Sunday, May 31, 2009

Alternative Medicine


Here's this morning's homily. In addition to red Pentecost balloons -- I don't know if there will be party hats and noiseblowers -- we're also baptizing a young man named David.

I love Pentecost, when I was baptized myself, so I'm always happy to preach about it. For those of you unfamiliar with the story, the essential reading is Acts 2:1-21.

*

In his book The Prophetic Imagination, theologian Walter Brueggemann says that churches exist to provide an alternative to the dominant culture. We’re not supposed to fit in with the rest of society: we’re supposed to offer gentle, but pointed, critiques of business-as-usual, to model a more loving way of life. That is, after all, what Jesus did, and what he commanded his followers to do.

Today we celebrate Pentecost, the birthday of the church. Jesus has ascended into heaven, telling his followers that he’ll send the Holy Spirit to guide them. In this morning’s reading from Acts, the Holy Spirit finally arrives, with rushing wind and tongues of flame, giving everyone gathered in that place the ability to understand any language spoken by anyone else.

This scene was most certainly not business as usual. The witnesses were “amazed and perplexed,” and some suspected that many in the crowd had been drinking, until Peter set them straight. If we read more of Acts, we learn that three thousand people were baptized that day. That’s why Pentecost is one of our traditional church dates for baptism. I was baptized on Pentecost in 2000, and today we welcome David to the Body of Christ. As we heard in this morning’s Collect, Pentecost is also the day when God “opened the way of eternal life to every race and nation.” Pentecost is when everyone is welcomed into the church.

The early church, though, didn’t look much like what we know today. “All who believed were together and had all things in common,” Acts tells us; “they would sell their possessions and goods and distribute the proceeds to all, as any had need.” These first church folk “ate their food with glad and generous hearts, praising God and having the goodwill of all the people. And day by day the Lord added to their number those who were being saved.”

The early church was endlessly joyful and hugely successful at attracting newcomers, but it also operated on economic principles that alarm many Americans. “From each according to his ability, to each according to his need” is a sentiment we associate with Karl Marx, not with Jesus. According to the Book of Acts, though, this is exactly how the early church functioned.

There have been similar arrangements throughout American history. In the 1960s, we called them communes, and the people who lived there -- and who also tended to be active in civil-rights and anti-war movements -- were often criticized by mainstream churches, not to mention the government. People in the dominant culture often feel threatened by alternative visions of how the world might work, by any change that might hurt their own interests. Just look at what happened to Jesus.

The college students I teach use the word “hippie” as an insult. Nonetheless, the Book of Acts invites us to view the early church, the post-Pentecost church, as a bunch of hippies: people in sandals and robes, blissed-out on the Holy Spirit, preaching universal love and peace and sharing anything they had with anyone who needed it.

Is that what our church looks like today? Is it what it should look like? If not, why not? The church is 2,000 years older than it was on that first Pentecost. Do we still challenge the dominant culture, or have we become part of it, just another piece of business-as-usual, blending in instead of standing out?

In mid-April, I got to spend a few days in a place that looks a little like the early church. A medical student I was working with at UNR invited me to lead a writing workshop at HEART, the Humanistic Elective in Alternative Medicine, Activism, and Reflective Transformation. This one-month, fully accredited elective for fourth-year medical students takes place at a secluded retreat center nestled among towering redwoods. The elective focuses on “intentional community building, complementary, alternative, holistic and integrative medicine, social justice and activism, reflective transformation including meditative practices, and personal growth.”

Traditional physicians might roll their eyes at this description, and HEART has a keen sense of humor about itself. Their website includes a photograph of a medical student hugging a tree. While the twenty-five medical students who attend, and their teachers, are serious about transforming the culture of medicine, the whole project can indeed look a little kooky from the outside. When I arrived, I found twenty-five barefoot medical students, blissed out after sesame-oil massages, sprawled on yoga mats in the main meeting space. I felt acutely out of place.

The teacher that afternoon was a western-trained MD, a family-practice doctor, who also practices Ayurvedic medicine, the ancient healing system from India. She taught the students a bit about Ayurveda and then led a lively discussion of the challenges they’d face during their upcoming residencies. Fascinated, I offered a few of my own comments, although each time I apologized for doing so. After all, I have no medical credentials, alternative or otherwise.

Afterwards, my student came up and scolded me. “Susan, you have to stop doing that! You have as much right to speak as anyone does. You aren’t an outsider here.”

The teacher added, more gently, “HEART wants to change how medicine works. We’re here to do things differently. If you aren’t welcome here, no one is welcome here.”

“If you aren’t welcome here, no one is welcome here.” As soon as I heard that sentence, I felt like the universe had turned upside down, and I’ve been thinking about it ever since.

Every group I’ve ever been part of, including the church, has considered welcome a privilege it could grant or withhold. “We were here before you came,” such groups might say, “and we’ll be here after you leave. We decide whether to open our doors to you.” The HEART model doesn’t work that way. The HEART model says, “If we do not welcome you, we will not exist as a group. If you are not part of the group, there is no group.” Followed to its logical conclusion, this means that the group embraces the entire world, the entire universe. No one can be left out. No welcome can be withheld. Everyone and everything is connected and beloved.

I’m not sure what that model would look like in practice at St. Stephen’s, or any other congregation, but I have a hunch that it would look a lot like those early church communities. The HEART philosophy certainly offers a provocative alternative to a business-as-usual culture obsessed with competition, consumerism, and exclusivity.

Peter, and Walter Brueggeman, both describe one of the main effects of the Holy Spirit as the gift of imagination. We can only work towards change we have first imagined. “I will pour out my Spirit upon all flesh,” Peter says, quoting Joel, “and your sons and daughters shall prophesy, and your young men shall see visions, and your old men shall dream dreams.”

This Pentecost, let us rejoice in the power of the Spirit, and dream our own dreams of how we can offer God’s alternative medicine -- love and peace and social justice -- to the people around us, to everyone who is lost and hurting and needs healing and welcome. Let us imagine what it would be like to say to everyone we meet, “If you aren’t welcome here, no one is welcome here.” Let us imagine the entire cosmos as the Body of Christ, in which everyone and everything is connected and beloved. And as symbol and token of that welcome, let us joyously welcome David into that body, and into our St. Stephen’s family.

Amen.

Saturday, May 30, 2009

The Moms are All Right


My mother's head scan checked out fine -- as did x-rays of a number of lumps and bruises from the fall on other parts of her body -- so she and my sister got to go home. Yay!

I called this evening to ask if my sister had forgiven me for complicating her morning. "I'm the one who called you," she reminded me. "I half figured you'd talk me into it. I wanted your input, anyway."

"Well, it could have been worse," I said. "At least I didn't call the police this time."

I'm never going to live that one down.

Meanwhile, Gary's mom Doris arrived safely from New Jersey to visit us for a week. It's the first time she's traveled since her husband died in December, and the first time, I believe, that she's ever flown by herself. For someone who's seventy-nine, that's a big deal!

We're putting her up in a nice hotel so she doesn't have to manage the stairs in our house. We got her an accessible suite, which turns out to be roughly half the size of Nevada: the only view is of an airshaft (ugh!), which is a pity since this place is right on the river, but she has tons of room. And she can go outside to see the river.

Tomorrow I'll pick her up and take her to church with me -- it will be the first time she's heard me preach, although she's read many of my sermons -- and then we'll come back to the house for lunch. In the afternoon we'll swim and go to a violin concert at the university. It should be a very nice day!

R/O TBI


My sister called to say that my mother fell out of bed this morning and hit her head. Mom had a cut and a large bruise, and was on the floor for about two hours before my sister found her. "The cut was superficial, and I cleaned it up. The bruise looks awful, but Mom's fine: alert and talking, better than usual, if anything."

I spoke to my mother, who confirmed all this. Being on the floor had been scary, but she was fine now. My sister had cancelled her Saturday plans so she could stay with Mom and watch her, but didn't plan to take her to the hospital, even though there was no reliable way to know if Mom lost consciousness when she fell.

My sister's the mellow, laid-back, watch-and-see kid in the family. I'm the one who panics and starts doing obsessive research, and my default position is always, "when in doubt, go to the hospital."

So I cranked up Google and turned up all kinds of articles, like this one, saying that any head injury in an elderly person should always be evaluated in an ER, because a subdural hematoma (a brain bleed) can go undetected for hours or days before causing sudden death, and there may be only a small window for treating it. If you wait and see, you may be too late. It turns out that Traumatic Brain Injuries from falls are a major cause of death in the elderly.

So I called my sister with this cheery information. She put Mom on the phone, and I explained the issue. "Oh," Mom said, politely.

"Will you go to the hospital?"

"Hell no!" said Mom, less politely. In the background, I could hear my sister laughing.

"Mom, do you understand that not going to the hospital could mean that you'll die, or wind up gorked out from a brain injury, even if you feel fine now?"

"Sure," Mom said, and that was that. I talked to my sister, who was unwilling to go against Mom's wishes. I hung up. I sat and chewed my fingernails until the phone rang just a few minutes later.

It was my sister. "Okay, she's going."

"Thank God," I said, and meant it.

Of course I hope there's nothing wrong, but only a head CT will tell us for sure. I know it's inconvenient and uncomfortable and a lousy way to spend a Saturday, but I'm still glad she's getting checked out.

Friday, May 29, 2009

The Good Servant


My latest column, about chaplains ministering through their own grief, is up over at Hope and Healing.

This topic is newly resonant for me, since I've returned to volunteering as a chaplain after my father's death. During my shift this week, I chatted with a security guard I've known for years now. He was curious about why he hadn't seen me for a while, so I filled him in on our family dramas these last six months. His eyes widened, and he said, "But you can still come here, to be positive for other people."

I explained that being at the hospital makes me feel better, for the reasons I describe in the column, and also that I'm better equipped to deal with grieving patients and family now, since I'm walking in those shoes myself. The guard nodded solemnly.

I've found this at work too, though, or even in the grocery store: when you say that your dad just died, people get it. This isn't a grief anyone has to suffer in isolation. Almost all of us will lose our parents -- unless, tragically, we die before them, the situation the chaplain in the column was facing -- and everyone who does will have to get on with life. It's a real blessing that so many other people know the territory.

Thursday, May 28, 2009

Now what?


Our story so far: Several years ago, I went to Urgent Care with a sudden burst of knee pain and was diagnosed with arthritis via x-ray. Since then, that knee has remained cranky. A recent increase in pain sent me to my primary-care doc, who ordered more x-rays, and (in response to bloodwork) referred me to a rheumatologist, who was supposed to call me to make an appointment when the referral paperwork came through.

The rheumatologist never called and I never got the x-ray results, so today I called both offices, especially since my knee has been particularly sore these last few days, so much so that I was limping a bit in the ER last night (even on ibuprofen while wearing a knee brace). Turned out the rheumatologist had never gotten the paperwork; the primary's office said they'd refax it. A nurse told me that the x-rays were normal -- "they showed some bone spurs, but no sign of arthritis" -- and recommended physical therapy for my knee.

What the hay? Did the first doctor mistake bone spurs for arthritis? Can arthritis repair itself? Could the bone spurs be causing my current pain level, and if not, what could be, other than arthritis? And will the rheumatologist be able to answer any of this (if, of course, he ever gets the paperwork)?

I'm frustrated. Arthritis at least made sense of the pain, but now that simple explanation has been yanked away. I'll try PT when I get back from my trip, but I hope I get to see the rheumatologist next week (highly doubtful, given doctors' schedules and the high incidence of arthritis in a city with lots of retirees; the guy's probably booked out to 2011).

On the plus side, yesterday an unexpected consulting project fell into my lap, and I decided to use the proceeds to buy a Samsung N110 netbook. I love my VAIO, but it's very slow and the touchpad died about a year ago, which means I have to use an external mouse: decidedly annoying! The Samsung should be a lot faster than my current machine, and with any luck the touchpad will keep working for a while. And it costs one-quarter what the VAIO did, so what's not to like? Actually, I don't like the fact that it's slightly heavier than the VAIO, but on the plus side, it's also slightly smaller. I bought an external drive for loading software, since the one big drawback of the Samsung is no CD drive. I won't have to bring the drive with me when I travel, though; it will live at home.

So if everything arrives according to shipping estimates, I'll have a shiny new machine for my trip back East. Yippee!

And if my knee's behaving itself by then, I'll be even happier.

Tuesday, May 26, 2009

A Few of my Favorite Things


Good stuff that's happened today:

* Getting the remaining putty and the stitches out, and having my periodontist compliment me on how well I'm healing. "Whatever you're doing, keep it up." (As I've said before, smoothies rule.)

* Learning that my periodontist volunteers his services at nursing homes, and has also done so on a kibbutz in Israel and on a bus serving migrant farm workers and their kids in California. "We initially thought we'd just be treating the adults so they wouldn't be in pain in the fields, but then they started bringing their kids and asking us to treat them, instead. It's just like with anybody else: your kids always come first. So we wound up retooling to do pediatric dentistry." I love stories like this, which always make me feel better about the world.

* Swimming for forty-five minutes. Yay!

* Treating myself to some new notecards and a copy of John Crowley's Endless Things. I first started reading the Aegypt cycle in 1988; it's been twenty-one years in the finishing, although I'll probably need to reread the first three volumes to make sense of this one.

* Eating fully solid food again, and being able to chew without worrying about dislodging putty. Yay!

* Looking at the huge pinecone sitting on my desk. When we moved into our house, one of the trees in our front yard was an itty bitty pine tree that barely came up to our waists. Eleven years later, it towers over us. Gary handed me the pinecone today and said, "Look what Sven made!" (Sven is the pine tree; Lars is the gigantic, shaggy juniper bush that dominates the yard.) We're very proud parents. The timing is especially fortuitous because this evening, I'm leading a civic reflection group, and we'll be talking about Pablo Neruda's famous essay The Lamb and the Pinecone. I'm going to bring the pinecone with me as a show-and-tell item.

Sunday, May 24, 2009

Great Review


Jo Walton has written another glowing review of my work, this time of The Fate of Mice.

This makes me very happy, because I love Jo's writing as much as she loves mine. Praise from someone I respect so much is heady wine indeed.

Thanks, Jo.

Saturday, May 23, 2009

Pots o' Gold


We have a lot of sky here in Nevada, and we tend to get spectacular rainbows, on the rare occasions when we get rain. Such was the case last night, when everyone at the barbecue we attended was treated to a sound-and-lightning show from our friend's deck. This photograph doesn't do the rainbow justice -- and I was completely unable to capture the double rainbow into which it morphed later -- but I was happy to get any image at all.

What amused us, though, was that (as you can dimly make out in this shot), the rainbow ended at the Grand Sierra casino. Whatever good luck this signaled for the gamblers inside was probably canceled out by the fact that the Grand Sierra was also struck by lightning as we watched.

We heard sirens around town, but I don't think the lightning started fires anywhere. That's a very serious concern here, especially as the summer progresses and the heat dries out vegetation. Cheatgrass, both combustible and epidemic, is a particular worry. We aren't safe from wildfires until the first snowfall.

Friday, May 22, 2009

Wist


If the adjective is "wistful," the noun should be "wist," not "wistfulness." Fewer syllables are always better. (Yes, I know I'm an English professor, but I'm on vacation!)

It feels pretty weird not to be at WisCon this year, especially since two of my favorite writers, Ellen Klages and Geoff Ryman, are the Guests of Honor. Given recent expenses and my general exhaustion, combined with how much else I have to do this summer, skipping WisCon was a mature and grown-up decision (me? grown up?), but I still can't help wondering what's happening in Madison.

This morning, I read through some of the participant bios for the Narrative Medicine workshop I'll be attending in June. One of the professional chaplains who'll be there is also an Episcopal deacon. That gave me a real pang, since I've foregone both of those credentials. (I may yet do CPE sometime -- like, when I retire -- but I don't intend to revisit ordination.) Also, I'm a little nervous about how the ProChaps (TM) at the workshop will respond to my lowly volunteer status. This is not mature or grown up, I know, but the feelings are there anyway, given what a charged issue accreditation is in the field. I got a blog comment once from a ProChap informing me ever so sweetly that I wasn't even entitled to call myself a chaplain, since I'm not board-certified. Oy!

Yeah, I know: it shouldn't matter to me what other people think of me (and the good folk at the workshop probably couldn't care less). I've gotten a lot of lectures on this topic. Kinda ironic, since the people doing the lecturing seem to think I should care what they think about my caring about what other people think. Isn't there, um, a contradiction in there somewhere . . . ?

This afternoon, I cheered myself up by buying lavender and yarn. The woman who runs the lavender store has just gotten a six-week old golden retriver *PUPPY!* which is the cutest thing on four legs, even if it did try to eat my skirt and my hand. At the yarn store, I bought some Noro sock yarn to make myself a scarf, in colors that will go beautifully with the gorgeous cat pin Inez gave me at last year's WisCon.

Oh, a coupla new wrinkles on the medical front. First, the piece of putty covering the donor site for the gum graft popped off last night (the periodontist had said it probably would, although the one covering the actual graft should stay in place), so I've now learned that this procedure can be very painful indeed. I'm back on alternating Advil and Tylenol every four hours -- I haven't needed the Vicodin, thank goodness -- and my mouth lets me know about it if I'm only a few minutes late. And I'm back on a semi-liquid diet. Smoothies rule! Applesauce is good, too.

Which brings us to medical item #2. Longterm readers will recall my talking about how my father always choked on food and liquids; he had dysphagia from a stroke in 2001. He was supposed to be on a thickened diet, but hated it, although he loved applesauce and mashed potatoes with gravy, so we fed him as much of those as he'd eat.

For a while now, I've tended to start coughing when I drink water, because the water goes down the wrong way. I didn't think anything of it -- and didn't even notice that I hadn't been having the same problem with the smoothies -- until two nights ago at dinner, when I took a sip of water and started choking. Suddenly, everything clicked.

"Oh my God," I told Gary. "I have dysphagia! Have you noticed it? That I choke on water?"

"Yeah, you do that all the time. It's really alarming."

"How long have I been doing it?"

"Years."

Since then, I've tried using some of the swallowing techniques Dad's speech therapists taught him (like tucking my chin when I swallow), and those help. I can't believe it took me this long to figure it out, though!

A lot of things can cause dysphagia, including the various autoimmune diseases that would also bump up my ANA. So I'll definitely mention it to the rheumatologist, although I still don't think I have any of those diseases. I called that office yesterday to try to make an appointment, but they hadn't gotten my paperwork from my primary yet. They'll call me when they do.

We're going to a barbecue tonight, although between my sore mouth and the fact that it's looking like thunderstorms, I'm not sure how long we'll stay. If we come home early, we'll watch some more True Blood, which we started watching last night on DVD and adore.

Thursday, May 21, 2009

Wednesday, May 20, 2009

Not Bad


I've now had my gum procedures. My doctor was very pleased with how everything went -- I tend to do well with surgeries, since my baseline health is good -- and while I won't say the surgery was my favorite two hours, it could have been a lot worse. The most unpleasant parts were the initial anesthesia shots (lidocaine hurts going in!) and the yucky tastes in the back of my mouth: blood plus anesthetic cream, ick! None of that lasted long, though.

My pain's been minimal, largely because my doc did a very good job putting putty over raw areas. There was one gingivectomy site he couldn't cover, but that hasn't even been very sore. He has me on a combo of Advil and Tylenol (alternating every two hours yesterday, every four hours today) that's done a fine job controlling discomfort. I have some Vicodin if I need it, but he said that most people don't, and if I didn't need it yesterday, I doubt I'll need it at all.

I'm very impressed with how well he takes care of his patients. Before I left, he gave me several lists of instructions, along with a care package of tissues, gauze pads (these in case of seepage), and packets of Advil and Tylenol. "For your purse," he told me. Most doctors would just tell their patients to stock up on that stuff, but wouldn't supply it. He also gave me his home and cell numbers and told me to call him any time with questions or problems. "I'd rather you called me at ten in the evening than had a sleepless night." He called me at 8:30 to check in and see how I was doing, and emphasized again that I should call him any time. In fact, I was more eager to get off the phone than he was!

I commented that his wife must be very patient with patient phone calls, and he laughed and said, "I've done ten thousand surgeries in twenty years, so she's used to it."

Great guy. Of course, the cynical part of me is thinking, Yeah, for $2,200 out of pocket, he'd better treat his patients well!, but I suspect he'd be a great guy regardless of finances.

I can't swim until next week when the sutures come out, because pool water has a lot of bacteria in it. I can walk starting tomorrow, though.

For the first twenty-four hours, I have to eat only cold things, so I've been living on applesauce, soy yogurt, and various smoothies. Yesterday Gary made me a yummy smoothie with banana, vanilla soy milk, vanilla soy yogurt, and honey. This morning I made myself a smoothie with coffee, vanilla soy milk, and vanilla soy yogurt: quite pleasant, although I should have added some honey. I'm looking forward to being able to eat slightly more solid food beginning this evening, but I'm not going to starve.

Final verdict: the terrors of periodontal work are overstated. Thanks be to God!

Monday, May 18, 2009

More Fun With Medicine!


My doctor called this afternoon with the results of my bloodwork. My thyroid levels are splendid. The various tests that measure infection and inflammation (sed rate, etc.) were all normal. My Vitamin D is a bit low, so I went out and bought a supplement. The weird finding, though, is that I had a positive antinuclear antibody (ANA) test.

This test is often positive in people with lupus and other autoimmune disorders, but there's also a high false-positive rate. I'm sure mine is a false positive; even given my overactive medical imagination, I can't for a minute fit myself into the profile for lupus or any of the other conditions. My doctor's sure it's a false positive too. He's referring me to a rheumatologist anyway, as soon as he finds one who accepts my insurance (oy!).

I have a long history of alarming test results that turned out to be nothing. "You have a huge ovarian mass! It's almost certainly cancer!" Ultrasound a few days later reveals . . . nothing. "You have a visual-field defect! It could indicate a brain tumor!" Brain MRI a few days later reveals . . . nothing. (No brain! No, that's not what I meant. Hold the jokes, please.) "You have an abnormal abdominal CT! It could be Crohn's Disease, or even lymphoma!" Colonoscopy a few days later reveals . . . nothing.

So this is almost certainly also nothing. But when I called my sister to tell her about it, she freaked. She's the one who always minimizes medical stuff, mind you; I'm the one who always asks a zillion questions. But she was shooting out questions as quickly as I could say "I don't know" or "hang on a sec, I gotta check this webpage for the answer."

"What's the false-positive rate? Why did your doctor order this test, anyway? What else besides lupus can cause it? When are you going to the rheumatologist?"

My favorite was, "Are the conditions this tests for hereditary? I don't think I want to be related to you anymore!" (My response was, "You're older than I am. You'd have them already.")

I just kept saying, "Liz, relax. I'm fine. It's going to be a false positive." I probably shouldn't even have called her, but I'm used to checking in with family about this stuff. I really didn't think she'd be so alarmed, but in retrospect, this wasn't the day to lay more medical crud on her. Mea culpa.

She's also more rattled than I am about my gum-graft-plus-two-gingivectomies tomorrow. Her own gum work was miserable, so she's anticipating the same for me; I'm anticipating that mine will be better, since hers was a number of years ago and I've heard very good things about my doctor. I hope I'm the one who's right! But if not, miserable gum procedures are still better than losing teeth.

Gary and I went grocery shopping today and picked up a lot of soft stuff for me: soy and rice milk, soy yogurt, potatoes for mashing -- I can also have polenta -- and some bottled smoothies. I'm going to turn into a soybean by the time this is over.

We also went shopping at REI. I got a phone case that attaches to a backpack strap, and each of us got new shoes (both pairs on sale). Because, y'know, if you're about to spend several thousand dollars on dental work, of course you need to splurge on spiffy new shoes to cheer yourself up.

Sigh.

Downward Slide


My sister just called to stay that my mother's been diagnosed with vascular dementia, the second most common kind of dementia after Alzheimer's (at least in the States). We knew that something was going on with Mom -- she alternates between lucidity and confusion, and has trouble with basic tasks like getting undressed to take a shower, because she puts clothing back on instead of taking it off -- but we'd hoped that these were side-effects of medication. Taking her off the meds didn't help, though, and only increased her pain level.

My sister and I responded in characteristic ways. Liz took the news in stride, as just a label for something we already knew was happening; I immediately did a Google search and started rattling off questions, and then started crying. I'm terrified of dementia, which frightens me more than cancer. I was so grateful that Dad died with his mind more or less intact -- he had his moments of being somewhere else, but always came back again -- and I hate to think of my mother slipping away. My sister's response was a sad, but matter-of-fact, "She's already half gone."

I don't know how long Mom will be able to keep living with my sister. My sister doesn't know and hasn't asked; they're just taking it day by day, although some of Mom's persistent confusion -- for instance, she keeps holding up her oxygen tubing and saying, "I just don't know where I'm supposed to cut this" -- suggests to me that she may need round-the-clock monitoring. To the best of my knowledge, she hasn't tried to cut the tubing, but what if she did? This is the kind of thing I worry about much more than my sister does; her approach is to deal with things as they happen and not to borrow trouble.

Elsewhere in the wonderful world of bodies, I am, as of this morning, officially overweight. Yesterday I walked for half an hour and swam for forty-five minutes, and I don't think my calorie intake was excessive (although I did have some Forbidden Sugar at church), but when I weighed myself this morning, I weighed two-and-a-half pounds more than I did yesterday. (!) This puts my BMI at 25. Nertz! I know my doctor included thyroid tests in the recent blood panel, so I'll be interested to see what that shows. Otherwise, it's almost certainly just perimenopause. This kind of thing isn't unusual in women my age, but if anyone has tips for how to deal with it, I'd be most grateful.

On the plus side, during my dawn walk yesterday morning, I saw a coyote. Beautiful!

Saturday, May 16, 2009

Heckuvaday, Part II


In Which We Make Unexpected Connections

After I got home from the hospital, I ate lunch, decompressed a bit, and headed off to the NAMI walk here in town. I've been intending to join NAMI, or at least get more information about it, for ages now, but this is the first time I've actually done something, thanks to a woman I met at church -- actually, at our visiting Lutheran congregation -- who announced the walk.

Because I got there late, I didn't get to do the actual walk or hear the speakers. But I did get to meet the keynote speaker, Patrick O'Bryan, a local police officer who helped start the Mobile Outreach Safety Team to serve the homeless mentally ill and addicted. O'Bryan is also the head of the Reno Crisis Intervention Team, a police unit specially trained in mental-health issues. He's a huge force for compassion in Reno, and it was an honor to talk to him.

It turns out that O'Bryan's wife is a lecturer in my department; I'd heard her name a million times, but never met her, so he called her over. She'd heard my name a million times, too: small world! We had a nice chat, and have many interests in common.

O'Bryan was also featured in an article in the February 13, 2006 New Yorker. Among other things, the article discusses the social costs of homelessless; a very small number of chronically homeless people account for most of that cost. (In other words, 10% or less of the homeless account for 90% of the ER and other costs in any given city.) To save money, a few cities -- including Denver, Washington D.C. and Seattle -- have started programs where the hardcore homeless are given free housing, no strings attached.

The hardcore homeless are those who've flunked social services, been washed out of every available treatment and recovery program, and keep showing up in emergency rooms. To get the housing, these clients don't need to be straight, sober, or medicated; in fact, they need to have proven unable to maintain consistent recovery. A social worker is attached to the building, and I think some basic healthcare is provided too, but the clients do nothing to "earn" any of this. Nonetheless, once they're in safe, stable housing, the hospital visits decrease dramatically. Society saves money: a lot of money.

Although these programs are successful from an economic standpoint, they're also very controversial. Critics object to "rewarding" people for being a social burden, and think it's wrong to help people who've repeatedly proven unable to help themselves.

As you can probably guess, I'm a huge fan of this program. The minute I read the New Yorker article, I started talking it up in the ER, which gets its share of hardcore homeless. I intensified my efforts after the infamous scapegoat episode, and even got one of our more conservative physicians to admit that it sounded like a good idea. I hadn't heard anything about a program like that in this area, though.

So today I asked O'Bryan about it. He's a huge fan of the program too, and -- yay! -- he's trying to start it here. He thinks it's possible. He's been talking to the legislature. I asked what I could do to help, and he said, "Write about it. You blog? Blog about it."

So here I am, blogging. When I get more information, I'll let you know!

Heckuvaday, Part I


In Which Life Imitates Television

Y'know those TV hospital shows where everything's always going wrong at once? In the ER, three patients are dying at the same time while three others have gotten into a fistfight, and upstairs two newly-divorced-from-each-other surgeons are trying to separate conjoined twins while on the roof, a desperate husband holds hostage the Care Flight crew because his wife has to be coptered to another, fancier hospital now, and the SWAT team is climbing up the side of the hospital to intercept the husband when one of them has an asthma attack, requiring a heroic intern -- the one whose affair with one of the surgeons precipitated the divorce, and who's also deathly afraid of heights -- to climb out on a ledge to administer a breathing treatment, and meanwhile there's a fire in the administrative offices that's trapped the CEO and the President of the Board, who've been feuding for months, in the same closet, and the fire has also blown out the power in the NICU, where noble, harried doctors and nurses are agonizing over which tiny babies they'll save by blowing air through drinking straws, since the backup generator's failed and none of the respirators are working? And through all this, there's nary a chaplain to be found, because hospital TV shows have never heard of chaplains, not even Scrubs, which is set in Sacred Heart Hospital?

Yeah, you've seen that episode. More than once, probably.

My shift this morning wasn't quite that dramatic, but it's as close as I've ever gotten. It started as just another sleepy weekend-morning shift; for the first hour, I didn't do much except restock the blanket warmers and speak to a couple of patients. Then a few more drifted in. I was having a pleasant chat with a delusional patient (whose reality sounded like the aforementioned TV episode, but who was extremely polite and coherent) when the fire alarms went off. I went into the hall to see what was going on. Apparently there was a fire in the hospital kitchen. The ER staff matter-of-factly closed all the doors in the department and kept about their business, although the fire alarm -- which consists of an ear-splitting klaxon and miniature strobe lights blinking above each doorway -- made it really hard to think straight.

While I was out in the hallway, I saw a group of staff outside one of the trauma rooms. I went to investigate. Sure enough, a patient had been brought in by ambulance and was coding. A nurse told me that family was coming in.

I ran back to the delusional patient's room, concerned that the noise and lights might have triggered panic, but the patient was calm and cheerful. So I returned to the trauma room and watched the code, as the klaxon wailed and the strobe lights gave the ER the aspect of a surreal disco club. One tech, standing on a stool for height and leverage, had just spelled another to do chest compressions when I turned and saw five or six firemen clad in full protective gear, including large scuba tanks, trooping through the back of the ER on their way to the kitchen. I think that was when I thought, Is this a TV episode, or what?

The klaxon and disco lights finally stopped shortly before the patient died, which in turn occurred shortly before the family got there. I was sent into the waiting room to speak to the family, but because I'm not supposed to tell people their loved ones have died -- that's the doctor's job -- I made somewhat strained small talk until the nurse motioned us back into the department.

"How're they doing?" she asked me in a whisper.

"They don't know! I didn't tell them! The doctor has to do that."

We ushered the family into an empty room just as the case manager came up to me and said, "There's been a death upstairs. The family wants to talk to somebody."

I blinked and gestured at the first family. "When you have time," the case manager said.

I went in and joined the family, who were starting to get alarmed, especially when the nurse brought in a box of tissues. The doctor came in, looking frazzled and slightly annoyed -- I think he'd been hoping that I'd tell them -- and gave them the news. The family took it better than we'd all feared. They didn't cry. The nurse cried. I was sad, but didn't cry.

The family said they didn't need my services, so I went upstairs to talk to the second bereaved family, who'd asked for my services. I prayed with them and talked about grief and listened to their pain. I shared (very briefly) some of my own experiences from my father's death, and one of the relatives nodded emphatically. I think we found common ground.

On my way back down to the ER, a nurse stopped me and said, "We have a patient who's just gotten a bad diagnosis. The family's very upset. Can you talk to them?"

I spent about twenty minutes with that family, although the nurse was really doing a much better job of pastoral support than I was. The diagnosis was life-changing, but not fatal (a relief to me after the previous two episodes, but not much comfort, at that moment, to the family).

Oh, and while all of this was going on, another chaplain -- a specific professional chaplain, not yours truly -- kept being paged to the ER entrance, and every other person I saw asked me, "Are you Chaplain _______?" and I kept saying, "No, I'm not Chaplain ______" and showing them my name tag. I would have gone to the ER entrance anyway, to find out what was going on, except that I had too much else to do, and by the time I had time again, whatever had happened was evidently over.

I got back downstairs forty minutes before the end of my shift, having not even visited half the ER patients yet. I zipped around the department and saw most of them, I think, before I left. A lot of people wanted prayer, but nothing was quite as dire as the earlier sequence.

Amid all that loss and pain, what hit me hardest was walking into a room and seeing a patient (alert, cheerful, not terribly sick) who looked like my father. He had the same eyebrows.

Last week things were very slow, and I wondered what I was doing there. This week, I didn't wonder that at all. I'm glad I was there. I hope the families were, too. As stressful a shift as it was, it was also intensely satisfying.

But I really, really hope that nothing like that first paragraph ever happens at My Hospital.

Friday, May 15, 2009

Summer Lace


I've started knitting a new scarf in a diagonal eyelet pattern, with lovely Noro sock yarn. Although the yarn's a wool-nylon blend, the eyelets will make it cool for summer.

It's an easy pattern, but on Wednesday I was working on the scarf at a concert, and one of the women behind me leaned over and said, "What's that stitch? That's beautiful!"

The thing I love about knitting is that so many easy patterns look very impressive. Bwah-hah-hah!

This scarf will be a gift, if it's long enough, but I want to make one for myself, too.

Medical Crud


The other day, the periodontist's office called with insurance info for my procedures. The two gum grafts will cost $1,400 each, and the gingivectomies will cost $1,600. I have $800 in dental insurance remaining for this year, and $1,000 total (if the state doesn't cut it, as seems likely) for next year.

I'm lucky to have any dental insurance, but that's still a lot of money out of pocket. I was hoping that my summer-teaching salary could go towards a nice trip to Hawai'i or Alaska, but it's going to be paying for periodontal work instead.

But at least we have the money. So many people don't.

Meanwhile, I went to see my primary-care doc, who sent me for knee x-rays and bloodwork. He doesn't think I have asthma, and the allergies have been doing better on Zertec.

I've been exercising again these last two days, but I'm still achy everywhere. It usually takes about a week of daily exercise for me to start feeling like myself again, so I just need to keep at it.

Meanwhile, though, my weight's skyrocketed to an all-time high. I've always been a tiny person, and I don't think I look particularly heavy -- although there's definitely more padding than there used to be -- but my BMI's 24.4, which is still in "normal" range but alarmingly close to "overweight."

Some of this is undoubtedly perimenopausal metabolism change, and some of it's the fact that I gain weight on antidepressants. (When I went off Prozac some years ago, I lost twenty pounds.) I can't do anything about the perimenopause, and it doesn't seem like a great time to go off meds, so I'm just going to have to exercise like an Energizer Bunny and try to eat less.

Sigh.

Teaching Progress


My grades are in! Yay! After we turn in grades, we get to read our course evaluations, so I did that, too. They were very strong in both classes; in fact, my 101 evals were the best I've ever gotten for a freshman comp course.

Although I'm happy about this, it's also puzzling, given what a basket case I was this semester because of Dad. (One of my colleagues said that she was amazed I was able to teach at all, at least while he was still alive and I was running around taking care of him.) I'm not sure how to apply this to future teaching, since I neither expect nor want to undergo a major loss every semester. On the other hand, evaluations often have more to do with the personalities of the students than with the performance of the professor, and this was a pleasant, laid-back group. And they knew what was going on in my life -- one student included a very sweet note with her final portfolio, telling me that I was a role model for her in dealing with grief -- so maybe that had something to do with the evals, too.

Meanwhile, yesterday I wrote the syllabus for my summer Tolkien course, and today I hope to get started on my narrative-medicine freshman comp class for the fall. My goal's to have both fall classes prepped before I leave to go back East on June 10. That's a little ambitious, but any progress I make will be A Good Thing.

I don't usually remember my dreams, but the last two nights, I've had very vivid dreams about narrative medicine. In the first, two English Department colleagues were ragging on me about how it's not a real intellectual discipline: classic academic anxiety dream! In the second dream, I was at the hospital, having a long conversation about Langston Hughes with one of the ER docs. I'm not sure what to make of these, except that my unconscious seems to be working on integrating these two aspects of my life.

Today's the med school graduation, and I'll be going to wish my student well as she heads off to residency. On Monday, my three first-year NM students are leaving for Ecuador, where they'll be helping out in a hospital for a few weeks. I can't wait to read their writing about it!

Monday, May 11, 2009

Fastest Trial in the West


I reported for jury duty this morning and was indeed seated on a jury. We were done at 3:00 in the afternoon. The judge said that in thirty-six years, it's the shortest trial he's ever seen. I think our lunch break was longer than the actual trial.

So I came to work, caught the tail end of my last fiction class (I was touched that so many of them were there!), and am now waiting for my freshman-comp students to hand in their final portfolios. And I won't have to reschedule any of my doctors' appointments. Yay!

Oh, and not only was I included on the jury even though I have a PhD, but the jury also included an attorney and a physician. So much for the people who expected the Nevada judicial system to be anti-intellectual!

All in all, a painless way to complete one's civic duty.

Sunday, May 10, 2009

Blessing the Garden


Here's my Mother's Day homily. It's not one of my favorites, but it does what it has to do. My primary goal when I preach on Mother's Day (which I've done a lot) is to reach out to people for whom the holiday's painful, to get past the Hallmark pieties that can be so grating to those of us who have complicated family relationships. And, really, who doesn't?

My relationship with my father was very difficult for decades, and I used to have a devil of a time finding a Father's Day card that reflected any recognizable form of what I felt for him. Hallmark just didn't sell cards that said, "I love you even though you're the reason I've been in therapy half my life." (A lot of the time, I went with blank cards.) It got much easier over the years, and finding a Mother's Day card was always a snap, but I know that for a lot of people, it's not.

And don't even get me started on the various insults, subtle and otherwise, Mother's Day dishes out to those of us who've chosen not to have kids. I am, of course, talking about the sentimental fluff-fest Mother's Day has become in contemporary America, not the rousing peace proclamation issued by Julia Ward Howe in 1870.

So, yeah, anyway. It's an annoying little holiday, but one that preachers ignore at their peril.

The readings are Acts 8:26-40, 1 John 4:7-21, and John 15:1-8.

*

About a month ago, I sat in on a workshop for medical students about to begin their residencies. The workshop facilitator asked them to draw a tree with their non-dominant hand; in other words, to draw with their left hand if they usually wrote with their right, or vice versa. Afterwards, we put the trees in a circle and admired them. There were short trees, tall trees, bushy trees, elegant willows, trees laden with fruit and trees whose branches sheltered birds. The facilitator lavishly praised each tree. Only afterwards did she say, very gently, “Have all of you noticed something? None of these trees have roots. They only exist from the ground up.”

She proceeded to remind the students that to get through the infamously brutal process of residency, they’ll need to remain grounded. “Remember your roots,” she told them. “Protect and nurture what feeds you, even when other people can’t see it.”

This past Thursday, I helped my friends Katharine and Pamela bless Katharine’s garden. Katharine scattered dried flowers on the soil around the plants, while Pamela sprinkled them with fertilizing ash and I gave them water. We made our way from potted shrubs, to bright blossoms, to the two saplings Katharine planted when her granddaughters were born, to the vegetable garden she’s just planted. Each plot of earth received the same blessing, even if no growth was visible. The vegetable garden looked like mere dirt, but Katharine has faith that in a few months, it will produce delicious food. She loves her vegetables even though she can’t see them yet.

To paraphrase -- very broadly! -- today’s lesson from 1 John, Katharine learned to love vegetables she can’t see by loving vegetables she can. And she learned to love vegetables in the first place because God first loved her, and all of us, by creating the fertile earth and the countless things that grow on it: carrots and eggplant and tomatoes, not to mention flowers and trees.

This is the progression described in the Epistle: God loves us into being, and we learn to love the people we know. If we’ve mastered that first lesson, we can then begin to love people we can’t see and don’t yet know, including God, and far-flung neighbors, and maybe future versions of ourselves, grown from humble sprouts into the fruitful branches Jesus admonishes us to be. None of this would be possible, though, if God hadn’t first loved us.

When I was researching this homily, I learned an interesting fact about vines. In the 19th century, a plague of insects called phylloxera decimated the vines used to grow wine grapes in Europe. American vines were immune to the pests, but the wine made from their grapes wasn’t nearly as good. Someone solved the problem by growing American vines and grafting the European plants onto them. The European vines produced excellent fruit, but only because the American roots remained untouched by the phylloxera.

“I am the vine and you are the branches,” Jesus tells us. “My Father is glorified by this, that you bear much fruit and become my disciples.” We are charged to bear good grapes, but we must also remember and honor our roots, the God who nourishes us even when others can’t see him, and without whom we would wither and die. Prone to countless pests and plagues, we need God to nourish us into fruitfulness. But God needs us to bear fruit.

Because today is Mother’s Day, it’s easy to think about these ideas in terms of parents and children. Parents, and other caring adults, love children into being. Unloved children all too often wither as adults; loved children are much more likely to become loving, fruitful people themselves. Most mothers love their children even before they’re born, and continue to love them when they’re out of physical sight. By the same token, if we have loving relationships with our mothers, we continue to love them long after we can no longer see them.

On Friday, I went to the Post Office to Express-Mail a Mother’s Day card to my mother in Philadelphia. “I always send cards late,” I told the clerk, “and I want this one to get there on time. This may be my mom’s last Mother’s Day, and I don’t want to regret a late card.”

I was embarrassed at paying the outrageous $17.50 Express Mail charge to send a measly greeting card, but the clerk nodded. “I understand completely,” she said. “This is my first Mother’s Day without my mother. I don’t need to send a card, though, because I think about her every day, whether it’s Mother’s Day or not.”

Another clerk, this time at the grocery store, told me that every Mother’s Day, she releases a balloon to float up to heaven. “I know mom’s in a better place,” she told me simply.

This can be a very painful day for people who have lost, or who have strained relationships, with mothers or children. Sometimes it feels as if those branches have been thrown away and withered. Faith that our dead loved ones are in a better place doesn’t change our yearning to have them with us here and now, where we can see and hear them. Sometimes the pain from broken relationships -- with loved ones who could see and speak to us, but don’t -- can be even more difficult. But we are an Easter people. We need to remember that God will always nourish us. We need to remember that seeds can sprout from seemingly barren ground.

And we need to remember that there are many ways to bear fruit. The famous verse from Galatians tells us that “The fruit of the Spirit is love, joy, peace, patience, kindness, generosity, faithfulness, gentleness, and self-control.” On Mother’s Day, this may be especially reassuring to those of us who, either by choice or necessity, have no children. Galatians reminds us that we don’t need to have biological offspring to be fruitful and multiply. We don’t even need to be gardeners: a great comfort to me, since I’ve always had a black thumb.

Galatians doesn’t include hope or imagination on the list, but it seems to me that those gifts are Fruit of the Spirit too, and that the Ethiopian eunuch from Acts illustrates them admirably. Physically unable to have children, he is nonetheless a man of great faith. He invites a stranger, someone he has never seen before, into his chariot to guide him through the Scriptures. He questions what he reads, and when Philip explains the passage to him, the eunuch says, “Look, here is water! What is to stop me from being baptized?”

The eunuch moves gracefully from something he can see -- the water by the road -- to something he has only just imagined, his own baptism. He moves from what is real to what is possible, and then, in turn, makes that possibility fact, stopping the chariot so he can be baptized right there and then. He becomes one of Jesus’ branches, a grafted limb ready to produce wonderful fruit. The eunuch reminds us that questions can be a sacrament, the first step to making God visible in the world. We follow his example when we pay attention and take action.

“Look, here are my neighbors! What is to keep me from loving them?”

“Look, here is injustice! What is to keep me from correcting it?”

“Look, here is the Kingdom of God! What is to keep me from sharing it with the world?”

This Mother’s Day, may we bless all our gardens: those we can see and those we can only, as yet, imagine. And may we always remember, and rejoice in, the roots that ground and nourish us.

Amen.

Saturday, May 09, 2009

When the Going Gets Slow, the Slow Go Shopping


We had a very, very sleepy shift in the ER this morning. Not only was my census low, but hardly anyone needed spiritual support. One or two people asked politely for prayer, but there was nothing dramatic or particularly urgent. I took long breaks, outlined my homily for tomorrow, chatted with an EMT who loves science fiction (and who greeted me this morning with an excited, "So, have you seen the new Star Trek movie yet?"), talked to a couple of my favorite nurses, and made sure the blanket warmers were stocked.

I also shopped. I've long had my eye on some glass-bead lanyards in the gift shop, and today I went ahead and bought one. It was overpriced -- I could have made the thing myself for half the cost, probably -- but hey, the money supports the hospital. And while this may have been a vain purchase, I firmly believe that God likes pretty colors; why else would she have filled the world with them?

And I know patients like pretty colors. I chose this particular lanyard because it goes so well with my scrub top, on which I get compliments all the time. This top hasn't quite reached Magic Shirt status, but I still always feel good when I put it on. It makes me feel a little like a walking Monet painting.

Friday, May 08, 2009

Nertz!


I indeed have to report for jury duty at 7:45 a.m. (whimper) on Monday. AND -- horror of horrors! -- they don't allow sharp objects, expressly including knitting needles, in the courtroom.

Hmmmph. Well, I guess I'll get a lot of reading done. If I'm not chosen for a case, I'll probably be able (I hope?) to keep my Tuesday commitments. If I am chosen, then I'll probably be able (I hope?) to keep my commitments next week.

Or I may just have to cancel and reschedule everything for both weeks. Sigh.

I like jury duty, honest, and I feel strongly that everyone who's capable should indeed serve. I think I made a difference, the one time I was on a jury in New Jersey. The prosecutors were clearly counting on race and class bias and did a very sloppy job making their case, which made me and two other people (both black) angry. The three of us convinced the other nine jurors, whose attitude was basically, "Yeah, he's guilty, let's get out of here so we can eat lunch," to acquit the defendent on one of the charges, although we all agreed he was guilty on the other.

I don't know what difference, if any, this made in the defendent's life, but I felt like the three of us talked the others into doing the right thing, and did so by reminding them of the law. The burden of proof rests on the prosecution, and these prosecutors had gotten really lazy.

A friend to whom I told this story said, "I'd want you on my jury if I were on trial, but I'm not sure how many lawyers would want you on their jury." And my boss said, "You think they're going to put someone with a PhD on a jury in this county?"

We'll see!

Fun with Gums!


Turns out I need three periodontal procedures; two can be done at the same time, but the third will have to wait until the other two have healed and until my insurance has rolled over. Two involve grafting new gum tissue onto places where it's missing, and one involves snipping gum tissue away from places where pockets between the gum and the tooth have allowed bacteria to collect, resulting in bone loss.

The periodontist was extraordinarily thorough. First he examined every tooth, calling out arcane descriptions to a scribe. "Fickle buckler on the ninth meziodontal tyrannosaurus!" (Okay, obviously I'm not remembering this precisely, but that's more or less what it all sounded like.) Then, after telling me, "This will be the worst part," he probed every millimeter of gum with a sharp instrument. It actually hardly hurt at all, which means he's good at what he does. Then he pondered his notes and drew up a treatment plan, and then he showed me diagrams and charts and explained in exhaustive and dizzying detail -- making notes in handwriting even worse than mine -- the treatment options for each situation. Then he had the scribe hold a magnifying mirror in front of my face, had me open my mouth, and showed me the three places that absolutely must be fixed now, as opposed to many others where the gum integrity's somewhat compromised but where he doesn't expect it to get any worse.

(Having my gums poked with the sharp instrument wasn't the worst part of the exam: looking at my magnified face in a mercilessly brightly lit mirror was the worst part of the exam. Ah, the perils of middle age!)

There's a two-week healing period and I'm leaving town June 10, so we've scheduled the first two procedures for May 18, if I'm not on jury duty. Right now, everything in my life is contingent on whether I'll be on jury duty starting Monday, or possibly the following Monday.

If I'm not on jury duty next week, I'll teach one final class, attend one departmental meeting, and go to two doctor's appointments (including the one with my PCP about allergy/arthritis/asthma issues). If I'm not on jury duty the following week, I'll have the periodontal procedures, and if I'm on jury duty long enough to have to reschedule the periodontal appointment, but not for the entire week, I'll be having lunch with one of my priests. If I'm not on jury duty and do have the periodontal procedures, I may or may not be up to lunch, depending on how my mouth feels.

It's all very complicated. I need a flow chart to keep track of my life these days.

My sister had gum grafts some years ago and says they were hideous. My doctor said that the pain level depends on whether the putty he puts over the donor sites stays on or not: if it does, you don't feel anything, but if it comes off, you're very sore (and it can't be replaced).

When I told my sister how thorough he'd been, she snarled, "He probably knows my guy. My guy teaches the damn stuff."

"So does mine. Did you like yours?"

"His job was to inflict pain. How could I like him?"

Of course, I doubt that would be his description of his job. I'd asked my Gum Doc if he likes his job, and he says he loves it, and I said I was glad to hear that, because I'd always heard that dentists were miserable and had high rates of suicide. He said, "That used to be true, but not anymore. We've gotten a lot better at giving shots and handling pain, so people don't hate us anymore." My sister's Gum Doc was back in the dark ages, I guess. I hope his patients are happier now!

Meanwhile, the good news is that we're going to start a new Literature & Medicine discussion group, this one as part of a new program at VA hospitals, next year, and I'll be facilitating it. Yippee! I love Lit & Med, and I feel like I have a connection to the VA through Dad. I met the VA folks over lunch today, and they were all very nice and seemed enthusiastic, so I'm really looking forward to it.

Also, I express-mailed a Mother's Day card to Mom today. I'd already sent her a small gift, which she received today and seems to like. I'm terrible about mailing cards on time, though, and one of the things I regret about Dad's time in Reno is how holidays went by the wayside. He was in the hospital on Thanksgiving, and Gary and I were out of town on Christmas, because my father-in-law's funeral had been just a few days before. We meant to have a belated Christmas celebration with Dad and Fran when we got back, but it never happened. Dad said he didn't mind, but I minded. I've always loved Christmas.

So, anyway, I'm doing whatever I can to observe holidays on time with Mom, so I won't have those regrets with her when the time comes. The postal clerk who waited on me understood completely, even though $17.50 postage for a greeting card seems a bit extreme. "This is my first Mother's Day without my mother," she said, and we shared stories about our parents. I told her about Dad, and she told me about her Mom, who died very suddenly, in apparently perfect health and on vacation, at the age of 76. We agreed that there are much worse ways to go, and that we both think about our dead parents every day.

Pretty Kitty

Thursday, May 07, 2009

Kvetching


Okay, I lied: I do have something of substance to say, although it mostly takes the form of whining.

My health's been crotchety lately. Until a few days ago, the arthritis in my right knee was really acting up, so much so that I went to Urgent Care one day when the knee had buckled and then started crunching and clicking much more than usual. The UC doc didn't even do an x-ray: just slapped an Ace bandage on me and sent me home. "Yeah, it's just arthritis." As my sister points out, my symptoms could have been exacerbated by our recent rainy spell, which is now -- blessedly -- over. We always need rain here, but I still much prefer sunshine!

Meanwhile, my allergies have been going nuts, and Claritin just isn't cutting it. Gary has gently urged me to go see my doctor, and I should probably do that. I've been coughing a lot at night, and my chest's been a bit tight. My sister said, "You don't have asthma, do you?" which prompted me to do a search for adult-onset asthma. I still don't think I have it, but I certainly have a bunch of risk factors: female, check; menopausal, check; allergies, check; rhinitis, check.

I like my primary-care doc, but he's following the pattern I've seen with a lot of physicians: first they're great listeners and really take their time with diagnoses, but then they succumb to the fifteen-minute my-eyes-are-glazed-because-I-have-ten-more-patients-after-you-and-I'm-running-late office visit, the one where you're lucky if you can get a distracted "uh-huh" out of them. (And this is a guy who started his own practice to get away from all that.) I'm not blaming him -- it's very difficult to practice humane medicine in today's insurance environment -- but it's frustrating, and there's part of me that always takes the rushed-ness personally, even though I know full well that it has nothing to do with me. Plus, I feel like most of what he does is being a gatekeeper for specialists. Plus, I've seen him a few times in the last few months, and I always feel like if I go to my doctor too often, I'll get pigeonholed as "that neurotic depressive hypochondriac," which may already be happening with this doc and certainly happened with the last one. (Intellectually I know that depression's a risk factor for more purely "physical illnesses," and vice versa, but I've had a lot of years of feeling as if any physical symptoms are being chalked up to my depression diagnosis.) This doc is great about answering e-mail -- very admirable, given his hectic schedule -- but I feel like e-mailing him counts as pestering, too.

But if nothing else, I should go see him to get better allergy meds, right? Plus, I've been under real-world stress which could cause legitimate health flare-ups, right?

Sigh.

Meanwhile, today I see the Gum Doc to find out if I need grafts. Oh, joy. At least my dentist told me to see this guy, so I'm there on someone else's authority and can't be accused of malingering.

Also, last night I had another good cry about Dad. I'm not sure what triggered this one, but I guess it's not important. After all, it's been less than seven weeks since he died. And crying's healthy. Right?

On the plus side, I swam for an hour on Tuesday, so obviously my lung function can't be too impaired!

Cute Critter #2

This guy's enjoying his orange peel. PetSmart always has cats for adoption, but none of them were posing for the camera yesterday.

Cute Critter #1

Because I'm easily amused and have nothing of substance to say right now, and because I owe my readers a cute critter shot after missing the darling ducklings, here's a canary we saw at PetSmart yesterday. There were also gerbils nestled in their food bowls, but they didn't stay there long enough for me to snap their picture.

Monday, May 04, 2009

A Little Help from my Friends


Last night we got together with our musician friends Katharine and Jim (with whom we'll also be having a gala end-of-the-semester dinner tonight). Both of them have extraordinarily fine literary taste, based on the fact that they both adore The Necessary Beggar. (What: me, biased?) Jim, who's a composer, even wrote an art song based on a poem in the book; Gary and I got to hear its world premiere at a campus concert a few years back, with Jim playing the piano while Katharine sang. Very cool, especially since these two are world-class performers.

More reliably than anyone except Gary (and Dad), they keep encouraging me to write new stuff. Last night I told them that I'm really blocked, for a lot of complicated pyschological reasons I won't go into here, including but not limited to Dad's death. Jim sometimes teaches his students light self-hypnosis to help them get past stage fright, so I wondered if he could do the same thing to help me past writer's block.

He may be able to do that, and I'd like to try it. In the meantime, though, Katharine's decided that what I need to do is to reread a chapter of TNB every night before I go to bed, to try to get back to the creative space in which I wrote that book.

I haven't started this yet, but I sure hope it works. Writing that book was definitely one of my peak experiences, ten and a half weeks of bliss. If I could find a way to get back there, I'd never want to come out. (Which may, actually, be one of my fears about going back, although as Katharine points out, I can write -- and have written -- in less ecstatic states, too.)

Darling Ducklings Manque


This morning, walking to my office on campus, I saw a mother duck parading up the sidewalk, followed by five thimble-sized, downy, brown-with-darker-spots ducklings. All the women in the vicinity immediately started squealing and pointing their cameras, and even the men looked charmed.

But did I point my camera? Did I take a video of the darling toddling ducklings? Did I call the local paper to report that Spring Has Officially Sprung, based on duckling sightings? Noooooooo, because I, nimnoid that I am, had left the friggin' camera/video/phone IN THE CAR.

So I can't show you a picture of the utterly irresistable ducklings, which is just as well, because if I did, you'd all collapse into swoons and be found hours later in puddles of drool, which isn't good for the economy.

As Gary knows, I've been forgetting everything lately. The phone, three times now. My swim goggles, two days ago. Two of the three rings I wear on my wedding finger, this morning. Names, constantly. I was starting to become truly alarmed (often without remembering why, of course), until I did a Google search and learned that forgetfulness is one of the most common behavioral symptoms of grief.

Whew! That explains it, then.

Forgetfulness is also, as Gary points out, a common symptom at the end of the semester. Classes met for the last time today, although we're required to meet during the "final exam" time even if the class doesn't have a final, as mine don't. That's next Monday, for both classes, but I may be on jury duty -- and won't know for sure until I call the recorded number after six on Friday to learn if I need to report, ho hum -- so I've made alternate arrangements for collecting final assignments.

I'm sure I'll forget all kinds of things between now and then.

Saturday, May 02, 2009

Birthday Beast

Harley is ten years old today. Happy birthday, Sir Harlequin the Hilarious!

Friday, May 01, 2009

Weird Wrinkle


The first sentence of C.S. Lewis's A Grief Observed is, "No one ever told me that grief felt so like fear." I've been thinking about that lately, because although I'm not scared, exactly, I have been very anxious: waking up with my muscles in knots, that kind of thing.

This is counter-intuitive. It made sense for me to be anxious when Dad was sick and I was running around nonstop trying to take care of him, but you'd think I'd be more relaxed now that the long vigil's over. Gary says that I'm probably anxious about losing other people, now that I've lost a parent (for all our differences, my father was definitely someone who loved me no matter what), and that makes sense, but -- although I'm even clingier than usual with Gary, poor patient soul -- I'm not conscious of that kind of fear. For instance, I'm not (consciously, anyway) more anxious about the prospect of my mother's death than I was before Dad died, and there's no one else I'm immediately worried about.

Of course, anxiety often goes along with depression, which I certainly have, and which I'm sure is kicking up right now, although I've actually been feeling pretty good, moodwise. The anxiety feels physical.

So has anybody heard of, or experienced, anxiety as a side-effect of grief? And if so, do you have any clue what to do about it, aside from my usual staples of prayer, exercise and knitting?

Thanks!