The Onion and the Orchid

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Originally uploaded by R2DC

Fortunately for me, my mother-in-law collects magazines. If you ever visit her idyllic country home in western Maryland, you will see them artfully arranged in crocks and antique half-barrels. They are quite pretty and colorful as a home accent, especially the covers of the periodical Country Living. They can be easily read, and they span decades. Actually they are quite a resource, as I haven't found many of the articles from these periodicals available using a Google search.

I do not usually read women's magazines. I usually read books, online articles, or the local newspaper. I always try to bring a book with me to the beauty salon, as I find the pile of fashion and home care magazines a bizarre foreign territory. Once I forgot to bring my book to a hair appointment and spent quite a while sifting through a mountain of Vogue and Good Housekeeping in order to find one Architectural Digest at the bottom of the heap.

Although I do not often read these types of magazines, once in my life they were the only periodicals I read. In late March of 2009, I began reading these light and airy magazines as I sat with my mother-in-law at my husband Fred's side during his hospitalization. Most of the magazines belonged to my mother-in-law Joan. She brought piles of them with her to the hospital. As we whiled the hours away waiting for a surgery that never came, we read. We read everything she brought. When we finished those magazines Joan would stretch her legs and go to the cafeteria to get a coffee. Then she would stop by the gift shop and come back with another handful of magazines.

I find I hate most magazines published in March 2009. Be it Family Circle, O, People, or any other title, I have read it cover to cover, and I loath it. Joan and I would sit there waiting--for the doctors, for the tests, for some answers to our questions with nothing to stop our frantic swirling thoughts. As we sat within a maelstrom of worry we read these magazines. Each night I would research kidney cancer online, and each day I would read about the life and times of Sally Field or find out about the best method to clean a shower head.

After weeks of such reading, Fred died in June. I found out I could no longer read a book. I could not fall into the warm embrace that literature had once provided me. My mind was a gnat always flitting away. I would prowl Joan's living room at 2:00 in the morning in the weeks after the funeral. Desperately, I looked for something to read. Under a pile of Country Living from 1993 was an old Family Circle with an article by an author named Ann Hood about onion letters and orchid letters. My mind stilled as I began to read.

Ann Hood wrote about her past experience as an airline attendant. She wrote about a concept called the onion letter and the orchid letter. Apparently, if a customer wrote a letter to the airline extolling her virtues and excellent service that letter would go in her employee file as an "orchid letter". If her service was abysmal, she might get a letter pointing out her many faults and that too would enter her permanent file as an "onion letter". As Ann's life continued and she became an author, she utilized this concept she learned as an airline attendant.

She took the horrible frustration she felt when being met with bad service and channeled that into onion letters. Her goal was not to get cash back or a reward. She was doing this to alert the business of the bad service she had received in a hope of creating a better experience for those who came after her. She was also doing this to regain dignity and respect that was denied her by the uncaring service person or institution. After she wrote the onion letters she also began writing orchid letters to spread the happiness she felt upon being treated well. In her article she encouraged everyone to write onion and orchid letters in order to facilitate better communication in every aspect of our lives.

It was a great article. It struck such a chord with me. Having worked in retail environments for 16 years, I have received quite a few orchid letters and even the occasional onion. I know how much these letters can affect you as a service provider. As I read the article I thought about the onion letter I had sent just a few weeks before.

While Fred was in hospice I wrote a very long letter to the first hospital Fred had been admitted to. This was the hospital that told me I could see his record after I paid 73 cents a page and waited 21 days. I sat next to my sleeping husband as he approached his death and calmly wrote a letter that referenced his medical record and provided dates and names and recounted the many types of harms this institution had inflicted upon Fred. My sweet Fred was laying there dying, and I was writing an onion letter.

Why do this? I wasn't preparing to sue the hospital. My reasons for writing were far closer to the reasons Ms. Hood gave for writing an onion letter. I wanted to inform the management of this facility of the problems we had encountered. I had hoped we could encourage a necessary change within the organization. I hoped to channel the grief and frustration I was feeling into some kind of positive outcome. I also wished to regain our dignity, for in the process of becoming victims we had lost our personhood.

Fred was not the patient in room 6218. He was Fred Holliday II, PhD. I was not "Little Miss A-Type Personality". I was Regina Holliday. We had names; we were people. As I read Fred's record I grew angry that the story of his care never called him by name. He was only the patient, and I was only the wife. When did HIPAA compliance trump personhood? I thought of all the ways they took our names away. They dressed Fred in faded hospital gowns that made him look the same as every other patient they had ever treated. They made our friends and family wear visitors' passes every day. It was a name tag wherein the names of all those who loved Fred became simply a non-descript: "Visitor to RM 6218".

It reminded me of the book A Wrinkle in Time. In that children's tale a cloud of darkness is putting out the stars in the sky. I remember a particularly chilling scene on a planet controlled by darkness. On a street where all the houses look the same and all the children look the same the little children bounced their balls in unison to the beat of a sinister heart. Within this mockery of child’s play, one boy did not match the rhythm of the others. As he faltered in his attempts to bounce the ball, I could not help but think he would be terribly punished for being so out of step.

So in a way my onion letter was an attempt to stop the darkness from overtaking us all. The characters of our childhood can tell us so many things. They can warn of us of danger or give us advice. And these characters can tell us that onions have layers.

In the summer of 2001 our two year old son Freddie saw his first his first movie in the theater. This was a proud moment for Fred. He was pursuing his doctorate in film studies at the time. He was so happy to take Freddie to his first movie. It was the film Shrek. In a conversation the ogre Shrek had with his friend Donkey, Shrek explained that ogres are like onions: they have layers. In writing my onion letter, I found Shrek’s statement to be horribly true. I wrote page upon single-spaced page detailing the many failures and miscommunications.

Months later I got a response. The hospital, physician’s board, and insurer had decided that Fred had been treated within the “standard of care”. Well, if Fred’s care was standard, the standard must be changed. I began to peel back the onion of our experience and paint those images on walls and jackets. I would remove a layer and cry. I would speak, and I would share our horror, and so doing I slowly regained our personhood.


If you came to the "e-Patient Ephemera" art exhibit at Clinovations on July 29th you would have seen a painting entitled The Onion and The Orchid. The painting contains two Freds and two Reginas. Fred and Regina on the left, look sorrowful and worried. Upon close inspection, you will see Fred’s gown is made of paper bus transfers from the months of March, April, May, and June. Regina is wearing a visitor’s tag, and more tags have pooled at her feet, and in her right hand she holds an onion. They have lost their names and identities.

The Fred and Regina on the right seem proud and hopeful. Fred is now dressed in a suit made entirely of his business cards. Again and again his image says Frederick A. Holliday PhD., American University. Regina is wearing a speaker’s nametag from WHIT 2009. At her feet pool nametags from Health 2.0 goes to DC, Cerner and the Better Care Campaign. In her left hand she holds an orchid.

That orchid is a type of ephemera. It was sent as a thank you gift from by the staff of National Partnership of Women and Families after a speech I gave on June 24 at their annual luncheon. That flower meant a lot to me. It almost seemed like a gift from Fred and the Partnership. Throughout our marriage Fred was only allowed to give me flowers if I appeared on stage. Money was always so tight, and I only was onstage a couple of times during our marriage. It was a perfect compromise. So when this flower was delivered I cried. I cried for joy. The wonderful people at the National Partnership and the Better Care Campaign had listened to me tell our tale and had spread the word far and wide. They had listened as I peeled an onion and in return gave me an orchid. I cried because I knew Fred would be so happy and proud. The orchid will lose its blossoms soon. I have given it to my mother-in-law. She is much better with green and growing things. Perhaps she can save it, or perhaps it will die. But it will always be blooming in the picture, and Fred will always be standing beside me wearing his name.

That is the story of The Onion and The Orchid. In writing this I tried in vain to find a link to the original article by Ann Hood. I found two other blog posts about it. I also found out that Ann Hood lost her five year old daughter Grace after a strep infection raced through her body in a 36 hour period. She wrote a book called Comfort about the horrible grief that consumed her after that event.

In a magazine I read an article by an author who has suffered so much. I hope she knows how much her writing has helped all the rest of us who find her while we are grieving. And after all of these things I have seen and read I will never look at women’s magazines in the same light.