The Great Wall Mural

Designers are adding zing to clients’ décor with unique wall paintings commissioned from local artists.

A couple of years ago, artist Linda Sarkissian and her team painted a scene from a glamorous black-tie celebration on the wall of a contemporary home in Pasadena’s exclusive Linda Vista neighborhood. Done in tones of gray, black and silver, tuxedoed gentlemen mingle with ladies in elegant gowns as they toast champagne, a permanent party the length of a formal dining room wall.

“You can see part of the mural as you enter the house,” says Sarkissian, an American Society of Interior Designers (ASID) Pasadena board member and founder of Glendale-based LS Decorative Art, which has specialized in murals, decorative fine art and frescos since the mid-1980s. She notes that it’s such a surprising and dramatic image, the common reaction to it is to gasp — in a good way, of course.

Murals that evoke visceral reactions are just one of the reasons homeowners choose to use the walls (or ceilings or floors) of their homes as canvases for creativity. “The beauty of murals and custom finishing is that they showcase the personality and individuality of the homeowner,” Sarkissian adds, noting that her client is a very social guy who enjoys throwing parties. “They’re also conversation pieces.”

Home murals are a centuries-old design element that can cost from $3,000 to $50,000, depending on size, detail and scope of the project. Along with faux finishes and decorative fine art, murals continue to be popular among homeowners and interior designers who want to make a statement or strive for distinction — sometimes in surprising ways.

After art for children’s rooms, landscapes — popular on domestic walls in late-17th-century Europe — are the most requested type of commission, designers say. Such natural scenery is often depicted in an abstract style. “A couple of years ago, I did a project at the Showcase House of Design where the interior designer wanted a contemporary but organic scene on the wall,” Sarkissian recalls. “We painted the walls white and created a pomegranate tree using only tones of brown,” the designer’s palette of choice.

Most commonly found in dining rooms, bathrooms, hallways and master bedrooms, murals can also be uniquely personal. “We recently did a mural for a homeowner who wanted to have a scene of her children at the beach, taking her back to a time when they were small,” says Sierra Madre interior designer Debbie Talianko, who often works with Sarkissian. “It looked like a [vintage] watercolor and made you feel as if you had traveled back in time. It was really dramatic.”

Marlene Oliphant, a Montrose-based interior designer, recalls a scene she commissioned, a large trompe l’oeil of a window overlooking a faraway place, inspired by a client couple’s anniversary trip. “I designed a condo kitchen that had no window over the sink,” she says, “and I had [L.A.] artist Lucy Jensen copy a photo of a Tuscan retreat; she painted it on paper and applied it to the wall like wallpaper and framed it in travertine tile molding.”

When it comes to what can be painted on one’s walls, “you’re only limited by your imagination,” Sarkissian says. In contemporary homes, like the one adorned with a party scene, metallic finishes in silver, pewter and gold are an ongoing trend. “The look you can get with it is quite interesting and one metallic on top of another makes a really interesting wall,” says Pasadena artist Virginia Fair, who, along with her business partner, Jay Richards, has created murals, faux finishes and other decorative embellishments in homes around the world.

Along with murals, interior designers commonly employ decorative fine art, including antique washes, faux stone and other faux finishes to bring distinction to a room, color match other design elements or hide imperfections. “They’re great for camouflaging bad walls and for matching something that’s already there but cannot be replaced,” Oliphant says. “If you have outlet covers running straight across the center of a kitchen backsplash, for example, you can faux finish them to blend into the tile.

“I had a client who had a big mural on two kitchen walls and they were cracked,” she continues. “I asked Jay [Richards] if he could camouflage them and he patched and painted and made everything blend. You’d never know they were there.”

“It’s a really good solution for challenging areas,” adds Talianko. If a client has a wood mantle that they want to look like stone, for example, “there are different plaster finishes that can be applied” to achieve that look.

While Venetian plaster is hardly a new idea, Fair has devised methods of applying it to create unique looks (“It’s like heavy embossing on the walls,” she says). She and Richards recently embellished an entire dining room in this manner, covering its walls in leaves and vines that were individually hand-painted.

Similarly, Sarkissian uses stencils with plaster, “creating very interesting textured designs,” she says. “We make it raised and paint them in silvers, grays, whites and pearlescent colors. It’s an extreme compliment when people go to the wall and touch it just to see if it’s wallpaper or a painting.”

Custom-made wallpaper murals, a traditional and evergreen addition in upscale homes, are another option for homeowners seeking to add zing to a room. Deciding whether to paint a mural or have it created in wallpaper form —  an extremely expensive option that takes months to prepare, Sarkissian says — often comes down to the designer’s preference.

Oliphant, for one, isn’t a fan. “You have a whole other set of problems with wallpaper,” she says. “A lot of walls are just not perfect — they would have to be skim coated to make them flat in order to mount wallpaper. When you do a faux finish, you don’t have to worry about that. You can just create whatever you want. It’s totally customized and you don’t have to worry about matching everything; the faux finisher has his kit and he just creates the matching tone. It’s like waving a magic wand and it’s done.”

Sometimes, muralists are asked, rather than create something new, just to fix a faded or damaged mural already in place. Fair recalls a recent three-week project she and Richards were called in on, restoring an 80-year-old mural painted on the ceiling of a Glendale home, one-third of which had extensive water damage. They had to study the original artist’s hand and technique and make sure they stayed true to that in restoring the image, reminiscent of a scene one might find in an old hunting lodge, complete with pheasants and trees.

“They didn’t have photos of the entire mural, so we took photos of the other undamaged side, worked out the color and design and completely duplicated it,” Fair says. “Our challenge was to make it look like the original — and we did it! The owners were blown away. They couldn’t believe that anybody could actually put it back together like that again.”

Arabia Felix?

Try a taste of beleaguered Yemen’s warm hospitality.

have always believed that food is an important social and political tool. It has the power to bring people together, and it promotes understanding between cultures. You may think you don’t like the South, but you’ll put up with it because of barbecue, country ham, cheesy grits and biscuits. You might think the French are a bunch of snoots, but you cherish every single croissant. So, in this vein, I have decided to highlight the culinary contributions of the (now) six countries targeted in the latest incarnation of a travel ban, blocked by a federal judge in Hawaii and facing a likely appeal. It is my hope that, through an understanding of their culinary traditions, you will be more compassionate toward their peoples. 

I begin with Yemen, a country with so many problems that a ban on travel to the United States seems unlikely to even be on their radar. 

Yemen lies east of North Africa and south of Saudi Arabia, Syria and Iraq. Civilization has thrived in the region since the 8th century B.C., and its location on the western Arabian Peninsula, bordering both the Red Sea and the Gulf of Aden, made it an important crossroads in the lucrative spice, textile and incense trades between India and Europe. Everyone wanted to control Yemen to compete with the East India Trading Company. The Ottoman Turks tried to steal it twice. The British tried once. It was the epitome of a hot property. 

In addition, the early-15th-century Sufi monasteries were cultivating the coffee beans they found in Ethiopia, and by 1500 coffee was leaving the Yemeni port of Mocha to supply the Ottoman Empire. This early success transformed Yemen into one of the most advanced Arabian societies. Everybody loved it! The Romans even dubbed it Arabia Felix, or “Happy Arabia.”

The influence of trade on this culture is reflected deliciously in its cuisine. Though the food is similar to that found across the Arabian Peninsula, it is uniquely influenced by Indonesia, eastern Africa and India. Fenugreek, ginger, cilantro, cumin, turmeric and cardamom are ubiquitous. Hawaij, the traditional spice mixture found in many recipes, contains a very Indian mixture of anise seed, fennel seed, ginger and cardamom. 

Flat breads are not unusual in the region, but the Yemeni menu includes an Indian roti and a spongy pancake similar to Ethiopian injera. They are baked daily in a taboon – a clay oven shaped like a truncated cone, with its opening on the bottom or at the top like a tandoor. Similar to the Indian and Asian tables, many dishes are enlivened with highly spiced condiments, including the frothy hulba, made from whipped fenugreek, herbs and hot chiles.

But more than their multicultural pantry, it is the Yemenis’ hospitality that makes them unique. Guests are treated like royalty, and a refusal of food is considered an insult. In remote areas it is said that a Yemeni will shoot over the heads of travelers who do not stop to sample their hospitality. (I have no such tradition. Feel free to keep moving.) Meals are communal, and Yemen has not bothered to incorporate such western frivolity as tables, chairs or utensils. Dishes are scooped up with pieces of bread or simply the right hand (which is ceremonially washed beforehand). 

If you are a guest you will probably be served meat dishes (mutton, chicken, goat or fish along the coast), which are generally reserved for special occasions or an ill family member who needs the extra nourishment. Porridges from local grains (sorghum, millet, corn) or legume flour are popular and highly nutritious. There is also a giant flour dumpling called aseeda, which is garnished with either sweet or savory condiments. Aseeda has a long history as a Bedouin staple and resembles similar African fare. The national dish of Yemen is saltah, a stew made from lamb or lentils, with many regional variations.

There is no alcohol served in the Muslim home, although Yemeni Jews enjoy raisin wine and arak, anise-flavored spirits. Tea is the preferred beverage, after the meal, served highly sweetened with cardamom or mint. Coffee is too expensive for most families, but qishr is a popular drink made from ground coffee husks and ginger. Dessert is rare, but, if you are very lucky, you might be served the brioche-like bint-al-sahn, to be dipped in butter and honey. Yemeni honey is considered a delicacy and a status symbol, but you likely will only find it in the cities, along with more exotic fruits. 

Rather, you would have found it, when there were cities in Yemen.

Struggle for control of this strategic site has seemingly never ended. The current civil war is two years old, but it’s rarely covered in the news, because the situation in Syria is so much bigger.

In 2015 the Houthi, a Shia minority group, took over the capital, Sanaa, and kicked out the U.S.-backed government. Worried that the Houthis were being supported by Shia forces from Iran, a Saudi-led, mostly Sunni, multinational coalition with support from the U.S., U.K. and France began a targeted air campaign. As in Syria, the bombings took out civilian targets, including schools and hospitals. And as in Syria, these actions created the perfect breeding ground for Al-Qaeda and ISIS. Also as in Syria, rebel-held regions have been cut off from international aid. So Yemenis are dying not only from violent military attacks, but from starvation. The UN currently estimates Yemen has nearly 2 million malnourished children. Not a lot of saltah being enjoyed of late.

But unlike Syria, the people are very, very poor. Conflict throughout the modern era has created a failed economic state, so most Yemenis cannot afford to flee. Plus, Yemen is much farther away from Europe. Consequently, there are no boatloads of refugees (another reason Yemen is not making the 6 o’clock news). Nevertheless, 3 million Yemenis are internally displaced.

So — since you aren’t getting much Yemeni news, I’m offering you a chance to get to know Yemeni culture, a spoonful at a time. Make this meal. Invite a friend to your table (or floor). Don’t take “no” for an answer. Learn a little more about this rich history. It’s important to understand and empathize with these places. Because high population growth, drought, female inequality, widespread poverty, escalating food prices and the collapse of the state will make young men in any country pick up arms.     

Any country. 


SALTAH: THE NATIONAL DISH OF YEMEN

Make this great variation on beef stew and, while it’s cooking, make the accompanying flat bread and condiments. Then brew some tea and throw some pillows on the floor. 

Ingredients

¼ cup olive oil

1 pound ground lamb or beef

2 yellow onions, chopped

2 cloves garlic

2 green chiles

2 large tomatoes, chopped

4 large red or white potatoes,
peeled and cubed

5 cups beef broth

2 eggs, beaten

¼ cup fresh cilantro leaves, chopped

Salt and pepper to taste

2 tablepsoons hulbah*

2 tablepsoons zhoug**

Method

1. Heat oil in a heavy-bottomed soup pot over medium heat. Add the meat and onions and cook until onions are translucent. Then add garlic and chiles, cook for another minute, then add tomatoes and potatoes. Cover with broth, bring to a boil, then cover and reduce to a simmer. Cook for 30 minutes, or until potatoes are tender.

2. Use a potato masher to smash all the potatoes, until the stew thickens. Add beaten egg and stir for another minute, until it cooks. Finally, add the hulbah to the center of the pot, and as it heats, spread it across the surface. Remove from heat and serve with extra zhoug, plain yogurt and flatbread.


*Hulbah: a Yemeni condiment

Ingredients 

2 tablespoons ground fenugreek seeds

1 tomato

1 clove garlic

1 green chile

Grated zest and juice of 1 lemon

2 tablespoons zhoug*

Method

1. Place fenugreek seeds in a bowl and cover with cold water. Set it aside to soak for 1 hour.

2. Drain off all but a little water from the seeds, and whisk them with an electric mixer (or by hand) until they thicken to a paste. 

3. Transfer fenugreek paste to a blender or food processor, add remaining ingredients and blend until the mixture is smooth and frothy.


** Zhoug: another Yemeni condiment

Ingredients

4 green chiles

1 bunch fresh parsley, chopped

2 bunches fresh cilantro, chopped

4 cloves garlic, chopped

1 tablespoon lemon juice

1 teaspoon sea salt

1 teaspoon black pepper

1 teaspoon ground cumin seeds

1 teaspoon ground coriander seeds

½ teaspoon ground cardamom

¼ to ½  cup olive oil

Method

Combine all ingredients except oil in a blender or food processor. Process to begin breaking everything down, then slowly add the oil until a paste forms. The consistency is just like Italian pesto.


 Khobz: a Yemeni flat bread

Ingredients

4½ cups all-purpose flour

2 teaspoons sea salt

½ teaspoon baking powder

1½ cups water

2 tablespoons olive oil

Method

1. Combine the dry ingredients in a large bowl, and whisk together. Make a well in the center and add the water. Stir until a dough forms, then transfer to a work surface and knead for 8 to 10 minutes, until soft, smooth and not at all sticky. (Add more flour as needed.) Divide the dough into golf ball–size pieces, roll each into a ball, brush lightly with oil, then cover and set aside to rest for 1 hour.

2. Heat a griddle or cast-iron skillet over high heat. Roll each dough ball out as thinly as you can. Use your hands to stretch and pull it out even more. (Get it as close to see-through as you can.) Place on the hot griddle and fry until golden and puffed, about 30 to 60 seconds a side. Serve immediately, or store airtight to keep fresh.

 


Leslie Bilderback is a certified master baker, chef and cookbook author. She lives in South Pasadena and teaches her techniques online at culinarymasterclass.com.

Showcase House’s Beachy Vibe

This year’s palette of deep blues and earthy neutrals inspires airy spaces that evoke the sun, sand and sea.

This year’s Pasadena Showcase House of Design, also known as the Hinds House, was designed by prominent architects Marston and Van Pelt in 1916, when Pasadena was an untrammeled sylvan paradise. Some of the country’s wealthiest tycoons were just discovering the city’s untamed beauty and opting to build mansions there for their families. New Yorker Samuel Southey Hinds, a Harvard and New York University law school graduate, was one. After graduation, Hinds, born in 1875, moved to Pasadena, and into the 7,479-square-foot Tudor Revival home on two acres, with eight bedrooms and four baths. He practiced law, supported the arts and indulged his hobby of acting in local theater. A founder of the Pasadena Playhouse, he was a successful attorney until the 1929 stock market crash, when he lost all his assets. Undaunted, he gave up law and became a successful actor at age 54. Tall and distinguished-looking, he appeared in more than 200 films, often playing kindly authority figures. (Of note, he played Pa Bailey, Jimmy Stewart’s father, in the Frank Capra 1946 classic It’s a Wonderful Life.)

Although the Pacific didn’t lie just outside the palatial doors of early Pasadenans, it was a palpable presence in those years, reachable by motor car on rutted coastal roads that led south toward San Diego through onion fields and citrus groves, or west to other then-undeveloped sandy shores. It was a glorious adventure to reach the ocean, and many designers who participated in this year’s Showcase House chose to honor the beachy charms and Pacific blues that so enthralled those original Pasadena settlers.

In more recent years, the Hinds home has maintained its Hollywood connection. It has been the setting for many films, including Beaches and La La Land, and TV series such as Columbo and Mad Men. Here are a few highlights from the 2017 Showcase House of Design:

THE LIVING ROOM

There were no family rooms in the early 1900s, even in sumptuous homes such as this one, says Robert Frank, who designed the 416-square-foot living room. “The living room is the main space in this home where the family was meant to gather informally and also where guests were welcomed,” says Frank, owner of Robert Frank Interiors in San Marino. His goal, he says, was to “transform the room into a bright and beautiful space to entertain guests while also being a comfortable, functional and peaceful retreat for the family.” He replaced the dark shutters with pale drapes framing elegant windows that open onto beautiful views of surrounding gardens. Using a neutral palette of flax, creams and white, along with touches of periwinkle and navy, he created two conversation areas with the airy feel of a beach house. On one side of the room, two blue chairs flank a white linen custom sofa; on the other side, a white linen sofa, wing chair and off-white longue. All fabrics are by Robert Allen and Beacon Hill. Walls are covered with a shimmery ivory grasscloth;  Dunne Edwards’  White Picket Fence paint shade brightens the ceiling and moldings. “We’re a coastal city, and this room was inspired by the pale sands and the ocean,” he says.

THE MASTER SUITE

Designer Goli Karimi of Home Front Build, Los Angeles, described her master suite design as “a seaside escape” because “the palette of restful blues and neutrals replicate the experience of the ocean, sky and sand,” she says. Rooms were smaller in 1916, she notes, and this master bedroom measures around 300 square feet. She combined pale sandy tones and shades of white against the softest teal for the bedding, curtains, carpet, even walls. “The base color is off-white,” she says. “We had an artist brush over it with pale shades of teal and beige to create a look that seems as if you’re looking at the sea and sky coming together at the horizon.” The tan, off-white and teal rug is from Norbert Rug Gallery in Pasadena; the Weitzner drapes are made of Donghia cotton viscose and silk. The wing chair and ottoman by Baker are clad in Donghia chenille. The subtly patterned coverlet is by Zoffany.  A television drops down from the ceiling, and very small ceiling speakers are concealed in the four corners of the room.

Karimi’s design for the blue master bath includes a tub by Crosswater with polished stainless-steel exterior that reflects like a mirror and makes the space look larger, she says. The tracery ceiling is done with applied molding by J.C. Weaver. Walker Zanger made the azure dimensional tile on the walls and the azure hexagonal ceramic floor tiles.

POOL LAWN

Here’s an imaginative table for outdoor dining with family and friends. The custom fire-water table is made of more than 1,400 pounds of concrete and has a narrow river meandering gracefully across its top, with river rocks on either side. Succulents peep up through the rocks here and there and, at the flip of a switch, flames rise from beneath the stones. The water cascades down the table’s edge into a little pool and recirculates for a constant, soothing effect. Terry Morrill, owner of Pacific Outdoor Living in Sun Valley, says he and colleague Dominic Boinich designed the table together. “Our firm has always worked with water features and fire elements for outdoor living,” Morrill says. “Here we simply incorporated both features to create a durable, comfortable and attractive table for those with outdoor dining rooms.”

Putting a Fresh Face on the Past

Two Pasadena cultural landmarks have been partly renovated as they head into their second century.

Like many grande dames, two cultural landmarks in Old Pasadena — the Castle Green bridge and the Pasadena Playhouse lobby and stage — have recently undergone a bit of a facelift. You can check out the refreshed theater the next time you see a play; you can see the bridge for yourself during Castle Green’s Mother’s Day open house and tour — if you’re not fortunate enough to know a resident there.

CASTLE GREEN BRIDGE

Around the turn of the 20th century, Pasadena was a popular destination for affluent visitors wanting to escape winters in the East and Midwest, and in 1893 developer George Gill Green built the luxurious Hotel Green on the east side of Raymond Avenue. The destination was so popular that the hotel soon expanded, and a second complex was built across the street, which became known as Castle Green. Today Castle Green is the only phase of the development that remains intact after Hotel Green was largely dismantled and replaced by Stats Floral, which still houses part of the lobby.

The Castle, an architectural mix of Moorish, Spanish and Victorian elements, was converted into apartments in 1924, says architect and architectural historian Bill Ellinger, who will be a bridge docent during the May tour. “They added kitchens, added bathrooms to serve each apartment,” he says. “They’re so different, from small studios to the tower units,” says Susan Futterman, chair of the Friends of Castle Green, which is hosting the Mother’s Day event; visitors will be able to see the grand lobby with its Moorish and Turkish sitting rooms, plus about a dozen apartments and the enclosed bridge that used to connect Castle Green to the Hotel Green across Raymond Avenue.

Today the bridge juts out perpendicularly from the building toward Raymond but stops at the sidewalk — the other half having been taken down some time ago — and it has been undergoing much-needed repairs and updating. It is a wide corridor lined with windows and a tower at the end, and has at various times been home to several artists, as well as a private bookstore. In the 1960s the noted African-American artist Charles Wilbert White used it as studio, as did director Tim Burton and Pasadena artist Kenton Nelson, separately, later on.

The tower’s window frames were recently restored by Mary Gandsey, who stripped, repaired and shellacked the wood. The wainscot panels propped on the floor against the wall await remounting — they’re made of slate painted to look like marble, a feature apparent throughout the building, Ellinger says. The old floor covering has been taken up, revealing a set of small-gauge tracks running the length of the bridge. What were they used for? There’s a clue in a charming news blurb from the inaugural issue of Sunset magazine in May 1898, which begins, “The aristocratic residence town of Southern California and rendezvous for the traveling upper ten has enjoyed a remarkably gay season and the hotel accommodations have been sorely taxed.” It then mentions the Hotel Green and its new addition — the bridge. “The Hotel Green has an annex under construction which will be completed about July 1st and one hundred additional rooms will be added to the La Pintoresca during the summer which will relieve the pressure next season.

“The Hotel Green annex will be connected with the main building across the street by a covered archway forming a charming promenade and furnished with a miniature trolley car which will convey guests to and from the office.” That was certainly a much-appreciated amenity after the long trip from back East.

The tour runs from 1 to 5 p.m. Advance tickets cost $30 and are available at brownpapertickets.com/event/2891231; on tour day they’re $35 at the gate.  The tour plus a Mother’s Day tea at noon go for $85 and tickets must be purchased in advance on the website. Proceeds benefit Castle Green preservation.

PASADENA PLAYHOUSE

Meanwhile, a few blocks away on El Molino Avenue, the Pasadena Playhouse has been undergoing its own renovations. That’s thanks to a special allocation from the State of California, part of a measure authored by Assemblymember Chris Holden (D-Pasadena) because of the playhouse’s special status as the State Theater of the California, an official honor bestowed in 1937. The funds have been used for some much-needed repairs and upgrades, such as new lobby lighting and a new stage floor, as well as an overall lobby redesign. 

“As our productions have grown larger and larger, the stage itself needed to be rebuilt to accommodate that,” says Joe Witt, the theater’s general manager. Many layers of the old flooring were torn out, says Brad Enlow, the theater’s technical director, as he pries away a bit of paneling from the side of the stage to show what’s underneath. Workers installed four new layers, starting with one made of marine-grade tongue-and-groove plywood, topped with two layers of marine-grade plywood and finished with Masonite. “That adds a tensile strength that will take the weight that we require,” he says. He mentions the 2016 production of Casa Valentina, which “had a two-story house that rotated 360 degrees up and down the stage. That was 18,000 pounds, and we had to engineer around it.”

The interior designer hired to redo the lobby is Rozalynn Woods, who says, “The building is Spanish Colonial Revival, built in 1925, and we wanted to do things in keeping with that style.”  She quickly saw that the wall-to-wall carpeting had worn down, and the mustardy color of the paint seemed too dark. So she ordered wide-planked oak for the flooring, typical of the 1920s, and had the walls repainted a creamy white. “Just by doing those two things we were able to create a fresh, bright and welcoming space,” she says in a telephone interview. To make the area even more welcoming, a sitting area was added where the reception counter used to be. Two loveseats face each other across a low table, and behind the table is a console — a 19th-century Spanish antique.

Various elements in the lobby remind visitors of the theater’s long and celebrated history. On the landing of the two staircases leading up to the balcony are oil portraits of Pasadena Playhouse founder Gilmore Brown. The wall facing visitors as they enter boasts six vertical banners, adorned with a selection of past hit plays and historical photographs, including one of Laurence Fishburne and Angela Bassett in the 2006 production of August Wilson’s Fences and another of Mary Bridget Davies in A Night with Janis Joplin from 2015.

A particularly significant oil painting hangs nearby, over the Spanish console. It shows the jubilant crowd in front of the Pasadena Playhouse on opening day, and it was painted by the architect Elmer Grey himself. After years hanging in the playhouse’s library, where it was seldom seen by the general public, Grey’s work now has its proper pride of place.

The Fundamentals of Self-Care

Stressed out by the election? Consider Tracey Cleantis’ tips for nurturing yourself.

Self-care is, to a large extent, a framework for seeking happiness.

— Tracey Cleantis, An Invitation to Self-Care

Walking into Tracey Cleantis’ home office in Pasadena’s San Rafael district, one encounters all the elements of a relaxing spa — soft lighting; the aroma of a scented candle in the air; plush, inviting couches and chairs. It’s an appropriately welcoming, stress-free place. As a licensed marriage and family therapist, Cleantis, a gracious and elegant woman who greets a visitor with a big smile and an easy laugh, makes her living helping folks dealing with a variety of difficult issues. In her new book, An Invitation to Self-Care: Why Learning to Nurture Yourself Is the Key to the Life You’ve Always Wanted, 7 Principles for Abundant Living (Hazelden Publishing), she aims to enlighten readers about the importance of “treating yourself like the person you respect and care about the most.”

The concept of self-care has been having its moment in the spotlight lately, with numerous books and articles written on the subject. “As a Google search term,” Cleantis says, “‘self-care’ hit its pinnacle the weekend after the presidential election.” Indeed, anxiety since last Nov. 8 is so common, mental health professionals have given it an unofficial diagnosis: post-election stress disorder. (On that subject, she offers coping advice: “Set limits for yourself, when and how much you’re allowing yourself exposure to Twitter feeds and news media. It’s still going to be there at the end of the day.”)

Why another book on self-care? Cleantis argues that most self-care advice is superficial. Most people assume it is “what you do when you’re burned out, when you have nothing left,” she says. “It’s what you do on Saturday and Sunday after you’ve ignored yourself all week — going to the spa or getting your nails done or treating yourself in some way.” Cleantis adds that true self-care is something that should be done every day, in every aspect of one’s life: psychologically, emotionally, physically, spiritually — in relationships both personal and professional, at work and play; in dealing with one’s finances; even in relation to physical belongings. “It’s essentially about being in a relationship with you, listening to yourself, being an adult,” she says.

In An Invitation to Self-Care, Cleantis points to psychologist Abraham Maslow’s hierarchy of needs, represented as a pyramid with basic human necessities at the bottom and self-actualization at the top, and how certain needs have to be fulfilled along the way before you can reach the peak. She says Maslow was a self-care expert before the term was coined. Inspired by his writings, Cleantis developed her own ideas, focusing on seven principles she reinforces throughout the book: Self-care is a daily, lifelong practice; it is self-love; it requires taking personal responsibility; it means noticing what matters to us; it requires attention and responsiveness; it must be realistic to be effective; and it precedes self-fulfillment.

To help understand these concepts, Cleantis categorizes self-care in different hues of “magic” — white, gray and black — which, she is quick to point out, has nothing to do with the occult, but rather is used as shorthand. “A wonderful, surprising and almost miraculous method of change,” she says. “White magic” encompasses the ideals of self-care that we all pursue (or should pursue) as a matter of course — things like going to the dentist twice a year, getting an annual mammogram, participating in regular exercise, sleeping eight hours a night. “Black magic” is the opposite: drinking too much, sex addiction, compulsive shopping or overeating — in other words, activities that can bring harm, bodily or otherwise.

“All of those things, in some ways, are an attempt at self-care,” Cleantis says of black magic, “to change how you feel and to take some difficult stressor and make it tolerable, but that’s never okay. What I’m particularly interested in is shining a light on the ‘gray magic’ self-care — things like watching too much television or eating ice cream for dinner or going to Sephora to buy another lipstick. Sometimes you need that and it’s okay to give space for things like that; there’s value in it.” It’s when eating ice cream for dinner happens regularly that it might suggest there’s a need for something more, something deeper, in one’s life.

Filled with personal anecdotes, real-life stories, quizzes and self-assessments to help readers along the way, An Invitation to Self-Care is aimed at both women and men, dispelling the myth that self-care is just for mothers, health-care professionals and other caregivers, Cleantis says. In reality, “all of us are in the self-care business, even if we aren’t doing a very good job at it.” She says, in fact, that men tend to be better at self-care than women. In interviewing men for the book, she found that they tended to have “an absolute commitment to certain aspects of their self-care [anything from a standing date with a golf club to ritually going to Starbucks]. I didn’t hear that as loudly from women. Things were a little more negotiable for them,” she says. “I found myself admiring the male attitude of ‘This thing is for me and I’ve got to do it.’”

In fact, there was a time when Cleantis wasn’t very good at her own self-care. “I hate to admit it, but I’ve been lousy at it at times, coming as I do from a family that neither modeled self-care nor taught me its value,” she writes. “I’ve always tended to neglect my needs, even well into adulthood. Once, during a period of exceptionally bad self-care, a friend suggested that if I were treating a child the way I was treating myself, I would lose custody.”

She changed her approach after going through a particularly difficult period in her 30s. At the time, Cleantis desperately wanted to have a baby and spent more than $100,000 in her attempt to have a biological child, undergoing four rounds of in vitro fertilization and 21 of artificial insemination. Even a later attempt at adoption didn’t work out. “I became addicted to the dream,” she recalls. “I believed that the only way I could be happy was to have a child of my own. There were tons of books telling me I could do it, in all sorts of genres: if you believe it, you can see it; if you make a vision board for it; if you see this right doctor or if you do this right thing — but there was nothing saying how to deal with the death of a dream.”

From this pain emerged Cleantis’ first book, The Next Happy: Let Go of the Life You Planned and Find a New Way Forward (Hazeldon Publishing; 2015). “I wanted to normalize for people that sometimes no matter what you do and how hard you work, dreams don’t work out. So it became a guidebook to surrender. I found out that a lot of therapists were giving The Next Happy to their patients who weren’t dealing with infertility but who needed to learn to do self-care.”

That knowledge was the inspiration for An Invitation to Self-Care. “In a way, by writing this book, I’m getting to do what I wanted to do with having a child — I’m helping people come to take better care of themselves. It has certainly helped me. I am kinder to myself and have a more responsive, tending internal voice just by being with those seven principles.”

Before she became a licensed marriage and family therapist in 2008, Cleantis worked as a newspaper journalist and later wrote the “Freudian Sip” blog for Psychology Today. She says she has always been fascinated by people’s motivations and the why of things. She doesn’t see much difference between her two professions. “In some ways, they’re not so different. It’s all about, ‘Tell me your story. What made you do this? Why are you doing it? Where does this stem from?’

“In my work as a therapist, I always feel like I’m just a couple of feet ahead, shining a light on the process and helping people come to their own answers,” she continues. “I don’t want to tell you how to do self-care and I don’t believe there’s just one answer. What I hope people walk away with is the ability to ask themselves better questions so that they can continue to check in [with themselves] every day.”

Boomeritis

Many baby boomers, among the first generation to be bitten by the exercise bug, are now paying the piper in pain.

Susan J. Long lives life in forward motion.

The Pasadena resident played competitive tennis in high school and college, and early in her marriage to Tom Long, both ran. When tennis beat up their joints too much, the couple started cycling in 2006, eventually riding up to 60 miles a day, and touring the U.S. and Europe. But by then, Long’s athleticism had taken its toll.

Enter pain. Long, now 68, first noticed it in her left knee in 2011.  Arthritis. She tried injections, topical ointments, physical therapy and over-the-counter NSAIDs (nonsteroidal anti-inflammatory drugs) for two years. Eventually, the pain exceeded her tolerance threshold. It would take a full two minutes for the wincing and hurt to subside when she stood up from sitting. Unable to cycle, Susan handed her bike to Tom, exasperated. “I am done,” she said.

In October 2013, she had complete knee replacement surgery. That was on top of another procedure she’d had 10 months earlier — a complete reverse reconstruction of her shoulder, replacing both the ball and socket with metal parts. The cause was a fall she’d sustained when she reacted too slowly to cyclists stopping suddenly in front of her. Her surgeon said existing osteoporosis had caused her shoulder to shatter so severely.

“So here I am, years later, cycling,” said Long, speaking by phone from New Zealand, where her cycling group was touring the island, pedaling up 2,000-foot-high hills and up to 50 miles a day. “Today we went deep into a cave where the glowworms are and then rafted down the river. I was thinking all along that I would never have been able to do any part of that tour if I hadn’t gotten a new knee.”

Aging baby boomers — the 76.4 million Americans born from 1946 to 1964 — are finding that habitually active lives have a flipside: painful arthritis and worn-out, achy joints. With many boomers ignoring their age as they engage in physical activities, some are outliving their joints.  Dr. Nicholas DiNubile, an orthopedic surgeon at the Hospital of the University of Pennsylvania, coined the term “boomeritis” to describe arthritis, tendonitis and bursitis afflicting aggressively physical boomers.

Indeed, arthritis is the leading cause of pain and disability globally, according to the Mayo Clinic. Recent studies suggest that by 2030, when the last of the baby boomers turns 65, the number of people 65 and older with arthritis and chronic joint symptoms will double. From 2010 to 2012, an estimated 52.5 million U.S. adults (22.7 percent) were diagnosed with arthritis (joint inflammation) and osteoarthritis (degenerative cartilage disease of the joints), according to the Centers for Disease Control and Prevention.

Boomers are faring worse than their parents for a couple of reasons: One, they are in the first generation to make vigorous exercise an important part of their lives, and any high-impact movements make their joints especially susceptible to arthritis. And previous injuries, such as torn ligaments, fractures or sprains, in their younger years can also lead to arthritis.

But fitness obsession isn’t the only cause of boomers’ joint ailments. Paradoxically, another problem is their weight: boomers have higher rates of obesity and arthritis than their parents, “the silent generation” (born 1925–42), and they were heavier at a younger age than their predecessors, a 2005 American Journal of Public Health study found. The study suggests that obesity contributes to more cases of arthritis in boomers, and the overweight 65-and-older set are at greater risk for arthritis. Some 23 percent of overweight older adults and 31 percent of the obese ones were diagnosed with arthritis, according to the study.

“Baby boomers are one of the biggest generations in total numbers, and they are staying physically active while they age, and they expect to stay active while they age,” said Dr. Thomas Muzzonigro, a Pennsylvania orthopedic surgeon who chairs the American Academy of Orthopedic Surgeons’ communications committee. “Older generations gave up physical activity as they aged. I never saw my grandparents do any active sports. They were old at 50.”

At 50, Dr. Muzzonigro is nothing of the sort, but the former rugby player is also an example of the boomeritis epidemic. He still works out and plays football and basketball, but his arthritic back prompted him to add yoga with his daughter. Though many boomers are still active and fit, he says that he has conversations with people all day “where I say, ‘You know you have two bad knees, but I cannot do surgery safely unless you lose weight.’ Then they say, ‘How can I lose weight when I have two bad knees?’”

For Brandon Flowers, 53, fitness is not just a lifestyle but also a calling. As owner of Dynamix Strength Advantage in Eagle Rock for the past 24 years, he lives what he preaches. Flowers uses weights, rubber-tubing resistance training, balance boards, stability balls and discs in his training sessions. He offers them twice weekly for employees at Pasadena’s Jet Propulsion Lab, and for cancer survivors at The Wellness Community in Pasadena. But after a life of playing football, running and working out, Flowers’ knee was shot despite employing all his own strengthening tactics. “I had severe tri-compartmental degenerative arthritis,” he said, adding that he was three weeks post-surgery and rehabbing with ice and elevation. “The technical term for what the MRI showed was the tibia and thigh bone were kissing each other.”

A self-described “big guy,” Flowers had knee surgery in high school to repair torn ligaments. His knee became arthritic and by the time he was 50, an orthopedic doctor said he would need a new joint. Three weeks into recovery, he is stir crazy but energized by the prospect of returning to an active life, pain-free. “The knee got to a point where I just could not keep going,” he said. “I was living with ice packs and anti-inflammatory [drugs] and physical therapy.”

Around 7 million Americans are living with a hip or knee replacement and, in most cases, are mobile, according to the Journal of Bone and Joint Surgery 2015 study. About 1 million replacement surgeries are done annually. By 2030, when the youngest boomers turn 65 and the oldest boomers are 84, annual demand for total hip replacement is estimated to almost triple, from 209,000 to 572,000. Total knee replacement is estimated to increase more than seven times over the same period, from 450,000 to 3.48 million a year.

Recovery from knee or hip replacement surgery is arduous, but Flowers is sure he will get back to his “normal” active self. The doctor said he could expect to be 80 percent back to normal in 10 to 12 weeks. As for Long, she said that with each surgery (she also broke her neck in a car accident), she feared she would never reclaim her former life as an active and vibrant woman. “Much to my surprise, in each case, I did recover,” she said. “With my broken shoulder I thought I would never be able to lift even a coffee cup and with my knee, I thought I would never be able to push one pedal stroke on a bike. The body is an amazing thing. It does heal, along with the heart and soul.”

Julena Lind, 69, a retired university administrator, is six months into her recovery from a hip replacement surgery. A life of running, jumping, skiing, skating, high-impact aerobics and squatting, plus genetics (her mother had arthritis and hip replacements) had resulted in arthritic hip pain which first appeared in occasional twinges at age 60. But the pain did not impinge on her ability to exercise as intensely as she liked for some time. It would be eight years later, when the pain grew so severe that Lind stopped high-impact workouts but continued doing low-impact training sessions.

“There was no way I could run, do jumping jacks or squats anymore,” said Lind, who sat gingerly, nursing a cup of Earl Grey tea, at Starbucks. “My ortho said you need a hip placement, you have no more cartilage. It is bone on bone.” Whippet-thin and a longtime exercise addict, Lind says she decided at that appointment not to have the surgery yet. She wanted to wait until it ‘‘hurt a lot.’’

That didn’t take long. “Ten months later, it hurt a lot,” said the Santa Monica resident, and her doctor again recommended surgery. “I was able to accept it,” she said. “The ortho said you are going to do fine. You are fit.” On the third day post-surgery, Lind walked for 2½ hours along the Venice Boardwalk.  On the fifth day, she returned to the gym doing three to four low-impact aerobic classes a week. But, no more jumping or low squats. Ever.

Some boomers try musculoskeletal strengthening and fitness training rather than surgery. One of them is Patti Sheaff, 61, who has been surfing for 48 years. She started skydiving at 28 and snowboarding in her early 40s, which took her all over the U.S. and Canada. With all that snowboarding, her sacrum (lower spine) took a thorough beating, fracturing several times. After a bad fall in 2010, the Santa Monica adventurer had to hang up her snowboarding boots. A bone density test revealed she had arthritis, scoliosis and osteoarthritis. Yearly bone density tests, she says, show continuing bone loss.

To abate it, Line drinks bone broth and takes supplements with bisphosphonates, calcium and magnesium. For two years, she stopped taking any pain medication and has been doing isometric poses combined with disciplined breathing exercises to strengthen her body’s musculoskeletal structure. She has been able to surf, paddleboard and body surf pain-free. “The idea [of isometric exercises] is for the muscular structure to absorb the impact of pounding rather than your skeleton,” she said, adding that she is studying a strengthening method to reduce pain, touted by buff actor Chris Hemsworth, called Foundation Training; it was created by a North Carolina–based chiropractor named Eric Goodman (foundationtraining.com).

Joint replacement surgery is major surgery and the remedy of last resort. Rehabilitation and physical therapy is typically prescribed for three months or more. It can be challenging and painful. But many boomers who opt for surgery to stay active say it is worth it. Today’s state-of-the-art materials and methods are far better than even what was available in 2000, Muzzinigro said. Replacements simply last longer, so that if a person in his/her 50s or 60s undergoes joint replacement today, it will likely last a lifetime.

Even though boomers typically pursue a physically active life, most understand that at some point, they may have to alter their attack-it attitude. As for the Longs, who have found their post-tennis passion in travel cycling with a tight group of friends, they know at some point they may need an assist. “Electric bikes are coming into fashion,” said Susan Long, referring to what is known as “pedal-assist electric bikes.”  “And we often say now that when we get into our 80s, perhaps we’ll want to get that extra boost!

Saving Seniors

The Pasadena Community Foundation’s blueprint for philanthropy by and for the elderly

You might say that Cornelia Eaton is a patron saint of Pasadena’s seniors. When she died in 1995, she left her entire estate — $816,225 — to the Pasadena Community Foundation, dedicating it to the city’s elderly, in a gift that keeps on giving in a way she couldn’t have imagined.

Eaton requested that the PCF use her bequest for only one purpose: to help local senior citizens who are financially, physically and/or mentally frail. Her gift is making a big impact in Pasadena, yet little is publicly known about her beyond her philanthropy and her modest home, which was razed to make way for the 210 Freeway. Jennifer DeVoll, executive director of PCF for the past 14 years, says neither she nor the foundation has information about Eaton’s life, but she knows almost everything about Eaton’s donation: Since the mystery woman’s death, the foundation has distributed more than the original $816,000 to charitable groups in the Pasadena area, DeVoll says. As of this year, the Cornelia L. Eaton Endowment for Assistance to the Elderly fund has amassed an additional $1.6 million yet to be distributed — and it’s still growing. Ms. Eaton’s name and fund will live in perpetuity, DeVoll says, and that’s just one of the beauties of giving to a community foundation.

The idea of giving locally can be particularly intriguing in an engaged community  like Arroyoland, where so many families live in bucolic splendor and have such passion for preserving their neighborhoods and cultural institutions while helping those less fortunate who may live nearby. Arroyo Monthly interviewed Jennifer DeVoll to find out more about Pasadena Community Foundation and the benefits of local philanthropy. The bottom line, it seems from listening to DeVoll, is that if you love where you live and want to preserve and maintain your neighborhoods and the people who live in and near them, then you might want to give to a foundation that works to uplift and sustain the local way of life. Of course, there are a million worthy causes, but one that stands out is helping those close to home — your neighbors in need.

ARROYO MONTHLY: What is the Pasadena Community Foundation?

JENNIFER DEVOLL: Community foundations, in general, are a unique type of charitable organization. They’re tax-exempt public charities, typically organized with an interest in a particular geography. They do fund-raising and grant-making primarily for local nonprofit organizations, so they work with local donors to establish and amass general funds and then make grants from those funds with an emphasis on giving locally. So far, PCF has distributed over $40 million through donor-advised funds. We work with individuals and their advisors to establish charitable funds for groups they care about today, and also to create a permanent legacy for the future.

What geographical area does PCF cover? Is it only Pasadena?

No, it’s the greater Pasadena area, including all the communities that border Pasadena.

Can you give some examples of organizations to whom you make grants?

In general, we cover six areas of interest locally: arts and culture, education, environment, health, youth and human services, with a special emphasis on the elderly. Individuals leave bequests for seniors to our organization, we invest the money and create a perpetual fund. The Eaton Endowment, for example,  is part of PCF’s senior grants program to aid seniors in need through such organizations as the Senior Care Network at Huntington Hospital, Meals on Wheels, the Pasadena Senior Center and Pasadena Villa, to name a few. But this is just one example. Others leave bequests for a variety of different uses, which we invest to create perpetual sources of support for whatever group or institution they’re particularly passionate about and wish to support.

Do you do any work with those who might want to volunteer their time to help these charitable groups?

No. We’re really a grant-maker and funder. We read applications, we do site visits, we meet the executive directors of local nonprofits. We concentrate on having very strong relationships with local nonprofits and our community in general, so we know who is really doing a good job, and what kind of impact they’re making on the local community. We focus on those who are making a difference right now in any area of interest.

How did you manage to distribute nearly all of Ms. Eaton’s original bequest and still have $1.5 million left, and growing, in her endowment?

We have $64.5 million in 300 different charitable funds that we manage through a Vanguard stock and bond portfolio. We have an extremely sophisticated finance investment committee on our board that oversees the Vanguard [investments]. They are all volunteers. For example, one of our investment committee volunteers is Sandra Ell, who was the chief investment officer for Caltech for many years. Now she volunteers helping with our investments. We make distributions every year from the earnings of our funds.

Who typically donates to PCF?

Last year we received $17 million in donations, mostly from Pasadena and surrounding-area residents,  along with bequests from people that have lived here. We also receive donations from organizations that partner with us. They give us their endowment to manage because we have a good, large diversified portfolio that has done well. We have a few instances where nonprofits have gone out of business and have a little money left, and they give an endowment to us to sort of carry on their mission.

Has there been any recent shift in services to the senior population?

Yes. A few years ago we suspended our program while we did research to find the biggest impact we could have on our senior population, and looked at the many providers of service to seniors in the community. We found an emerging food insecurity. Seniors were going hungry. The rising costs of health care and medications were causing them to sacrifice buying food so they could try to pay for medicine and care. So we changed our focus on senior grant-making, so that a larger part of it goes to food programs like those at the senior center, Meals on Wheels and the food pantry.

Do you have any specific programs for seniors who want to donate?

Yes, we have a new one called a Charitable Gift Annuity that’s for people 65 or older, with a minimum donation of $10,000. Based on your age and the size of your donation, you’ll receive an income stream for life. An 85-year-old person, for example, will receive 7.8 percent interest on whatever amount they donate. So if you give $100,000 you get a guaranteed annual income of $7,800 for life. It’s hard to explain, but it’s a way to give money for a local cause you believe in, and yet get something back each year to assist with your own living expenses.

Taking the Medical Mountain to Mohammed

Glendale tested a pilot program bringing paramedics’ emergency care into people’s homes.

For seven years, paramedic Gil Mejia was accustomed to the fast-paced action of emergency care: the quick response, the swift assessment of a patient in need, the near-immediate transport to a hospital or care center. When offered a chance to spend more one-on-one quality time with patients — especially seniors — Mejia raised his hand in a flash.

“When you are responding to 911 calls, there is no time to be personable. We are trained to follow certain steps in certain situations,” says Mejia. The Glendale paramedic participated in a statewide pilot program last year that could change the landscape for emergency care by expanding from ambulances and hospitals into patients’ homes. “So many of the people I met over the year made me feel like part of their family, offering me coffee and lunch,” says Mejia. “They would tell me, ‘No one has ever spent this much time with me.’ They were very grateful for the program. It was a very humbling experience for me.”

Called “community paramedicine,” the program expands the role of Emergency Medical Service (EMS) providers to use their life-saving skills in deeper and more extensive interactions with the public. That could be especially helpful for seniors, invested in their own or a loved one’s medical care, who may have great difficulty getting to a hospital. Across the country, community paramedicine has been embraced by many states as a way to provide better care while avoiding boosting the already sky-high costs of insurance and hospitalizations. In 2014, the National Association of Emergency Medical Technicians identified more than 100 community paramedicine services in the country. That number has grown to more than 260 today.

Working with other social-welfare providers, community paramedics can target a variety of health issues; they can help “repeat callers” with chronic conditions that prompt them to dial 911 time and time again, avoiding visits to the already crowded (and pricey) emergency room. Projects elsewhere in California focus on alternative destinations, with paramedics transporting patients to locations other than hospital ERs, such as urgent care clinics, behavioral health facilities or sobering centers.

These new projects allow California to dip its collective toes in the water, testing how a new approach by paramedics would work in the state’s diverse communities, from densely urban to vastly rural. “There is a national movement to transition to expand the role of EMS providers,” says Harold Backer, director of the state Emergency Medical Services Authority. “California is not in the forefront, since we have more restrictive status for paramedics that limit the scope of their work to the scene of the emergency, in transit and at the hospital. But we have outlets to test new roles, and that’s what these pilot projects are all about.”

California’s pilot programs (funded with individual cities’ budgets) have varied in focus, but the goal has been the same: Dispatch paramedics – those friendly, welcoming faces – to prevent a medical crisis rather than respond to one. “Think about it,” says Backer. “Paramedics are perfectly suited to bridge the gap. They go everywhere, are on 24/7 and are trained to deal with anyone – homeless people, substance abusers, etc. It makes sense to use them and their expertise and have them collaborating with existing services.”

California pilot programs ran the gamut from targeting frequent 911 callers and offering alternative destinations to collaborating with hospice nurses for home care and working with public health officials to help monitor tuberculous patients. “Community paramedicine may be a more effective use of our time and resources,” says Glendale Fire Chief Greg Fish. In 2016, his department received 19,446 calls, of which about 86 percent were medical in nature, Fish says, adding, “This idea also lets the patients hold their own health in their hands – and we are there to coach them along.”

The City of Glendale sponsored two pilot projects that ran from September 2015 to September 2016. The one involving alternative destinations enrolled only 12 patients; officials suspect the paperwork load turned off more potential participants. The other project, however, was more successful, enrolling 154 patients with congestive heart failure for home follow-up care after their discharge from Glendale Adventist Hospital. Since these patients typically have high readmission rates, paramedics like Mejia made home visits within three days of the patient’s discharge to make sure they were following doctors’ recommendations and that their lifestyle and home environment were fostering recovery. Follow-up care after congestive heart failure is critical, says Mejia, adding that after a hospital stay, people are often confused and/or weak and “don’t  take their medications properly, don’t make follow-up appointments or revert back to unhealthy eating habits. Some don’t have the support system they need at home to help them make the changes they need to make.”

Mejia first met the patients – most between 70 and 78 years old – in the hospital, told them about the program and got their consent to participate. He spent time visiting them in the hospital, so when they met later in patients’ homes, he would be a familiar face. Bilingual in Spanish and English, Mejia also had an Armenian translator with him when necessary.

His home visits were a stark contrast to his typical emergency response workload. Instead of rushing against the clock, Mejia would spend on average two hours at patients’ homes. “Each patient had a different set of needs and you had to tailor your visits to their needs and their mental stability,” he says.

Mejia monitored vital signs and checked for any possible complications that might require a return trip to either doctor or hospital. He examined the discharge papers, making sure the patient had the correct prescriptions and doses; if not, he made arrangements with the local pharmacy, doctor and insurance company. And he organized the medications (“That was always a huge endeavor”), and confirmed that patients had not only scheduled their follow-up doctor visit but, if necessary, arranged transportation. Mejia also assessed patients’ physical environments: Could they easily get around? Do they have a family to support them? Do they live alone? Is there a neighbor who helps out? Regular home health-care visit? What’s in their kitchen? Are they eating the right kinds of food?

“I would show them how to read a label, especially pointing out sodium levels,” says Mejia. “A lot of them were surprised to realize what they were eating had a lot of sodium in it. As with their medication, once you explained what each one did physically for them, you could see the light bulb go off when they made a connection. Doctors often don’t have time to get down to the details with patients.”

This kind of personalized attention to detail is what will make paramedicine even more effective, says Sandra Shewry of the California Health Care Foundation, which funded the final evaluations of California’s pilot projects. “I think this is the next wave of the future,” she says. “The secret sauce here is using trusted health professionals, especially when seniors want to stay longer in their own homes these days.”

UC San Francisco researchers’ evaluations of last year’s projects show promising successes; the data is expected to be used to develop two state bills, currently in their early stages, that would expand the kinds of services paramedics may provide. Both AB 820, introduced by Assemblyman Mike Gipson (D-Carson), and AB 1650, proposed by Assemblyman Brian Maienschein (R-San Diego), are what are known as “spot bills” – they indicate the author’s interest and intent to make a proposal on a topic but do not contain all the details.

Maienschein explains why community paramedicine could be an important advance, especially when it comes to seniors’ health. “AB 1650 will help increase access to care, while also reducing the overall cost of healthcare — two issues that especially affect the senior population,” he says. “By preventing excess trips to the emergency room and pairing patients with a health care advocate, community paramedicine will protect and promote the well-being of seniors throughout the community.”

But not everyone agrees: Legislators may face pushback from medical organizations that have historically objected to community paramedicine expansion, arguing it may be detrimental to patient care. “We oppose expanding the role of paramedics beyond their current scope of practice because it potentially endangers public health,” says Don Nielsen, Government Relations Director of the California Nurses Association. “The pilot projects for community paramedicine were unnecessary public health experiments that allowed paramedics to undertake care currently performed by physicians, RNs and social workers, without the additional training to acquire the level of expertise and skill needed.”

Elena Lopez-Gusman, executive director of the California Chapter of the American College of Emergency Physicians (CALACEP), says she doesn’t object to paramedics offering services to patients in their homes soon after they’re released from the hospital. “That’s additional care and we aren’t opposed to that,” she says. “But we look at risk assessment and the concept of taking those with mental illness or who are chronically inebriated to facilities other than an ER. They deserve the same care as other patients and shouldn’t be singled out.”

Most medical groups will not take a definitive position – pro or con – until the bills’ details are in print, probably this summer.

Paramedicine for civilians is actually a relatively new idea. Emergency medical services originated in war; in ancient Rome, aging centurions were tasked with removing the wounded from the battlefield and tending to them. Fast forward to the makeshift field hospitals of the Civil War, where triage was introduced; likewise, helicopters (medivacs) were used in World War II and the Korean War to evacuate injured soldiers.

It wasn’t until the 1960s that mobile medical care was provided to the general public; initially, nurses accompanied other medical professionals in the field. Following the passage of the Wedsworth-Townsend Act in 1970, Los Angeles County and City established the country’s first paramedic programs, followed by cities, states and countries around the world.

The concept got a big boost from the fictional 1970s television series Emergency! which followed paramedics on the job in L.A. County. When the show first aired in 1972 there were only six paramedic units operating in three pilot programs; by the time the show ended in 1979, paramedical teams operated in all 50 states.

These days, paramedicine may be poised for a new paradigm shift – and paramedics like Mejia are eagerly awaiting their prospective new duties. “I see the need and how we can make a difference for our patients, many who are senior citizens,” he says. Mejia shares the story of one home visit with a patient who needed to vent considerable frustration for about 20 minutes before getting down to business. “He knew I wasn’t there for that, but he looked me in the eye afterward and said, ‘Thank you for listening. You took the time to hear me and I appreciate it.’ That to me says it all.”

The Russian Kitchen: A Primer

It’s never too early to brush up on your Russian cooking skills.

As we collectively shudder at the political events of the past weeks and pray it is not the beginning of Lenin’s “capitalism in decay,” it occurs to me that I am utterly unprepared for life under a Russian flag. It will be hard to be a Russian chef if I know nothing about Russian cuisine. I learned how to make coulibiac and charlotte russe in culinary school.  But these are dishes of the pre-Soviet aristocracy (and created by French chefs). I know Russians like vodka, borscht and caviar, but that’s going to get old fast. Therefore, I decided that it behooves us all to get better acquainted with the Russian kitchen.     

Traditional Russian food is wildly diverse (it was a huge country, even before Soviet era).

It incorporates many cuisines from Europe, the Middle East and Asia. The typical meal consisted of several courses, starting with a soup — hot or cold, made from a base of kvass (a fermented bread beverage), broth, milk or puréed vegetables or grains. Kasha (porridge), made from a variety of grains, was a staple, as were a number of dumpling-like foods, including pot-sticker-like pelmeni; and the ubiquitous pirozhki, stuffed with meats, boiled eggs, potato, mushrooms or cabbage. Meat and offal were prepared in a hundred ways — boiled in broth, roasted and baked, skewered and spitfired, pickled and cured. Blini were topped with fruits, smetana (sour cream) or caviar. 

Food was good until the revolution, when the kitchen itself became politicized. The intention was to make all people equal. This required, among other things, relieving women from kitchen work, and encouraging them to develop other interests. (It’s the thought that counts, right?) But more to the point, the bourgeois idea of private property included private, personal kitchens. This led to houses being built without them, forcing people to eat in state-operated stolovaya (canteens). Food shortages and famine soon limited the mass-produced canteen fare. Stations served reliably similar dishes day in and out: a mayonnaise-based salad of meats or vegetables, a soup, a solid (which meant meat of some kind — chicken cutlets, fish, beef fried to oblivion, stringy mutton, liver in gravy), a garnish (usually a grain), a drink and a dessert. Limited ingredients and limited cooking methods emphasize the idea that food, and the pleasure it derives, was itself anachronistic and bourgeois.   

Under Stalin, food, like everything else, became industrialized. Food was fuel, after all, and the canteens became healthy-worker factories controlled by the Central Commission of Restaurants and Cafés. This commission designed every menu, every day, incorporating the latest nutritional science. Eventually the spread expanded, as the commission realized that more flavors and options lead to a healthier appetite. Foods from the expansive Soviet regions were incorporated, and boiled chuck and cabbage gave way to kebabs.

In addition to kitchenless homes, there were communal apartments. In structures that had once housed one aristocratic family, there were now 10 families sharing one kitchen. In these apartments there may well have been a spy who would rat out you and your radical opinions, so the kitchen was not a place to hang. Families would cook their cabbage soup and porridge, then carry it down the hall to eat in their room. 

By the 1950s even communal housing couldn’t alleviate the severe overcrowding, and during the Khrushchev Thaw, construction of Khrushchyovka began. These five-story cement apartment buildings were made quick and on the cheap. But at least the units were meant for one family each, and they had kitchens. It was here, around these kitchen tables, that Russian culture thrived. Despite the new, more liberal policies, there was still censorship, and there was no way to meet and discuss art or politics in public. But in the kitchen, groups of people could meet, and they did. Here, poetry and literature was self-published — typed in carbon copies on government-issued typewriters and passed from friend to friend. (Dr. Zhivago was written this way.) Here, banned music was recorded using handmade recording lathes to etch grooves onto old X-ray film. (It’s now known as “bone music.”) All of this happened over shared vodka, brown bread and pickled vegetables. Sure, there was probably a KGB agent in the stairwell. But as a chef, I like the thought that, when things spin out of control, there is some comfort to be had by the stove.

Then, in 1959, in a kitchen at the American National Exhibition at Sokolniki Park in Moscow, Vice President Richard Nixon met and tried to make nice with Nikita Khrushchev. At an exhibit of a typical American home that any American could afford (at $14,000), Nixon proudly pointed out the technologically advanced dishwasher. Khrushchev crowed that the Soviets would catch up in a few years and would then quickly surpass the United States. When Nixon lost the election in 1960, Khrushchev proudly took responsibility. (Everything old is new again.)

So, I’m thinking that now is a good time to get your kitchen ducks in a row.  Be sure you’re stocked up on vodka, brown bread and pickles, and cultivate a group of friends you can trust. But do it on the down-low.

Soviet Pickled Mushrooms

Pickled vegetables began out of necessity, but gradually became beloved. Now there is a salty-sour component to most Russian meals. I’m thinking we should all brush up on our food preservations skills now, while we can.

Ingredients

3 pounds button mushrooms, stems removed (save them for mushroom soup!)

1/3 cup vegetable oil

1/3 cup cider vinegar

1/3 cup wine vinegar

1 tablespoon sea salt

4 cloves chopped garlic

1 large yellow onion, sliced

2 bay leaves, crushed

1 bunch of fresh dill, chopped

Method

1. Sterilize a couple of large jars and lids (I do it by running them through a dishwasher). Pack the jars with the mushrooms, then set aside.

2. In a large saucepan combine oil, vinegars, salt, garlic, onion, bay and dill. Bring it to a boil, then pour over mushrooms, filling to a quarter-inch below the top of the jar. Close the lids and refrigerate for 2 to 3 days. Serve chilled with vodka, brown bread and hope.


Leslie Bilderback is a certified master baker, chef and cookbook author. She lives in South Pasadena and teaches her techniques online at culinarymasterclass.com.

Dotson and Tennessee

Dotson Rader’s play about close friend Tennessee Williams has its world premiere at the Pasadena Playhouse, with Al Pacino starring as the brilliant, tormented playwright.

To kick off its new development program, PlayWorks, the Pasadena Playhouse is setting the bar high with its inaugural production of Dotson Rader’s God Looked Away, starring Oscar- and Tony-winner Al Pacino. The acclaimed actor portrays Southern playwright Tennessee Williams in a turbulent period of his life, following years of fame sparked by the critical success of The Glass Menagerie in 1944 and a string of other plays now part of the American theatrical lexicon: A Streetcar Named Desire (1947), Cat on A Hot Tin Roof (1955), Sweet Bird of Youth (1959) and more.

Joining Pacino on the boards is Judith Light (Transparent), a two-time Tony-winner, as Williams’ close friend Estelle, and Miles Gaston Villanueva (Jane the Virgin) as Baby. Directed by Robert Allen Ackerman, the production runs until March 19.

Williams’ work is no stranger to The Pasadena Playhouse, which served as the backdrop for three of his world premieres in the 1940s: You Touched Me in 1943 (co-written with Donald Windham), The Purification (1944) and Stairs to the Roof in 1947. More than 20 years later, writer and novelist Rader befriended Williams and later wrote a memoir about their close friendship: Tennessee, Cry of the Heart (1982). Both were gay men — never romantically linked — from different eras, who bonded at a time when taboos against homosexuality were beginning to be challenged in America.

Rader started writing a play about Williams after the playwright’s death in 1983 but later shelved it. He resurrected the project about a year ago, workshopping the play with Pacino. who, according to Rader, has uncannily captured Williams’ humor, pride and stubbornness as well as his unyielding defense of people living on the fringes of society.

Arroyo Monthly: You’ve written fiction, nonfiction and even a memoir about Tennessee. Why write a play, something you’ve never done?

Dotson Rader: Well, he was a playwright! I started working on this six months after he died because I was afraid of losing him. I’m aware that memory corrodes and memory revises itself and memory becomes unreliable. I wanted to get it all down. I also started to see things being written about him that were just not true and they were sanitizing his life. This happens all the time. They were making him acceptable — and part of his brilliance was his willingness to write about things that were unacceptable, about the outcasts and the broken, the disconsolate, the rejected of life, the wretched — all qualities that, in ways, you could apply to him.

This is the first play in the PlayWorks program. What are you looking forward to?

The live audience is like a second writer on the project. We are trying to get this play where it needs to be. We’ve had table readings, roundtables and workshops, but when you put it in front of a live audience, you see things so differently. You sense when the audience is getting restless or bored. Things you thought would bring a laugh don’t. Things you thought would get a little twitter get a big laugh. You gradually learn what works. Every other kind of writing, you’re dealing with a magazine editor, a movie director or other editors and that is really an audience of one. But not with a live audience…It’s exciting.

How has it been to see your words leap from the page to the mouths of actors?

Tennessee was difficult, we had arguments, but we loved each other. It’s like Lionel Trilling’s line about a marriage, “So often the very thing that makes a marriage unbearable, makes it unbreakable.” We were friends for 14 years, and I can only say this about a handful of people: not once, ever, was I bored. He was very self-dramatic, but he was so alive. And Pacino brings that vividness of Tennessee to life.

We had our first reading with Al about a year ago and I sat there listening to the actors read and I don’t know how the hell he does it, but Al caught the cadence of the way Tennessee talked. I could close my eyes and I could hear Tennessee.

Tell us why you chose this particular point in the playwright’s life.

The play takes place in 1981 and in the present. The play opens like Menagerie with a monologue by Baby, the narrator. All you’ll see on the stage are Baby’s memories of Tennessee, because that is all that exists now, because Tennessee is dead and everyone is gone. It’s over. Finished. These events take place so long ago and Baby is the survivor, like Tom in Menagerie. The play, his memory, is colored by his own feelings, as memory is.

I picked this point in Tennessee’s life because that is when the final bell rang. I don’t want to say too much, but this was a critical point in his life, this one weekend in Chicago, the weekend of his last play. Chicago is where fame found him, it’s where Menagerie opened; he had been a bit of a failed writer until then; his first play, Battle of Angels, flopped terribly. Suddenly Menagerie became this incredible phenomenon. Chicago is where success found him — only now, success is gone. And he’s back in Chicago hoping it will happen again.

A lot of what you’ll hear Tennessee say, he said in real life. Everyone is based on real people and I could tell you who they are, but I’m not going to. (Laughs.) You’ll see!

Why is God looking away?

The play will tell you that.

Like many artists, Williams was keenly creative but he also fought many inner demons, especially later in his life — alcoholism, drug addiction, abusive personal relationships. How do you make these moments a serious examination of life, loss and character on stage, instead of just a presentation of sensational events?

What’s in the play is in the play because it is true. These things are here because there is a theatrical reason for it, because it serves the drama. Look at this way: You’ve been married to someone for a long time and you have two hours to tell people what that person was like — so you edit his life, you pick out what is most representative of what it was like being with this person. While the play covers a weekend, that weekend becomes representational. The audience has to leave understanding why and where he was and why the play ended the way it did. The play is about the stripping away — everyone on the stage is stripping away, pulling off masks. As the play goes on, people reveal themselves as who they actually are. Things that don’t seem at all remarkable or sensationalistic to me, others may find discomforting. But truth is discomforting. I don’t want to be part of the coterie of sycophants and academics who sanitize the lives of public figures. Theater is a safe place where you can hear the truth — even when it is uncomfortable. (Pause) Maybe what you see on stage is the price he had to pay to give us the beauty he created.

What do you want the new generation of theatergoers to understand about Tennessee Williams, the man?

The play begins in the present and we step into the past, on that cusp of history just after the inauguration of Ronald Reagan; 1981 is the end of the ’60s and ’70s. It’s the end of that period of freedom, of social experimentation, of when people didn’t know that drugs were bad, of sex being wide open — that incredible period comparable to France and Weimar Germany in the 1920s. When every question was open, every possibility presented itself, when all restraints were gone.

It was also the period right before the beginning of AIDS and the beginning of terror. We started to realize that something was happening. We were losing friends and it suddenly begins to dawn on us the price we have paid for personal freedom. It’s a period in American social and artistic history that isn’t going to happen again. Not only in terms of Tennessee’s career — it’s about the closing of one chapter and the beginning of another in American history.

I think young people will like the play because it deals with freedom and a world without fear, unlike what they know now.

Is the play hopeful?

The play is true.

What would Williams think about the social media culture of 2017? Would he tweet?

Tennessee used a manual typewriter until he died. He didn’t like electric typewriters. If he were here today, he’d still be on Key West typing on his old Royal manual typewriter.

What do you miss most about Tennessee?

Of all the people I’ve known in my life, he had the most real presence. He was so completely aware of life and where people were around him. And he was sensitive to them. That’s what I miss the most. He had intense sympathy for the losers in life, for the marginalized, for the people who were beaten before they even began.

He had great contempt for the money people. The only problems he ever had with his plays, and what ultimately undid him, was with the money people. “Oh, you can’t write that! The matinee crowd won’t go for that!!!” He knew he needed them, but he often thought, “If you had so much money, can’t you make the world hurt a little less?” He got involved in the anti-war movement and protests with me and he was always baffled by the problems that could be fixed with just a little bit of money.

Tennessee, I don’t mean to speak for him, but you can see it in his plays, saw the immorality of money people who don’t put money into things that matter — like art, writers and the truth — but who spend only on themselves. He quoted Andrew Carnegie, “A man who dies rich, dies disgraced.” Tennessee saw his own talent and many gifts — he was a Christian, you see — from God as challenges to see if we can use them for good. Tennessee used his gifts the best way he knew how, on behalf of the people who had no voice.

God Looked Away runs through March 19 at the Pasadena Playhouse, 39 S. El Molino Ave., Pasadena. The curtain rises at 8 p.m. Wednesdays through Saturdays and at 2 p.m. Saturdays and Sundays. Tuesday performances are scheduled for 8 p.m. Feb. 14 and 28. Ticket prices range from $126 to $206. Call (626) 356-7529 or visit pasadenaplayhouse.org.

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