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This year we celebrated Thanksgiving with a family dinner at our home, bringing together family from both sides and various parts of the country. This morning I woke up reflecting on families and how we think about them.

Most physicians majored in science as undergraduates in college. I majored in anthropology. A generalist even then, without even the hint of medical school on the horizon, I was drawn to the study of humans, especially within the social and cultural matrix. This gave me license to also take any courses that interested me, which I happily did, including literature, psychology, sociology, the arts, language, and a variety of student-initiated courses through a pioneering and activist program called the Center for Participant Education (CPE), where I was part of the student staff.

In anthropology, we studied kinship, drawing elaborate diagrams of personal connection. It was important to understand that in different cultures, the meaning of family is also different, that the mother's brother might have a role in one culture which the father has in another.

I think that I have always perceived all humanity as connected in a vast web, ultimately kin, though the details at the edges vary in ways that can define separation and difference.

My family has its own definitions. I’m the oldest of three, with a sister 2 years younger and a brother 7 years younger. My parents divorced when I was young. My mother Adele’s family was enormous and present in my life. People traveled across the country to attend weddings, Bar/Bat Mitzvah celebrations, other important life events, and funerals. My father Leonard’s family was distant; his parents were people from whom he escaped as soon as he could, and who, after the divorce, weren’t there at all. Somehow we also lost touch with the rest of his family, though many years later, there was a marvelous reconnection with his brother’s family and his aunt and uncle and cousin. My mother remarried to Phillip when I was 15, and I suddenly had 2 stepbrothers, and there were five siblings instead of three. My father remarried once, giving me 2 stepsisters, then twice, then again, finally giving me a wonderful “wicked stepmother” Judie, and turning me into a “wicked stepdaughter.” My mother and Judie became close, supporting each other through each husband's last illness, and still calling each other "my wife-in-law."

When my mother remarried, she invented a new kinship category that described the relatives of her husband’s first wife, who had died at a young age. They became “our third family relatives.” She continued to use that descriptor, without explanation, into the present, as if everyone knows the meaning of this kinship term. My mother also fostered many teens and young adults, who came to her for respite and an accepting environment. This included some nieces and nephews as well as friends of friends of her own teens. These latter sometimes became permanent family members, especially Bayla, who we always considered to be another sister.

When I married Steven, not only did we now have each other’s family as our own, we also took on all the official and non-official family that each of us had accrued. Thus, his brother, Charles, became mine, but also his brother-in-law Calvin from his first marriage, became my brother-in-law as well.

There have always been different ways that we have the children that we raise. However they come to us, they are our children, the foundation of our families. We give birth to them, we adopt them, we foster them, we are drawn to each other as adults and adopt each other. Their children are our grandchildren. We also foster, adopt, and choose each other as grandparents and grandchildren.

Often, we become such close friends, that the relationship transcends even friendship and becomes family. This has happened to me, to my husband, to our children, and to so many others.

What is really important, it seems to me, is to acknowledge and cherish our families; however they come to be our fathers, mothers, children, grandparents, sisters, brothers. And then to do so for their fathers, mothers, children, grandparents, sisters, brothers. And moving on and outward through every connection and every generation, until we know without a doubt that we are all indeed part of the same family, connected irrevocably, our fortunes and fates linked forever.

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