#Goals

img_7351Yesterday I had my scheduled “Be Well” visit, one of the many annoying assaults to my dignity that I must endure, like a pigeon pecking a button for a pellet, to earn a lousy (taxable) $600.

A slim, bright-eyed doctor strode into the room. He looked all of twelve years old.

“So! Let’s talk about your Be Well goals for the year!”

I was taken aback. “Oh! I actually have been thinking about those all week, but I’m still working on them. I promise I’ll have them by my next phone appointment with my Be Well Advocate though.”

“Mmmhmmm,” he said with his fingers poised over the keyboard, “But I have to put them into the system, so let’s go ahead and work on those now.”

“NOW?!” I said in a mild panic, “Well, OK. I will…ummm…try to exercise four days a week.”

“Good one!” he said with an encouraging smile, “One more.”

“I’m blanking. Do you have any suggestions for me?” I asked.

“How about…I will meditate three times a week for five minutes. That seems easy enough, right?”

“Yes, but…shouldn’t it be something that I would realistically do?”

I continued to muse out loud, “I know I should lose some weight, but I also feel like the goal should be something that would actually be achievable…”

“Drink less?” he proposed.

“I don’t drink.”

“Eat less sweets at work?”

“I don’t eat a lot of sweets.”

“Eat a greater proportion of vegetables at meals?”

“I don’t eat meat.”

“Well! You’re just perfect.”

Exasperating medical health professionals is one of my special talents.

Until this year, it used to be the case that instead of going to a doctor, the Be Well program would require you to move through stations set up around a large conference room. At one station you would get weighed and measured. At another station you would get your blood drawn. At the final station, a nurse would interpret your results and give you recommendations to improve your health.

One year, a well-meaning nurse tried to get to the bottom of my high cholesterol numbers.

“Do you eat a lot of sugar?”

“No, I really don’t.”

“Do you eat a lot of fried foods?”

“No.”

He started to look at me with suspicion.

“Red meat?”

“I don’t eat meat, just fish occasionally.”

His eyes narrowed and he asked, “Fatty foods?”

“Not really, although…I do eat cheese,” I conceded.

The nurse pounced: “You MUST. EAT. LESS. CHEESE.”

Now, under pressure to come up with something, anything, I blurted out to the doctor: “OK, I have my second goal!” Forgetting all my scruples about setting a goal that was both realistic and achievable I announced: “I will eat less cheese.” I cringed as the words spilled from my lips, fully confident that no stupider-sounding goal had ever been set in the history of the universe.

Doogie Howser exacted his revenge on me.

“Hah! That’s the exact opposite of MY goal. My goal is to eat MORE cheese. I fantasize about quitting medicine and becoming a cheesemaker! But my wife says I have to pay off all my med school loans first.”

Well, I suppose we all have our crosses to bear.

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On Mortality, Banality, and Boobs, Part 3

My last post on the subject – promise!

I’ve heard it said that when one is suddenly face to face with one’s own mortality, the heart’s true desires come into focus with startling clarity. Hopes and aspirations, which may have been forced into dormancy or lost in the daily grind of existence, suddenly push themselves to the foreground with urgent insistence. Having recently experienced the looming specter of my own death, I can report that in my own case this was absolutely true.

Often people in extremis are consumed with the impulse to create a legacy in words, music, or art. Some remarkable souls choose to use their time on Earth to do good for others. During those few weeks when I was traveling through the valley of the shadow of death, I sat on a committee to award a prize for a student who demonstrated a commitment to community service. We ended up choosing a student who, while in no danger of dying, was bedridden with a serious injury for over a month, and spent that time spearheading an ambitious fundraising campaign for men’s health. I know of at least one other person who, faced with a terminal diagnosis, spent the last years of his life raising enormous sums of money for research into a cure for the disease to which he succumbed. Others create bucket lists of extraordinary experiences to have or places to visit before dying.

During the few days when I was waiting to hear the results of my needle biopsy, I tried to formulate a mental list of my own:

  • I would quit work immediately to spend whatever time I had left with my family and friends. There was no place in particular I wanted to go, and no exciting adventure I wanted to have with them. I simply wanted to be with them.
  • I wanted to play with cute baby animals. “You’re probably going to have to get me another puppy,” I announced to my husband, “and then take care of it after I’m gone.” God bless that long-suffering man – he remained stoically silent.

“Good Lord, woman. Get a grip!” I thought to myself. “Get a goal that’s not so pathetic!”

I tried, I really did try to rouse myself to come up with a list that was less trivial.

I recently re-read one of my favorite novels of all time – Dostoevsky’s The Idiot. It’s a novel teeming with striking, memorable characters. One of my favorite characters is Lizaveta Epanchina, a blustering, tyrannical, warm-hearted eccentric who is both the soul and comic relief of the novel. She reminds me so much of my own larger than life mother. Epanchina beats her breast in agony over her own unconventionality, but it’s a trait she obviously values and seeks out in others. I’ve always been struck by a scene in the novel in which she picks a fights with her daughter Alexandra, because she’s so annoyed by the banality of a dream she has, which “had the peculiarity of being as innocent and naive as those of a child of seven.” As I struggled to come up with some worthy goals, I imagined Lizaveta Epanchina clutching her head in despair at my list, or maybe even boxing my ears in frustration.

I managed to scrounge up one more item for my list:

  • Eat delicious food. I live in Charlottesville, a culinary mecca filled with award-winning chefs and restaurants for which people cross state lines. But by delicious food, I was thinking of Flamin’ Hot Cheetos, Funyuns, and Andy Capp Hot Fries. I could visualize myself snarfing these from a bowl balanced on my stomach while I lay bedridden, watching bad reality TV.

Alas, this episode in my life has revealed the truth to me. I am no Lizaveta Epanchina. I am her daughter Alexandra. Now I know what my greatest aspirations are: to live a normal life, to spend time with my family and friends. Oh, and to eat some Funyuns every now and then. I’m so grateful that I can.

Related posts:

On Mortality, Banality, and Boobs, Part 1

On Mortality, Banality, and Boobs, Part 2

On Mortality, Banality, and Boobs, Part 2

At the rather bluntly named “Breast Care Center,” a nurse escorted me back to the same room, where I had learned I would need to have a needle biopsy just a few days earlier. I couldn’t wait to get it over with. The sooner they got the pathology results back from the biopsy, the sooner I would know one way or another what my life would be like for the next few months, or perhaps years.

The nurse told me that a doctor would come in and talk with me in a little while. She left a clipboard and a brand new marker sealed in a plastic pouch on the counter and walked out. As I waited for the doctor to arrive, I idly wondered if the marker was for me to doodle with in case I got bored.

Suddenly, an adorable little boy dressed in slacks and a button-down shirt popped his head into the room. He wore wire-rimmed glasses, and smiled at me from his twinkly Asian eyes. I wanted to pinch his cheeks, give him a lollipop, and then help him find his mommy. He could have been my own son. It turned out he was my doctor.

He opened the marker, wrote something on my chest above the breast in which lurked the “areas of concern,” and then tossed the marker into the trashcan. He explained to me what was going to happen next and then we headed to the room.

Another young doctor and two nurses were waiting for us in the room. I lay on my side on a stretcher and they wheeled me up to the mammogram machine. They clamped my left breast into place and once again I got up close and personal with the cold hard surfaces of the mammogram machine. I couldn’t see anything or anyone, but I felt one of the nurses grab my fingers. She told me I could squeeze hers as they numbed the area with four or five shots of lidocaine. Disembodied voices asked me meaningless questions. I knew no one really cared where I was from, or how long I’d lived in Charlottesville, but I understood that these questions were meant as a kindness and so I gave answers as if they mattered. Every now and then throughout the procedure one of the nurses would give my hip a pat and then let her hand come to a rest there. I usually hate being touched by strangers, but I think I will remember the warm weight of her reassuring hand with gratitude for the rest of my life.

The area numbed up quickly and they extracted a tissue sample and inserted a titanium marker in its place as a permanent souvenir of my visit to the Breast Care Center. As for the tissue sample, they put it in what the nurse described as “our Suzy Bake Oven” to make sure they had enough and wouldn’t need to go in for more. Once they took a few more photos of my traitorous appendage, I was unclamped and wheeled away from the machine.

And now the second young doctor was mashing down my boob with both of his hands…hard.

“I have to do this for the next ten minutes,” he said apologetically, “It will stop the bleeding.”

“OK,” I said and I turned my head away to look at the clock. Making eye contact in such a situation did not quite seem the thing to do. The horrible thought suddenly crossed my mind that the two young doctors who had worked on me that morning, from Asia and India, might easily be one of the many international students who pass through my office on a daily basis for a travel signature or a program extension. I see so many students that it is impossible to remember all of their faces or names. Maybe I helped this young man file for work authorization so that he could be legally permitted to be here pinning down my boob as if it were going to run away. This thought – like so many of the other thoughts that had been racing through my head for the last couple of weeks – had to be shoved away just as quickly as it reared its ugly head.

After the ten minutes were up, I was bandaged and the nurses gave me my post-procedure instructions. It had seemed like an eternity, but the entire procedure was over in less than an hour.

“You’re heading straight home now, right?” one of them asked.

“I was planning to go to work, actually,” I answered.

“No, honey,” the nurse shook her head, “You’re not going to work. You’ve been through a lot and you’re going to be exhausted. Go home, get into pajamas, take some Tylenol and watch a movie.”

And so I did.

Related post: On Mortality, Banality, and Boobs, Part 1

On Mortality, Banality, and Boobs, Part I

I can’t stand suspense…not in movies or books, not in sporting events, and certainly not in real life. The past couple of weeks have been one long, suspenseful nightmare because I thought I might have cancer. Let me tell you right upfront that I do not.

It all began with a callback mammogram. I got a letter in the mail explaining that it was sometimes difficult for mammograms to produce clear images for people with “dense breast tissue.” Dense breast tissue — hunh?! After nursing three babies, more like droopy, flaccid hackysacks that have lost all their stuffing. But – whatever.

This was not my first rodeo. I had been called back for a second mammogram once before so I knew what to expect. I knew I would be in for a torture session that would somehow manage to be simultaneously futuristic and medieval. I would be asked to mash the side of my face against the plastic and metal of a mammogram machine. I would be made to sling my arm around it as if in a lover’s embrace. A stranger (a lovely and kind nurse, but a stranger nonetheless), would pat and squash and arrange my breast as casually as if she were making a biscuit…if making biscuits also involved mashing the dough impossibly thin between two cold, hard plates. I would endure the torture with stoicism, wincing only when I simply couldn’t bear it.

“Too tight?” the nurse would ask as she turned a knob that would cause the boob vise to clamp down ever tighter.

“Yes,” I’d gasp.

She would loosen the crank a touch, but then with a cruel, deft flick of her wrist, she would tighten it right back to its original position.

“I saw that!” I would think bitterly each time it happened.

Never mind. It would all be over soon enough. I’d receive my benediction and be dismissed to go on with the rest of my life. Only this time I wasn’t.

I knew something was up when the nurse escorted me to a back room I’d never seen before and told me that a doctor would come talk with me soon. I was pretty sure she was trying to avoid making eye contact with me. The doctor spoke to me in gentle, soothing tones. She told me that there were “areas of concern” that would need to be further examined. I would be scheduled for a needle biopsy. Once the pathology report was back, if there was evidence of cancer, we would discuss my treatment options.

 

Snake

When my father was eleven years old, his entire family was struck down by typhoid fever. Only his mother did not get sick, having developed immunity after surviving her own bout with the disease as a child. By the end of those terrible two weeks, my father’s father was dead. He left behind a widow with ten young children and a farm to run. This disastrous change in the family’s fortunes unleashed a whole chain of calamities. But this is the story of triumph over death in the midst of tragedy, and it came thanks to two venomous snakes. Here’s another installment of Stories from Easter Island, as told to me by my dad, whom we call (with great affection!) The Easter Island Head

My second oldest brother was thirteen or fourteen when our father got sick with typhoid fever. He tried to help around the farm, but he overexerted himself and hurt his side. He was completely incapacitated for months. He got so sick, we thought he would die. We lived in the country, and there were no doctors in the vicinity.

It was monsoon season, which is when snakes come out of hiding. There were men who would catch venomous snakes to sell for medicinal purposes. These snake catchers would keep them in boxes that they would carry around on their shoulders. One of those snake catchers heard that my brother was sick, so he visited our home. He told my mother that he could heal my brother with two snakes.

He had an earthen jar with a small opening at the top. These jars were used for boiling herbs or for storing food.

He put one of the snakes in the jar with some water and then he wrapped the jar with a straw rope from the bottom to the top. He plastered mud over the rope so the jar wouldn’t heat up too quickly, and then he lit a fire under it. He slowly, slowly heated up the jar, using just a few sticks of wood at a time. The fire burned for two days. The only time he ever left the fire was to use the bathroom. For two days he ate every meal sitting on his haunches, tending the fire.

At first the water felt warm and good to the snake. But as the water heated up, the snake started to feel uncomfortable and got angry. It started to strike at the walls of the jar, releasing all of its venom into the water.

On the second day, it started to smell like boiled chicken. After two days, the snake had mostly disintegrated. The head and bones were all that remained. The man dumped everything into a hemp cloth to filter out the liquid. He squeezed the cloth so that only the bones and some meat remained. The liquid made up a bowlful of soup.

There was a layer of fatty grease on top of the liquid. I remember that he used hanji, Korean handmade paper, to soak up the grease. He did that two or three times to get all the fat out. He said that if my brother drank any of the fat, he would get diarrhea and become even more sick.

Before he would give him the soup, he very carefully checked his mouth for any sores or open wounds to make sure he would not get poisoned. When he was absolutely sure there were no wounds, he let my brother drink the soup. My brother said it tasted good.

After a one day break, he did the same thing again with the second snake and served another bowlful of soup to my brother. After two doses of snake soup, he fully recovered. Two or three years later, the snake catcher returned and told our mother that it was time for my brother to have one more bowl of snake soup so that he could maintain his good health throughout his life. He was exceptionally healthy, even into adulthood, and it was thought that it was because of the snake soup.

ECG

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ECG

The day is only halfway done, and
The man is hungry and tired and worried.
It took two hours to drive through the snow to get to work today
The beltway – a junkyard littered with cars and ablaze with screaming sirens.
He moves the wand against the child’s skin, trying to capture her heartbeat on the screen.
In this dark, windowless room, there’s no telling if it’s still snowing out there.
God, he thinks, it’s going to take forever to get back home tonight
To an empty apartment that’s too cold and
Yesterday’s congealed takeout, and

Halfway through this appointment,
The little girl is thirsty and tired and bored
The man squeezes warm gel onto her chest and tells her
She might feel some pressure, and then utters not a single word more.
Staring at the screen, he glides and presses the wand around the electrodes on her skin.
The black and white images look like dancing ghosts, she thinks
Then wonders what she’ll order at the café downstairs
Where her mother has promised to buy her a drink
Before the next appointment.

In a few hours they can head back home
For now – the room is dark and quiet, but for the tapping of keys
The man freezes images of a beating heart that exists somehow on the screen
And also inside this child with solemn eyes and black curls falling on her perfect cheek
The mother gazes back and forth from the flickering ghosts on the screen to the child before her
The veil has been torn and just for a moment she peers into the Holy of Holies
And is witness to the sacred mystery that animates each blink, each breath
She should have fallen on her knees in wonder, she thinks to herself
All through the night, on the long journey home.

I spent the first two days of this week taking my daughter from one medical appointment to another for her routine biannual checkups. (She is absolutely fine)! I’ve always been amazed by equipment such as x-rays and ultrasounds that can reveal hidden mysteries inside the human body. My daughter had an ECG for the first time, and it struck me as miraculous to be able to see inside of her beating heart. It seemed absurd that something so ineffably wondrous could be happening in a banal hospital room, and that this miracle could be translated into a series of measurable sine waves.

Bloody Good

I brought my nine year old daughter to the hospital last Friday morning for her quarterly blood draw.

She took her seat and warily waited for the phlebotomist to begin.

“How are you doing?” the woman asked my daughter in a cheery voice as she readied her equipment.

“I’m fine,” my daughter mustered, valiantly trying to hide her misery, “How about you?”

The phlebotomist seemed genuinely surprised. She stopped what she was doing to say, “I’m fine! Thank you so much for asking! You’ve made my day!”

As we were walking back to the car after the blood draw, I launched into the entirely predictable, tedious, teachable moment speech that tiresome parents such as myself simply cannot resist inflicting upon their children:

“I was SO proud of you for being so polite to the lady! And did you hear what she said to you? You made her day! Do you see how easy it is to make people happy, by just…”

She cut me off and said, “Of course I’m going to be nice to someone who’s about to stab me with a sharp object!”

I guess we can all have teachable moments…