under the Affordable Care Act certainly aren’t worth risking the lives and health of 22 Million or more Americans, and locally we need to keep our health care industry robust, well-funded, and fully employed.

Letitia C. Page

The Senate BCRA Bill Part 1: What it Could Mean for Healthcare in America

Much debate and plenty of concern have surrounded the new GOP health plan released in June, putting an end to the waiting, but not necessarily all the worry. As the weeks ticked by with most Americans and more than a few senators left in the dark, majority leader Mitch McConnell and a handful of Senate Republicans met in secrecy, drafting their version of the GOP Health Plan.

Changes to the original House bill that passed last month were few but significant, and more appear on the horizon, facing opposition by both Democratic senators and some Republicans, not to mention a growing number of people in the US. To clarify some of the key issues at stake, here is a breakdown of a few pertinent changes in the Senate health bill as it currently stands and what they could mean for healthcare in the future.

Medicaid/Expansion Cuts

There are two key cuts to Medicaid under the Senate BCRA bill (Better Care & Reconciliation Act). But, make no mistake, it is less a health plan than it is a healthcare repeal, though most assumed that meant repealing the ACA. The news that Medicaid was on the chopping block was somewhat of a surprise. In fact, a recent poll found nearly 40% of voters didn’t know about the $834 billion dollar cuts to Medicaid expansion included in the AHCA (American Health Care Act) that House Republicans passed last month. The Senate version takes these cuts even further. The House bill called for ending Medicaid expansion completely by 2020, leaving 11 Million people without health insurance. The Senate bill plans to phase-out Medicaid expansion over four years starting in 2020 before cutting it all together, but also adds deeper cuts to Medicaid itself.

Annual & Lifetime Caps:  OK, bear with me. This gets a little technical, but it’s important! Currently, state or per-capita Medicaid funding is variable, based on need and use, and set to medical care inflation rates (CPI-M). The Senate bill would change this to a fixed rate, setting annual caps based on standard inflation rates (CPI-U). If coverage or treatment exceeds the fixed annual cap, the state must figure out how to pay the extra costs themselves, or pass those costs onto consumers. Between 2000- 2017, medical care rates increased by nearly 2: 1 compared to standard inflation rates. CBO estimated this would cause a 9% decrease in funding over time, or approximately $10 Billion dollars less each year under the original House bill. Early estimates under the Senate bill are closer to 25%, which would mean roughly a $20-25 Billion dollar cut in Medicaid funding annually. According to Business Insider, this switch could seriously impact low-income seniors, and others currently covered by Medicaid.

“Because Medicaid is already one of the lowest-cost providers of healthcare, a state could either cut benefits, which would affect the quality of coverage, or reduce who is eligible for the program, which could hurt people with disabilities, older people, or people suffering from substance abuse.”  – Harrison Jacobs, BI

Drastic cuts to Medicare would not only leave millions of Americans without health coverage, it would also defund key programs for low-income and working families, programs like Aid to Families with Dependent Children (AFDC), and Temporary Assistance for Needy Families (TANF), while  reducing resources for those who qualify for food stamps and WIC (Women, Infants, and Children food and nutrition program). Many low-income families with young children rely on programs like these to survive. This would also limit funding and resources for long-term senior care and the disabled, including long-term care through the VA.

While these cuts could decrease the deficit by up to $321 Billion over the next 10 years, it also leaves 22 Million people without health insurance and would cost millions more to resurrect the low-cost community programs, free clinics and treatment services replaced by Medicaid expansion.

In addition, the Senate bill adds work requirements for access to services. Each state could set mandatory employment hours to qualify for Medicaid coverage. This particularly impacts the elderly and others who work part-time, seasonal, or inconsistent hours. (Students, pregnant women, and people with disabilities would be exempt, but not seniors over age 65).

ACA Cuts/Changes

Age-Based Limits:  Under ACA, insurers can only charge seniors up to 3X what younger insured premiums for health coverage cost. The Senate bill raises this to 5X as much. This would create an 800% increase in premiums for older, low-income Americans after age 65, based on CBO’s assessment of the house bill. The Senate bill keeps this provision so similar hikes in premiums for those over 65 are expected. Seniors make up one of the largest growing demographics globally so the health impact on growing numbers of older Americans would be more than ever before, and the lower their income, the more they will pay:

  • AVG Annual Premium Rate: $3200
  • 60 & Over AVG Premium Rate: $17,900
  • 64 & Up @ $25,000 Annual Income: +$7,000 Premium Hike
  • 64 & Up @ $15,000 Annual Income: +$8,400 Premium Hike.

The Senate bill also puts caps on certain illnesses and a lifetime cap in general. For example, if a $120,000 annual cap is set for cancer treatment, and someone caps out in May, the rest of the years’ costs would not be covered. If an illness is prolonged, a person could reach their lifetime cap before treatment is completed as well, leaving patients to cover the cost of finishing treatment or go without.

There would also be an 18% reduction in discretionary funds, which could reduce funding or even eliminate entire programs not currently covered by Medicaid. Close to $600,000 annually could be cut from senior services like the Meals on Wheels program, Senior Center Meals, rides, counseling and legal services.

  • $290,000 from Meals on Wheels
  • $250,000 from Senior Center Meals
  • $40,000 from Senior/Disabled Rides & Counseling/Legal Services

Penalties:  One of the biggest complaints about Obamacare has been the mandates requiring people and employers to carry insurance plans or receive a financial penalty. The idea was “to avoid the insurance death spiral” where healthy people wait until they’re sick to seek treatment. This forces insurers to raise their premiums to cover more severe conditions or emergency services which are more expensive.

Under the Senate bill, these penalties, or mandates, are replaced, which may ensure the “death spiral” that ACA opponents claim mandatory insurance requirements have caused. The real issue, however, is not the mandates themselves, but unregulated insurance rates. Programs like Medicaid and Medicare are the only programs currently with government regulated pricing. On the free market, rates are anything but consistent and price-gouging is common as we’ve seen with the astronomical rise in drug prices in recent years. The House bill removed the mandatory insurance penalties completely. The Senate bill would replace them with a 6-month lockout on coverage if insurance lapses. someone without uninsurance or whose coverage lapsed during the prior year could see premiums go up as much as 30%.

The quality of Care: The ACA, whose full name is the Patient Protection and Affordable Care Act,  includes protections for what insurance plans must cover, linking Quality of Care to Medicare and Medicaid subsidies and reimbursements. The better the care that doctors, nurses, hospitals, and emergency rooms provide, the more money they receive through incentives. Those costs are absorbed by insurers, pharmaceutical, and medical device companies who can’t pass costs on to consumers under government-regulated pricing allowed through Medicare which sets limits on what they can charge.

This is arguably one of the main reasons that health insurance and pharmaceutical companies fight so hard to keep universal healthcare from passing, and certainly why the ACA isn’t working for everyone. HMO’s and insurance companies still set their own rates under ACA rules, outside of Medicare-caid programs, as does the Trumpcare Bill, so the issue of affordability still isn’t being addressed. Either would keep insurance rates higher for free-market health plans, though, the Trump care bill would push rates even higher. This may be why so many are joining the call for single-payer, or “Medicare-for-All” programs. Rather than government-funded or regulated insurance, we could have government-regulated pricing for insurers, which is currently not allowed. Being able to negotiate pricing for services and drug costs directly with the insurance and pharmaceutical industries could keep costs and care affordable and available for everyone.

Essential Protections & Waivers: There’s a little bait-and-switch in the current Senate bill over the pre-existing conditions clause. After a backlash from voters for removing pre-existing conditions in the House bill, the Senate version attempts to go around the issue by leaving the protections in without providing the coverage for chronic illness and/or expensive treatments usually associated with pre-existing conditions. While the Senate bill leaves the pre-existing conditions clause in place, it lifts the mandates for the 10 Essential Health Benefits required under the ACA. The National Academy of Medicine defines these “essential health benefits” as:

  1. Ambulatory Patient Services
  2. Emergency Services
  3. Hospitalization
  4. Maternity & Newborn Care
  5. Mental Health & Substance Use Disorder Services:  Behavioral Health Treatment
  6. Prescription Drugs
  7. Rehabilitative & Habilitative Services & Devices
  8. Laboratory Services
  9. Preventive & Wellness Services & Chronic Disease Management
  10. Pediatric Services, Including Oral & Vision Care

(Patient Protection and Affordable Care Act, n.d.)

Under the Senate health bill, states can request a waiver allowing insurers to waive coverage for essential services under the guise of providing a lower-rate insurance option. While prices might decrease slightly for some insurance plans, the plans would cover fewer essential services. Childbirth, for example, could cost tens of thousands of dollars if waived from insurance plans, while emergency and ambulatory services, already exorbitant in price may not be covered at all.

Even in states that don’t take advantage of these waivers, people could still lose basic services if insured through their employer. Companies that reside in more than one state are not required to offer insurance plans based on where you live and may opt to buy insurance for all their employees through a “waiver state”.  So, even here in Washington where it’s unlikely these waivers would be used by everyone, what the bigger, cross-state employers decide to do is up to them.

There are no guarantees these plans will be any cheaper, either. By removing mandatory penalties and cutting $600-$1400 Billion dollars from Medicaid and Medicaid expansion, fewer people would be covered, sending the millions of uninsured to emergency rooms when conditions become acute, requiring more treatment for unmanaged health, which would  hike premiums and costs for people who are insured, especially for higher-risk groups like the poor and elderly. Without enough people on the free exchange, health premiums could go through the roof again, just as they did before ACA.

Many of us remember the days and nights spent arguing with providers over denied claims for services that cost an arm and a leg to cover or struggling to find a doctor or nearby services included in our network. Unregulated insurance was a problem then and now, though much worse for anyone who moved or changed jobs after developing a “pre-existing” health condition. The result is we pay a lot more for less coverage with insurance-mandated pricing, and the poorer, sicker, and older you are, the more you’re likely to pay.

Women’s Health: While the Senate bill leaves in the stipulation that insurers cannot charge women more for insurance, states could receive a waiver for providing maternity care, contraceptives, or other basic women’s health services. No funding at all is allowed for women’s clinics providing abortion services. Planned Parenthood would lose 80% of their funding next year for all their services, which many low-income women at or below 150% of the federal poverty level rely on. Only 03% of Planned Parenthood’s budget goes to abortion services so the remaining 77% of cuts would remove vital services like prenatal care, breast cancer screenings, sex education services, contraceptives, and testing/treatment for STD’s. According to the Guttmacher Institute, 20 Million low-income women rely on Planned Parenthood for these and other women’s health services.

Planned Parenthood Annual Budget for Services:

  • 03%: Abortions
  • 07%: Cancer Screening
  • 13%: Prenatal/Pregnancy Care
  • 31%: Contraception
  • 45%: STD Tests & Treatment

Subsidies & Costs: Under ACA, 70% 0f health insurance costs must go to cover health care services. Under the Senate bill, only 58% of co-pays and prescription costs must be covered. It would also lower tax credits for incomes 400% above the poverty line, roughly $48,000 annual salaries down to 350%, or $42,000 annually.  This would mean middle-income brackets would receive fewer tax credits or reductions towards hikes in premiums. It is also tiered by age so, after turning 33 years old, the cap decreases to 175% above the poverty level, or $21,000 annual income, which means premium costs of 5.3% of someone’s annual income. After age 59, premiums would increase to  8.3% or roughly $1750 a year.

Service-Based Costs: ACA also requires 80% of the money spent on insurance to go towards health services or be reimbursed to the consumer. Insurers can only spend 20% for administrative costs, marketing or CEO salaries. Approximately $396 Million dollars in reimbursements went to 4.8 Million families in 2015 alone, the average rebate received approximately $138 per person, paid back from shareholder profits. AHCA removes this stipulation, leaving it up to the individual states to determine.

2018 BCRA Rates for Washington State:

  • Average Premium Hike” $571 per person
  • 344,300 Lose Coverage: 244,900 from Medicaid, 69,00 from employer-sponsored coverage, and 29,300 from individual market coverage.


Tax Break: This is the other area of contention among middle-income workers and small business owners hoping to see a reduction in what anticipated premium increases could be under the ACA’s “Cadillac Tax”. However, this excise tax is not a direct hike in premiums for all health insurance coverage. Rather, it’s a 40% hike in costs for insurers who provide premium health plans for what’s considered “excess” health care, according to the ACA facts website. In their words, “It’s 40% of every dollar spent over $10,200 for individuals and $27,500 for a family in 2018. It is not just a flat 40% increase on the total dollar amount.” ( Cadillac Tax).

While much of this cost would pass on to consumers, it only applies to non-essential services, or premium plans for companies and individuals who can afford higher rates for extra health perks, not plans for middle incomes already struggling with premium costs. While this excise tax was intended to cover high end “luxury costs”, without hiking up regular insurance rates for executive non-essential services, it also doesn’t lower rates for middle incomes and smaller businesses. It was only intended for big companies and wealthier individuals willing to pay more for extras they can afford- like buying a $50,000 Cadillac, instead of a $12,000 Nissan. The Nissan may fluctuate a little in cost as Cadillac prices increase, but there is still between a $35,000 to $75,000 difference in price. The same principle applies here. Yet, rather than get rid of the Cadillac Tax altogether, as Obamacare critics had hoped, the Senate Bill simply delays the date it will go into effect until 2026. Premium hikes will likely continue in the meantime, though not due to the Cadillac Tax which was not repealed after all.

The primary tax cuts Republican senators did include in the bill were only for a select few. They’ve included huge tax breaks for the very wealthy, approximately 45% of which only benefit the top 1%. Under the GOP health plan, the 3.8% investment tax on incomes over $200,000 per year is removed instead of the Cadillac tax. The result is a $44.5 Million dollar annual tax break for individuals with incomes over $875,000 while those with incomes over $5 million save closer to $250,000 each year. Business owners like casino- owner Sheldon Adelson, for example, or the Walmart family who owns “more wealth than the bottom 40% of America”, according to the true-false pedometer-rating from Politifact on this now infamous Bernie Sanders quote.

While some marginal breaks are given to lower income brackets, this bill resembles a Republican tax bill more than a health care reform bill with yet another tremendous tax break for the wealthy few at the expense of the many lower income, working-class Americans, children, and seniors struggling with healthcare costs. An estimated  $700 billion dollar loss over the next decade would result from removing the excise tax, as opposed to the $772 billion saved by removing Medicaid expansion before 2026, according to the CBO’s recent analysis.  In other words, nearly all 22 million people displaced under the Senate plan could keep their coverage if not for these excessive tax breaks only benefitting the ultra-rich.

Though, the losses from these cuts would continue well beyond the initial CBO figure, not to mention continue to spike health care premiums and gut Medicaid funds in the future. The billions of dollars added to the federal deficit for tax breaks only benefitting a wealthy few end up costing taxpayers considerably more than a one-time saving earned by cutting expansion.

The Senate BCRA bill includes other changes beyond the ones discussed here. If you’d like to read through a copy yourself for a more in-depth view, you can follow this link.

Letitia Page

Glitter & Be Gay

treasure-395994_1920“Ah, how can worldly things take the place of honor lost? Can they compensate for my fallen state, purchased as they were at such an awful cost?”

~ Quote from Leonard Bernstein’s musical adaptation of the Voltaire play, Candide.



The first connection that came to mind when I read today’s prompt was Cunegonde’s aria Glitter and Be Gay from Leonard Bernstein’s Candide. The more I thought about the aria and story, the more I realized how fittingly it illustrated my state of mind as I reflect on this beautiful, yet magnificently flawed country of ours, and the Grand Experiment that attempted something better than what was.

For those of you unfamiliar with the convoluted plot originally created by Age of Enlightenment philosopher Voltaire in his 30-chapter play, Candide is the story of how we travail through life’s trials and what we do to adapt, and the traps we so easily succumb to that can forever compromise who we are. Most of us don’t start out as corrupt and conniving and some of us end up. It’s usually a slow progression into ruin. The character Cunegonde who sings Glitter and Be Gay, and also the love interest of title character Candide, is a great illustration of that progression. We see through Cunegonda’s eyes how easily seduced we are by life’s pleasures when we’re desperate and in need. The choices we make in those moments may not feel choices at all, but once we’ve slipped down those slippery slopes of compromise, it’s hard to slide our way back up.

~After escaping a war which suddenly broke out on her wedding day, Cunegonda and her mother, The Old Lady, flee to Paris. Finding her way through life without money or a  husband, Cunegonda is forced to become a kept woman. She finds a benefactor in an old, wealthy Jewish man with whom she begins an affair – but only on alternating, mutually agreed upon days. This stipulation somehow seems to lessen the blow.

Bedecked amidst all her newly acquired finery, Cunegonda reflects in sorrow on her fallen state. Though, the comfort she finds in these new distractions is a little too enthusiastic to truly believe her sorrow real. Surrounded by all her pretty jewels and clothes, Cunegonde distracts herself from the reality of how this refinement was obtained with the aria,

Glitter & Be Gay:

“Glitter and be gay, that’s the part I play; here I am in Paris, France. Forced to bend my soul to a sordid role, victimized by bitter, bitter circumstance. 

Alas for me! Had I remained beside my lady mother my virtue had remained unstained until my maiden hand was gained by some Grand Duke… or other.

Ah, ’twas not to be; Harsh necessity brought me to this gilded cage. Born to higher things, here I droop my wings,  Ah! Singing of a sorrow nothing can assuage.

 And yet of course I rather like to revel, Ha ha! I have no strong objection to champagne, Ha ha! My wardrobe is expensive as the devil, Ha ha! Perhaps it is ignoble to complain…

Enough, enough of being basely tearful! I’ll show my noble stuff by being bright and cheerful, Ha ha ha ha ha! Ha!

Pearls and ruby rings…Ah, how can worldly things take the place of honor lost? Can they compensate for my fallen state purchased as they were at such an awful cost? Bracelets…lavalieres, can they dry my tears? Can they blind my eyes to shame? Can the brightest brooch Shield me from reproach? Can the purest diamond purify my name?”

And yet of course these trinkets are endearing, Ha ha! I’m oh, so glad my sapphire is a star, Ha ha! I rather like a twenty-carat earring, Ha ha! If I’m not pure, at least my jewels are!

Enough! Enough! I’ll take their diamond necklace and show my noble stuff by being gay and reckless! Ha ha ha ha ha! Ha!

Observe how bravely I conceal the dreadful, dreadful shame I feel. 

Ha ha ha ha!” (repeat, ad nauseum).

~ Not to be outdone, The Old Lady also entertains us with the ways in which she’s adapted to all life has thrown at her.  My favorite memory of this song is my own mother singing it when she played the role. I always hear her voice no matter what recording I listen to. It’s a role requiring a certain kind of irony that can’t be laid too thick or it falls into a campiness out of character with the serious, yet farcical undertones this story carries. To capture the right kind of humor you must walk a very thin line, one my mother was particularly adept at. ~The Old Lady’s Tango,

I Am So Easily Assimilated:

“I was not born in sunny Hispania; my father came from Rovno Gubernya. But now I’m here, I’m dancing a tango; Di dee di! Dee di dee di! I am easily assimilated…

 I never learned a human language. My father spoke a High Middle Polish. In one half-hour, I’m talking in Spanish: Por favor! Toreador! I am easily assimilated.

It’s easy, it’s ever so easy! I’m Spanish, I’m suddenly Spanish! And you must be Spanish, too. Do like the natives do. These days you must be in the majority.

Tus labios rubi dos rosas que se abren a mi, conquistan mi corazon, Y solo con una cancion. Mis labios rubi dreiviertel Takt, mon tres cher ami, oui ou, si si ja ja ja, yes yes, da da.

Je ne sais quoi! Je muero, me sale una hernia! A long way from Rovno Gubernya! Mis/Tus labios rubi dos rosas que se abren a mi, conquistan mi corazon, Y solo con Una divina cancion. De tus labios rubi! Rubi! Rubi! Hey!”


Candide is also a retelling of the Adam and Eve story, of falling out of blissful, idealistic naivete into the harsh realities of life and how to cope with what we see once we’ve fallen. It’s a story about the disillusionment we feel when our innocence has been spent, and we see the world, and all its false charms and pretense with unveiled eyes and look behind the curtain for the first time.

~ Upon discovering the two women who’ve just tried to swindle him out of his money are actually The Old Lady and his lost love Cunegonda, Candide retreats into silence for three long days. After spending a lifetime idealizing his love, believing her beyond reproach, Candide now realizes to his utter disappointment, that Cunegonde was just as human as he was all along. ~ Candide’s lament in his aria, Nothing More Than This:

“Is it this, the meaning of my life? The sacred trust I treasure, nothing more than this? All my hope and pleasure, no more than this? The love I dreamed and cried for, no more than this?

All that I killed and died for, no more than this? That smile, that face, that halo around it, that youth, that charm, that grace, behold I have found it. Is it this, the meaning of my life, nothing more than this, no more than this?

What did you dream, angel face with flaxen hair, soul as dead as face was fair? Did you ever care? Yes, you cared for what these purses hold, you cared for gold.

Take it for my kiss, my bitter kiss, is it this, the meaning of my life, the sacred trust I treasure, nothing more than this?”  

In the end, Candide is also a story of resigned hope. We’re reminded how to find beauty in all our varied flaws once we accept who and what we are, how much more resilient our love for one another is when we look unflinching into the light where all our dark secrets are laid bare. We see life for what it is and isn’t, and how heartbreakingly beautiful all of it is in the end.

(…at least, that’s what I got out of Candide. Others may have a different interpretation…)

~ After wallowing in disillusionment long enough, Candide accepts his plot and decides to forgive Cunegonde and start over. He settles into a little house outside of Venice where he asks Cunagonda to be his wife once more. The play ends with the two lovers reunited in marriage as they shed the chaos of their former lives and make plans for a fresh start.

This time, with the idea of building a  life deep with roots they plant and grow together. A simpler life, cultivated in the quiet, peaceful countryside where they’ll build their home.  ~ The finale of Candide, Make Our Garden Grow:

Candide:  “You’ve been a fool and so have I, but come and be my wife.  And let us try, before we die, to make some sense of life…We’re neither pure, nor wise, nor good, we’ll do the best we know. We’ll build our house and chop our wood and make our garden grow…”

Cunegonde: “I thought the world was sugar cake for so our master said. But, now I’ll teach my hands to bake our loaf of daily bread. Let dreamers dream what worlds they please, those Eden’s can’t be found. The sweetest flowers, the fairest trees are grown in solid ground.

Both: We’re neither pure, nor wise, nor good, we’ll do the best we know. We’ll build our house and chop our wood and make our garden grow…”

Yes, let’s all plant seeds and help them grow. Seeds that can create the world we know this could be but have just forgotten to tend for far too long…let’s hope it’s not too late to begin again.




I was remembering an old writer’s saying:

“when in doubt, write what you know”

So much of what I’ve been writing has been nothing at all about what I know and while I don’t consider myself a real writer, and I’m mostly fine with not taking myself too seriously, I still don’t like sucking at what I do. If I can do better, I should, even if what I’m writing isn’t particularly meaningful or doesn’t inspire me, it doesn’t mean I can’t still do a better job.

So, today I thought perhaps the place to start would be to write what I know when I’m not writing for someone else…

I went exploring for ideas and found on my way some musical pages I’d stopped and read and listened to, and eventually I remembered…

Some time ago I took myself out of the game… I stopped performing, I stopped practicing, I stopped singing…I even stopped hearing the music embedded in my heart.

I’d sidelined myself, for many well-remembered and important reasons, and for quite a while that was OK. I was happy out of the spotlight, out of the social interactions and engagement, out of the constant necessity for attention.


I needed to be silent for a while. I wanted to be still and separate, out from under the pressure, the constant, incessant, pressure that was mostly self-imposed. I needed to lick my wounds and figure myself out, who I was if not the girl with the beautiful voice. What and who was I beyond that, who… who was I, without her?

I was almost too afraid to ask that last question, so for a long time I sat back and just watched and rarely made an outward comment, and the world just passed me by  while still, I sat in silence, only watching.

Then last spring something started to change, a slight shift, somewhere, and sudden, and there I was engaging again, ever so slightly.

I started these fledgling attempts at writing, probably mostly out of  necessity, or a want to be heard by someone, somewhere again, even if only from the safety of my little laptop in my tiny room.

Even if I may not have anything important or  interesting to say. But, I started again. With words this time, which was, for a while I think, just enough.IMG_1311

Then I was searching for something else, something more, something newly missing.While I was searching, I read and listened to the beautiful poems and stories I found, and the music that inspired them.

When two things hit me and cut me to the quick.

Two simultaneous thoughts that buckled me, devastating me to the floor, as unabated, unending streams of tears poured and shook out of me, robbing me of all my energy.

Like a rag-doll splayed out and spent, left abandoned on the stair, half stuck from landing where she’d been carelessly tossed away.

These two thoughts hit me, all at once:

I Am a Witness

I am a silent witness of my own life. I have removed myself from the world, and in so doing, I removed my biggest part of myself…

I Am Not Me Without the Music

The notion I’d carried for so long that I could somehow divorce myself from the music, as though it was this foreign thing, maybe only something borrowed and not a part of who I am, was utter nonsense. There isn’t any separation between artist and art. I am not me without the part of me that is music. My soul sings out from within constantly, whether I like it or not. While quietly, inwardly, I am always moved from the center and the deep.

When I allow myself those exquisite moments of bliss within my musical self  I am home, and simultaneously bereft, and filled with such longing and love and pain-like I’ve abandoned my most precious, my own child, because what I have abandoned is the deepest most complete part of myself.

I can’t separate from what is at my core. That is like cutting myself in half and still walking around pretending that I’m still a whole person and not this missing person. Not even half a person, but a nonperson. I may not want to or sometimes work very hard to convince myself I don’t, but why when I stumble back upon myself do I miss this part of me so much?

I’ve decided I don’t want to be a witness anymore. I don’t want to be this silent nonperson who’s been abandoned by herself. I want to hear my own voice again, to reclaim it and connect, to feel and hear and know again what it feels like to be a part of the world, a part of the music- at least, if not entirely for anyone else, than myself, and maybe not only then. Maybe it’s time to stop being afraid, of what people might think and how it makes me feel, and realize there is something worse. Walking around without myself  is worse. So much worse, and I’m more resilient now than I sometimes like to believe, or remember.

So, I’m letting it all back in. I’m letting in the music, I’m letting my whole self in and will stop trying to redefine “me” as something other than who I am which is Tisha, the musician, the artist, the singer, the mother, the activist, the sometimes writer, the politically obsessed daughter, the sister, the partner, the friend.

No more bearing witness to my own life, no more abandoning, leaving my soul silent, bereft in some exile, self-imposed. So pointless, gut-wrenching-ly alone and oh, just such a lonely, disappointing place, where nothing but the abyss and the cliff which tempts and pulls and coaxes, and convinces me it doesn’t matter because all of it is meaningless and pointless anyway, that awful voice inside that wants to replace my beautiful voice, my musical voice- the one that loves, that’s passionate, and feels, who cares and tries, and fails and gets up and tries again.

The voice that devastates and hurts and lets everyone down then picks them back up with the sheer forcefulness of her will, my will, and the tyrannical insistence of my heart.

A bag of mixed and jumbled flaws, sharp edges, strangely odd disconnects, and a wildness that can scare even me. That is the whole me. the musical me, where everything resonates in a visceral harmony that sings out from the core of my soul.