Ok, I know I said once that I wouldn't crow about my fascinating patients, because it seems wrong to use them for blogfodder, but this one is just a medical marvel. I can't help myself. No one else in HospitalWorld gets excited like I do, so I have no one to share the thrill with -- and I'm going to explode if I can't share the thrill.
She's in her sixties, and totally healthy aside from the blood thinner she takes for a heart condition. However, for the past three months she's been losing weight and becoming more and more tired, while her adoring hubby has tried without success to get her to see a doctor. Finally, yesterday, she came to the ER.
Initial exam shows nothing but a pale woman without obvious physical problems aside from a slow heartbeat.
Initial labs show that her kidneys have utterly failed. Because of the kidney failure, she has uremia (toxic overdose of the body's waste products) and a potassium level high enough to stop her heart.
And she's missing two-thirds of her blood.
I got her potassium down from the danger zone, poured bags of red blood cells into her, and called my Kidney Man to do emergency dialysis.
My official diagnosis thus far is What the fuck?
More later. I can't wait to go to work today!
Monday, December 31, 2007
Sunday, December 30, 2007
flight 5234, seat 8c, part two
Y,
Please forgive me for using email, but I think this needs to be said and I have long since lost courage for speaking to you in person. Not that I had much to begin with.
It was four in the morning, and I had less than two hours to pack and get to the airport for my sunrise flight. But I couldn't sleep. He was too much on my mind.
I don't know why you keep doing kind things for me. It was nice of you to bring the leafblower over and help take care of my yard. Last week you helped me with the flat tire. I want you to know I appreciate the things you do.
Later, on the airplane, my thoughts swirled and heaved like boiling tar. Maybe I shouldn't have sent him that email. I didn't want any awkwardness between us, especially because our separation was running like a well-oiled machine. When we saw eachother, we joked easily about the kids and how much we either loved or hated them, depending on the moment. We ran down our list of patients, mocked their exasperating families, and groaned about the fencesitters -- the ones who had no hope of recovery, didn't want to go home, hated the hospital, but still clung to it as their last line of defense against the rap of Death's hand at their door. We got along better as a separated couple than we'd ever done as marrieds. In fact, I was so practiced at maintaining a cool, arms-length friendship with him that I could barely remember all the molten-lava days of our beginnings; days when I'd convinced myself he was my blazing passion and my one-and-only.
The smart cool woman in me said, don't rock the boat. But I kept thinking about the leafblower and the flat tire and those other nice things he was always doing for me. What if it meant-- something. What if this was his way of saying-- you know. And what if I missed my chance, once again, by not opening the door to make it easy for him to say more.
I appreciate your help, but I don't know why you do those things. I write because I guess there's a slim chance that this is your way of trying to get close to me -- like the way you acted during those weeks you hung around and did housework, after you said you were leaving. I just want you to know that I appreciate it . But also, I want you to know that actions alone will never touch me, because I no longer trust your intentions as I once did. It would take words to erase all the other words I've heard from you before. I'm telling you this because I would hate for you to do kind things for me for the next hundred years and find me unmoved, and wrongly conclude that there's no way you can ever get close to me again.
The flight attendant was making his way up the aisle, canvassing for beverage requests. He was a suspiciously young boy with smooth olive skin who, in an apparent nod to Queer Eye, wore a jaunty beret cocked low over one eye. He lacked even a hint of facial hair. I wondered: do boys of today lie about their age to become flight attendants, like boys of yesterday used to lie to join the army? Maybe it's one of those modern trends I'm too old to catch on to: like text messaging, or cameras that live in cell phones. Or cell phones themselves, for that matter.
I shook out my face like a wet rag to make my mouth set right. "Coffee. Cream and sugar," I told him. My voice came out crisper than I'd intended -- in fact I sounded stern and purposeful and no-nonsense, like one of those formidable women who knows exactly what she wants and plans to accept nothing less.
As he poured, I opened my tray table and set my book aside. I'd been reading it the whole flight, having bought it that morning in the airport gift shop just as the sun was rising. It was a good story: engaging, and a bit of a tearjerker. It was Anne Tyler's latest, Digging to America.
Please forgive me for using email, but I think this needs to be said and I have long since lost courage for speaking to you in person. Not that I had much to begin with.
It was four in the morning, and I had less than two hours to pack and get to the airport for my sunrise flight. But I couldn't sleep. He was too much on my mind.
I don't know why you keep doing kind things for me. It was nice of you to bring the leafblower over and help take care of my yard. Last week you helped me with the flat tire. I want you to know I appreciate the things you do.
Later, on the airplane, my thoughts swirled and heaved like boiling tar. Maybe I shouldn't have sent him that email. I didn't want any awkwardness between us, especially because our separation was running like a well-oiled machine. When we saw eachother, we joked easily about the kids and how much we either loved or hated them, depending on the moment. We ran down our list of patients, mocked their exasperating families, and groaned about the fencesitters -- the ones who had no hope of recovery, didn't want to go home, hated the hospital, but still clung to it as their last line of defense against the rap of Death's hand at their door. We got along better as a separated couple than we'd ever done as marrieds. In fact, I was so practiced at maintaining a cool, arms-length friendship with him that I could barely remember all the molten-lava days of our beginnings; days when I'd convinced myself he was my blazing passion and my one-and-only.
The smart cool woman in me said, don't rock the boat. But I kept thinking about the leafblower and the flat tire and those other nice things he was always doing for me. What if it meant-- something. What if this was his way of saying-- you know. And what if I missed my chance, once again, by not opening the door to make it easy for him to say more.
I appreciate your help, but I don't know why you do those things. I write because I guess there's a slim chance that this is your way of trying to get close to me -- like the way you acted during those weeks you hung around and did housework, after you said you were leaving. I just want you to know that I appreciate it . But also, I want you to know that actions alone will never touch me, because I no longer trust your intentions as I once did. It would take words to erase all the other words I've heard from you before. I'm telling you this because I would hate for you to do kind things for me for the next hundred years and find me unmoved, and wrongly conclude that there's no way you can ever get close to me again.
The flight attendant was making his way up the aisle, canvassing for beverage requests. He was a suspiciously young boy with smooth olive skin who, in an apparent nod to Queer Eye, wore a jaunty beret cocked low over one eye. He lacked even a hint of facial hair. I wondered: do boys of today lie about their age to become flight attendants, like boys of yesterday used to lie to join the army? Maybe it's one of those modern trends I'm too old to catch on to: like text messaging, or cameras that live in cell phones. Or cell phones themselves, for that matter.
I shook out my face like a wet rag to make my mouth set right. "Coffee. Cream and sugar," I told him. My voice came out crisper than I'd intended -- in fact I sounded stern and purposeful and no-nonsense, like one of those formidable women who knows exactly what she wants and plans to accept nothing less.
As he poured, I opened my tray table and set my book aside. I'd been reading it the whole flight, having bought it that morning in the airport gift shop just as the sun was rising. It was a good story: engaging, and a bit of a tearjerker. It was Anne Tyler's latest, Digging to America.
Wednesday, December 26, 2007
flight 5234, seat 8C, part one
But-- but-- You can't leave me! I have hand! -- george costanza
Yeah, well, you're gonna need it. -- george's departing girlfriend
I flew home for Christmas. The flights were on time, more or less. On the last leg to my hometown airport, someone was crying on the airplane. I don't mean a child, but a grown person: a middle-aged woman who was traveling alone. She wasn't making any noise, but intermittently a spill of tears would roll out from under her eyelashes and she'd swipe at it with the back of her hand.
She had a book open in her lap: Anne Tyler's Digging to America. At first, I guessed it was the book that was making her cry -- but then her face buckled suddenly and drew into a grimace: her eyes squeezed shut and silent tears rolled down. She recovered immediately, and her features resumed their normal arrangement. A few moments later, though, they contorted again.
Anne Tyler has made me cry before, but not like that.
From a medical standpoint, crying is weird. We did a unit on eyes, of course -- normal anatomy and physiology as first-years and eyeball pathology the year after. Eyes have so many parts and confusing dysfunctions. Even the words are odd. Lacrimal gland, iris, vitreous. Astigmatism, glaucoma, strabismus. (As an aside: If you ever have any worries about your eyes, don't waste your time going to your family doctor. Ophthalmologists are well paid to understand eyes, but every other doctor pretty much thinks of them as two gooey pits stuck in the head, as mysterious as quasars and best avoided.)
What we didn't learn in med school was the physiology behind emotional tears. I never learned what part of the brain turns sadness into sobs, why the face suffers those involuntary grimaces during hard crying, or why the nose gets all red and sniffly.
The woman's seatmate and the other passengers failed to notice anything strange about her. Or more likely, they were politely averting their gaze. No one spoke to her. I wondered if the other passengers were annoyed by the way she'd gracelessly thrust them into the awkward position of pretending she didn't exist. It was like a tense dramatic movie, maybe the dark sequel to Snakes on a Plane! This time, Crying Woman on a Plane! Oh, the humanity.
Really, it was pretty freakin selfish of her; she could have tried a little harder to control herself. Like the rest of the passengers, I pretended nothing odd was happening. One thought crossed my mind: good thing she's not seated in an emergency aisle.
I had set out very early in the morning, and had slept badly the night before. Actually, I had slept not at all -- first because of the kids and then because of the packing, and then just because. I had a lot on my mind. My ex had come over the preceding afternoon with a leafblower, and had rounded up the kids for some spontaneous raking and bagging action in my front yard. He's been full of spontaneous acts of goodwill lately. It troubles me, because I haven't figured out what he means by it.
When he first announced he was leaving me -- this was a year and a half ago -- I answered with nothing but a shrug. "Fine," I said. "Go ahead." Inside, I was actually shocked by the development -- not because things were good between us, but simply because it had never crossed my mind that I could leave our crappy marriage with its three breakable, needy little children, so of course it had never crossed my mind that he could leave, either. Still, I don't think my face changed expression when he told me his decision. I had long since reached the point when pride, and giving no quarter, mattered more to me than any memory of love.
After his declaration we entered a strange period. For weeks, I kept expecting to come home from work and find him packing suitcases. I have to admit that the thought of this final scene filled me with dread -- a dread which, of course, I was determined not to show.
But what happened was nothing like that. With no explanation, he suddenly began acting the part of a model husband. Instead of packing suitcases, he began playing with the kids in the evenings, after years of ignoring them. He did housework, cleared the plates after dinner, made the kids their school lunches. He asked permission each night to come back into the king-size bed that for a couple months had been mine alone. Every night, he turned to me in the dark.
I observed these developments with detachment. I was cynical. Well okay, I was actually fired up with crazy hope, but I hid my stupid little double-X-chromosome gooey center under a six-inch titanium-plated shell of cynical, and even fooled myself. Almost.
One thing that irked me was that his sudden change seemed to prove what I'd suspected all along: that he knew full well he'd never pulled his weight in the home or with the kids (though for years he'd postured and stormed at me like he was the hardworking breadwinner and I was nothing but a bonbon-eating layabout). Another thing was, his motives were suspect. I didn't want to let myself believe that true remorse lay behind his change. He's scared to be off on his own, I told myself. Or else he's realizing that without me to anchor him, he'll drift right out of the kids' lives. I pictured him in a small boat drifting out with the tide, waving his arms and calling the children's names while he got smaller and smaller in the distance.
(The kids would meanwhile be clustered around me on the shore, all clamoring for my attention and oblivious to the tiny dot of a father disappearing over the horizon. Eventually one of them would remark, "Hey, where's Baba?" and they'd all glance around in mild surprise and then look toward me. Oh -- he's working, I'd explain with a vague wave of my hand, and they'd nod and go back to their games.
This might seem to my readers like the bitter fantasy of a wounded woman, but it was actually a pretty accurate depiction of our family life. There were weeks when he dropped out of their sight, leaving home before sunrise and coming back after the children's bedtime, and still it would be days before any of them asked where he was.)
So, when I saw him sweeping the floor and running the dishwasher, I didn't ask him why he was suddenly a new man. I certainly didn't ask if he wanted to stay married to me. I watched silently and waited for him to explain himself. After a couple weeks I stopped fearing a confrontation with halfpacked suitcases, and started expecting that a stumbling confession was in the offing: Honey, I don't want to leave you. I see where I was wrong about things -- I see how you worked so hard and I never appreciated you. I had high hopes. He had found out that I wouldn't beg him to stay. I had found out that he didn't want to go.
It was a complicated game of brinksmanship: like negotiating for a car you desperately want to buy from a salesman who desperately wants to sell it to you, while both of you pretend indifference as a ploy to gain advantage. But my opponent had showed his cards, and the upper hand was mine for once. He wanted to stay with me -- and that meant he understood that he was in the wrong about everything. Soon he would break down and admit it out loud. I was exultant.
But as weeks passed, and I came home to find my minvan detailed and the kids' toys set in order, I became increasingly annoyed. No confession and no apology were forthcoming. He thinks that he can stay on indefinitely without any explanation and just sweep his ugly words under the carpet with all the other rancid and decaying things that we've already concealed there. He thinks he can announce that he's going and then decide he's staying, and I'm a doormat who's going to let him walk over me in both directions.
One night in bed when he reached for me, as he'd done for weeks, I did not melt. (Sex had always been our best thing, really, right up to very near the end). As he wrapped his arms around me and whispered, "Is this okay?" I felt a surge of power. It was time I staked out my position as queen of the castle, and made clear how far he'd need to climb to win back a place at my side.
"This can't go on," I said coolly. "I don't understand what you think you're doing. You said you were leaving, but you never go anywhere. You can't just stay forever."
I meant to force his hand. I wanted a pound of flesh, and then another, and then a hundred and forty more. I wanted to hear his beautiful warm lips form around the words, I'm sorry; I made a terrible mistake. Please let me have another chance. I wanted to know he knew he was wrong and meant to do better. Also, I wanted to rip his freakin heart out and spit on it, because God knows, he had it coming. It was my moment of triumph.
At my words, he froze with his arms around me. One second ticked by, the slowest second since the dawn of time. Then he let out his breath and said "You're right."
He let go of me and drew away to his side of the bed. We lay there in the cover of darkness, not touching.
I held still for a long time in the dark, waiting, but he didn't say anything more. After a while, I could tell he was asleep.
Yeah, well, you're gonna need it. -- george's departing girlfriend
I flew home for Christmas. The flights were on time, more or less. On the last leg to my hometown airport, someone was crying on the airplane. I don't mean a child, but a grown person: a middle-aged woman who was traveling alone. She wasn't making any noise, but intermittently a spill of tears would roll out from under her eyelashes and she'd swipe at it with the back of her hand.
She had a book open in her lap: Anne Tyler's Digging to America. At first, I guessed it was the book that was making her cry -- but then her face buckled suddenly and drew into a grimace: her eyes squeezed shut and silent tears rolled down. She recovered immediately, and her features resumed their normal arrangement. A few moments later, though, they contorted again.
Anne Tyler has made me cry before, but not like that.
From a medical standpoint, crying is weird. We did a unit on eyes, of course -- normal anatomy and physiology as first-years and eyeball pathology the year after. Eyes have so many parts and confusing dysfunctions. Even the words are odd. Lacrimal gland, iris, vitreous. Astigmatism, glaucoma, strabismus. (As an aside: If you ever have any worries about your eyes, don't waste your time going to your family doctor. Ophthalmologists are well paid to understand eyes, but every other doctor pretty much thinks of them as two gooey pits stuck in the head, as mysterious as quasars and best avoided.)
What we didn't learn in med school was the physiology behind emotional tears. I never learned what part of the brain turns sadness into sobs, why the face suffers those involuntary grimaces during hard crying, or why the nose gets all red and sniffly.
The woman's seatmate and the other passengers failed to notice anything strange about her. Or more likely, they were politely averting their gaze. No one spoke to her. I wondered if the other passengers were annoyed by the way she'd gracelessly thrust them into the awkward position of pretending she didn't exist. It was like a tense dramatic movie, maybe the dark sequel to Snakes on a Plane! This time, Crying Woman on a Plane! Oh, the humanity.
Really, it was pretty freakin selfish of her; she could have tried a little harder to control herself. Like the rest of the passengers, I pretended nothing odd was happening. One thought crossed my mind: good thing she's not seated in an emergency aisle.
I had set out very early in the morning, and had slept badly the night before. Actually, I had slept not at all -- first because of the kids and then because of the packing, and then just because. I had a lot on my mind. My ex had come over the preceding afternoon with a leafblower, and had rounded up the kids for some spontaneous raking and bagging action in my front yard. He's been full of spontaneous acts of goodwill lately. It troubles me, because I haven't figured out what he means by it.
When he first announced he was leaving me -- this was a year and a half ago -- I answered with nothing but a shrug. "Fine," I said. "Go ahead." Inside, I was actually shocked by the development -- not because things were good between us, but simply because it had never crossed my mind that I could leave our crappy marriage with its three breakable, needy little children, so of course it had never crossed my mind that he could leave, either. Still, I don't think my face changed expression when he told me his decision. I had long since reached the point when pride, and giving no quarter, mattered more to me than any memory of love.
After his declaration we entered a strange period. For weeks, I kept expecting to come home from work and find him packing suitcases. I have to admit that the thought of this final scene filled me with dread -- a dread which, of course, I was determined not to show.
But what happened was nothing like that. With no explanation, he suddenly began acting the part of a model husband. Instead of packing suitcases, he began playing with the kids in the evenings, after years of ignoring them. He did housework, cleared the plates after dinner, made the kids their school lunches. He asked permission each night to come back into the king-size bed that for a couple months had been mine alone. Every night, he turned to me in the dark.
I observed these developments with detachment. I was cynical. Well okay, I was actually fired up with crazy hope, but I hid my stupid little double-X-chromosome gooey center under a six-inch titanium-plated shell of cynical, and even fooled myself. Almost.
One thing that irked me was that his sudden change seemed to prove what I'd suspected all along: that he knew full well he'd never pulled his weight in the home or with the kids (though for years he'd postured and stormed at me like he was the hardworking breadwinner and I was nothing but a bonbon-eating layabout). Another thing was, his motives were suspect. I didn't want to let myself believe that true remorse lay behind his change. He's scared to be off on his own, I told myself. Or else he's realizing that without me to anchor him, he'll drift right out of the kids' lives. I pictured him in a small boat drifting out with the tide, waving his arms and calling the children's names while he got smaller and smaller in the distance.
(The kids would meanwhile be clustered around me on the shore, all clamoring for my attention and oblivious to the tiny dot of a father disappearing over the horizon. Eventually one of them would remark, "Hey, where's Baba?" and they'd all glance around in mild surprise and then look toward me. Oh -- he's working, I'd explain with a vague wave of my hand, and they'd nod and go back to their games.
This might seem to my readers like the bitter fantasy of a wounded woman, but it was actually a pretty accurate depiction of our family life. There were weeks when he dropped out of their sight, leaving home before sunrise and coming back after the children's bedtime, and still it would be days before any of them asked where he was.)
So, when I saw him sweeping the floor and running the dishwasher, I didn't ask him why he was suddenly a new man. I certainly didn't ask if he wanted to stay married to me. I watched silently and waited for him to explain himself. After a couple weeks I stopped fearing a confrontation with halfpacked suitcases, and started expecting that a stumbling confession was in the offing: Honey, I don't want to leave you. I see where I was wrong about things -- I see how you worked so hard and I never appreciated you. I had high hopes. He had found out that I wouldn't beg him to stay. I had found out that he didn't want to go.
It was a complicated game of brinksmanship: like negotiating for a car you desperately want to buy from a salesman who desperately wants to sell it to you, while both of you pretend indifference as a ploy to gain advantage. But my opponent had showed his cards, and the upper hand was mine for once. He wanted to stay with me -- and that meant he understood that he was in the wrong about everything. Soon he would break down and admit it out loud. I was exultant.
But as weeks passed, and I came home to find my minvan detailed and the kids' toys set in order, I became increasingly annoyed. No confession and no apology were forthcoming. He thinks that he can stay on indefinitely without any explanation and just sweep his ugly words under the carpet with all the other rancid and decaying things that we've already concealed there. He thinks he can announce that he's going and then decide he's staying, and I'm a doormat who's going to let him walk over me in both directions.
One night in bed when he reached for me, as he'd done for weeks, I did not melt. (Sex had always been our best thing, really, right up to very near the end). As he wrapped his arms around me and whispered, "Is this okay?" I felt a surge of power. It was time I staked out my position as queen of the castle, and made clear how far he'd need to climb to win back a place at my side.
"This can't go on," I said coolly. "I don't understand what you think you're doing. You said you were leaving, but you never go anywhere. You can't just stay forever."
I meant to force his hand. I wanted a pound of flesh, and then another, and then a hundred and forty more. I wanted to hear his beautiful warm lips form around the words, I'm sorry; I made a terrible mistake. Please let me have another chance. I wanted to know he knew he was wrong and meant to do better. Also, I wanted to rip his freakin heart out and spit on it, because God knows, he had it coming. It was my moment of triumph.
At my words, he froze with his arms around me. One second ticked by, the slowest second since the dawn of time. Then he let out his breath and said "You're right."
He let go of me and drew away to his side of the bed. We lay there in the cover of darkness, not touching.
I held still for a long time in the dark, waiting, but he didn't say anything more. After a while, I could tell he was asleep.
Saturday, December 15, 2007
today's six-year-old
Sarah: Mama, what are you mumbling about?
Me: I'm just talking to the computer.
Sarah: Oh, so computers understand English now?
**************
Me: Want some nuts?
Sarah: Can it be the kind you like? Brazil nuts?
Me: No; I already picked them all out and ate them myself.
Sarah: You're just joking.
Me: Actually I'm not. How about some cashews?
Jake: What are cashews?
Sarah: Cashews are nothing. They're just peanuts in the shape of a moon.
Me: I'm just talking to the computer.
Sarah: Oh, so computers understand English now?
**************
Me: Want some nuts?
Sarah: Can it be the kind you like? Brazil nuts?
Me: No; I already picked them all out and ate them myself.
Sarah: You're just joking.
Me: Actually I'm not. How about some cashews?
Jake: What are cashews?
Sarah: Cashews are nothing. They're just peanuts in the shape of a moon.
Friday, December 14, 2007
another dumb blonde joke
A sleepy blonde is on an airplane. A lawyer takes the seat beside her and looks her over. He likes what he sees.
Lawyer says, "Cutie, I know a game that will pass the time. I ask you a question, and if you can't answer it you give me five dollars. Then you ask me a question, and if I can't answer I give you five dollars."
Blonde twirls her hair with her index finger and giggles. "I don't think so, honey." Then she closes her eyes.
Lawyer persists. "C'mon, don't be a chicken. Tell you what: if you can't answer my question you give me five dollars, but if I can't answer your question I'll give you fifty dollars."
Blonde says, "Oh, okay, that sounds good. You can ask first."
Lawyer: "How many miles is it from the earth to the moon?"
Blonde thinks a moment, then hands the lawyer five dollars.
Lawyer cackles. "Your turn. Betcha can't stump me!"
Blonde considers. Finally she says, "Try this one. What goes up a hill on three legs, and comes down on four legs?" She closes her eyes again.
The lawyer puzzles. He googles it. He emails his friends. He can't figure it out. It's killing him. Meanwhile, the blonde is snoozing peacefully beside him. As the plane lands three hours later, she wakes up. "Well?" she asks him. "Figure it out yet?" The lawyer reluctantly reaches for his wallet and peels fifty dollars off his wad. She giggles and slings her carry-on over her shoulder as the plane rolls up to the gate.
"Wait!" shouts the lawyer as she disembarks ahead of him. "You didn't tell me the answer! What the hell is it that goes up a hill on three legs and comes down on four legs?"
The blonde hands the lawyer back five dollars. And walks away.
Lawyer says, "Cutie, I know a game that will pass the time. I ask you a question, and if you can't answer it you give me five dollars. Then you ask me a question, and if I can't answer I give you five dollars."
Blonde twirls her hair with her index finger and giggles. "I don't think so, honey." Then she closes her eyes.
Lawyer persists. "C'mon, don't be a chicken. Tell you what: if you can't answer my question you give me five dollars, but if I can't answer your question I'll give you fifty dollars."
Blonde says, "Oh, okay, that sounds good. You can ask first."
Lawyer: "How many miles is it from the earth to the moon?"
Blonde thinks a moment, then hands the lawyer five dollars.
Lawyer cackles. "Your turn. Betcha can't stump me!"
Blonde considers. Finally she says, "Try this one. What goes up a hill on three legs, and comes down on four legs?" She closes her eyes again.
The lawyer puzzles. He googles it. He emails his friends. He can't figure it out. It's killing him. Meanwhile, the blonde is snoozing peacefully beside him. As the plane lands three hours later, she wakes up. "Well?" she asks him. "Figure it out yet?" The lawyer reluctantly reaches for his wallet and peels fifty dollars off his wad. She giggles and slings her carry-on over her shoulder as the plane rolls up to the gate.
"Wait!" shouts the lawyer as she disembarks ahead of him. "You didn't tell me the answer! What the hell is it that goes up a hill on three legs and comes down on four legs?"
The blonde hands the lawyer back five dollars. And walks away.
Thursday, December 13, 2007
an hour in the mall
I went to the mall today for shoes. I rarely buy shoes, usually not until my toes are sticking out or the uppers are flapping free from the soles. My distaste for shoe-buying is one of the reasons I am not an ob-gyn -- but that's a whole different story.
Here are some disturbing things I noted during one hour in the mall.
1) Holy crap, the parking lot is crowded. It's eleven AM on a weekday in mid December -- who are all these people? Does no one work anymore?
2) Four school buses, from four different surrounding counties, are parked in the lot. Why are schoolchildren taking a fieldtrip to the mall? Is it for home ec class? Are they studying capitalism?
3) There are thousands of school-age kids at the mall, and I don't mean field-trippers. I saw eight-year-olds racing away from their mamas. I saw knots of teen queens on the prowl. I felt confused. Is today Saturday? Is school already out for Christmas? (It's only December 13, for God's sake.) Did the moms tell their tykes, "You're not going to school today, because I need you to come to the mall and tell me what electronic gadgets I should put under the tree for you this year." Are they all from Swiss boarding schools, enjoying a monthlong holiday before winter term? Are there that many well-heeled teenage dropouts in my nice middle-class city? I'm baffled. I don't get it. I give up.
4) A cluster of three beautiful trees, about fifteen feet tall, grace one of the auxilliary entrances of the mall. The leaves are almost all gone but the branches make a flawless silhouette -- perfectly shaped and perfectly grouped, like three old friends whispering to the sky. I recognized the trees as Japanese maples, probably of the bloodgood variety. As a person who spends far too much of her free time in garden stores and landscape outlets, I know how precious Japanese maples are. Elegant, slow-growing, and poetic in form, they are among the priciest of plants. A little one in a gallon pot can cost about a hundred dollars.
The ones at the mall must be fifty years old. They are priceless. They're works of art. They belong in a quiet garden or on a hillside, with a sweet breeze moving through their branches and a stream coursing at their feet. They deserve to enjoy fresh moonlight and the twitter of wild birds. There should be an old married couple, still in love, walking hand in hand beneath them on a winding gravel path. They deserve to thrive and be loved in a setting that honors them. I am utterly offended that the mall people used their millions to buy them up and trap them forever in this soulless place, between the parking lot and the east entrance to Dillard's.
That's it. I usually love malls, but not today. Even though I did get a pair of cheap black shoes, it hardly seemed worth the irritation.
Here are some disturbing things I noted during one hour in the mall.
1) Holy crap, the parking lot is crowded. It's eleven AM on a weekday in mid December -- who are all these people? Does no one work anymore?
2) Four school buses, from four different surrounding counties, are parked in the lot. Why are schoolchildren taking a fieldtrip to the mall? Is it for home ec class? Are they studying capitalism?
3) There are thousands of school-age kids at the mall, and I don't mean field-trippers. I saw eight-year-olds racing away from their mamas. I saw knots of teen queens on the prowl. I felt confused. Is today Saturday? Is school already out for Christmas? (It's only December 13, for God's sake.) Did the moms tell their tykes, "You're not going to school today, because I need you to come to the mall and tell me what electronic gadgets I should put under the tree for you this year." Are they all from Swiss boarding schools, enjoying a monthlong holiday before winter term? Are there that many well-heeled teenage dropouts in my nice middle-class city? I'm baffled. I don't get it. I give up.
4) A cluster of three beautiful trees, about fifteen feet tall, grace one of the auxilliary entrances of the mall. The leaves are almost all gone but the branches make a flawless silhouette -- perfectly shaped and perfectly grouped, like three old friends whispering to the sky. I recognized the trees as Japanese maples, probably of the bloodgood variety. As a person who spends far too much of her free time in garden stores and landscape outlets, I know how precious Japanese maples are. Elegant, slow-growing, and poetic in form, they are among the priciest of plants. A little one in a gallon pot can cost about a hundred dollars.
The ones at the mall must be fifty years old. They are priceless. They're works of art. They belong in a quiet garden or on a hillside, with a sweet breeze moving through their branches and a stream coursing at their feet. They deserve to enjoy fresh moonlight and the twitter of wild birds. There should be an old married couple, still in love, walking hand in hand beneath them on a winding gravel path. They deserve to thrive and be loved in a setting that honors them. I am utterly offended that the mall people used their millions to buy them up and trap them forever in this soulless place, between the parking lot and the east entrance to Dillard's.
That's it. I usually love malls, but not today. Even though I did get a pair of cheap black shoes, it hardly seemed worth the irritation.
a healthy curiosity
I see that everyone has gotten all nervous and uptight about global warming. I can't turn on CNN without seeing Al Gore's crumpled-paper-bag face looking earnestly back at me. Even the local paper today ran as its top headline, "ARCTIC IS SCREAMING, SCIENTISTS SAY." Or something. I didn't read it very carefully.
I'm a good liberal girl; at least, I was raised to be one. I memorized the leftie environmental catechism before I was three: you know, save the environment, protect the seal pups, boo the big conglomerates, hate the hunters and the timber companies and those people who are whacking down the rain forests. I was such a good liberal girl that the first almost-president I ever voted for was Michael Dukakis. Show me five other people in the country who can say that.
I've abandoned some of the quainter liberal sacred cows along the road to thirty-nine years old. But I still care about seal pups and frown at litterbugs. I recycle, as long as someone makes it really convenient for me. And although I drive a minivan, I occasionally feel bad about it. Okay, so mostly I feel bad because the price of gas is truly irritating when you drive a car that gets ten to the gallon, and because I think buying gas supports the Saudis, who run possibly the most loathsome regime on earth. But also, I feel a tiny bit bad because maybe my big car is polluting something. Or exploiting something. Or whatever.
But here's the thing. When it comes to global warming, I don't feel the way everyone says I'm supposed to feel. No gloom, no anxiety, no stress. Actually, I can't wait for global warming. I'm looking forward to it with an emotion that approaches breathless anticipation.
I don't mean that I'm hopeful of getting an ice-free winter and not having to dig up the cannas in fall -- though, admittedly, that would be a nice perk. No -- I'm mostly just eaten up with eager curiosity. Melting ice caps? Howling hurricanes? Rising water levels? Way cool! Wonder what that's gonna be like! I hope I live long enough to see the world get all shaken and stirred and changed around. Because you know, it's been this one same way my whole life, and I'm ready for a little climatic action!
I know what you're all thinking: People are going to lose their homes as the ocean invades the coasts. Subsistence farmers in Africa are going to see their dusty crops get swallowed in sandstorms and shriveled by desertification. Human beings will die from this. Worst of all, those cute little seal pups will drown by the millions. How can she be so callous?
OK, maybe I'm a horrible person. But I just really, really love to watch a good show. World, entertain me! Show me something different! I wanna experience something new under the sun!
Come to think of it, seven years ago I felt the same way about trying for the first baby. My then-husband was all mushy about it: I love you so much. I want to have a baby with you, sweetheart. But for me it was more like, Hey, I've never been pregnant before -- that'll be interesting! I ended up trying fetus for all the same reasons I had tried acid a few years earlier. (In an eerie parallel, fetus, like acid, turned out to be a much worse trip than expected, and it went on and on and on long after I desperately wanted it to stop).
Before that, curiosity got me to tie the knot with a stranger. Partly I got married in a rush of altruism brought on by romantic literature (see the post me and victor hugo from 11/07), but partly I was driven by the sudden thought of, Hey, marriage! Won't that be new!
It was the same thing when I lost my virginity. But, my God, how I hate that archaic phrase. Do people still actually say that in 2007? Let me start over:
It was the same thing when I had sex with my first guy. My roommate and I were hanging out on the sofa one night talking about our flowerful hymens and such, and she commented, "It's not that there's anything wrong with virgins, but I've been one for eighteen years and now I'm bored." I laughed and thought, She's so right! The next night there was a party at Sig Ep, and after eighteen years of saying "Non, monsieur, non, je te prie!" I changed my answer to, "Yeah, sure. Your place?" And that was that. I can tell you that it was marginally better than a bad acid trip or hyperemesis of pregnancy, but only in the way that being stabbed with a dull pocketknife is better than being shot in the head.
(In fact, it was bad enough that I didn't have sex again for two more years. For the rest of college, people were always asking me, "Hey, why are you putting your clothes back on already?" and I was always having to explain to them, "Well, I think sex is really boring, plus it hurts. So I pretty much just like to fool around, and then leave." Strangely, many people resented this answer; I never understood why. Regardless, they should have blamed Mr. Inept from Sig Ep instead of telling lies about me and calling me nasty names behind my back.)
So that's how it is. I just like to try new things. I thrive on novelty. I have an inquiring mind. Christ, stop frowning at me -- those are GOOD things.
Hey, you know what else I'm looking forward to? The destruction of the world's oil reserves. It's going to happen; it has to. When it does, we'll all be riding bicycles or strapping on daedalus-style wings of feather and wax. That would be fun. And one thing is for sure: when it happens, ten thousand Saudi princes and their nutcase Wahhabi clerics will all fall down sobbing and crawl out into the desert to die. I'm going to stop eating so many doughnuts and take better care of myself, because I really want to live to see that day.
Anyway, didja know the Arctic icecap may be all gone in just a few more years? How exciting is that! What do you think will happen next?
I'm a good liberal girl; at least, I was raised to be one. I memorized the leftie environmental catechism before I was three: you know, save the environment, protect the seal pups, boo the big conglomerates, hate the hunters and the timber companies and those people who are whacking down the rain forests. I was such a good liberal girl that the first almost-president I ever voted for was Michael Dukakis. Show me five other people in the country who can say that.
I've abandoned some of the quainter liberal sacred cows along the road to thirty-nine years old. But I still care about seal pups and frown at litterbugs. I recycle, as long as someone makes it really convenient for me. And although I drive a minivan, I occasionally feel bad about it. Okay, so mostly I feel bad because the price of gas is truly irritating when you drive a car that gets ten to the gallon, and because I think buying gas supports the Saudis, who run possibly the most loathsome regime on earth. But also, I feel a tiny bit bad because maybe my big car is polluting something. Or exploiting something. Or whatever.
But here's the thing. When it comes to global warming, I don't feel the way everyone says I'm supposed to feel. No gloom, no anxiety, no stress. Actually, I can't wait for global warming. I'm looking forward to it with an emotion that approaches breathless anticipation.
I don't mean that I'm hopeful of getting an ice-free winter and not having to dig up the cannas in fall -- though, admittedly, that would be a nice perk. No -- I'm mostly just eaten up with eager curiosity. Melting ice caps? Howling hurricanes? Rising water levels? Way cool! Wonder what that's gonna be like! I hope I live long enough to see the world get all shaken and stirred and changed around. Because you know, it's been this one same way my whole life, and I'm ready for a little climatic action!
I know what you're all thinking: People are going to lose their homes as the ocean invades the coasts. Subsistence farmers in Africa are going to see their dusty crops get swallowed in sandstorms and shriveled by desertification. Human beings will die from this. Worst of all, those cute little seal pups will drown by the millions. How can she be so callous?
OK, maybe I'm a horrible person. But I just really, really love to watch a good show. World, entertain me! Show me something different! I wanna experience something new under the sun!
Come to think of it, seven years ago I felt the same way about trying for the first baby. My then-husband was all mushy about it: I love you so much. I want to have a baby with you, sweetheart. But for me it was more like, Hey, I've never been pregnant before -- that'll be interesting! I ended up trying fetus for all the same reasons I had tried acid a few years earlier. (In an eerie parallel, fetus, like acid, turned out to be a much worse trip than expected, and it went on and on and on long after I desperately wanted it to stop).
Before that, curiosity got me to tie the knot with a stranger. Partly I got married in a rush of altruism brought on by romantic literature (see the post me and victor hugo from 11/07), but partly I was driven by the sudden thought of, Hey, marriage! Won't that be new!
It was the same thing when I lost my virginity. But, my God, how I hate that archaic phrase. Do people still actually say that in 2007? Let me start over:
It was the same thing when I had sex with my first guy. My roommate and I were hanging out on the sofa one night talking about our flowerful hymens and such, and she commented, "It's not that there's anything wrong with virgins, but I've been one for eighteen years and now I'm bored." I laughed and thought, She's so right! The next night there was a party at Sig Ep, and after eighteen years of saying "Non, monsieur, non, je te prie!" I changed my answer to, "Yeah, sure. Your place?" And that was that. I can tell you that it was marginally better than a bad acid trip or hyperemesis of pregnancy, but only in the way that being stabbed with a dull pocketknife is better than being shot in the head.
(In fact, it was bad enough that I didn't have sex again for two more years. For the rest of college, people were always asking me, "Hey, why are you putting your clothes back on already?" and I was always having to explain to them, "Well, I think sex is really boring, plus it hurts. So I pretty much just like to fool around, and then leave." Strangely, many people resented this answer; I never understood why. Regardless, they should have blamed Mr. Inept from Sig Ep instead of telling lies about me and calling me nasty names behind my back.)
So that's how it is. I just like to try new things. I thrive on novelty. I have an inquiring mind. Christ, stop frowning at me -- those are GOOD things.
Hey, you know what else I'm looking forward to? The destruction of the world's oil reserves. It's going to happen; it has to. When it does, we'll all be riding bicycles or strapping on daedalus-style wings of feather and wax. That would be fun. And one thing is for sure: when it happens, ten thousand Saudi princes and their nutcase Wahhabi clerics will all fall down sobbing and crawl out into the desert to die. I'm going to stop eating so many doughnuts and take better care of myself, because I really want to live to see that day.
Anyway, didja know the Arctic icecap may be all gone in just a few more years? How exciting is that! What do you think will happen next?
Wednesday, December 12, 2007
pay no attention to the man behind the curtain
My ex is reading a book called "The Four-Hour Workweek". It's written by some sort of (self-described) millionaire entrepreneur and renaissance man. It purports to tell all us wage-slaves how we, too, can have the life he leads: working only an hour a day and papering our kitchens with spare hundred-dollar bills.
In the introduction, he gives a brief biography of himself and his various business adventures. He first became rich inventing and marketing a vitamin product called brainQUICKEN. He was a Princeton undergrad at the time, with no background in health or nutrition.
Now, this suggests to my cynical brain that he has a proven track record of selling snake oil to the overly optimistic.
His book is hardcover. The retail price is something like twenty-two dollars; a fairly high price for snake oil even in today's market. I ask myself why my ex -- a doctor and overall a smart man as far as I can tell -- bought twenty-two dollars worth of snake oil and is eagerly rubbing it all over his body. Apparently he hopes that this book will teach him to see twenty-five hospital patients each day in under an hour.
Is he really that gullible?
But then I remember: he swallowed Islam whole in childhood without giving it a cursory critical thought. And although the only way he manages to live with it is by breaking every rule he finds inconvenient, he still never asks himself if Islam really is, as he was taught, a perfect system for living created by God.
So that pretty much answers my question.
In the introduction, he gives a brief biography of himself and his various business adventures. He first became rich inventing and marketing a vitamin product called brainQUICKEN. He was a Princeton undergrad at the time, with no background in health or nutrition.
Now, this suggests to my cynical brain that he has a proven track record of selling snake oil to the overly optimistic.
His book is hardcover. The retail price is something like twenty-two dollars; a fairly high price for snake oil even in today's market. I ask myself why my ex -- a doctor and overall a smart man as far as I can tell -- bought twenty-two dollars worth of snake oil and is eagerly rubbing it all over his body. Apparently he hopes that this book will teach him to see twenty-five hospital patients each day in under an hour.
Is he really that gullible?
But then I remember: he swallowed Islam whole in childhood without giving it a cursory critical thought. And although the only way he manages to live with it is by breaking every rule he finds inconvenient, he still never asks himself if Islam really is, as he was taught, a perfect system for living created by God.
So that pretty much answers my question.
Sunday, December 9, 2007
pomegranate 2
I was actually going somewhere different with that pomegranate thing, before I got sidetracked.
What I meant to write about, is the fact that I'm in love with pomegranates. I think they're so freakin sexy. They give me that flip-flop in the stomach when I think of them, same feeling my ex used to give me way back when. There's nothing like them -- truly; they're in a genus by themselves: Punica granatum. And I can only get them in the fall, which drives my lust to unimaginable levels the rest of the year.
They were first cultivated in Iran and Kandahar, a dry semi-desert region in southeast Afghanistan where frost rarely touches the ground. Kandahar is best known now as a stronghold of poppies and of the Taliban, but still the Kandahar people take pride in their pomegranates -- said to be the finest in the world.
Pomegranates traveled the silk road. They fell into the hands of the Phoenecians, who gave them their genus -- Punica, the Roman name for Carthage. They gave their name to Granada, home of the thousand arches of the Alhambra. They are mentioned in the Old Testament. Hundreds of years later Mohammed said of them, There's not a pomegranate in the world that doesn't have among its seeds, at least one seed that comes from Jannah (heaven). They are a beloved part of Rosh Hashoneh celebrations around the world. They are pictured in the art of ancient Egypt. They flowered in the hanging gardens of Babylon.
Pomegranate means "seeded apple". It has no relatives among other fruits. It stands unique: rind around clustered arils, each aril a blob of pulp around seed. The juice that sprays from the arils can stain clothes like blood; nothing but bleach can get it out. In fact, the boiled rind is used to make a red dye for cloth. The tree has a high tannin content and has long been useful in leather preparation. The leaves can be processed into ink. The pressed arils make pomegranate juice, which is the main ingredient in grenadine, the syrup that makes tequila sunsets blush.
Pomegranates. I've got a thing for them. I mean, who doesn't?
Hades touched Persephone on the shoulder. Before you go, he said, take one gift from me, in farewell. The girl had spent months sitting motionless upon the throne he built for her, refusing all food, not speaking to her captor or even looking his way. But when he unfolded his hand and showed her a cluster of pomegranate seeds glistening in his palm, she caught her breath. She had a thing for pomegranates.
The gods had intervened and she would soon be home safe with her mother. What was the harm? Yes, she'd always been warned that even divine visitors to the underworld must eat no food there, or risk being trapped in the land of the dead forever. But -- these were pomegranate seeds. She bit her lip. Her mouth watered. No, she told him, really. I'm not hungry.
Just have a taste, he said.
When Hermes came to spirit the young goddess up to the sunlight after her long, dreary imprisonment, he found Hades smiling. She can't go, said the dark god. She ate the food of the dead. She is mine now, forever.
Persephone gasped, Demeter raged, and in the end Zeus struck a bargain to keep the peace. Because she had eaten four seeds, she would spend four months a year in the land of the dead. Each year when she goes to her black throne, Demeter wanders the earth in sadness. Crops die and the land falls barren until her daughter returns with the spring.
Thus did Persephone inflict winter upon us all, and blight the land she loved -- all because she couldn't say no to a handful of pomegranate seeds.
Well. I guess I can understand that.
What I meant to write about, is the fact that I'm in love with pomegranates. I think they're so freakin sexy. They give me that flip-flop in the stomach when I think of them, same feeling my ex used to give me way back when. There's nothing like them -- truly; they're in a genus by themselves: Punica granatum. And I can only get them in the fall, which drives my lust to unimaginable levels the rest of the year.
They were first cultivated in Iran and Kandahar, a dry semi-desert region in southeast Afghanistan where frost rarely touches the ground. Kandahar is best known now as a stronghold of poppies and of the Taliban, but still the Kandahar people take pride in their pomegranates -- said to be the finest in the world.
Pomegranates traveled the silk road. They fell into the hands of the Phoenecians, who gave them their genus -- Punica, the Roman name for Carthage. They gave their name to Granada, home of the thousand arches of the Alhambra. They are mentioned in the Old Testament. Hundreds of years later Mohammed said of them, There's not a pomegranate in the world that doesn't have among its seeds, at least one seed that comes from Jannah (heaven). They are a beloved part of Rosh Hashoneh celebrations around the world. They are pictured in the art of ancient Egypt. They flowered in the hanging gardens of Babylon.
Pomegranate means "seeded apple". It has no relatives among other fruits. It stands unique: rind around clustered arils, each aril a blob of pulp around seed. The juice that sprays from the arils can stain clothes like blood; nothing but bleach can get it out. In fact, the boiled rind is used to make a red dye for cloth. The tree has a high tannin content and has long been useful in leather preparation. The leaves can be processed into ink. The pressed arils make pomegranate juice, which is the main ingredient in grenadine, the syrup that makes tequila sunsets blush.
Pomegranates. I've got a thing for them. I mean, who doesn't?
Hades touched Persephone on the shoulder. Before you go, he said, take one gift from me, in farewell. The girl had spent months sitting motionless upon the throne he built for her, refusing all food, not speaking to her captor or even looking his way. But when he unfolded his hand and showed her a cluster of pomegranate seeds glistening in his palm, she caught her breath. She had a thing for pomegranates.
The gods had intervened and she would soon be home safe with her mother. What was the harm? Yes, she'd always been warned that even divine visitors to the underworld must eat no food there, or risk being trapped in the land of the dead forever. But -- these were pomegranate seeds. She bit her lip. Her mouth watered. No, she told him, really. I'm not hungry.
Just have a taste, he said.
When Hermes came to spirit the young goddess up to the sunlight after her long, dreary imprisonment, he found Hades smiling. She can't go, said the dark god. She ate the food of the dead. She is mine now, forever.
Persephone gasped, Demeter raged, and in the end Zeus struck a bargain to keep the peace. Because she had eaten four seeds, she would spend four months a year in the land of the dead. Each year when she goes to her black throne, Demeter wanders the earth in sadness. Crops die and the land falls barren until her daughter returns with the spring.
Thus did Persephone inflict winter upon us all, and blight the land she loved -- all because she couldn't say no to a handful of pomegranate seeds.
Well. I guess I can understand that.
Friday, December 7, 2007
kristallnacht USA
Today I read a despicable item on AOL. Goes like this:
In a quiet Missouri town, a thirteen-year-old girl, MM, hanged herself in her closet after being victimized by cyberbullying. She had been exchanging myspace messages with a 16-year-old boy named Josh who first won her trust then turned against her, posting nasty things like, "You should die. Everyone in this town knows what you are. Everyone here hates you." After her death, a neighbor tipped off police that Josh was an invention, created by a 47-year-old woman on the same street, whose teen daughter had had a falling out with MM. Allegedly, the mother-daughter pair cooked up the idea to pose as a friendly boy, win MM's trust, and find out what she thought about the daughter. The password of fake-Josh was passed around to other kids in the neighborhood. As things got uglier, many kids took turns playing Josh, making up vicious things to write to the child.
You're probably thinking that this is the despicable part. Actually, I haven't gotten there yet.
As far as I can tell, it's completely unclear what part the woman actually played. She may have come up with the fake-Josh idea herself. She may have learned of it after the fact from her daughter. She may have encouraged her daughter to write nasty things. She may have written nasty messages herself, spread the Josh-password around, and encouraged other kids to participate in the hoax. Or maybe she knew almost nothing about it. Or maybe she knew, but didn't stop it. Or maybe she did try to stop it. The story is long on rumor and short on facts.
Since the news of her alleged involvement broke, the woman has become a lightning rod for hatred in the name of moral outrage. She now stands at the whipping post where other women (yes, it's always women) have stood before: Linda Tripp, Susan Smith. She receives death threats daily. Her home has been vandalized. Her teenage daughter has had to change schools. She's lost her job. Her phone number and address have been publicized, and posters exhort eachother to hound her until she kills herself like her alleged victim. On a hundred webpages, people are posting messages which all sound very familiar. "You should die, cunt. Everyone knows what you did to that poor girl. Everyone hates you." The girl's suicide was a year ago, but the groundswell of hatred continues to gain momentum on the internet, like plague or wildfire.
Let's review. She is hated because she stands accused of bullying a girl to death. The people who hate her must be tenderhearted souls who are taking up for the victim, who can't bear to think of poor MM's pain. They are shocked by the woman's alleged crime, because they themselves would never do such a thing. Would never threaten or bully or seek to hurt another living soul. They would not destroy someone's life because of rumor. They would not mob together to call for a woman's death. They would not litter the web with words like, "You should die, cunt!" Right?
Christ. I'm no fan of cyber-bullying, but my tolerance for bloodthirsty hypocrites is far, far less.
I suppose some of the haters might say they are deliberately giving her a taste of her own medicine, to show her how it feels. I don't buy that excuse. She has become the target of a runaway mob: mindless as sheep and vicious as jackals on the scent of blood. What's sickest of all is that this mob credits itself with acting in the name of virtue and decency.
Here's what I think:
Within every person lives a secret bully, caged and stowed in a down-deep hidden cave, but always starving for a chance to break loose and be a mad little kid again, taking vicious delight in throwing stones at cats, torturing bugs, and making weaker kids cry. Bullying satisfies something dark in our souls that we can't quite explain and pretend not to have. But it's there, lurking. There is nothing like the gleeful blood-rush that comes from dominating another person: knowing you can do anything you want to him, take all your savagery out on him, see fear in his eyes. Power is a drug. Absolute power is a high that can't be equaled.
What feels even better than bullying, is bullying as part of a mob. The power-rush increases exponentially when you can have an orgy instead of just a solo thrill. Imagine: you not only get to beat up a kid, you've got your friends there holding him down and laughing as they egg you on. You not only get to storm into town and rape any girl you want, you're drunk on the shouts of your fellow soldiers as they take turns with her mother and sisters, and machine-gun her brothers against the wall.
But wait. There's one thing that feels even better than bullying with a mob: bullying with a mob and claiming God on your side. Imagine: you not only get to run wild in the streets with your jackbooted comrades, beating up old men and women, smashing their homes and shops -- you also feel the pride of righteousness and just vengeance against your enemy. As you swing a bat into a man's skull, you tell yourself, This parasite deserves it, he's been asking for it, and by God it's time I deliver it! You return home swaggering to the cheers of your neighbors, to parades and patriotic speeches in your honor: Well done, boys! You've struck a blow for the Fatherland tonight. Your country and your Fuhrer salute you!
Hatred looks for a target. Thanks to education, many people in America today are queasy about jumping on the bandwagon of kike-hating, nigger-hating, fag-hating -- they've been conditioned since Sesame Street to think, Nice people -- people with class -- aren't allowed to do that anymore. If we do that we'll look ignorant. But hating a woman who's been accused of an immoral act, that's admirable. She's stepped outside decent behavior and broken the rules, so now we have license to pick up stones and chase the bitch naked through town until she drops to her knees, sobbing and begging for her life. She asked for it; she's a fallen woman. We, the righteous, are gonna give her what she deserves! Come on everyone, join the party -- let's make this cunt bleed!
Hatred looks for a target, and in a quiet neighborhood in Missouri, it has found one. The Enemy has a name and a face now -- she's forty-seven and a killer of children. America cheers for its righteous citizens as their bricks and rocks find their mark, as they scream for her blood.
But me, I think the Fuhrer is grinning in his grave tonight. This is my lesson to the world, he chuckles, though the world stops its ears and pretends not to hear it. I saw the truth of it when I was barely grown. In any land, in any century, people are the same. You are no different from what we were. Your moral superiority is hypocrisy, a lie of arrogance. I created no evil; I only channeled the natural impulses of men to my purposes. Look at Dachau, then look in the mirror and know: in you and your children and your children's children, I'm still alive, and always will be. The final victory and the last laugh are mine.
In a quiet Missouri town, a thirteen-year-old girl, MM, hanged herself in her closet after being victimized by cyberbullying. She had been exchanging myspace messages with a 16-year-old boy named Josh who first won her trust then turned against her, posting nasty things like, "You should die. Everyone in this town knows what you are. Everyone here hates you." After her death, a neighbor tipped off police that Josh was an invention, created by a 47-year-old woman on the same street, whose teen daughter had had a falling out with MM. Allegedly, the mother-daughter pair cooked up the idea to pose as a friendly boy, win MM's trust, and find out what she thought about the daughter. The password of fake-Josh was passed around to other kids in the neighborhood. As things got uglier, many kids took turns playing Josh, making up vicious things to write to the child.
You're probably thinking that this is the despicable part. Actually, I haven't gotten there yet.
As far as I can tell, it's completely unclear what part the woman actually played. She may have come up with the fake-Josh idea herself. She may have learned of it after the fact from her daughter. She may have encouraged her daughter to write nasty things. She may have written nasty messages herself, spread the Josh-password around, and encouraged other kids to participate in the hoax. Or maybe she knew almost nothing about it. Or maybe she knew, but didn't stop it. Or maybe she did try to stop it. The story is long on rumor and short on facts.
Since the news of her alleged involvement broke, the woman has become a lightning rod for hatred in the name of moral outrage. She now stands at the whipping post where other women (yes, it's always women) have stood before: Linda Tripp, Susan Smith. She receives death threats daily. Her home has been vandalized. Her teenage daughter has had to change schools. She's lost her job. Her phone number and address have been publicized, and posters exhort eachother to hound her until she kills herself like her alleged victim. On a hundred webpages, people are posting messages which all sound very familiar. "You should die, cunt. Everyone knows what you did to that poor girl. Everyone hates you." The girl's suicide was a year ago, but the groundswell of hatred continues to gain momentum on the internet, like plague or wildfire.
Let's review. She is hated because she stands accused of bullying a girl to death. The people who hate her must be tenderhearted souls who are taking up for the victim, who can't bear to think of poor MM's pain. They are shocked by the woman's alleged crime, because they themselves would never do such a thing. Would never threaten or bully or seek to hurt another living soul. They would not destroy someone's life because of rumor. They would not mob together to call for a woman's death. They would not litter the web with words like, "You should die, cunt!" Right?
Christ. I'm no fan of cyber-bullying, but my tolerance for bloodthirsty hypocrites is far, far less.
I suppose some of the haters might say they are deliberately giving her a taste of her own medicine, to show her how it feels. I don't buy that excuse. She has become the target of a runaway mob: mindless as sheep and vicious as jackals on the scent of blood. What's sickest of all is that this mob credits itself with acting in the name of virtue and decency.
Here's what I think:
Within every person lives a secret bully, caged and stowed in a down-deep hidden cave, but always starving for a chance to break loose and be a mad little kid again, taking vicious delight in throwing stones at cats, torturing bugs, and making weaker kids cry. Bullying satisfies something dark in our souls that we can't quite explain and pretend not to have. But it's there, lurking. There is nothing like the gleeful blood-rush that comes from dominating another person: knowing you can do anything you want to him, take all your savagery out on him, see fear in his eyes. Power is a drug. Absolute power is a high that can't be equaled.
What feels even better than bullying, is bullying as part of a mob. The power-rush increases exponentially when you can have an orgy instead of just a solo thrill. Imagine: you not only get to beat up a kid, you've got your friends there holding him down and laughing as they egg you on. You not only get to storm into town and rape any girl you want, you're drunk on the shouts of your fellow soldiers as they take turns with her mother and sisters, and machine-gun her brothers against the wall.
But wait. There's one thing that feels even better than bullying with a mob: bullying with a mob and claiming God on your side. Imagine: you not only get to run wild in the streets with your jackbooted comrades, beating up old men and women, smashing their homes and shops -- you also feel the pride of righteousness and just vengeance against your enemy. As you swing a bat into a man's skull, you tell yourself, This parasite deserves it, he's been asking for it, and by God it's time I deliver it! You return home swaggering to the cheers of your neighbors, to parades and patriotic speeches in your honor: Well done, boys! You've struck a blow for the Fatherland tonight. Your country and your Fuhrer salute you!
Hatred looks for a target. Thanks to education, many people in America today are queasy about jumping on the bandwagon of kike-hating, nigger-hating, fag-hating -- they've been conditioned since Sesame Street to think, Nice people -- people with class -- aren't allowed to do that anymore. If we do that we'll look ignorant. But hating a woman who's been accused of an immoral act, that's admirable. She's stepped outside decent behavior and broken the rules, so now we have license to pick up stones and chase the bitch naked through town until she drops to her knees, sobbing and begging for her life. She asked for it; she's a fallen woman. We, the righteous, are gonna give her what she deserves! Come on everyone, join the party -- let's make this cunt bleed!
Hatred looks for a target, and in a quiet neighborhood in Missouri, it has found one. The Enemy has a name and a face now -- she's forty-seven and a killer of children. America cheers for its righteous citizens as their bricks and rocks find their mark, as they scream for her blood.
But me, I think the Fuhrer is grinning in his grave tonight. This is my lesson to the world, he chuckles, though the world stops its ears and pretends not to hear it. I saw the truth of it when I was barely grown. In any land, in any century, people are the same. You are no different from what we were. Your moral superiority is hypocrisy, a lie of arrogance. I created no evil; I only channeled the natural impulses of men to my purposes. Look at Dachau, then look in the mirror and know: in you and your children and your children's children, I'm still alive, and always will be. The final victory and the last laugh are mine.
an evil grandmother
The following comes from an aol feature -- "Tell us the worst gift you've ever gotten!" People wrote in to complain about receiving sticks of gum, expired tea bags, and duct tape. This one made me laugh the most.
With Love From Granny
"My grandmother gave my sister this beautiful leather jacket and top of the line baby clothes. She gave me a box of black hair dye. She said, 'Red is such an ugly color for hair. I know you were born with that deformity, but at least you can fix it and have beautiful black hair like your sister.' My mom slapped her."
With Love From Granny
"My grandmother gave my sister this beautiful leather jacket and top of the line baby clothes. She gave me a box of black hair dye. She said, 'Red is such an ugly color for hair. I know you were born with that deformity, but at least you can fix it and have beautiful black hair like your sister.' My mom slapped her."
Sunday, December 2, 2007
pomegranate 1
Persephone played in the golden fields. It was late summer. Flowers bloomed at her feet, and all around, a sea of heavy-laden wheatstalks swayed and whispered in the breeze. She hummed a song that she was making up on the spot, which had no words and not much tune but was nonetheless heartbreakingly enchanting. Always a lighthearted girl -- quick to laugh and given to spontaneous cartwheels -- she was even happier than usual that day. The sky was exactly her favorite shade of azure and a fair wind carried with it the scent of ripening figs. The moist earth was warm and springy under her bare feet. Harvest-time had come around again. It was her favorite season of the year.
She bent for a moment and picked some buttercups, twining them into a circlet for her hair. Across the sea of wheat she spied her mother moving with stately grace among the far fields and orchards of the gods. Persephone gave her a wave. In all her fifteen years, the daughter of Demeter had lived on sunshine and sweet rain, marking her years by the round of crop seasons and the measured drift of the stars. She had never known, even for an instant, the darkness that must eventually touch every life -- even the charmed life of a girl-goddess. But as she stood, shoulder-tall to the swaying wheat ready for harvest, that was about to change.
Hades was watching. Hades, deep in his cold kingdom in the earth, fixed bloodshot eyes on her young form and was racked with bitter anger. Her radiant youth and light steps, her honey hair fired by the sunlight that never touched his world, stirred him to emotions he could barely put a name on. Her song choked him with grief, like a memory of lost joy -- but when it echoed off the cold walls of his dark palace, the echoes sounded like mockery. Ha, Hades! King of the dead, king of nothing, lord of empty places!
He grew furious. Why should this youngling have the youth and joy that he -- one of the mightiest of the gods! -- was denied? He spat on the ground, which was cold black rock. In fact his entire palace was hewn from black rock -- the walls, the parapets, his mighty throne, even his bed -- all rock which had once been seething magma, until his chill hand quenched its fire. Hades himself, one might say, was made of cold black rock as well -- or might as well have been. He sat day and night on his obsidian throne, lost in melancholy thought. From time to time, as now, he would look out at the happy doings of the sunlit world above. Meanwhile all around him, the shades of dead heros and long-forgotten lovers flitted like silent shadows to and fro across the mute dark lands he ruled.
Watching the girl, his anger turned to envy. He was a god and she a barefoot child -- but he would have sold his godhood in an instant to live a brief life of simple joys in the warmth of the sun; to enjoy for even a single month the carefree bright world she took for granted. He watched as she leapt across a brook from rock to rock with her skirts raised up, surefooted as an ibex. Her legs were golden like the laden wheatstalks, curved like the lyre of Apollo. He stared. And now a different feeling stirred within him.
It must be said, it had been a long time since any girl had turned the head of Hades. His brothers were famous for dabbling -- sodden Poseiden had his harem of sea-nymphs, and Zeus, the old goat, would chase anything in a skirt whether she were willing or no. The two randy deities had littered the known world with a mob of half-breed offspring: one-eyed monsters, scheming heros and other mixed-race abominations beyond counting. It had gotten so you couldn't throw a pebble on the most farflung godforsaken island in the Aegean without striking some loudmouth braggart shepherd boy who claimed kinship to the gods.
Frankly, his brothers' conduct made Hades sick. He himself had little passion. For eons in his chilly kingdom he had sought no nubile beauty to warm his bones, no consort to rule beside him. He did his work well with all efficiency, kept order in the land of the dead, and retired each night to his hard stone bed alone.
So what changed in his hard heart that day, no one can say. Was it lust or loneliness, anger or avarice that drove him to do what he did? Maybe it was her song that moved him. Music has power: it can cast a listener down into the realm of sorrow and longing, where even a god may lose his reason and succumb to madness. Perhaps he didn't even mean to keep her, at first; maybe he merely thought to snatch a bright bit of earth's joy for an afternoon, then return her to her mother. Was that so wrong -- to want an hour's companionship with a girl of shining hair, smooth cheeks and goldflecked irises? Perhaps he hoped her transitory presence would bring sunlight and warmth enough to raise a few thin stalks of wheat in his lifeless kingdom, or make a couple weedy flowers bloom where she stepped. Maybe all he wanted was a little bit of what she had, a crumb of happiness off her overflowing table. If this was what he wished for, I would not say it was too much to ask.
However, it's likely that Hades himself could not have found words to explain his actions. He did not think. He simply leapt into his chariot and laid his whip across his chargers' flanks. Shouting Faster! Onward! with foam flying from his lips, he tore up through a crack in the earth with one thing on his mind.
You know what happened next. The damsel, all in innocence, turned at the sound of thunderous hoofbeats. No sooner did she gasp in fear at the chariot bearing down on her, than she was grabbed about the waist by mad-eyed Hades, her half-uncle. He hoisted her up and then flung her down in the seat beside him. With a slash of his whip he struck a cleft in the earth itself, and shouting to his stallions, he drove wild and headlong back down to the underworld with his captive.
At the last moment, just before the earth sealed closed behind them, Persephone recovered her wits and screamed for help. Demeter was half a mile away when she heard the cries. Dropping her armful of flowers, the harvest goddess rushed to save her daughter. She was too late. When she arrived, all was still and silent. Demeter charged wildly through the fields, shouting the girl's name and crying out to her fellow gods for assistance. But it was no use: Persephone was gone, as utterly gone as if the earth itself had opened and swallowed her up. Which, of course, it had.
A nightmarish time followed, during which days and nights bled and melted together, and weeks, and months, all passed without Demeter's notice. The grief-crazed mother ran and shouted and searched high and low across the world, crying out the name of her precious one. The temperature plunged, and crops browned and shriveled while she paid no attention. Grapes rotted and dropped from the vine, and people went hungry, and their desperate prayers fell on deaf ears, for Demeter no longer spared a thought for her work or the humans she was meant to serve. Finally the last of her hope and strength ebbed away. She dropped to her knees on the frozen ground, bone-tired beyond words. Leaning her face in her hands, she sobbed.
Then, something in the dirt caught her eye. It was a circlet of buttercups, torn and smashed into the mud, but still blooming bright and fresh as if just picked and undaunted by the cold. She reached out her hand in wonder and touched a petal. Among the flowers was a strand of honey-color hair.
Demeter raised her tear-stained face to Mount Olympus, new hope dawning in her breast. Great Zeus, she whispered. Hear me now. I will have my daughter back, or I will bring this world to ruin. No more will men sacrifice the best of their cattle in your name; no more will you hear them praise you. Your temples will stand empty and their stones will be pried out one by one to line the burial-mounds of men and women. All will be gone to wailing and weeping, to hunger and death. I, without the aid of thunderbolts and storms, will do this. So I promise, unless you help me find my girl.
Zeus, who saw all from atop Mount Olympus, trembled at her words, and a chill ran up his spine. He called to Hermes, the fleet-footed messenger of the gods. Carry a message to my brother in the underworld, he said slowly. Tell him, this thing must stop. The daughter of Demeter must be returned. Tell him he must prepare himself, and bid her farewell.
She bent for a moment and picked some buttercups, twining them into a circlet for her hair. Across the sea of wheat she spied her mother moving with stately grace among the far fields and orchards of the gods. Persephone gave her a wave. In all her fifteen years, the daughter of Demeter had lived on sunshine and sweet rain, marking her years by the round of crop seasons and the measured drift of the stars. She had never known, even for an instant, the darkness that must eventually touch every life -- even the charmed life of a girl-goddess. But as she stood, shoulder-tall to the swaying wheat ready for harvest, that was about to change.
Hades was watching. Hades, deep in his cold kingdom in the earth, fixed bloodshot eyes on her young form and was racked with bitter anger. Her radiant youth and light steps, her honey hair fired by the sunlight that never touched his world, stirred him to emotions he could barely put a name on. Her song choked him with grief, like a memory of lost joy -- but when it echoed off the cold walls of his dark palace, the echoes sounded like mockery. Ha, Hades! King of the dead, king of nothing, lord of empty places!
He grew furious. Why should this youngling have the youth and joy that he -- one of the mightiest of the gods! -- was denied? He spat on the ground, which was cold black rock. In fact his entire palace was hewn from black rock -- the walls, the parapets, his mighty throne, even his bed -- all rock which had once been seething magma, until his chill hand quenched its fire. Hades himself, one might say, was made of cold black rock as well -- or might as well have been. He sat day and night on his obsidian throne, lost in melancholy thought. From time to time, as now, he would look out at the happy doings of the sunlit world above. Meanwhile all around him, the shades of dead heros and long-forgotten lovers flitted like silent shadows to and fro across the mute dark lands he ruled.
Watching the girl, his anger turned to envy. He was a god and she a barefoot child -- but he would have sold his godhood in an instant to live a brief life of simple joys in the warmth of the sun; to enjoy for even a single month the carefree bright world she took for granted. He watched as she leapt across a brook from rock to rock with her skirts raised up, surefooted as an ibex. Her legs were golden like the laden wheatstalks, curved like the lyre of Apollo. He stared. And now a different feeling stirred within him.
It must be said, it had been a long time since any girl had turned the head of Hades. His brothers were famous for dabbling -- sodden Poseiden had his harem of sea-nymphs, and Zeus, the old goat, would chase anything in a skirt whether she were willing or no. The two randy deities had littered the known world with a mob of half-breed offspring: one-eyed monsters, scheming heros and other mixed-race abominations beyond counting. It had gotten so you couldn't throw a pebble on the most farflung godforsaken island in the Aegean without striking some loudmouth braggart shepherd boy who claimed kinship to the gods.
Frankly, his brothers' conduct made Hades sick. He himself had little passion. For eons in his chilly kingdom he had sought no nubile beauty to warm his bones, no consort to rule beside him. He did his work well with all efficiency, kept order in the land of the dead, and retired each night to his hard stone bed alone.
So what changed in his hard heart that day, no one can say. Was it lust or loneliness, anger or avarice that drove him to do what he did? Maybe it was her song that moved him. Music has power: it can cast a listener down into the realm of sorrow and longing, where even a god may lose his reason and succumb to madness. Perhaps he didn't even mean to keep her, at first; maybe he merely thought to snatch a bright bit of earth's joy for an afternoon, then return her to her mother. Was that so wrong -- to want an hour's companionship with a girl of shining hair, smooth cheeks and goldflecked irises? Perhaps he hoped her transitory presence would bring sunlight and warmth enough to raise a few thin stalks of wheat in his lifeless kingdom, or make a couple weedy flowers bloom where she stepped. Maybe all he wanted was a little bit of what she had, a crumb of happiness off her overflowing table. If this was what he wished for, I would not say it was too much to ask.
However, it's likely that Hades himself could not have found words to explain his actions. He did not think. He simply leapt into his chariot and laid his whip across his chargers' flanks. Shouting Faster! Onward! with foam flying from his lips, he tore up through a crack in the earth with one thing on his mind.
You know what happened next. The damsel, all in innocence, turned at the sound of thunderous hoofbeats. No sooner did she gasp in fear at the chariot bearing down on her, than she was grabbed about the waist by mad-eyed Hades, her half-uncle. He hoisted her up and then flung her down in the seat beside him. With a slash of his whip he struck a cleft in the earth itself, and shouting to his stallions, he drove wild and headlong back down to the underworld with his captive.
At the last moment, just before the earth sealed closed behind them, Persephone recovered her wits and screamed for help. Demeter was half a mile away when she heard the cries. Dropping her armful of flowers, the harvest goddess rushed to save her daughter. She was too late. When she arrived, all was still and silent. Demeter charged wildly through the fields, shouting the girl's name and crying out to her fellow gods for assistance. But it was no use: Persephone was gone, as utterly gone as if the earth itself had opened and swallowed her up. Which, of course, it had.
A nightmarish time followed, during which days and nights bled and melted together, and weeks, and months, all passed without Demeter's notice. The grief-crazed mother ran and shouted and searched high and low across the world, crying out the name of her precious one. The temperature plunged, and crops browned and shriveled while she paid no attention. Grapes rotted and dropped from the vine, and people went hungry, and their desperate prayers fell on deaf ears, for Demeter no longer spared a thought for her work or the humans she was meant to serve. Finally the last of her hope and strength ebbed away. She dropped to her knees on the frozen ground, bone-tired beyond words. Leaning her face in her hands, she sobbed.
Then, something in the dirt caught her eye. It was a circlet of buttercups, torn and smashed into the mud, but still blooming bright and fresh as if just picked and undaunted by the cold. She reached out her hand in wonder and touched a petal. Among the flowers was a strand of honey-color hair.
Demeter raised her tear-stained face to Mount Olympus, new hope dawning in her breast. Great Zeus, she whispered. Hear me now. I will have my daughter back, or I will bring this world to ruin. No more will men sacrifice the best of their cattle in your name; no more will you hear them praise you. Your temples will stand empty and their stones will be pried out one by one to line the burial-mounds of men and women. All will be gone to wailing and weeping, to hunger and death. I, without the aid of thunderbolts and storms, will do this. So I promise, unless you help me find my girl.
Zeus, who saw all from atop Mount Olympus, trembled at her words, and a chill ran up his spine. He called to Hermes, the fleet-footed messenger of the gods. Carry a message to my brother in the underworld, he said slowly. Tell him, this thing must stop. The daughter of Demeter must be returned. Tell him he must prepare himself, and bid her farewell.
Saturday, December 1, 2007
paradox
Me: You've got to understand. Your mother is eighty-nine years old. And she's frail: hospitalized seven times in the last two years. She doesn't have a good chance of surviving this pneumonia.
Them: But she's a fighter! She's been through worse than this. Do you know how many times before we've heard this same gloom-and-doom speech from doctors like you? Do everything you can, doc. We're sure: Mom's going to live.
I've discovered a paradox. I can't untangle it. It ties my brain into a Mobius strip and makes me claw the insides of my skull if I think on it too long. Here it is:
Experience tells me that the older a patient is, the more likely she is to die from her illness. Families, however, have the opposite experience. If their mom has come through eighty years of life without dying a single time, that's a convincing pattern of staying alive. If she's spent ninety years not dying, that's even better. And as she goes on amassing years of life on earth, her statistical probability of being alive and not dead at any given moment continues to increase.
Experience also tells me that the more times a patient has been hospitalized in the past, the more likely she is to die. A patient who's in and out of the hospital is by definition made of weak stuff -- which means she's slow to recover and always in danger of complications. But here again, the family's viewpoint is different. Mom's always beaten the rap before, they say. If she's survived three past admissions, she's got a three-and-o record under her belt for beating the spectre of death. If she's come home alive from nine admissions, that makes her nine-and-o -- a hell of a winning record. She didn't die the last nine times, her loved ones muse; so why would this time be any different?
The doctor bases her argument on common-sense medicine. The family bases theirs on pattern recognition and inferring probabilities from past experience. Which side has the greater claim to truth and logic? I've been contemplating this conundrum for years now, and I still can't resolve it. Someday I'm going to dwell on it too long, and be found dead with black smoke issuing from my ears.
Them: But she's a fighter! She's been through worse than this. Do you know how many times before we've heard this same gloom-and-doom speech from doctors like you? Do everything you can, doc. We're sure: Mom's going to live.
I've discovered a paradox. I can't untangle it. It ties my brain into a Mobius strip and makes me claw the insides of my skull if I think on it too long. Here it is:
Experience tells me that the older a patient is, the more likely she is to die from her illness. Families, however, have the opposite experience. If their mom has come through eighty years of life without dying a single time, that's a convincing pattern of staying alive. If she's spent ninety years not dying, that's even better. And as she goes on amassing years of life on earth, her statistical probability of being alive and not dead at any given moment continues to increase.
Experience also tells me that the more times a patient has been hospitalized in the past, the more likely she is to die. A patient who's in and out of the hospital is by definition made of weak stuff -- which means she's slow to recover and always in danger of complications. But here again, the family's viewpoint is different. Mom's always beaten the rap before, they say. If she's survived three past admissions, she's got a three-and-o record under her belt for beating the spectre of death. If she's come home alive from nine admissions, that makes her nine-and-o -- a hell of a winning record. She didn't die the last nine times, her loved ones muse; so why would this time be any different?
The doctor bases her argument on common-sense medicine. The family bases theirs on pattern recognition and inferring probabilities from past experience. Which side has the greater claim to truth and logic? I've been contemplating this conundrum for years now, and I still can't resolve it. Someday I'm going to dwell on it too long, and be found dead with black smoke issuing from my ears.
Thursday, November 29, 2007
end
It wasn't colon cancer. It was worse: malignant carcinoid, a zebra, one in a million, and untreatable. He's dead this morning -- barely four weeks from his first touch of abdominal pain. He was 38. He leaves a large family. I got nothing more to say except, sometimes things suck.
Monday, November 26, 2007
run through the jungle
The whereabouts of a long-missing Dutch woman have been confirmed. The woman, who was raised in a wealthy family in Holland, had moved to Colombia in her early twenties to teach and volunteer among the poor. She was last seen by relatives four years ago, ,when she told her family she was moving to the jungle to teach indigent children. It now turns out that she is fighting with a Colombian rebel group called FARC. Fragments of her diary were found when the Colombian army overran a rebel camp.
I love this story. It is the story of a woman who broke all bonds of conformity and dared to live big and crazy.
I come from a well-off family too, but unlike my Dutch heroine I chose the life expected of me. When danger called me, I shrank from it and turned my face away.
I was twenty-two and living in Prague when the first bombs lit the sky over Croatia. At that time, I was used to rootlessness and all-night trainrides across the continent, so it felt like all Europe was my neighborhood and my stomping ground. When the first fissures appeared in Yugoslavia that summer -- when I heard the blood-pulse of rising war, of drums and thunder on the horizon -- my blood rose up in answer and an electric thrill ran along my nerves. Think of it: only a trainride away, a mighty storm was gathering. I was drawn to Yugoslavia like a moth to flame.
I had an apartment in Praha 2 -- Prague section 2 -- on Plavetska ulice by the river Vltava. Almost every day that summer I'd cross the river on Charles Bridge and mount the hill to the American embassy. The second floor of the embassy was always crowded with expats, standing in line to pick up packages. Next to the mail pickup counter stood a bulletin board where travel advisories were posted. Neat rows of index cards warned American travelers about hotspots around the world. Recent rash of carjackings on the highways of Spain, said one card. Another read, Caution urged for travelers in eastern Turkey -- British professor kidnapped by Kurdish insurgents and held for ransom. My eyes sought out the latest travel advisories concerning the Balkans. These were updated frequently, and grew more ominous day by day. Unrest in the region. Travelers advised to use caution and stay on main roads. A week later the card read: Sporadic violence; roadblocks, security of civilians declining. All unnecessary travel in Yugoslavia should be avoided. Later it changed to: Strongly urge no pleasure travel to the Balkan peninsula at this time. Additionally, all Americans in the region on business are urged to leave as soon as possible.
Finally that card too came down. In its place this notice ran: The US has closed its embassy in Yugoslavia and all nonessential personnel have been evacuated. Any Americans remaining in the area do so at their own risk and should expect no assistance from the U.S. government.
Reading those words, I got chills.
I used to go to the train station late at night and check the trains heading southeast: the times, the prices. I would imagine myself boarding one of those trains. There was nothing to hold me in Prague. Everything I owned, I could pack in less than an hour. I could walk up to the window and push a few bills across the counter and get msyelf a ticket. I could climb aboard, settle myself in a car, ride all night to Zagreb and get off there. Then I could look around and wait to find out what would happen next.
But I never did buy the ticket. People like me -- Barbie-girls from the suburbs -- just didn't go to wars. We had worried mothers and fathers who would never understand, who would call us selfish and foolish, who would pace the floor, who would never forgive us if we got hurt or killed. We had guilt. We had liberal antiwar politics. We had friends and brothers who would make shocked faces and say, What the hell do you think you're doing?
It was years later when I heard a story about a boy I'd gone to high school with. He was an aspiring photojournalist (I remembered him only as a gawky kid with big ears) and when war came to the Balkans, he dared what I did not. He took his camera and went to the war, carved out a life as a stringer there, made a name for himself and launched his career. I still wonder what his mother and father thought of him going. Didn't they worry? Didn't he care? And why didn't that stop him?
Here is what I think: We are all born with our feet in cement, stuck to the ground before our first breath is drawn, by the expectations of our families and class background. We grow up in cages with clear plexiglass walls we barely take note of. A few of us stretch the walls a bit. A very few of us break them down and walk free.
Me, I was meant from birth to go to college and keep my hands soft -- become a professional something and marry a professional someone like myself. I was never meant to be a cop or a carpenter, a soldier or an adventurer. In the summers I made money as a babysitter, then later as a Kelly Girl, typing for six-fifty an hour. I never considered that I could have made more money on a construction crew. After college I knocked around Europe for a while but in the end I came home, driven by a sense that I was being left out, left behind in a strange backwater while everyone I knew was moving ahead into the Real World without me. I got a small-time job, but still I felt left behind. So I went to med school. Something was still missing, so I got married. That wasn't enough, so I had a kid. Then I got into the habit of pregnancy, so I had a couple more of them. At last I felt like I had caught up. And here I am. It's a fine life -- a routine one, comfortable. It fits me well. After all, it's exactly the life I was raised for.
Here: I have another secret, a secret kinship with the Dutch woman. No one knows this part. At thirteen I fell in love with Eden Pastora. He was called Commander Zero at that time -- a wild Nicaraguan rebel who took half the government hostage in Managua and lived to brag about it. I saw his picture in a magazine in the early eighties: all windblown black beard and fiery gaze. I never told anyone what I felt for him -- who would I tell? But the first man I ever looked at twice was him, and the first thing I ever wanted to be was a freedom fighter in the jungles of Nicaragua. I was never too serious about it, though. I always thought, girls like me don't actually do stuff like that.
Except, now I find out that some of us do -- the brave ones, the ones who crash through the walls and move out into the world, away from the path they were born to.
That is what the Dutch woman is to me: a living monument to all the possibilities that open to those who dare and who fear no borders of geography, or mind, or class, or anyone's expectations.
I love this story. It is the story of a woman who broke all bonds of conformity and dared to live big and crazy.
I come from a well-off family too, but unlike my Dutch heroine I chose the life expected of me. When danger called me, I shrank from it and turned my face away.
I was twenty-two and living in Prague when the first bombs lit the sky over Croatia. At that time, I was used to rootlessness and all-night trainrides across the continent, so it felt like all Europe was my neighborhood and my stomping ground. When the first fissures appeared in Yugoslavia that summer -- when I heard the blood-pulse of rising war, of drums and thunder on the horizon -- my blood rose up in answer and an electric thrill ran along my nerves. Think of it: only a trainride away, a mighty storm was gathering. I was drawn to Yugoslavia like a moth to flame.
I had an apartment in Praha 2 -- Prague section 2 -- on Plavetska ulice by the river Vltava. Almost every day that summer I'd cross the river on Charles Bridge and mount the hill to the American embassy. The second floor of the embassy was always crowded with expats, standing in line to pick up packages. Next to the mail pickup counter stood a bulletin board where travel advisories were posted. Neat rows of index cards warned American travelers about hotspots around the world. Recent rash of carjackings on the highways of Spain, said one card. Another read, Caution urged for travelers in eastern Turkey -- British professor kidnapped by Kurdish insurgents and held for ransom. My eyes sought out the latest travel advisories concerning the Balkans. These were updated frequently, and grew more ominous day by day. Unrest in the region. Travelers advised to use caution and stay on main roads. A week later the card read: Sporadic violence; roadblocks, security of civilians declining. All unnecessary travel in Yugoslavia should be avoided. Later it changed to: Strongly urge no pleasure travel to the Balkan peninsula at this time. Additionally, all Americans in the region on business are urged to leave as soon as possible.
Finally that card too came down. In its place this notice ran: The US has closed its embassy in Yugoslavia and all nonessential personnel have been evacuated. Any Americans remaining in the area do so at their own risk and should expect no assistance from the U.S. government.
Reading those words, I got chills.
I used to go to the train station late at night and check the trains heading southeast: the times, the prices. I would imagine myself boarding one of those trains. There was nothing to hold me in Prague. Everything I owned, I could pack in less than an hour. I could walk up to the window and push a few bills across the counter and get msyelf a ticket. I could climb aboard, settle myself in a car, ride all night to Zagreb and get off there. Then I could look around and wait to find out what would happen next.
But I never did buy the ticket. People like me -- Barbie-girls from the suburbs -- just didn't go to wars. We had worried mothers and fathers who would never understand, who would call us selfish and foolish, who would pace the floor, who would never forgive us if we got hurt or killed. We had guilt. We had liberal antiwar politics. We had friends and brothers who would make shocked faces and say, What the hell do you think you're doing?
It was years later when I heard a story about a boy I'd gone to high school with. He was an aspiring photojournalist (I remembered him only as a gawky kid with big ears) and when war came to the Balkans, he dared what I did not. He took his camera and went to the war, carved out a life as a stringer there, made a name for himself and launched his career. I still wonder what his mother and father thought of him going. Didn't they worry? Didn't he care? And why didn't that stop him?
Here is what I think: We are all born with our feet in cement, stuck to the ground before our first breath is drawn, by the expectations of our families and class background. We grow up in cages with clear plexiglass walls we barely take note of. A few of us stretch the walls a bit. A very few of us break them down and walk free.
Me, I was meant from birth to go to college and keep my hands soft -- become a professional something and marry a professional someone like myself. I was never meant to be a cop or a carpenter, a soldier or an adventurer. In the summers I made money as a babysitter, then later as a Kelly Girl, typing for six-fifty an hour. I never considered that I could have made more money on a construction crew. After college I knocked around Europe for a while but in the end I came home, driven by a sense that I was being left out, left behind in a strange backwater while everyone I knew was moving ahead into the Real World without me. I got a small-time job, but still I felt left behind. So I went to med school. Something was still missing, so I got married. That wasn't enough, so I had a kid. Then I got into the habit of pregnancy, so I had a couple more of them. At last I felt like I had caught up. And here I am. It's a fine life -- a routine one, comfortable. It fits me well. After all, it's exactly the life I was raised for.
Here: I have another secret, a secret kinship with the Dutch woman. No one knows this part. At thirteen I fell in love with Eden Pastora. He was called Commander Zero at that time -- a wild Nicaraguan rebel who took half the government hostage in Managua and lived to brag about it. I saw his picture in a magazine in the early eighties: all windblown black beard and fiery gaze. I never told anyone what I felt for him -- who would I tell? But the first man I ever looked at twice was him, and the first thing I ever wanted to be was a freedom fighter in the jungles of Nicaragua. I was never too serious about it, though. I always thought, girls like me don't actually do stuff like that.
Except, now I find out that some of us do -- the brave ones, the ones who crash through the walls and move out into the world, away from the path they were born to.
That is what the Dutch woman is to me: a living monument to all the possibilities that open to those who dare and who fear no borders of geography, or mind, or class, or anyone's expectations.
silence
"... ?" -- willow
"... ?" -- xander
"... !" -- giles
--"Hush" (the auditorium scene). Buffy tVS season 4
(because today, I have no voice)
"... ?" -- xander
"... !" -- giles
--"Hush" (the auditorium scene). Buffy tVS season 4
(because today, I have no voice)
Saturday, November 24, 2007
update: code 11/14 and social services
I hate loose ends, so I'll wrap up and put these stories to bed.
The patient from Code 11/14 did well -- so well, in fact, that I totally lost interest. He went off to rehab to get his strength back, and hopefully will be back home with his family soon.
Brenda the social worker came to my home at the appointed hour, this time bringing not one but two reinforcements (either she was scared of me, or she wanted to point me out to her assistants as "this is what a really bad mother looks like.") She had actually stalked my children and interviewed them at school. "Does your mommy let you play on the street by yourselves? Does your mommy ever tie you up with that rope hanging inside the house?" She was satisfied with their answers, though disturbed that the younger two were wearing sandals in thirty-degree weather. Clearly she herself has never tried to argue shoe choices with small strongwilled children.
I was outraged. I understand she's just doing her valuable and necessary job, but I'm outraged anyway. My shy oldest girl was probably terrified and embarrassed. I wonder how on earth Brenda introduced herself -- "Hi, honey, I'm a friend of your mommy's, stopping by for no reason and asking nosy questions"? Or "Hi, honey, I'm checking up on whether your mommy takes care of you"?
Then, to "close the case" so I wouldn't have to endure serial home visits, she had made up a document for me to sign. Loulou3 will dress the children in weather-appropriate clothes. Loulou3 understands that she is responsible for supervising her children at all times. Loulou3 will take down the rope hanging in her house as this is a choking hazard, or will closely supervise the children when they are playing with it.
She had actually typed the thing up using my first name. This irritated me more than anything else -- which I suspect means I'm turning into my mother much sooner than anticipated. I signed it. I smiled. I showed her and the others to the door. I ripped up the poisonous piece of crap as soon as she was gone.
She did tell me one thing I wanted to know. The person who'd called in the tip about my allegedly negligent parenting was named Anonymous. So now, on top of everything else, I'm going to die wondering.
The patient from Code 11/14 did well -- so well, in fact, that I totally lost interest. He went off to rehab to get his strength back, and hopefully will be back home with his family soon.
Brenda the social worker came to my home at the appointed hour, this time bringing not one but two reinforcements (either she was scared of me, or she wanted to point me out to her assistants as "this is what a really bad mother looks like.") She had actually stalked my children and interviewed them at school. "Does your mommy let you play on the street by yourselves? Does your mommy ever tie you up with that rope hanging inside the house?" She was satisfied with their answers, though disturbed that the younger two were wearing sandals in thirty-degree weather. Clearly she herself has never tried to argue shoe choices with small strongwilled children.
I was outraged. I understand she's just doing her valuable and necessary job, but I'm outraged anyway. My shy oldest girl was probably terrified and embarrassed. I wonder how on earth Brenda introduced herself -- "Hi, honey, I'm a friend of your mommy's, stopping by for no reason and asking nosy questions"? Or "Hi, honey, I'm checking up on whether your mommy takes care of you"?
Then, to "close the case" so I wouldn't have to endure serial home visits, she had made up a document for me to sign. Loulou3 will dress the children in weather-appropriate clothes. Loulou3 understands that she is responsible for supervising her children at all times. Loulou3 will take down the rope hanging in her house as this is a choking hazard, or will closely supervise the children when they are playing with it.
She had actually typed the thing up using my first name. This irritated me more than anything else -- which I suspect means I'm turning into my mother much sooner than anticipated. I signed it. I smiled. I showed her and the others to the door. I ripped up the poisonous piece of crap as soon as she was gone.
She did tell me one thing I wanted to know. The person who'd called in the tip about my allegedly negligent parenting was named Anonymous. So now, on top of everything else, I'm going to die wondering.
old people
Last night a nurse called me for help: an elderly patient was cursing her, wandering the halls, barging into other patients' rooms and shaking his fist at them. Finally he hurled a phone book at the nurse's head and shouted something about child molesters.
I come across a lot of old people at work. Most of them are a bit demented (some more than a bit) and they tend to go to pieces mentally once they're stuck in the hospital. They wake up in the night and blink around at the dark shadows and think, Where the hell am I? This place doesn't match anything my mind can put a name on. Am I lost? Kidnapped? What happened to my family? Eventually, their brain supplies some sort of answer to try to make sense of things. Damn hot here. What's that weird smell? Oh, Christ, I'd forgotten -- we made land yesterday. Iwo Jima, the sarge called it. OK, you motherfuckers, I'm ready for ya! Come and get me!
The vagaries of mind and memory are amazing to me. One night in med school I woke up in darkness clutching my bed, sure that I was back on the volcano Stromboli in a makeshift tent, with the ground booming underneath me. But under me I felt mattress instead of rock, so I couldn't make sense of anything and fell asleep again in confusion -- like Billy Pilgrim unstuck in time. The next day the local news reported that several blocks from my apartment, an abandoned home had exploded in the night and sent a shockwave through the earth that could be felt a mile away. See how amazing? I hadn't thought of Stromboli in years, but the earth went boom and my body remembered that feeling from the single night, a lifetime previous, when I'd lain on booming earth before. In my sleep my brain slung me backwards like a time-traveler, and I woke up twenty-two in Sicily and in trouble again -- and it felt as real and solid as it had been the first time around. How cool is that.
So now I'm looking forward to senility, when I will at last recapture my lost youth. I'm going to pay someone to set off explosions near me at intervals while I'm sleeping, so I can wake up night after night in Sicily, and be twenty-two forever.
I come across a lot of old people at work. Most of them are a bit demented (some more than a bit) and they tend to go to pieces mentally once they're stuck in the hospital. They wake up in the night and blink around at the dark shadows and think, Where the hell am I? This place doesn't match anything my mind can put a name on. Am I lost? Kidnapped? What happened to my family? Eventually, their brain supplies some sort of answer to try to make sense of things. Damn hot here. What's that weird smell? Oh, Christ, I'd forgotten -- we made land yesterday. Iwo Jima, the sarge called it. OK, you motherfuckers, I'm ready for ya! Come and get me!
The vagaries of mind and memory are amazing to me. One night in med school I woke up in darkness clutching my bed, sure that I was back on the volcano Stromboli in a makeshift tent, with the ground booming underneath me. But under me I felt mattress instead of rock, so I couldn't make sense of anything and fell asleep again in confusion -- like Billy Pilgrim unstuck in time. The next day the local news reported that several blocks from my apartment, an abandoned home had exploded in the night and sent a shockwave through the earth that could be felt a mile away. See how amazing? I hadn't thought of Stromboli in years, but the earth went boom and my body remembered that feeling from the single night, a lifetime previous, when I'd lain on booming earth before. In my sleep my brain slung me backwards like a time-traveler, and I woke up twenty-two in Sicily and in trouble again -- and it felt as real and solid as it had been the first time around. How cool is that.
So now I'm looking forward to senility, when I will at last recapture my lost youth. I'm going to pay someone to set off explosions near me at intervals while I'm sleeping, so I can wake up night after night in Sicily, and be twenty-two forever.
Wednesday, November 21, 2007
sneeze if you're muslim 2
Me: Sarah, does your teacher explain why Muslims say "Alhamdulillah" when they sneeze?
S: shrugs
Me: Well. Here's the thing.
S (looking nervous as she recognizes her mother's Imminent Pontification face): What thing?
Me: "Alhamdulillah" means "thank God" or something. The thing is, if I were God, I'd want people to thank me when they meant it and not just because someone told them to.
S: Oh.
Me: Like, suppose someone says "A-choo! alhamdulillah," all in a rush, and you know they're not actually thinking, "Wow, God! Thank you for giving me that terrific sneeze!" They're just saying it as a habit.
S (brightening with recognition): You mean, like Baba!
Me: Shhh. Well, yes, smart girl. But don't tell your baba I said so.
S: Why not?
Me: Just don't.
S: Can I have a snack now?
S: shrugs
Me: Well. Here's the thing.
S (looking nervous as she recognizes her mother's Imminent Pontification face): What thing?
Me: "Alhamdulillah" means "thank God" or something. The thing is, if I were God, I'd want people to thank me when they meant it and not just because someone told them to.
S: Oh.
Me: Like, suppose someone says "A-choo! alhamdulillah," all in a rush, and you know they're not actually thinking, "Wow, God! Thank you for giving me that terrific sneeze!" They're just saying it as a habit.
S (brightening with recognition): You mean, like Baba!
Me: Shhh. Well, yes, smart girl. But don't tell your baba I said so.
S: Why not?
Me: Just don't.
S: Can I have a snack now?
Tuesday, November 20, 2007
ACLS recert
Yesterday and today I've been stuck in class, recertifying for advanced cardiac life support. We broke up into groups of six and practiced using defibrillators on dummies. Everyone in the class of 25 was an RN or student EMT, except me. So right away, people jumped to the wrong conclusion.
M: Hey, who here knows how to charge the machine for a synchronized shock?
T: Ask Dr. L! You must know, right, doc?
Me: Actually, no. I don't know how to do anything with my own hands.
R: But you're a doctor.
Me: Yes, but I'm the kind with no useful skills. That's what you guys are for.
M: So, what do you do, exactly?
Me: I just write stuff in the charts.
The best description I've ever read of what an internist is, goes like this: "Internists are the guys who write very detailed notes in the chart, carefully documenting the patient's downhill course."
There are lots of ways to tell the specialties apart. Here is a classic tip:
Internists know everything and do nothing, whereas surgeons know nothing and do everything. Psychiatrists know nothing and do nothing. Pathologists know everything and do everything, but too late.
Then, there are the orthopedic surgeons. They're great -- all big strapping guys, bluff and personable, ,who played sports in their glory days. The best epigram I've heard about them goes like this: Orthopods -- strong as an ox, and twice as smart.
Surgeons take a lot of cheap shots, mostly well-deserved. "A surgeon is like a stupid child who has learned to tie a very complicated pair of shoes and is really proud of the accomplishment."
Here's my favorite. This is a story about two subspecialties famous for not knowing when to quit.
The oncology team meeting got underway on Monday morning with a discussion of the sickest of their cancer patients. "What about Ms. Brown?" asked the department chair, looking around at her colleagues. "How's she doing with her metastatic cancer of the everything?"
"She died on Friday," answered the onc nurse. "I saw her name in the obits. The viewing was today."
"That's too bad," the chair answered. "Well, let's give her at least one more round of chemo. After all, you never know. Maybe it will do some good."
All the oncologists agreed it was worth a shot. So that night they crept out to the cemetery with picks and shovels and unearthed the woman's coffin. They pried open the lid. But they were shocked at what they saw.
The body was gone and the coffin was empty, except for a yellow post-it note written in the careful hand of the renal physician. It said: "Gone to dialysis."
M: Hey, who here knows how to charge the machine for a synchronized shock?
T: Ask Dr. L! You must know, right, doc?
Me: Actually, no. I don't know how to do anything with my own hands.
R: But you're a doctor.
Me: Yes, but I'm the kind with no useful skills. That's what you guys are for.
M: So, what do you do, exactly?
Me: I just write stuff in the charts.
The best description I've ever read of what an internist is, goes like this: "Internists are the guys who write very detailed notes in the chart, carefully documenting the patient's downhill course."
There are lots of ways to tell the specialties apart. Here is a classic tip:
Internists know everything and do nothing, whereas surgeons know nothing and do everything. Psychiatrists know nothing and do nothing. Pathologists know everything and do everything, but too late.
Then, there are the orthopedic surgeons. They're great -- all big strapping guys, bluff and personable, ,who played sports in their glory days. The best epigram I've heard about them goes like this: Orthopods -- strong as an ox, and twice as smart.
Surgeons take a lot of cheap shots, mostly well-deserved. "A surgeon is like a stupid child who has learned to tie a very complicated pair of shoes and is really proud of the accomplishment."
Here's my favorite. This is a story about two subspecialties famous for not knowing when to quit.
The oncology team meeting got underway on Monday morning with a discussion of the sickest of their cancer patients. "What about Ms. Brown?" asked the department chair, looking around at her colleagues. "How's she doing with her metastatic cancer of the everything?"
"She died on Friday," answered the onc nurse. "I saw her name in the obits. The viewing was today."
"That's too bad," the chair answered. "Well, let's give her at least one more round of chemo. After all, you never know. Maybe it will do some good."
All the oncologists agreed it was worth a shot. So that night they crept out to the cemetery with picks and shovels and unearthed the woman's coffin. They pried open the lid. But they were shocked at what they saw.
The body was gone and the coffin was empty, except for a yellow post-it note written in the careful hand of the renal physician. It said: "Gone to dialysis."
Monday, November 19, 2007
deconstruction
Something that drives me nuts, is that no one in my family -- aside from the tiny monsters -- ever asks me what I do for a living. I mean, they know I'm a doctor, of course. But they act like I work for the mob and it's impolite to ask too many questions.
So anyway, here's what I did last night on call:
1. Admitted a middle-aged paraplegic with a bladder infection and a funny-looking kidney. Threw antibiotics at her and asked Urology to see her in the morning.
2. Admitted a young woman with a bad pneumonia, getting worse despite oral antibiotics at home. What makes her interesting is that she's taking a immune-suppressing medicine for another medical condition - which means she might have something offbeat and cool, like TB or a lung fungus. Threw antibiotics at her, put her in respiratory isolation (quarantine) and asked Pulm and ID to see her in the morning.
3. Admitted a middle-aged woman who'd overdosed on muscle relaxants, hoping to cure a bad headache. Muscle relaxants don't usually help headaches. However, they do cause low blood pressure, slow heart rate and hallucinations when taken to excess. I tried to explain this to her but she was too busy hallucinating and clutching her head to pay attention.
4 and 5. Admitted twin strokes: two lively octogenarians who both came to the ER with sudden weakness. Threw antiplatelet medicine at them and asked Neurology to see them in the morning.
My God, is that really what I did all night? It sounds incredibly boring. Actually, it WAS incredibly boring. Huh. Maybe that's why my family doesn't ask any questions.
So anyway, here's what I did last night on call:
1. Admitted a middle-aged paraplegic with a bladder infection and a funny-looking kidney. Threw antibiotics at her and asked Urology to see her in the morning.
2. Admitted a young woman with a bad pneumonia, getting worse despite oral antibiotics at home. What makes her interesting is that she's taking a immune-suppressing medicine for another medical condition - which means she might have something offbeat and cool, like TB or a lung fungus. Threw antibiotics at her, put her in respiratory isolation (quarantine) and asked Pulm and ID to see her in the morning.
3. Admitted a middle-aged woman who'd overdosed on muscle relaxants, hoping to cure a bad headache. Muscle relaxants don't usually help headaches. However, they do cause low blood pressure, slow heart rate and hallucinations when taken to excess. I tried to explain this to her but she was too busy hallucinating and clutching her head to pay attention.
4 and 5. Admitted twin strokes: two lively octogenarians who both came to the ER with sudden weakness. Threw antiplatelet medicine at them and asked Neurology to see them in the morning.
My God, is that really what I did all night? It sounds incredibly boring. Actually, it WAS incredibly boring. Huh. Maybe that's why my family doesn't ask any questions.
Sunday, November 18, 2007
crack in the mirror
Sometimes this happens: You're driving along the highway. Up ahead, you catch sight of a car like yours -- same color, same make and model and subtype. You close in on it. The woman behind the wheel has your haircolor, and in fact, your hairstyle too. She seems to be smiling but you can't make out her face. The thought strikes you: What if I pull up beside her and take a good look -- and see my own face grinning back at me?
Here's what to do: Press the accelerator, pull alongside and pass her quickly while keeping your eyes fixed on the road. Do not check your rearview mirror. Get home as fast as you can, and lock the doors.
Here's what to do: Press the accelerator, pull alongside and pass her quickly while keeping your eyes fixed on the road. Do not check your rearview mirror. Get home as fast as you can, and lock the doors.
Saturday, November 17, 2007
return of the sea monkeys
Scene one: preschool
Jake: Guess what! We got little shrimp at my house!
Miss Bethany: Oh, I love shrimp too. Do you dip them in cocktail sauce?
Scene two: home
Jake: Mama, when the sea monkeys grow up, can we make them be dead and eat them with sauce?
Jake: Guess what! We got little shrimp at my house!
Miss Bethany: Oh, I love shrimp too. Do you dip them in cocktail sauce?
Scene two: home
Jake: Mama, when the sea monkeys grow up, can we make them be dead and eat them with sauce?
my name is not loulou 3
My mother had car trouble the day before I was to leave. I didn't panic. I called my best friend's mom: could she drive me to the airport? Then I told my mother not to worry, as I wouldn't be needing her after all.
I had meant to spare her a burden, but instead she burst into tears. The car was already fixed, she said. And in spite of all the trouble between us, she'd always assumed she would be at my side in that last moment, before I flew.
So the next day, she drove me. It was a strained parting. During the month we'd been under the same roof, my mother had not cheered for my plan. In the middle of our silent dinners I'd see her eyes fixed on me, mouth pursed up and lines of pain and anger etched into her face. She'd burst out, It's not going to be like you think, you know. I've traveled in Europe. They're sick of young American bums on their streets. You think they'll be friendly to you? You're wrong.
Or, What do you know about biking any distance? What's the longest you've ever biked, anyway? How will you even get out of the airport? You've never put a bike together. What's going to happen if you can't do it?
Or, Your father and I saved every penny when we were first married. We didn't go running around, loosey-goosey, because we thought it was fun. We were too responsible for such nonsense.
My mother was scared for me; I knew that. She was also impossible, bitter, envious, and mean: a dragging anchor against all my optimism and hope. At least that's how I saw it then. Now that I've got a few young things of my own, I would say she let me off easy. If one of my own kids ever threatens to take wild risks too far from the nest, I'm going to chain her to a radiator until I can beat some sense into her silly, ungrateful skull.
At the airport, my mother helped me maneuver my luggage cart through the lines. The only baggage I checked was an oversized flat box of heavy cardboard. I had paid a local bike shop to disassemble and pack my bike for me, since I had no idea how to do it myself and wasn't interested in learning. The bike was new: a Univega Gran Touring, twelve speeds, gunmetal gray. It had cost four hundred dollars. I'd ridden it in my neighborhood a couple times with the panniers on, trying to get the hang of balancing with all that unfamiliar weight on my rear wheel. I didn't go far, though; just up and down my street. It was sort of a drag, to tell the truth -- slow and heavy and hard to manage. But I wasn't worried. I'd learn by doing, on the road in Europe. I'd chosen Holland as a strategic starting point in my campaign: according to Let's Go: Europe, it was bike-friendly. And flat.
My carry-on luggage was a strange-looking creation. It consisted of two panniers (stuffed with clothes and a tarp), a sleeping bag, a bike pump, a Kryptonite lock, and a handlebar bag full of Allen wrenches and such. The whole mess was bound together with an assortment of bungee cords. Under my clothes I wore a hidden pouch that hung from a string around my neck: it held my passport and asthma inhaler and every cent I'd saved in my entire life, converted into travelers' checks. I'd always been a saver. I'd also been something of a kept woman my last year in college, so that helped.
Something occurred to me years later, that never crossed my mind at that time. My mother had taken out loans, maybe a hundred grand's worth, to put me through college. I had been able to "save" money from my campus jobs and summer work, because my living expenses were paid by those student loans that she signed for. Rightfully, my mother could have reminded me of this and laid claim to every cent I had. But for all those times she'd said, Don't go and I'd stormed, I have the right and I have the money, she had never once pulled that trump card. She was a class act.
Eithet that, or she was just scared it wouldn't be enough to stop me.
At the security gate, we paused for a moment. She looked at me. I was steeled for some final twist of the knife or bitter remonstration. Instead she said softly, "Have fun out there, kiddo. Enjoy your freedom. The real world closes in pretty fast."
That was the last gift she gave me, and the last thing I took with me when I left.
I had meant to spare her a burden, but instead she burst into tears. The car was already fixed, she said. And in spite of all the trouble between us, she'd always assumed she would be at my side in that last moment, before I flew.
So the next day, she drove me. It was a strained parting. During the month we'd been under the same roof, my mother had not cheered for my plan. In the middle of our silent dinners I'd see her eyes fixed on me, mouth pursed up and lines of pain and anger etched into her face. She'd burst out, It's not going to be like you think, you know. I've traveled in Europe. They're sick of young American bums on their streets. You think they'll be friendly to you? You're wrong.
Or, What do you know about biking any distance? What's the longest you've ever biked, anyway? How will you even get out of the airport? You've never put a bike together. What's going to happen if you can't do it?
Or, Your father and I saved every penny when we were first married. We didn't go running around, loosey-goosey, because we thought it was fun. We were too responsible for such nonsense.
My mother was scared for me; I knew that. She was also impossible, bitter, envious, and mean: a dragging anchor against all my optimism and hope. At least that's how I saw it then. Now that I've got a few young things of my own, I would say she let me off easy. If one of my own kids ever threatens to take wild risks too far from the nest, I'm going to chain her to a radiator until I can beat some sense into her silly, ungrateful skull.
At the airport, my mother helped me maneuver my luggage cart through the lines. The only baggage I checked was an oversized flat box of heavy cardboard. I had paid a local bike shop to disassemble and pack my bike for me, since I had no idea how to do it myself and wasn't interested in learning. The bike was new: a Univega Gran Touring, twelve speeds, gunmetal gray. It had cost four hundred dollars. I'd ridden it in my neighborhood a couple times with the panniers on, trying to get the hang of balancing with all that unfamiliar weight on my rear wheel. I didn't go far, though; just up and down my street. It was sort of a drag, to tell the truth -- slow and heavy and hard to manage. But I wasn't worried. I'd learn by doing, on the road in Europe. I'd chosen Holland as a strategic starting point in my campaign: according to Let's Go: Europe, it was bike-friendly. And flat.
My carry-on luggage was a strange-looking creation. It consisted of two panniers (stuffed with clothes and a tarp), a sleeping bag, a bike pump, a Kryptonite lock, and a handlebar bag full of Allen wrenches and such. The whole mess was bound together with an assortment of bungee cords. Under my clothes I wore a hidden pouch that hung from a string around my neck: it held my passport and asthma inhaler and every cent I'd saved in my entire life, converted into travelers' checks. I'd always been a saver. I'd also been something of a kept woman my last year in college, so that helped.
Something occurred to me years later, that never crossed my mind at that time. My mother had taken out loans, maybe a hundred grand's worth, to put me through college. I had been able to "save" money from my campus jobs and summer work, because my living expenses were paid by those student loans that she signed for. Rightfully, my mother could have reminded me of this and laid claim to every cent I had. But for all those times she'd said, Don't go and I'd stormed, I have the right and I have the money, she had never once pulled that trump card. She was a class act.
Eithet that, or she was just scared it wouldn't be enough to stop me.
At the security gate, we paused for a moment. She looked at me. I was steeled for some final twist of the knife or bitter remonstration. Instead she said softly, "Have fun out there, kiddo. Enjoy your freedom. The real world closes in pretty fast."
That was the last gift she gave me, and the last thing I took with me when I left.
a satisfying life
You know what I really look forward to? Buying stuff. I keep a list in my head of things I need. Right now I'm needing frames for the kids' school pictures; some sort of light fixture to chase the gloom out of the downstairs office; a wall-mounted CD organizer; girly soap; socks for me; socks for kids, and construction paper. There's also forty other things that won't occur to me until my eye falls upon them in the store and I realize how much better, more attractive and more organized my life will be when I acquire them. Nothing feels as good as coming home with my haul and running around the house, putting everything in its place.
Wait, that's not true. Here's something that feels even better: throwing things out, bags and bags of it. I don't know where all this crap comes from.
Wait, that's not true. Here's something that feels even better: throwing things out, bags and bags of it. I don't know where all this crap comes from.
Friday, November 16, 2007
sometimes words fail me
"Seven?!" -- Jerry
"Seven!" -- George
E (flashing a pic of a smiling baby): Here she is! Five weeks old now!
Me: Oh, cute girl! What did you name her?
E: Well, we wanted to name her after my grandmother -- but her name is Geneva Rose, so of course that was out!
(Makes an 'Ick' face and laughs, looking to me as if I'd recognize immediately that Geneva Rose is an appalling name beyond consideration. Actually, I like Geneva Rose -- it makes me think of Alps and roses; two things I approve of. But I laugh and nod sympathetically. She's my friend, after all.)
Me: Okay, so what did you pick?
E: Bevin!
"Seven!" -- George
E (flashing a pic of a smiling baby): Here she is! Five weeks old now!
Me: Oh, cute girl! What did you name her?
E: Well, we wanted to name her after my grandmother -- but her name is Geneva Rose, so of course that was out!
(Makes an 'Ick' face and laughs, looking to me as if I'd recognize immediately that Geneva Rose is an appalling name beyond consideration. Actually, I like Geneva Rose -- it makes me think of Alps and roses; two things I approve of. But I laugh and nod sympathetically. She's my friend, after all.)
Me: Okay, so what did you pick?
E: Bevin!
sneeze if you're Muslim
My six-year-old daughter came home last week with stuff her Islamic teacher wants her to memorize. This includes:
1) the Arabic phrase to say when you sneeze
2) the phrase to say when you witness a sneeze
3) the phrase to answer the sneeze-witnesser if you are the sneezer
4) which foot steps into the bathroom first
5) the phrase to say when one enters the bathroom
6) which foot gets to leave the bathroom first
7) the phrase you should say when leaving the bathroom
8) the thirteen-step ritual for washing (wudu) before praying
It's a good subject for a blog. But I'm so damn exhausted by the whole thing that I can't even find the will to make jokes about it.
1) the Arabic phrase to say when you sneeze
2) the phrase to say when you witness a sneeze
3) the phrase to answer the sneeze-witnesser if you are the sneezer
4) which foot steps into the bathroom first
5) the phrase to say when one enters the bathroom
6) which foot gets to leave the bathroom first
7) the phrase you should say when leaving the bathroom
8) the thirteen-step ritual for washing (wudu) before praying
It's a good subject for a blog. But I'm so damn exhausted by the whole thing that I can't even find the will to make jokes about it.
Thursday, November 15, 2007
social services I
The woman from Social Services called again. She's coming over tomorrow. I'm tired of this story, so I'll make it brief.
I came home from work one day to find a card from the county social work agency, Child Protection division, tucked in the crack of my front door. I was baffled but terrifically curious, so I called. The social worker, Brenda, said there was "something she needed to talk to me about" but refused to do it over the phone. I said fine, come on over.
My house smelled a bit like urine (the cat has kidney stones and likes to pee in odd places) but by our ten a.m. appointment I was mostly dressed and fairly sober, so I figured I'd make a good impression. Brenda showed up with a silent assistant in tow. I invited them in.
Someone had called in a report on me -- that was the gist of it. The informant (I asked who it was and got, "I'm sorry, I can't give you that information") had accused me of neglecting my kids, specifically my youngest daughter. The social worker was evasive about the details. I think I'd been accused of letting her run loose in the street or something. Brenda also asked me if it were true that I go running sometimes at night.
Well yes. I do. So what?
What neighborhood idiot saw me out running at night and reported this to Child Protection?
Suspicion falls on two neighbors. First, across the street and three houses down is a little old couple I don't know. I think they're the ones who keep calling our subdivision's Homeowners Association to complain about my poor mowing habits and penchant for leaving my trash cans by the curb all week. Also, when my six-year-old went out selling chocolates for her school, they were the only ones in the neighborhood who didn't humor her by buying a damn chocolate bar. They said, "No, we don't need those. And you shouldn't be out by yourself, should you?" They're Nazis. I can tell.
More interestingly -- and I really hope it's her -- it could be the high-strung woman six streets over who last year accused me of sleeping with her husband. This was after she kicked him out of the house for losing his license to practice medicine because he'd forked a patient on the exam table who later accused him of rape. It's all very convoluted. I'll be really entertained if she's still plotting petty revenge against me. Whether I did or didn't sleep with him, I won't say, but since she kicked him out and she knew he was a big fat slut long before I allegedly sank my claws into him, I don't know what she can blame me for in any case -- except poor taste in lovers, I suppose. And that would be a case of the pot calling the kettle mean names.
Anway, I answered Brenda's questions and showed her to the door and I assumed it was all settled. Before she left, she remarked over the long rope that hangs from the upstairs hallway down into the foyer. It's made of cloth belts and gis all tied together and the kids play with it a lot -- hoisting stuffed animals into the air, lassoing me when I'm making important phone calls, tying up the neighbor boy and so forth. The lady pointed out that it was a choking hazard and asked me to take it down. I said I would. She left. The end.
Except that she left me a message a couple weeks later saying she "still had some concerns." And once again, it can't be settled over the phone; she has to come to my damn home tomorrow and interrogate me in person. The rope is still hanging there. I thought of taking it down before she comes over, but I'm not going to. I think I'll draw a freakin pentagram on the floor with sheep's blood and drink tequila in front of her and leave my full-color anatomy atlas open to the page titled Genitalia: Male And Female.
I was interested at first, but by this point I'm just irked and bored. Sometimes I do stupid things for amusement when I'm bored. Usually I regret it for a long time afterward. I suspect tomorrow will be no exception.
I came home from work one day to find a card from the county social work agency, Child Protection division, tucked in the crack of my front door. I was baffled but terrifically curious, so I called. The social worker, Brenda, said there was "something she needed to talk to me about" but refused to do it over the phone. I said fine, come on over.
My house smelled a bit like urine (the cat has kidney stones and likes to pee in odd places) but by our ten a.m. appointment I was mostly dressed and fairly sober, so I figured I'd make a good impression. Brenda showed up with a silent assistant in tow. I invited them in.
Someone had called in a report on me -- that was the gist of it. The informant (I asked who it was and got, "I'm sorry, I can't give you that information") had accused me of neglecting my kids, specifically my youngest daughter. The social worker was evasive about the details. I think I'd been accused of letting her run loose in the street or something. Brenda also asked me if it were true that I go running sometimes at night.
Well yes. I do. So what?
What neighborhood idiot saw me out running at night and reported this to Child Protection?
Suspicion falls on two neighbors. First, across the street and three houses down is a little old couple I don't know. I think they're the ones who keep calling our subdivision's Homeowners Association to complain about my poor mowing habits and penchant for leaving my trash cans by the curb all week. Also, when my six-year-old went out selling chocolates for her school, they were the only ones in the neighborhood who didn't humor her by buying a damn chocolate bar. They said, "No, we don't need those. And you shouldn't be out by yourself, should you?" They're Nazis. I can tell.
More interestingly -- and I really hope it's her -- it could be the high-strung woman six streets over who last year accused me of sleeping with her husband. This was after she kicked him out of the house for losing his license to practice medicine because he'd forked a patient on the exam table who later accused him of rape. It's all very convoluted. I'll be really entertained if she's still plotting petty revenge against me. Whether I did or didn't sleep with him, I won't say, but since she kicked him out and she knew he was a big fat slut long before I allegedly sank my claws into him, I don't know what she can blame me for in any case -- except poor taste in lovers, I suppose. And that would be a case of the pot calling the kettle mean names.
Anway, I answered Brenda's questions and showed her to the door and I assumed it was all settled. Before she left, she remarked over the long rope that hangs from the upstairs hallway down into the foyer. It's made of cloth belts and gis all tied together and the kids play with it a lot -- hoisting stuffed animals into the air, lassoing me when I'm making important phone calls, tying up the neighbor boy and so forth. The lady pointed out that it was a choking hazard and asked me to take it down. I said I would. She left. The end.
Except that she left me a message a couple weeks later saying she "still had some concerns." And once again, it can't be settled over the phone; she has to come to my damn home tomorrow and interrogate me in person. The rope is still hanging there. I thought of taking it down before she comes over, but I'm not going to. I think I'll draw a freakin pentagram on the floor with sheep's blood and drink tequila in front of her and leave my full-color anatomy atlas open to the page titled Genitalia: Male And Female.
I was interested at first, but by this point I'm just irked and bored. Sometimes I do stupid things for amusement when I'm bored. Usually I regret it for a long time afterward. I suspect tomorrow will be no exception.
code 11/14
Yesterday I coded someone. It went better than it usually does. He's in the ICU now. He's 8o-plus but tough as nails and we got the pulse back within a couple minutes. He's a really nice guy and he's got a great family: smart, nice, reasonable people who love him to bits -- and that's pretty rare. We'll see what happens.
It's always like a story to me.
Chapter One: he comes to the hospital and gets admitted by my partner; I meet him a few hours later.
Chapter Two: he goes pulseless down in Dialysis -- a "code 500" as they call it at my hospital -- but snaps out of it and goes to the Unit on mechanical ventilation with a not-quite-reliable heartbeat.
That's as far as I've gotten in the plot. I'm hoping for a happy ending.
It's always like a story to me.
Chapter One: he comes to the hospital and gets admitted by my partner; I meet him a few hours later.
Chapter Two: he goes pulseless down in Dialysis -- a "code 500" as they call it at my hospital -- but snaps out of it and goes to the Unit on mechanical ventilation with a not-quite-reliable heartbeat.
That's as far as I've gotten in the plot. I'm hoping for a happy ending.
syntax
Loulou [doing some kind of three-year-old badness, then shrieking joyfully]: EeeeeeeeeeKaaaaaa MAMA! Booobah!
Me: You! Behave!
Loulou [stomping foot]: I! AM! BEIN'! HAIVE!
Me: You! Behave!
Loulou [stomping foot]: I! AM! BEIN'! HAIVE!
Wednesday, November 14, 2007
allison's story I
Today I thought of Allison. Hard to believe she'd be in kindergarten now. I used to think of her all the time, picturing a curious baby with a frizz of black hair pinned with plastic barretts, framing a round brown face. That was just my imagination, though. Actually I never met her, or even saw a picture. She was coming up on one year old when her life and mine swandived toward eachother, almost but not quite colliding, before she slid past me into her future and I went a different way, into my own.
This is her story, what I know of it.
It all started with the ICU. Every second-year did at least a one-month rotation there. It was the toughest rotation for us Medicine residents: we carried six or eight patients apiece on average, did all their procedures (intubating them, putting in lines, sticking needles into chests and bellies and spines and so forth) and took call every third night. You were guaranteed to never see the inside of your call room -- a closet big enough for a bed and a phone -- because you'd spend the whole night on the run between the ER and the six intensive care units on the first two floors of the University hospital. The team consisted of three residents, one Pulmonary fellow, one attending, and a pharm.D. student. There was a mirror-image team called CCU, or Cardiac Care Unit, which took the critical heart cases. Residents on CCU took call every third, as well, so at night the ICU resident and CCU resident could call on eachother if things got hairy. Both residents were on the code team, which meant we carried a code pager that alarmed and sent us running when a patient anywhere in the hospital had a cardiopulmonary emergency. In addition to that we had our regular pagers, which went off every five minutes. The code pager was honkin' big and really annoying to carry around. Plus, it sent me into a cold sweat when it went off.
First-year residents -- interns -- never rotated in ICU or CCU, not anymore. One time I asked an upper-level why that was. "Too many mistakes," he answered, "and too many cases ending like this--" He put his left hand down on Harrison's Internal Medicine and raised his right hand like a man solemnly swearing to tell the truth, the whole truth and nothing but the truth in a malpractice trial.
It was the only month I ever felt any resemblance to those stupid doctors on TV shows. It was scary and exhausting and I wasn't any good at it, but, God, it sang in my blood like a drug. Every patient had a flashy story and ten sobbing relatives, and most of them came in balanced on a knife's edge between living and dying. I felt all the way alive, like I'd made it to the throbbing passionate heart of everything that mattered. It was a soap opera. It was glorious; it was terrifying; I couldn't wait for it to be over and then I felt lost and let down when it finally was. And I miss it so much: miss it like you miss the wild bad boy who stole your heart and took you on a mad ride across Mexico, doing ninety miles an hour with a posse on your tail. I didn't have the cojones to do a Pulm fellowship myself, so I'm going to be missing it for the rest of my sorry chickenshit life.
One day a guy was flown in, a suicide attempt. He was a family man who'd drunk away his job and his money and then decided to end it all, so he downed several glasses of antifreeze while driving around in his car. Eventually the police stopped him and asked what the hell he was doing, at which point he declared, "I'm drinking antifreeze!" The cop asked, "How many glasses did you drink?" but the man, in lieu of answering, fell unconscious behind the wheel.
The great thing about this guy was his name. See, when I was a kid in grade school we had jump-rope songs, and my favorite went like this:
Lincoln, Lincoln, I've been thinkin --
What the heck have you been drinkin?
Looks like water,
Smells like wine,
Oh my gosh it's turpentine!
How many glasses did you drink?
One! Two! Three! Four!
(and so on)
The antifreeze man, believe it or not, was named Lincoln. That cracked me up. It was so damn good I couldn't keep it to myself. So the next morning, after I presented his case to my team -- told them about his medical problems and the treatment I'd started him on -- I added, "Now, listen. There's a song I have to sing for you, a jumprope song." And for the rest of the month the ICU nurses would whoop and chant "Lincoln, Lincoln!" when I walked through the halls.
All of this, by the way, has nothing to do with Allison. So I'll get to it.
I was on call one night when the ER paged. They had a sick guy needing a bed in the ICU, and as resident it was my job to pick up where the ER left off -- examine the patient, ask him a million questions, look over all the tests the ER had ordered and then come up with a treatment plan and write his admission orders. He was a 35-year-old black guy, a bit slow mentally, with no known pre-existing health problems -- in fact he was afraid of doctors and had avoided them his entire life. He was brought in by his brothers after four days of belly pain and nonstop vomiting. When he got to Triage, the nurses noticed right away that his heart rate was 150 and he looked bad. So they ushered him into the first open bed on Side A -- where the serious patients go -- instead of sticking him back in the waiting room. (The ER docs see side A patients right away; it's the people with sniffles and cuts who spend three hours in the waiting room and then two more hours in a bed on side B, before they finally get seen by an intern who doesn't know what she's doing anyway.)
So, that's how it started. It was about to get much worse. It was maybe five or six o'clock when I got the page, and I don't know what Allison was doing right then -- maybe playing or napping or chasing cheerios around a plate in her mom and dad's apartment on the slightly crappy side of town. She was too young to know about the ER, and she never had a clue what was coming.
This is her story, what I know of it.
It all started with the ICU. Every second-year did at least a one-month rotation there. It was the toughest rotation for us Medicine residents: we carried six or eight patients apiece on average, did all their procedures (intubating them, putting in lines, sticking needles into chests and bellies and spines and so forth) and took call every third night. You were guaranteed to never see the inside of your call room -- a closet big enough for a bed and a phone -- because you'd spend the whole night on the run between the ER and the six intensive care units on the first two floors of the University hospital. The team consisted of three residents, one Pulmonary fellow, one attending, and a pharm.D. student. There was a mirror-image team called CCU, or Cardiac Care Unit, which took the critical heart cases. Residents on CCU took call every third, as well, so at night the ICU resident and CCU resident could call on eachother if things got hairy. Both residents were on the code team, which meant we carried a code pager that alarmed and sent us running when a patient anywhere in the hospital had a cardiopulmonary emergency. In addition to that we had our regular pagers, which went off every five minutes. The code pager was honkin' big and really annoying to carry around. Plus, it sent me into a cold sweat when it went off.
First-year residents -- interns -- never rotated in ICU or CCU, not anymore. One time I asked an upper-level why that was. "Too many mistakes," he answered, "and too many cases ending like this--" He put his left hand down on Harrison's Internal Medicine and raised his right hand like a man solemnly swearing to tell the truth, the whole truth and nothing but the truth in a malpractice trial.
It was the only month I ever felt any resemblance to those stupid doctors on TV shows. It was scary and exhausting and I wasn't any good at it, but, God, it sang in my blood like a drug. Every patient had a flashy story and ten sobbing relatives, and most of them came in balanced on a knife's edge between living and dying. I felt all the way alive, like I'd made it to the throbbing passionate heart of everything that mattered. It was a soap opera. It was glorious; it was terrifying; I couldn't wait for it to be over and then I felt lost and let down when it finally was. And I miss it so much: miss it like you miss the wild bad boy who stole your heart and took you on a mad ride across Mexico, doing ninety miles an hour with a posse on your tail. I didn't have the cojones to do a Pulm fellowship myself, so I'm going to be missing it for the rest of my sorry chickenshit life.
One day a guy was flown in, a suicide attempt. He was a family man who'd drunk away his job and his money and then decided to end it all, so he downed several glasses of antifreeze while driving around in his car. Eventually the police stopped him and asked what the hell he was doing, at which point he declared, "I'm drinking antifreeze!" The cop asked, "How many glasses did you drink?" but the man, in lieu of answering, fell unconscious behind the wheel.
The great thing about this guy was his name. See, when I was a kid in grade school we had jump-rope songs, and my favorite went like this:
Lincoln, Lincoln, I've been thinkin --
What the heck have you been drinkin?
Looks like water,
Smells like wine,
Oh my gosh it's turpentine!
How many glasses did you drink?
One! Two! Three! Four!
(and so on)
The antifreeze man, believe it or not, was named Lincoln. That cracked me up. It was so damn good I couldn't keep it to myself. So the next morning, after I presented his case to my team -- told them about his medical problems and the treatment I'd started him on -- I added, "Now, listen. There's a song I have to sing for you, a jumprope song." And for the rest of the month the ICU nurses would whoop and chant "Lincoln, Lincoln!" when I walked through the halls.
All of this, by the way, has nothing to do with Allison. So I'll get to it.
I was on call one night when the ER paged. They had a sick guy needing a bed in the ICU, and as resident it was my job to pick up where the ER left off -- examine the patient, ask him a million questions, look over all the tests the ER had ordered and then come up with a treatment plan and write his admission orders. He was a 35-year-old black guy, a bit slow mentally, with no known pre-existing health problems -- in fact he was afraid of doctors and had avoided them his entire life. He was brought in by his brothers after four days of belly pain and nonstop vomiting. When he got to Triage, the nurses noticed right away that his heart rate was 150 and he looked bad. So they ushered him into the first open bed on Side A -- where the serious patients go -- instead of sticking him back in the waiting room. (The ER docs see side A patients right away; it's the people with sniffles and cuts who spend three hours in the waiting room and then two more hours in a bed on side B, before they finally get seen by an intern who doesn't know what she's doing anyway.)
So, that's how it started. It was about to get much worse. It was maybe five or six o'clock when I got the page, and I don't know what Allison was doing right then -- maybe playing or napping or chasing cheerios around a plate in her mom and dad's apartment on the slightly crappy side of town. She was too young to know about the ER, and she never had a clue what was coming.
freak of conscience
I bought a sea monkey kit for my three year old. Yesterday we did the preparatory steps, putting fresh water and a purifying mixture into the little aquarium. Today was the day for adding the eggs, which come in a small packet and look like white powder. She was excited. The two big kids grabbed seats next to her at the table, eager for the show.
I tore open the packet and showed Loulou how to pour it in. But I was hurrying, and some powder spilled on the table. Salt and glue and crumbs of God knows what were all over the table, so the eggs were unsalvageable. I swept the powder into my hand and tossed it in the sink.
Sea monkeys, if you don't know, are a cryptobiotic version of brine shrimp. A sea monkey kit can sit on a dusty shelf in Walmart for ten generations, until a monkey-lovin' freak like me comes along and buys it. Then, a few days after the eggs are poured into water, voila! Tiny swimmy plankton spring to life and careen around in nutty spirals, bursting with energy and fierce intentions. I love the damn things. They make me think of great oceans and blue whales, of mystery and magic, of the beaches I used to run on with my brothers, and all the cunning tricks life plays to beat the odds.
I stopped and stared into the sink. How many sea monkeys would never be born because of what I'd done? Or -- more horrible -- how many would be born unloved in the dark hostile world of the drain, to live brief lives of terror before suffocating or dessicating or getting smashed in the blades of the garbage disposal?
Here's what's funny. I've always thought I could abort a fetus -- my own or someone else's -- without blinking an eye. But when I washed those microscopic eggs down the drain and thought of the tiny shrimps who had waited so long for their turn at life and had come so close before my careless moment stole their one chance, I felt sick.
Go figure.
I tore open the packet and showed Loulou how to pour it in. But I was hurrying, and some powder spilled on the table. Salt and glue and crumbs of God knows what were all over the table, so the eggs were unsalvageable. I swept the powder into my hand and tossed it in the sink.
Sea monkeys, if you don't know, are a cryptobiotic version of brine shrimp. A sea monkey kit can sit on a dusty shelf in Walmart for ten generations, until a monkey-lovin' freak like me comes along and buys it. Then, a few days after the eggs are poured into water, voila! Tiny swimmy plankton spring to life and careen around in nutty spirals, bursting with energy and fierce intentions. I love the damn things. They make me think of great oceans and blue whales, of mystery and magic, of the beaches I used to run on with my brothers, and all the cunning tricks life plays to beat the odds.
I stopped and stared into the sink. How many sea monkeys would never be born because of what I'd done? Or -- more horrible -- how many would be born unloved in the dark hostile world of the drain, to live brief lives of terror before suffocating or dessicating or getting smashed in the blades of the garbage disposal?
Here's what's funny. I've always thought I could abort a fetus -- my own or someone else's -- without blinking an eye. But when I washed those microscopic eggs down the drain and thought of the tiny shrimps who had waited so long for their turn at life and had come so close before my careless moment stole their one chance, I felt sick.
Go figure.
Tuesday, November 13, 2007
prosopagnosia IV
So, getting back to the grocery store:
I stuck out my hand to the man and said, "Thank you! But I'm so bad with faces. Tell me, who is your mother?" It turned out that his mother was the woman I wrote about in Saturday Superlatives a few days ago, whose death had such an effect on me. And the devoted daughter-in-law who cried and held the old woman as she lay dying -- that was his wife. Isn't that an amazing coincidence? I remembered that I had met him at the old woman's bedside a couple weeks before, back when we were still pretending she was going to live forever.
So I took the opportunity to tell him that I thought his mother and his wife were two great women. He smiled in a quiet way and said yeah, he knew that. Meanwhile the teenage kids stood around looking embarrassed. It was a sweet moment. I felt like the guy and I were bonding for life in a really meaningful way.
Now I just have to hope I never see him again -- because I won't recognize him next time either, and that will just be damn awkward.
I stuck out my hand to the man and said, "Thank you! But I'm so bad with faces. Tell me, who is your mother?" It turned out that his mother was the woman I wrote about in Saturday Superlatives a few days ago, whose death had such an effect on me. And the devoted daughter-in-law who cried and held the old woman as she lay dying -- that was his wife. Isn't that an amazing coincidence? I remembered that I had met him at the old woman's bedside a couple weeks before, back when we were still pretending she was going to live forever.
So I took the opportunity to tell him that I thought his mother and his wife were two great women. He smiled in a quiet way and said yeah, he knew that. Meanwhile the teenage kids stood around looking embarrassed. It was a sweet moment. I felt like the guy and I were bonding for life in a really meaningful way.
Now I just have to hope I never see him again -- because I won't recognize him next time either, and that will just be damn awkward.
prosopagnosia III
I used to have a line I used whenever I committed an especially gaffish gaffe, like when I introduced myself to a big-boss-guy I'd actually known for years, or when I treated a friend like a stranger. I'd apologize for my mistake, then explain that I'd had an head injury in medical school that had left me unable to recognize faces. I came up with this line because I really did suffer a head injury in med school, and it's a really good story, too: it starts out with me on my way to a baby shower, and ends with me getting whacked over the head and going under in a freezing river. So I was happy to have a reason to bring it up a lot.
But after a while I stopped using this line. I noticed people would look at me funny after I told them. I came to realize that brain damage is one of those things some people don't appreciate in a doctor.
But after a while I stopped using this line. I noticed people would look at me funny after I told them. I came to realize that brain damage is one of those things some people don't appreciate in a doctor.
prosopagnosia II
Here's another example of how bad I am with faces. This is a true story:
I had been dating my husband for about two months when for the first time, I took the bus to his city instead of letting him drive to me. When I got off the bus and looked around the crowded station trying to find him, I couldn't remember anything about his appearance except skinny guy, brown skin, some sort of facial hair. So I sat down with a book and pretended to read. A few minutes later he came up behind me and tapped me on the shoulder with a friendly grin. I was so happy to see him again, I hugged him and held on for a long time. We walked out to his car. As we sped down the dark highway, I put my hand down in his lap. He gave me a slow sideways smile and put his hand on top of mine. And then he said, "So, baby -- ya gonna tell me your name?"
Okay, so I made up that last part. But it could have happened. And that would have been really funny. In a very icky way.
I had been dating my husband for about two months when for the first time, I took the bus to his city instead of letting him drive to me. When I got off the bus and looked around the crowded station trying to find him, I couldn't remember anything about his appearance except skinny guy, brown skin, some sort of facial hair. So I sat down with a book and pretended to read. A few minutes later he came up behind me and tapped me on the shoulder with a friendly grin. I was so happy to see him again, I hugged him and held on for a long time. We walked out to his car. As we sped down the dark highway, I put my hand down in his lap. He gave me a slow sideways smile and put his hand on top of mine. And then he said, "So, baby -- ya gonna tell me your name?"
Okay, so I made up that last part. But it could have happened. And that would have been really funny. In a very icky way.
Monday, November 12, 2007
prosopagnosia I
The monsters and I were in the grocery store. They were looking at reduced-price sticky eyeballs and plastic spiders, while I was snarling at them to hurry up. That's when a man came around the corner, flanked by a couple of teenage kids. He came right up to me and said, "I might never have the chance to see you again, so I just want to say, thank you for the way you took care of my mother."
That was nice.
That never happens to me.
The problem: I had no idea who he was.
I have trouble with faces - serious trouble, like I can meet the same person ten times and still believe I've never seen them before. It's a terrible handicap. In the hospital I'm always ending up on elevators with complete strangers who fix their eyes on me urgently and say things like, "So, have you seen the CT yet? Does Dad have cancer?" This is why I try to take the stairs.
That was nice.
That never happens to me.
The problem: I had no idea who he was.
I have trouble with faces - serious trouble, like I can meet the same person ten times and still believe I've never seen them before. It's a terrible handicap. In the hospital I'm always ending up on elevators with complete strangers who fix their eyes on me urgently and say things like, "So, have you seen the CT yet? Does Dad have cancer?" This is why I try to take the stairs.
einstein's secret
George: You know, Einstein wore the exact same outfit every day.
Jerry: Well, if she splits the atom, I'll let it slide.
Recently I bought two long sleeveless black dresses, identical to the original that I wear as often as possible. This brings my total to five long sleeveless black dresses, three of them identical and the other two near-copies. I wear them under my white coat. They are long enough that I don't have to shave my legs, shapeless enough that they fit me at plus or minus fifteen pounds, and black enough to not show dirt if I wear them while building a retaining wall in the backyard.
I try to wear them in rotation but it's hard to remember which was yesterday's dress and which should be today's, since they live in a heap on my floor beside the shower. Possibly I'm just wearing the same one over and over. But I don't have a problem with that. Whenever I have a full load of wash, I throw all the black dresses into the machine. Then I can't think what to wear, so I stand in my closet blinking around stupidly like Columbus in the New World.
The only problem is, unlike Einstein I still care a little bit about public opinion. I don't give a damn if people say my clothes are boring, but I don't want them to actually suspect I'm wearing the same black dress off my floor every day. So at work yesterday I remarked in a loud voice to no one in particular, "Did you know, I have five black dresses like this one? I'm like Einstein!"
My partner L. overheard from across the nursing station. Her head snapped around and she looked visibly perturbed.
"Einstein wore dresses?" she gasped.
Jerry: Well, if she splits the atom, I'll let it slide.
Recently I bought two long sleeveless black dresses, identical to the original that I wear as often as possible. This brings my total to five long sleeveless black dresses, three of them identical and the other two near-copies. I wear them under my white coat. They are long enough that I don't have to shave my legs, shapeless enough that they fit me at plus or minus fifteen pounds, and black enough to not show dirt if I wear them while building a retaining wall in the backyard.
I try to wear them in rotation but it's hard to remember which was yesterday's dress and which should be today's, since they live in a heap on my floor beside the shower. Possibly I'm just wearing the same one over and over. But I don't have a problem with that. Whenever I have a full load of wash, I throw all the black dresses into the machine. Then I can't think what to wear, so I stand in my closet blinking around stupidly like Columbus in the New World.
The only problem is, unlike Einstein I still care a little bit about public opinion. I don't give a damn if people say my clothes are boring, but I don't want them to actually suspect I'm wearing the same black dress off my floor every day. So at work yesterday I remarked in a loud voice to no one in particular, "Did you know, I have five black dresses like this one? I'm like Einstein!"
My partner L. overheard from across the nursing station. Her head snapped around and she looked visibly perturbed.
"Einstein wore dresses?" she gasped.
Sunday, November 11, 2007
Amish people
I met an Amish family. They live in a valley with over a hundred acres. There are more than ten children -- the oldest married, and the youngest few running around in bowl haircuts and suspenders and impish smiles. The boys look exactly like Lukas Haas. They cluster around the window on the top floor of the hospital, pulling up all the blinds and pointing with excitement at the city spread out below them.
The family trains horses and ponies. They have chickens for eggs, and cows that give them milk. They do organic farming and sell their produce to local stores. They raise and sell roses too. Every couple of months, they put up some homemade wine. They make a salve of beeswax, comfrey and other herbs which they also sell. It is good for chapped cow udders, and in people it can be used for a number of skin ailments. They gave some to one of the nurses when she mentioned that her son has psoriasis. They are very friendly and blunt, without guile, and have a sly sense of humor and a nice way of teasing eachother. There are always seven or ten or fifteen of them together. Even the youngest girl wears a bonnet, though the little boys sometimes go hatless. The adults strike up conversations with other patients in the hallways, befriending them quickly and inviting them to come visit their farm.
The family trains horses and ponies. They have chickens for eggs, and cows that give them milk. They do organic farming and sell their produce to local stores. They raise and sell roses too. Every couple of months, they put up some homemade wine. They make a salve of beeswax, comfrey and other herbs which they also sell. It is good for chapped cow udders, and in people it can be used for a number of skin ailments. They gave some to one of the nurses when she mentioned that her son has psoriasis. They are very friendly and blunt, without guile, and have a sly sense of humor and a nice way of teasing eachother. There are always seven or ten or fifteen of them together. Even the youngest girl wears a bonnet, though the little boys sometimes go hatless. The adults strike up conversations with other patients in the hallways, befriending them quickly and inviting them to come visit their farm.
annika's story
I grew up in a village near Bremen. You've heard of Bremen? It's a port city. I was about eleven and we would hear the bombs falling. If we were in school we would have to leave and go into bunkers.
My sister and I were sent to the south of Germany with a lot of children, because the Allied forces weren't bombing there, that is, not until later. We stayed with strangers -- foster parents, as I called them. There was primary school but no secondary school there. It was not an easy time, being a child -- but things were not easy for a lot of people. After a while the bombs started falling in the south too, so I thought I might as well go back home and be with my mother. Our home was bombed. We had a piece of land in the country and later we built another house there, a small one.
The end of the war, that was the worst time. The Allied soldiers came into the city. They were everywhere. I was with my mother and sister in the bunker. There were animals outside, horses and goats, and they were screaming because the shrapnel was hitting them. I heard the sound of gunfire. Then an Allied soldier came into our bunker and told us, "You go back to your home and stay there."
After the war, my father came home. He had not been at the front. He had worked for the war industry. Sometimes, though, he would visit the front to see what the soldiers needed. Only two uncles didn't come back. They died in Russia.
I had wanted to be a doctor, a diagnostician, but after the war I got a job with the Americans. I worked for the Immigration and Naturalization Service. Many of the displaced people, Poles and Hungarians who had been brought to Germany to work, now wanted to go to America. Sometimes there would be hearings to decide if they could go or not. I worked as a translator for the hearings. Someone would translate the Hungarian into German, and then it would be my turn to translate the German into English. I was eighteen only but I had a knack for languages, English in particular.
The reason the people didn't want to go back to Poland and the eastern countries was very simple: the Russians had come. The Russians were terrible, brutal. They raped the women. No one wanted to go where the Russian soldiers were. So people chose America.
Later, when I was married, I went with my husband and visited a concentration camp. I could not believe what I saw there. During the war, we had no idea.
(Annika is a patient of mine. She says she's too old to write her memoirs. So I'm setting down the little she told me -- in the interest of preserving history, and because I love a good story, and because she deserves the tribute.)
My sister and I were sent to the south of Germany with a lot of children, because the Allied forces weren't bombing there, that is, not until later. We stayed with strangers -- foster parents, as I called them. There was primary school but no secondary school there. It was not an easy time, being a child -- but things were not easy for a lot of people. After a while the bombs started falling in the south too, so I thought I might as well go back home and be with my mother. Our home was bombed. We had a piece of land in the country and later we built another house there, a small one.
The end of the war, that was the worst time. The Allied soldiers came into the city. They were everywhere. I was with my mother and sister in the bunker. There were animals outside, horses and goats, and they were screaming because the shrapnel was hitting them. I heard the sound of gunfire. Then an Allied soldier came into our bunker and told us, "You go back to your home and stay there."
After the war, my father came home. He had not been at the front. He had worked for the war industry. Sometimes, though, he would visit the front to see what the soldiers needed. Only two uncles didn't come back. They died in Russia.
I had wanted to be a doctor, a diagnostician, but after the war I got a job with the Americans. I worked for the Immigration and Naturalization Service. Many of the displaced people, Poles and Hungarians who had been brought to Germany to work, now wanted to go to America. Sometimes there would be hearings to decide if they could go or not. I worked as a translator for the hearings. Someone would translate the Hungarian into German, and then it would be my turn to translate the German into English. I was eighteen only but I had a knack for languages, English in particular.
The reason the people didn't want to go back to Poland and the eastern countries was very simple: the Russians had come. The Russians were terrible, brutal. They raped the women. No one wanted to go where the Russian soldiers were. So people chose America.
Later, when I was married, I went with my husband and visited a concentration camp. I could not believe what I saw there. During the war, we had no idea.
(Annika is a patient of mine. She says she's too old to write her memoirs. So I'm setting down the little she told me -- in the interest of preserving history, and because I love a good story, and because she deserves the tribute.)
Saturday, November 10, 2007
the week at work: saturday superlatives
Worst moment: Talking to parents of a really troubled young woman who'd just OD'd. I hate being stuck in the middle of people's messy lives and not knowing what to say. Um, so sorry your daughter is like this. Guess she didn't turn out how ya hoped, huh? Wish I could fix her but I can't.
Most emotional moment: Death of an elderly woman who was much loved by her daughter-in-law, who had cared for her at home for many years. When she passed away (after a week of waiting for the end to come), the daughter-in-law totally lost it, crying and hugging the woman's still body and telling me what a great lady she had been. It reminded me of that story in the Old Testament: Ruth. Whither thou goest... I don't usually give a damn when people die expected deaths, but those two women were something special. I needed a tissue.
Best moment: At the nursing station, we were talking about a patient -- a drug-addicted, malodorous kind of guy with rotting toes about to be amputated -- whose name rhymes with Moby Blow. I was saying that all the docs in my group have come up with different nicknames for him: E. calls him "No Toes Below" and L. calls him "Grody Toe" and I call him "Toeless Joe", which I think has a nice, swingin' kind of ring to it. Then the infection specialist put in her vote, drily noting, "I just call him disgusting." She had perfect deadpan delivery. I laughed and laughed.
Most emotional moment: Death of an elderly woman who was much loved by her daughter-in-law, who had cared for her at home for many years. When she passed away (after a week of waiting for the end to come), the daughter-in-law totally lost it, crying and hugging the woman's still body and telling me what a great lady she had been. It reminded me of that story in the Old Testament: Ruth. Whither thou goest... I don't usually give a damn when people die expected deaths, but those two women were something special. I needed a tissue.
Best moment: At the nursing station, we were talking about a patient -- a drug-addicted, malodorous kind of guy with rotting toes about to be amputated -- whose name rhymes with Moby Blow. I was saying that all the docs in my group have come up with different nicknames for him: E. calls him "No Toes Below" and L. calls him "Grody Toe" and I call him "Toeless Joe", which I think has a nice, swingin' kind of ring to it. Then the infection specialist put in her vote, drily noting, "I just call him disgusting." She had perfect deadpan delivery. I laughed and laughed.
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