It's 4am and I Must Be Dreaming

Here an oink, there an oink, everywhere an oink, oink...Seems like swine flu is on everyone's mind these days. The reason that I am up at 4 am is due to guilt. I managed to make my good friend's 40th birthday memorable b/c I successfully caused enough paranoia in her mind that she has likely quarantined her entire family for the next 365 days. But, when she told me that her colleague just came back from Mexico and stayed home from work today b/c he was feeling fluish-well, I couldn't resist the "oh my god's" and the "are you kidding me's". I truly thought she was pulling my leg. Chances are it is probably nothing remotely related to swine flu, but that natural human reaction (which, if I may bash on my own gender, is often times more pronounced in females) to switch into hysteria mode kicked in. Normally I pride my self in being even-keeled, but she caught me in a moment of weakness when my mind was processing about 17 things at once and wasn't completely focused on the conversation. So, those interal thoughts that usually get filtered out before they leave your lips were given life. No time to think about implications of what I might say, the verbal diarrhea came bubbling forth! Then, in the hours that followed our conversation I got caught up in my own caca and forgot to call her back. Forgotten...until about an hour ago when, as I am peeing and in a fog like state, I think, "Oh no! I forgot to call her back!" So, knowing there is nothing I can do right now, I figure I might as well read everything I can on swine flu b/c 4 am is a really good time to make rational decisions! To avoid any other potential damage, I think I'll go back to bed!!!

Today Was a Tough Day

Is it March or April that is in like a lion and out like a lamb (or is it the other way around)? Whatever...March was a fairly dry month concerning bloggable insights and so is this month quite honestly. Mainly I'm writing because I need to clean out my 'closet of insecurities' and see if I can get these negative thoughts of imminent death from pinging around in my head.

This is a yucky feeling-fear. I just don't like it. I've been floating along, carefree, in my little bubble for a couple of months without too much preoccupation about cancer. I've enjoyed my time off. But doggone it if a series of events didn't cause me to come undone this morning. First I heard about another 40ish year old woman diagnosed about 10 years ago and with kids not much older than mine with widespread metastases and approaching death. Then I gave a lecture to the medical students about being a doctor and a patient. It was a small group and the discussion, using some of my own writing from my own experiences, was insightful and thought provoking. I didn't tell the students that they were reading about me and that I had written the stuff till the end of the session and I hadn't realized how much it would affect me. It made me sad to listen to some of my own story in the words that I had written. Not so much because I had been morose when I was writing, but more because I was completely open and exposed when I was telling about my experiences. Maybe I was mourning for myself. I think that process occurs in waves, self-mourning. Sometimes the waves are so big that they come crashing right on top of you and you feel like you might get knocked over and swept away. I think right now I'm trying to do what you are supposed to do if a riptide carries you out into the ocean. I'm just floating along in the current and trying not to struggle till I gather enough strength to swim back to shore.

After these 2 things I had a conversation with my brother about the likelihood of him having to care for our mother should we play the odds and assume that I go before him and my mom. I hadn't really been thinking about checking out anytime soon (minus the two events that I just described), but we started talking about him having to care for his mother-in-law eventually and in my already depressed state I decided, 'hell, why not take this scenario one step further' and gave him my cheery prediction that he would be the sole provider for two old ladies one day. He decided to top me on my gloom and doom report and relived his experience playing bingo with and feeding ice-cream to a some middle aged woman who had suffered a traumatic brain injury and now had the mental capacity of your common garden vegetable for some church do-good event this weekend. He said it reminded him to remind our mother to figure out some retirement plan for herself so he could afford to put her in a place as nice as the one he had been to if she ever suddenly became incapacitated. I think that bummed me out even more, because in his recollection to me of his conversation to mom, I was already out of the picture. He was providing for our proposed elderly and invalid mother all on his own and I hadn't even joked to him about this yet-that he would be doing it all on his own b/c I'd be dead. He'd already thought of that. I know that all of my friends and family probably already think it. Not that they wish me dead, but they probably have scenarios in their heads that don't include me. I just don't want to hear them. I only want to hear the, "Of course you'll be at your kids' weddings!" It's not denial. I can postulate what the actuarial tables calculate just as well as the next guy, but normally I figure that it's better to have hope than not and I want people around me to feed me hope. My brother wasn't being cruel. He probably didn't even realize how it sounded (it was kind of like when my middle son drew a picture of the family right after I was diagnosed and everyone was in the picture except me. I have-joked that he had some sort of grim-reaper 6th sense).

I got so worked up that today while I was shopping at Cosco I was convinced that I was having some kind of preseizure aura and I was about to fall on the ground in convulsions at any moment with my legs splayed wide open and my skirt all askew with my soiled undies showing for the world to see. I kept waiting for an arm to twitch or a facial palsy and the resulting public humiliation of having to get dragged out of Cosco on a stretcher after causing a huge spectacle in the middle of the clothes tables. The stress of all the worry caused a sharp piercing headache in my left occiput that I was convinced was a huge tumor from whence all the neurological symptoms were originating. The fact that I could massage away the pain was only mildly reassuring.

On the way home I called my dad for reassurance and he did his best, but no one really knows how to reassure you the way you need to be reassured, so I decided that I'd just try to brush it off and suck it up. You know, repress the feelings deep down as far as they would go. It seemed to work for a little while till I remembered that my good friend who also has breast cancer and 3 small kids was probably coming out of surgery for her 2nd mastectomy with plastic surgery & reconstruction (why do we have to be in this club?). And then the icing on the shit-cake was when I read that a Sunday School friend's mom (who is in her early 60's) has just taken a turn for the worst and is going to die imminently from pancreatic cancer. This friend has 2 kids less than the age of 5 years old and a year ago thought that her mom would be around to see her grandkids grow and now she's sitting at her mother's bedside waiting for her to die. The woman who brought her into this world is about to make her final exit.

I know that I need to just focus and get my eyes back on God. But every once in a while there will be a day like today and it just gets so easy to lose sight. Huh, interesting...right after I wrote that last sentence I read from Sarah Young's book, Jesus Calling this passage, "When you focus on what you don't have or on situations that displease you, your mind also becomes darkened. You take for granted life, salvation, sunshine, flowers and countless other gifts from [God]. You look for what is wrong and refuse to enjoy life until that is 'fixed'"

So I will do my best to give thanks even on days like today.

Sex Ed 101 for Your Elementary Schooler

The boys got a crash course in animal reproduction this past weekend. We were driving and it always seems as though all important conversations happen in the car when you can't see the expressions on their faces. I think they do this on purpose. I'm not sure how the topic turned to the mating practices of canines, but it did. My oldest was concerned that even though our dog has been spayed, more importantly, because she was not married it was inconceivable to him that she could become impregnated. Now Lee and I are pretty conservative, but practical. While we won't be advocating teen pregnancy in our home, the whole "wait until you are married" concept, though in a perfect world would be ideal, might be impossible to enforce. And we already know plenty of people who have conceived/had their kids outside of the "marriage bed", so to speak. So, thinking that the whole idea of tolerance is more important than idealism, I decide that 290 west is the optimal location to disspell the myth of not only dog matrimony, but matrimony as a prerequisite to childbearing in general.

"Son, dogs can't really get married."

"But then how do they have babies?" he asks, bewildered.

Thus, the sex education lesson begins. Already they are well versed in the correct terminology of male and female anatomical parts, so I explain that the male dog's penis goes into the female dog's vagina. Lee expounds and decides to make it relateable, "You know how it feels good to touch your penis and it can get hard? Well a dog's penis can get hard too." I remind them of the times that they have seen a dog's penis which leads them to recollect all the different times that they have seen various animal's genitalia. Collectively, the two of them can remember a fair number of animal gaint-testicle sitings. After the digression, my younger son wants to know about the mechanics of the whole encounter. He is puzzled as to how exactly a dog's penis can fit into another dog's vagina. The two parts just don't seem to fit. Then I explain "humping." This is a term that is not in their vocabulary, so I clarify things for them.

"Well, they can't lay down together, so the male dog kind of pounces on the female dog from behind and his penis can go into her vagina", I offer to them.

Since we've gone this far, Lee figures we might as well go all the way with our lesson and starts in on embryology. "The testicles have sperm in them, which are like little seeds and these seeds go out thru the penis into the girl dog's vagina. The girl dog also has a little seed inside of her and it's called an egg and the sperm and the egg join together and puppies grow from this. It's the same thing for humans. This is how they have babies too."

My oldest, Mr Concrete, dumbfounded, exclaims, "No way, the girls have eggs inside of them? How did they get in there?"

So, Lee backtracks and explains the difference between the eggs that are seen in a cardboard dozen and the eggs in a woman's body. The oldest seems satisfied with our lesson and is quietly pondering these things in his mind, though the concept of canine promiscuity is rattling his sense of right and wrong. I know he is still thinking, "Surely, they must get married before they have babies. Who would take care of the puppies? Just the mom?" He does't realize, in the animal kingdom, there is not an equal division of labor, with dad taking the pups to soccer practice so mom can make dinner.

Our younger boy gets it right away (mercifully, our daughter who is far more savvy than both of her brothers combined, is asleep in her car seat). In the rear view mirror I can see his wheels spinning and putting all the pieces of the puzzle together. Boy dog's penis in girl dog's vagina. Boy dog pounces on girl dog. Boy dog's seed and girl dog's egg combine and make a baby. And this is the same as humans! I can see the moment his little mind is screaming, "Eureka!" and with an impish look on his face and a glimmer in his eye, he raises his eyebrows and says to Lee, "So dad, is that what you did to mom? Did you pounce on her?"

I'm sure that we will have this conversation (or versions there of) time and time again, but I don't think that Lee and I will laugh as hard as we did on this occasion, with tears streaming down our faces and urine soiling our underpants. Hands down, that was one of the top ten moments of parenthood. I don't see how people can avoid talking to their kids about "sensitive subjects". They (kids) are so damn smart that you really aren't sparing them from anything and you, as the parent, are, at the least, withholding some really funny stuff from yourself. Child-rearing, no matter how exhausting it may be, is awesome!

Addictions and Missions

Our dog, Star, has a fondness for small stuffed creatures. Either the furry creatures that populate our daughter's room (more accurately, the four corners of our home) are little known canine delicacies or upon seeing them she enters into some sort of predatory mode and is simply protecting us all from the dangers of Beanie Babies and Webkins. My desk has become a make-shift stuffed toy infirmary. Cuddly dogs and cats, bears and wombats are lined up next to the computer, some with simple lacerations and others destined to be amputees. When my daughter sees one of her stuffed animals in the dog's mouth she feels betrayed by the dog. Like she, the dog, had promised my daughter that she would end her addiction, but then she is caught red-handed (or red-snouted to be precise). The look in my daughter's face is one of disgust and deep sorrow because she knows that she can't trust the one that she loves.

Speaking of addictions, my middle son has developed a fetish of sorts with temporary tattoos. I blame my aunt and uncle who sent him a book of over 500 temporary tattoos. Even though he is not quite 7 years old, his arms, neck and chest resemble those of a 42 year old biker. All he is missing is the motorcycle, leather apparel, long white beard and the bandana. His father and I are hoping that he gets the need to have body art out of his system while he can still remove them with a little soap and water. His addiction is like any other; it's done in secret and he is somewhat ashamed by it. We find wet papertowels and washclothes in unseeming places, evidence that he has been feeding his habit. Later, he wants us to remove them or he covers them with shirtsleeves. He is horribly fearful of having his classmates see them. If he weren't too young to understand the tenets of a 12 step program we might have to consider finding one is some church basement or school cafeteria. Either that or hide the book of tattoos.

I have much more to write, particularly about my soul-searching mission I just completed. Well, maybe I didn't complete it, but I did start it. Rather than journeying to the far east, I went southwest to Laredo, TX. If you can believe it, this trip to a border town was the trip of a lifetime. I credit God and my husband for forcing me to go on this pilgrimage. I must admit at first I was somewhat reluctant. More than anything, it gave me the opportunity to ask really difficult questions. But after I started talking, I realized the questions weren't all that hard to ask, they weren't all that taboo and most people wanted to (or were at least willig to) talk about the topics I proposed. Talk about clearing up a lifetime of misconceptions! Had I had these conversations 20 years ago I could have saved myself a hell of lot of time and money in therapy. But it was probably all those hours over all those years sitting in that chair that enabled me to get to the point where I was ready and preparred to ask the questions without judgment, anger or fear. It encourages me to tell others to do the same. Don't wait to ask the questions or have the conversations. You'll be suprised at what you may learn and mostly, even if it's not what you expect, it's all good.

Just Another Day at the Office

I am sick. That is not meant as a judgement of myself, rather it is an actual physical description. My office mate told me that I sound like Brenda Vaccaro. I'm not sure who she is, but if she sounds like she's been a smoker for the past 60 years, then I sound like her. I have not been able to breathe out of either nostril in days and I bark like a seal when I cough. The reason I had been feeling like I couldn't breathe is because my body was getting ready to mount this assault on me with this horrific cold. Basically, I'm miserable and I want the whole world to know. I laid in bed for almost 3 entire days. The good news is that I finally got to watch "The Millionairre Matchmaker" on Bravo.

Despite my fragile state, ever the martyr, I went in to work today. The first part of the day was spent lying on a nogahide couch in the resident's lounge in the back of the ER. Every time the residents or students had a patient to discuss they would tiptoe back to where I was napping and gently rouse me out of my misery. They could have ordered an open-heart biopsy to be performed right there in the ER (just like they do everything in the ER on the show ER) and I would have agreed to it. After lunch I decided that I had better make an appearance and actually see a few patients. This was a critical error in judgment.

Mostly, I really like the ER. It is a fun, strange, surreal, crazy, hectic, humbling place to practice medicine. Occassionally you have to deal with the scourge of the earth and you want them to crawl back under the rock from whence they came. Today was one of those days. Maybe it was because I felt so shitty. Regardless, after my interaction with one of the patients I found myself wondering why I hadn't bothered calling in sick today. The man wanted cough syrup; prescription cough syrup. Well, no one gets a prescription for cough syrup with codeine from the ER. It just doesn't happen. Besides, I didn't hear him cough one time the entire 15 minutes I spent interviewing and examining him. His lungs were crystal clear and he was finishing a course of antibiotics his primary care doctor had prescribed for him. When I told him that I could give him a prescription strength cough drop, otherwise he'd have to buy over the counter cough syrup, he went ape-shit on me. He pulled out the race card. I had not seen this coming. He told me that I wasn't giving him prescription cough syrup because he was black and all white doctors thought that black patients "just wanted the syrup and they were all drug heads!"

His tactic backfired. It was all intimidation. He thought he could intimidate me into prescribing him narcotics by calling me a racist. This was not the most well thought out plan. After my initial desire to tell him to shut the f-ck up while biting my tongue so as not to call him a f---ing, sh-thead, a--hole and curbing my urge to spit in his face, I took a deep breath (through my mouth b/c, unlike my patient, I actually could not breathe out of my nose) and told him (with the utmost professionalism, of course) that he could not speak to me in that manner and if he continued to speak to me in the tone that he was using (by the way, when he told me I was racist, he was yelling at me and in my face) that I would be happy to call security to escort him out of the hospital. He didn't like this plan so he decided that he would leave on his own. Right then and there. I didn't go running after him, I'm not that much of a martyr, but I did offer, one last time, to give him the cough drops that he didn't want. He declined, though not politely.

I was hopping mad after that little interaction. I was like Deputy Dawg mumbling all sorts of things under my breath, "Sassen frassen...Scourge of the earth...syrup!...hah!...sassen frassen..." It took about 2 to 3 more patients for me to completely pipe down, but by the time the HIV positive lady asked me to look at her "27 vaginal warts", I was as cool as a cucumber. I guess it's just all in a day's work...

Alicia Keyes Listen to This: "I am NOT Superwoman."

I've been especially neurotic lately. At least I can identify it now. When I get anxious I get ailments. Most recently, I have chosen to highlight my respiratory system. Last week, while Lee and I were lying in bed, suddenly I felt like I couldn't breathe. I made Lee go out to the car and pull his nasty public hospital stethescope out of his doctor coat and listen to my lungs. You know, I really want to be tough all of the time but I simply cannot. Lee is priviledged to witness my weaknesses and frailties. He and my housekeeper. But mostly Lee. It must be burdensome. However, I am the one that needs reassurance, so I have him listen a second and third time and assure me that my lungs aren't filled with fluid or riddled with metastatic disease.

Two girls that I know, friends, have been diagnosed with breast cancer since my diagnosis. They are both in their 30's and they both have 3 kids, 8 and younger. Being a good, supportive friend in this situation is not complication-free. As much as I want to be objective, I can't completely extract my own story from their situations. I don't think that it is just about reliving my own circumstances. Rather, I have not yet come to peace with my whole scenario. I guess it is a little bit like picking a scab off of a wound when it is almost healed. But I don't know if this sore ever completely heals. If I isolated myself I don't think that the rawness of it would go away. I'd just be by myself with this exposed nerve and I'd still be getting zapped. I guess I just need to come to terms with the notion that no one is expecting me to be the expert in 'how to be a breast cancer patient'. No one needs me to write the manual with the '10 simple steps to achieving breast cancer survival nirvana'.

Validation-it boils down to this. Somehow by helping these girls, coaching them along, it validates the year I spent wrestling with the breast cancer demons. It puts all that time to good use. In my mind, somewhere deep in my psyche, I can think, "It was all worthwhile. It was purpseful. I can recycle it and use it for something better." That is the type of girl that I am; never sitting still. I need to allow that year, 2007 and the whole frightening ride that it was, to just be. It happened and it happened to me and my family and it was unfortunate, but it is okay now. God or Lee or my parents or my family or my friends are not expecting me to make something profound and useful out of the experience. I'm doing that to myself. My only job is to be me.

Their experience, now, sends me back to those places that I did not like; the dark corners of uncertainty. I have no more control over my destiny now than I did a year and a half ago. And, I have no control over their destinies. It's between them and God, just like everyone else's life is between them and their maker. So, when my friend has to have a mastectomy and reconstruction and her 3 kids have to wait for months to hug their mother, I can cry for her. I can remember my surgery and my recovery and not sugar-coat it. It was hard for everyone. We made it through, but I can still cry for me too. Not because I am feeling sorry for myself, but because I can just let it out. I should not, nor could not, hold this sadness inside anymore than I should or could hold in a sneeze or a hiccup. Because my other friend has finished her treatment and is scared because there is no longer a battle plan and she feels helpless and out of control, I can understand her fear. I still feel her fear. I know the terror of waiting for test results because you think you have some new complication. I can tell her, "I know you are scared. I've been scared too. Whatever it is, it is going to be okay. I am here for you no matter what." I don't have to try to explain away her fears. Acknowledging them is enough.

I am not Superwoman. No one thought I was. There wasn't even a job vacancy. I made myself put on the tight, constricting costume. This is why I couldn't breathe. It was my own anxiety. This is a journey and I can simply join my friends. I don't have to lead the way and sometimes I can fall behind. As I wrote on my friend's poster to hang in her hospital room, in the word of Robert Earl Keen, "The Road Goes on Forever and the party never ends..."

Fillin My Nights With Song

Before I go to bed, I want to share an observation I made regarding the differences between boys and girls...Girls like musicals and boys don't. I think you can draw a line in the sand and have boys stand on one side and girls on the other when it comes to this critical issue. I chose the movie tonite for me, my 3 kids and my nephew. My daughter is 5, my sons are 6 & 8 and my nephew is 7. I told them my kingdom is a dictatorship and they had to watch what I wanted to watch or go to bed. There was lots of R rated stuff that I could have picked out, but I didn't want to spend the whole movie explaining inappropriate stuff to the 4 kids, so I settled for a PG-13, Mamma Mia!

All of the boys' choices were immediately vetoed. As we left Blockbuster they hung their heads in defeat. We started the movie soon after we arrived home. My daughter was immediately enraptured. The singing, the dancing, the costumes, the love story...it was all too good to be true. She sat next to me on the couch, snuggling close and smiling from ear to ear. I could tell what she was thinking; "Where has this genre of movie been hiding for all these years?" She wanted to know all about the girl and the wedding and the dress and the traditions. Who was going to walk her down the aisle? How old would she be when she got married? In her mind, it was all good. And suddenly I had a new partner with whom I could watch chick flicks!

At the same time my daughter was experiencing nirvana, the boys were somewhere in between complete and utter disgust and bewildered resignation. My nephew could not sit still. He stood up. He sat down. He bounced to the left. He crawled across the back of the sofa. He crawled under the sofa. He crawled under the coffee table. He stood up. He sat down. He bounced to the right...About half way through the movie, he turns to me, completely befuddled and with the utmost sincerety and asks, "Why do the keep speaking out in song?" And that will be the same question that he and other men will continue to ask for the rest of their lives. Some day, 30 year from now, he will be sitting in a theater with his wife, having just paid top dollar to see Chicago or something like it and he will turn to his wife and say, "I don't get it. Why do they keep breaking out into song? When are they gonna kill somebody?" That was the question that my 6 year old had for me. "When is there gonna be some action?" As if watching Meryl Streep and Pierce Brosnan proclaim their unrequited love via a ballad wasn't action enough. My 5 year old daughter got it. As the credits roled, I know she would have sat there through another viewing while the boys were wondering how the could have been duped so easily. That was an hour and forty five minutes of their lives that they would never get back that they could have used playing video games or watching Sponge Bob. While I don't think I could ever get my 8 year old to admit that he liked the movie, I do think that there was some morbid curiosity on his part (like watching the monkeys mate at the zoo).

I know they will never trust me again. I don't see how they can. It was a complete abuse of my power and I know it. I subjected them to a musical without a grown man nearby to come to their defense. I suppose if I allow them to use the Play Station 2 for 4-6 consecutive hours tomorrow, I may be able to atone for my sins. But, I'm not too worried about it because I have my new ally and tomorrow she and I will probably watch the movie another time or two or at least till we know all the songs by heart!