Not White (Or Something) Fri 3 Mar 17

At work earlier this week, a middle-aged man with a “Make America Great Again” hat asks me “Where are you from?” I ignore the possibility of racial motivation and casually answer “Oh, I’m from Indiana” without looking up from the computer. He doesn’t ask a follow-up question, and I can’t tell if he found my answer satisfying. 

This isn’t the first time this has happened. In a way, it’s something I’ve been dealing with most of my life. I grew up in an overwhelmingly white area. I always knew I was a bit different than most, though I can’t say whether I came to that conclusion by myself or if I’d picked up on external cues. I didn’t know quite what I was racially. I recall learning a certain word in American History class — probably around the age of 10 — and coming home excited to tell my mother that there was a word for what I was: I was a mulatto. (She looked surprised & told me, “Dad’s not black!” But that didn’t help me figure out what I was.) I would go back and forth on whether my Disney princess was Jasmine or Pocahontas. I thought maybe I could be Native American — after all, I was kind of brown and enjoyed connecting with nature. I knew it wasn’t quite right; it was just the closest thing I had, and I had to categorize myself somehow, didn’t I…

Because that’s how people function:  we like to name things. We need labels so we know what to do with them. But that’s not the way life works. Most things, ideas, and especially people don’t fit neatly into a box. We realize this by the time we’re adults, but we still like to organize things whenever we can so we know how to think about them. 

Of course I eventually became comfortable with my racial ambiguity; as I got older, I gradually felt it made me special instead of abnormal. (It probably helped that my high school had a little [and I do mean little] more diversity.) I got comfortable with identifying myself, even though the answer wasn’t simple. Many times over the years I’ve been asked the somewhat-offensive “What are you?” or, the awkward-but-probably-my-favorite-to-date “So, are you like, not white or something?” I’ve been approached by a stranger speaking rapid Spanish, having assumed I was Latina. (He was met with a blank stare.) I once went to a burrito place with a college boyfriend, and the man behind he counter allegedly said to his co-worker, “His girlfriend is Spanish. He likes to eat Spanish.” And frequently, someone will ask about the origin of my last name — probably once a week, in fact. But to my memory, I usually don’t get “Where are you from?” from strangers.  This is a recent occurrence.

The last time someone asked me where I’m from was on Inauguration Day. The man came in rather excited about the whole thing, and had asked what I thought of our new President. (I politely but firmly told him that I don’t discuss politics at work — partly because things go more smoothly when everyone is civil, but mostly because even if we do happen to agree there’s just no denged time to get into it.) When he asks, I answer — but it wasn’t what he was looking for. 

“Well where are your parents from?”

“My mother is Dutch, and my father is from Pakistan [pronounced PAH-kiss-stahn, thank you very much].”

“Oh. I have a couple good friends who are Pakistani [pronounced PACK-iss-STAN-ee]. … So, did you go to medical school there, or did you come here to do it?”

I pause, and repeat: “I’m from Indiana.” I’d literally just told him.

These exchanges are generally pleasant. People have never been aggressive or purposefully rude with me, I’ve never been physically threatened, and I don’t feel like my brownness makes me unsafe. (In that respect I feel very lucky.) And it doesn’t make me angry exactly, but these instances stick with me. So maybe I’m being overly sensitive. Maybe I’ve got my own prejudices, and I made assumptions about these men’s beliefs before they even opened their mouths. (In fact, I have to make an conscious effort to ignore their political leanings so I can focus on helping them.) After all, I don’t mind when people ask the origin of my last name. But there’s a quiet nuance surrounding “where are you from.” It’s different than inquiring about my name or even my ethnicity. It seems what they’re really saying is, “You don’t seem quite white. Do you belong here?” Like I’m stuck back in my 10-year-old self, except it’s other people who are trying to categorize me. Like they need to know which box to put me in, so they know what to do with me. 

Perhaps I could have handled myself better this week; I ignored the big brown elephant in the room. Maybe it’s best to face microaggresisons directly. The next time someone asks me that dreaded question (and I suspect they mean something else), I’ll clarify: “Indiana. But were you asking about my heritage?” That would at least open the door for a conversation and show that I’m proud of what makes me me. And by facing it head-on, maybe we could both remind each other to focus on who we are instead of what we are. 

The Breast of Me Tue 20 Oct 15

My baby is a year old today — which seems unbelievable to me but must be a phenomenon every parent experiences. Certain things were worrisome about becoming a parent. I was worried about getting through labor. I was worried about my stress level during those times that a baby just can’t be appeased by any means. I was worried about being away so much at work. I was even worried about how to get a toddler to eat vegetables. But these were things I expected. I could plan ahead as best as I could to make these situations better. The things I didn’t worry about — that’s where I ran into trouble. I didn’t consider for a moment that my baby wouldn’t do well during labor. I certainly didn’t expect him to need respiratory support. And I never expected to have trouble breastfeeding.

Of course I was going to breastfeed! — for at least the first 12 months, as recommended by the AAP, and beyond if I could manage! All the mothers I know personally have breastfed. I was a breastfed baby. It’s natural, it’s healthy. I’d read blogs. I was going to breastfeed in any public place necessary, and when strangers stared disapprovingly, I was going to stare right back. I was going to be a breast crusader. I was gonna breastfeed the hell outta that kid.

So brace yourself, because I’m about to say something that seems wildly unpopular in the online community: breastfeeding is horrible.

Let me back up. I’m a big advocate of breastfeeding. I love when my pediatric patients are breastfed, and I always wholeheartedly congratulate their parents. I try to convince new mothers to at least try to nurse their babies (barring any contraindication, their drug use being most common). I rattle off the numerous health benefits to both them and their infants. And if they decide to go straight to bottle-feeding — yes, I looked down on them. Why wouldn’t they do the best thing for their precious progeny? And I was allowed to judge — because I was going to breastfeed.

But all those blogs, those crusades, those lactating purists — they don’t tell you the whole truth. Because breastfeeding is a nightmare.

Perhaps I’m not being fair. I was under special circumstances. My baby was intubated before he got a chance to eat. Even after he was extubated, he was tongue-tied and had a pretty strong oral aversion. I tried to breastfeed once the tube was out, but even with the support of hospital lactation consultants we didn’t do too well. He wasn’t gaining weight, and they wouldn’t let him leave until he did. He had to get fed breast milk through a tube in his nose. I finally decided to give him breast milk in a bottle. It felt like surrender. But after several days, he finally started gaining weight, and we got to take him home to continue trying to nurse. He still couldn’t do it right. It hurt.

So maybe my situation wasn’t typical. My baby didn’t get the chance to learn how to suck. Surely others’ experiences aren’t as heinous. But when I talk more in depth with mothers, I found something that was rather surprising:  they ALL had trouble breastfeeding in one way or another. Nipple soreness. Bad latch. Weak suck. Exhaustion. Low supply. Biting.

Do I still look down on mothers who decide not to even attempt breastfeeding? Yes, a little. Maybe even more than before, because I’ve been through so much in the pursuit of the coveted art. But I also understand how ungodly difficult it is, and when a patient’s mother tells me she couldn’t do it, I’m very careful not to suggest that she’s to blame. I tell them that their babies will still be happy, will still be healthy, and will still know that they are loved.

As for me, I’m proud to say that we’re still breastfeeding. A couple nights ago, I looked down on him during our bedtime nursing session, and realized how grateful I felt that we’d made it this far. There were days we didn’t breastfeed at all. There were days he got more formula than breast milk. But after a lot of pain, and tears, and visits with lactation consultants… After the laser ligation of his labial and lingual frenulums, and two osteopathic manipulations, and lactation cookies, and hundreds of cups of tea intended to boost my supply… After nipple shields, and searing razor-like pain, and countless hours spent locked away pumping at work trying to make enough to keep up — we’re still breastfeeding. Maybe there was a lot that went wrong. Maybe it’s not like the blog posts I read in anticipation while pregnant. And maybe my supply won’t last much longer once I slow down on the pumping. But it feels a hell of a lot like success to me.

Brutal Mon 18 Mar 13

Family Portrait, Sept 2011
About 1 year before my brother died

Several attempts at this entry. I’ll succeed eventually. Besides, I’ve been waiting until I’ve been guaranteed a job before airing this…

2012 was brutal — viciously, senselessly, and unforgivably brutal. specifically the last 6 months. Every time I catch the clock at 11:11, I silently wish that the entire year never happened at all. (And no, I don’t actually expect it to happen — but I can’t help trying.) I’m aiming for brutal honesty here. I have a tendency to internalize whatever I’m experiencing; emotions are uncomfortable to deal with, and I doubt most people care to delve too deeply into the complexities of my psyche. So my goal is to admit in words — to myself and to anyone else who cares to know — what’s really going on in my head. (Except my family. I’d prefer they just believe that I’m doing generally well.) And I expect it to be brutal. But maybe if I can organize it all, I can start to understand it; and maybe if I can understand it, I can figure out what to do about it.

Bubba & Layla, Apr 2012

I’m not okay. I might say I am, and I might mean it — but what I mean is that I’m holding steady at my average or maybe doing a bit better than usual. I don’t mean I’m actually okay. If you ask how I am, I generally won’t lie outright; I’ll say something like, “Oh, you know, hanging in there,” and force an exasperated smile that’ll make you think I’m just dealing with stress, maybe I’ve been working long hours. I think this is generally socially acceptable:  I feel like I’m being honest, and I’m not opening up a big package of personal problems on some unsuspecting person who had the poor judgment to wish me good morning.

I don’t sleep well. Sometimes I have nightmares, sometimes not. I dream about dead family members — sometimes as living people & sometimes as spirits or cold inanimate bodies, sometimes I’m trying to save them & sometimes I can accept that they’re gone. Sometimes I dream that different family members have died, as if my brain can’t keep track of who’s still left alive. My boyfriend has reported that I have episodes where I wake up moaning & kind of whimpering in the middle of the night, of which I have no memory. And my trouble sleeping may be the root of my fatigue and seriously decreased concentration — but to be fair, these may be their own issues. I’ve always had rather low energy, but lately I’m always exhausted. I can spend 12+ hours in bed if I don’t have to be at the hospital. I’m forgetful; I can’t keep things in my head (which can be problematic when it comes to patient care). I forget conversations I’ve had with people. I just can’t organize and recall simple information. My brain just isn’t functioning at a normal capacity.

I’m carrying a heavy heart. Recently, my dad asked me if that aching feeling in his chest was literally his heart causing him pain. I told him, No, they just call it heartache because that’s exactly what it feels like. Physiologically, I don’t know what causes it — but I have it, every day. Not 24 hrs a day, but not a day goes by when I don’t feel it. It’s not a new sensation for me, but I can’t remember a time when it’s been quite so persistent… My heart feels weighted down and enlarged, blown up like a leaden balloon and pumping with severe force. Sometimes I pray to fortify my sternum so my heart doesn’t break straight through my chest wall. You’d think maybe at some point it could develop a hard, sturdy outer layer — but right now it’s all soft and mushy and bruising itself with every beat. It’s a lot to carry, and it makes it difficult sometimes to focus on much else.

I’m angry at everything. It’s not fair, and it’s not right. This isn’t news to anyone, but my inner 3-year-old keeps screaming it anyway. I’m simultaneously fatigued and antsy; I have no energy until I try to relax, and then I can’t find anything to do with myself. I’m angry at people who posted rumors about my brother to facebook (though only because it made my mother upset, they didn’t upset me personally). I’m angry at anyone who tries to make my brother’s death about themselves (though I acknowledge there’s a fine line between that & grieving in their own personal way). I’m mad at my brother’s ex-wife for making the last few months even more difficult on him than they needed to be, for not being willing to grieve while respecting others’ pain as well, as though my family didn’t have the right to be upset since it was our fault Layla had died. And I’m angry at her for refusing to call Layla’s death an accident (as though it had been intended!), and for letting her son think that his sister had been killed as maliciously as if my brother had stabbed her in the chest. I’m full of these horrible negative feelings toward everything and everyone. I’m mad at all my classmates excited to graduate and move forward (sorry, guys), and I only feel so hateful because I don’t feel the same joy inside that everyone else seems to. I’m mad at the city — I hate the litter in the streets and the people yelling, I hate crowded areas and people in my personal space, I hate the lights and the traffic, I hate the sulfurous steam rising from the sewer grates polluting the air with everyone’s shit. I actually don’t hate the rain…. The rain, I don’t mind as much. All this hating really frustrates me; I like to think I’m the sort of person who finds redeeming qualities in people, not the sort of person who hates others for no good reason. And even though I can tell myself that, all this angry negativity radiates from inside of me and I can’t manage to push it down.

I’ve been isolating myself from other people for other reasons (that is, other than being a total downer). I find it exhausting to interact with people some days, like it takes an inordinate amount of effort just to act normal. And I can’t always act normal, either; I only wear waterproof mascara anymore, because I can’t predict when I might end up hiding myself in a public bathroom to cry. And maybe this ties back into to my habit of hiding my emotions from people — but most times I just want to be around no one. When I’m alone, I can breathe a sigh of relief and relax, sink comfortably into my sadness like a warm bath and just soak in it. I’m tired of life; I really feel such little drive to keep going. Even getting my first choice for residency, what should be a time of excitement just feels like another burden… it’s not an adventure or a step forward or a chance to grow; it’s just another weighty task that I have to reluctantly force myself through. I’d love to just quit — quit med school, quit life, just lie down on the floor & wait for the world to end.

And now we’re left with the reason I tend to hold back all this crazy:  you have no idea what to do, there’s really nothing to be done, and now we both feel dejected. Chances are, you feel awful for me and really want to help, but are at a loss as to what could possible make this any better. Well I don’t want anything. Really. I know it doesn’t make sense to spill all this emotional vomit and not be fishing for pity or sympathy — but I don’t want anything. This isn’t a cry for help. (I do recognize that last paragraph was rather concerning. I promise I’m not a danger to myself, and I’ll let someone know if it gets to that point.) I don’t want anyone to feel as though they need to take care of me, and I certainly don’t want anyone feeling guilty because they don’t think they’ve paid enough attention to me or checked in on me often enough.

So the question remains, what to do? I never really know. Hell, I’m still not too sure it’s a good idea to put this post out into the world. Well I’m going to keep on moving, finish school, & plan for next year… I’ll mostly be doing it because I don’t know what else to do, but I’m going to try to motivate myself to make my life good and productive and useful. I’m essentially going to fake it until I make it. As for anyone reading this, I don’t have much of an answer for what you should do, either. Leave a comment, I suppose; even if you have no words, “<3” lets me know that you read this, that you’re thinking of me, and that maybe you don’t think I’m a completely insane bitch-troll for hating the entire world and wishing it would implode into itself.

And I’m sorry that I can’t end this with any kind of answer. I didn’t expect to, but I was hoping.

Good Grief Sat 21 Jul 12

Auntie & B

This post was transcribed from a voice recording that I dictated while driving — thus the excessive ellipses, “um”s, and inserted noises.

 

It’s been awhile since I’ve paid much attention to this blog… which probably doesn’t matter much, but a lot has been going on.

 

Three weeks out, and I still… don’t know how to tell the story. … On June 30th, my 4-year-old niece died in an ATV accident. It is, without a doubt, the worst thing to happen in my life thus far. The only family member I ever remember losing is my grandmother, and… I’ve never known someone even relatively close to me to die so young.

 

I spent the month (starting in early to mid June) at home because I was studying for one of those eight-hour exams that… they just love to give us in med school… So… I got to spend a lot of time with both my niece and nephew. Um… In the week before she died, we celebrated her birthday — which was actually the 21st. Uh. *laugh* My sister took it upon herself to make her a Barbie cake — where the cake is in a bell shape like a gown and the Barbie sticks out from the middle of it. Uh… The cake fell apart, but Layla loved it *laugh* anyway. Um… I got her a… a little stuffed animal — it was a lamb. It was battery-operated; you pet its back and it makes baaing noises and uh, kinda moves around, wiggles its tail. I spent probably… Well I spent a long time in the toy aisle of Target, uh, and a good portion of that time was trying to decide which small, fuzzy, mechanical baby animal she would most love. And it was time well spent, because she *laugh* really loved that thing! Uh… She named it Lamby Lamb. And that night, she insisted that it, you know, it came to bed with her when I went to tuck her in. Uh… I also sat with her up pretty late, past 10:00, just playing with some of her new toys. And… that night, I tucked her in, and I read her a bedtime story. Um… She wanted three or four of them. I only would read one. I kind of wish I’d read the four she wanted… Um… But I got to tuck her in that night, and put her to bed, and uh… This was actually on my birthday, which was three days after hers.

 

Also in the week before she died I gave her a bath. Uh… She got to play with her new Barbie, which was a mermaid tub toy Barbie, which she named “Mermaidy.” … I tried to talk her out of that; it didn’t work. Um… Also in that week, she got the hiccups and wasn’t able to get rid of them. And I was busy studying, so I told her to hold her breath. And… she inhaled for about five seconds, and said that that was all she could do. Uh… She wanted me to color with her. She said she can’t do it, she doesn’t know how… which is bullshit, because she was a great colorer. What she meant was, she wanted me to do it with her.

 

Um… *laugh* Also in that week, she was helping her dad pack so they could go camping. She has one of those pillow pets that’s a purple unicorn. And she took it to me, had me fold it and Velcro it so it, you know, kinda folded in half or was standing up, and then she plopped it in the suitcase, and it took up like half the volume of the suitcase. And I told her, “B… I think you’re gonna have to carry that.” *laugh*

 

Umm. I didn’t say goodbye to them, when they left to go camping. Of course, I wish I had. I saw them outside in the driveway; I don’t know why I didn’t go down. I don’t know if I just felt too tired or if I was in the middle of a lecture or what I was doing. I don’t blame myself for it, but… God, I wish I had. Um…

 

Another night that week before she died, I put both her and her brother to bed. And uh… She was always kinda hard to get to sleep; you know, she’d get in bed and she’d lie down and… You know, she’d act all sleepy. And then she’d hear the cat meow and — she’d sit up immediately and say “What was that!” and then you know, want to get up and go chase the cat and… She needed redirection, as it were. Um… And that night, I think it was the puppy actually. She wanted the puppy to sleep in their room. But the puppy wouldn’t say in their room, so the puppy you know…  well, obviously has boundless energy, and you know, ran upstairs and… I don’t even know where the puppy wanted to sleep. And I caught B out of bed. And I got kinda mad at her, because it was almost 11:00, and… I was fuckin’ tired, and… I put her back in bed. And I told her to stay there, I told her I didn’t want to see her out of bed again. And then before I closed the door I said, “I love you guys.” And Mahlon said, “I love you too.”

 

I guess looking back in the weeks before she died, it’s all just kind of this conglomerate of… regrets and… gratitude, and… occasionally just, you know, pure joy, just — moments when she was happy, or when she made me happy. *sigh* And it’s… It’s almost not even so much… a collection of moments… as it is a collection of emotions attached to those moments.

 

In the week after she died, I wore purple and black every day. Purple was her favorite color and… black is just the traditional mourning color. I don’t think she wanted us to be sad but… it was impossible not to. The day after, everyone in the house just… was like a zombie. Partially because no one got much sleep at all. We kind of… walked around the house, blankly. Didn’t eat much. Went out shopping for nice funeral clothes. ….. And every so often, someone would break down sobbing. Sometimes there was something specific that set it off — like when Dad saw her toothbrush, or… or just, you know, thoughts that came to your head. And sometimes it was sobbing for… really no specific reason, it just… came over you. … *sniff* I think throughout the week either… things slowly got a little better, or I just started numbing over a little. At any rate it never got quite as bad as that first day… Or as bad as the day it happened. I think there was probably a period of at least two days where I didn’t cry at all.

 

And… in this period was also the task of planning the funeral. Which my brother, racked with guilt over her death, largely ceded to her mother. Who, herself, was an emotional mess and rightfully so. As a result, naturally, there was friction. Because as the initial stages of shock wore off, Bubba realized that there were at least a few things that he felt he really wanted for the funeral — uh… Layla’s favorite songs, or a personally written eulogy that he could read. And because of… all the ugly emotions and anger, and blame and just… bottomless grief… of course, these things couldn’t go smoothly. And… I found myself — I still find myself, actually… having to remind myself that these things didn’t really matter. I mean, not really. I mean, sure, it’s… it’s good to have a nice funeral and, it’s good to have a lot of flowers and of course beautiful pictures of her and… And maybe, you know, you… you want the right to say a few words and… Yeah, it’s important. But… in the scope of things, it just — didn’t matter. It didn’t matter that the pastor mispronounced the name of everyone on our side of the family. It didn’t matter what Layla’s body was wearing. Or how the funeral home was decorated. Or who got to read the eulogy. It didn’t matter that she was cremated instead of buried, even though I was against it. None of these things… change anything. And none of it is gonna matter.

 

Bubba did end up getting to say a few words, like he wanted to. It was after the funeral, when most of the people had dispersed, and there were left just close friends and our side of the family. I don’t know why Jess wouldn’t let him read it… But he got to do it. And he got to play their favorite songs — the songs that they listened to while he was driving her wherever, the songs that she would sing (like Bohemia Rhapsody)… *sigh*

 

And in the weeks after the funeral, I returned to Philadelphia, as my school schedule dictated. I’m sure I could’ve taken time off. I think it would’ve been completely understandable and… I don’t think anyone would have had a problem with it. But… I didn’t know what I would do if I stayed home. I didn’t feel like I could really be helpful. I rescheduled my massive eight-hour exam a month down the road. … I thought maybe the best thing to do would be to… try to get back to my regular schedule, back to some sort of normalcy. And when you really consider it, my everyday life isn’t any different. I wake up, I go to the hospital, I see patients… I come back, I eat dinner for one, I cuddle with my cat, I shower, I go to bed. … It’s not as though… Layla was physically present in my everyday life. … And yet, it still feels like something’s missing. I think it’s just… the knowledge that she’s gone. … Even if I’m not home to… really appreciate her… tangible absence. Even if I… don’t see her — her toys and, her clothes every day. I still know.

 

My first day back, everything felt… awkward. Every step I took just felt wrong… and I felt heavy. Like, that feeling where your heart is just a big stone… And everywhere I went, everything I saw, felt like… walking through a dream world. Like none of it was real.

 

I’m not psychotic; I know what’s real. … But it just didn’t feel right. … And I could smile, when I tried, and I could make it look genuine. Most of the time I didn’t bother. Didn’t feel much like talking to people, even though I saw some people I hadn’t seen in… months, almost a year. …

 

And I’ve been in a bit of a depression ever since. Which isn’t surprising. It’s actually normal bereavement. (There are actually specific parameters for normal bereavement as opposed to major depressive disorder. Of course, I already have major depressive disorder, so… I’m not sure any of it actually applies to me.) *sigh* … But I feel listless, I feel slow… I think sometimes I even drive slowly. Sometimes when I’m at the hospital all I want to do is just go home, curl up on the couch & fall asleep. But I know that as soon as I go home I’ll be awake… and feel just as bad. And just as hollow, and heavy, and low.

 

I know Layla wouldn’t want me to be sad., She was a pretty happy child. … You know, she got grumpy, and she cried and… she’d get angry and she’d get stubborn, but — but life made her happy. You know, hugging her dog. Walking through the grass. You know, feeding the ducks at the park, just… I mean, little things. You know, when Daddy would come home from work. She always appreciated those things. *laugh* The baby goat.  … But I can’t make myself be happy… I don’t know if I’d want to. Sometimes “happy” just doesn’t feel right. … And I haven’t been… completely despondent. … I’ve had happy times. I’ve smiled. I’ve joked, I’ve laughed. You know, I’ve watched my cat bounce across the room and, I’ve been amused, and I’ve giggled. But it’s hard to… to shake the emptiness for very long.

 

It’s not even just Layla being gone. It’s… it’s everything leading up to it, it’s… everything that came after it, it’s everything that… has yet to… be resolved. I worry about my nephew, I worry about my brother. I worry about her mother. I worry about my mother. … I worry that… there’s gonna be a time when… I forget how much we’ve lost. …

Local Letter to the Editor Tue 8 May 12

Found this in today’s paper…

The U.S. is a shell of its former self, having been gutted by power-hungry politicians, cash-hungry special interest groups, and socialist reformers disguised as liberals, Democrats, and progressives. It’s clear for anyone who has eyes to see.

Okay, I’m following. The part about socialists may be a little off, but I’m with you on the politicians and greed. Go on.

The federal government is nationalizing banks, granting itself invasive, emergency powers, and passing laws that give near-total power to do whatever it pleases.

Maybe a little paranoid, but I see your point. Patriot Act and such, bailouts, it’s rather troublesome. Go on.

One of the key reasons it’s allowed to happen is because most Christians no longer believe in God’s Word as the basis of justice and direction for America.

Whoops — back up, you lost me. I fell out of the caravan. About 60% of the American population subscribes to one Christian denomination or another (Protestants & Catholics both included), and I happen to enjoy being in the minority. In Indiana, as it is difficult to forget, this minority is a bit smaller than in the general American population. The author goes on to cite the importance of the church of God in supporting American virtues. Now that I’ve been alienated (i.e., my values are not qualified to define justice or guide America’s future), I feel much less compelled to listen to what this letter has to say.

The author then likens our current situation to the early stages of the Holocaust. Strike two. That’s like comparing someone with whom you disagree to Hitler; it’s done so often and so cheaply, that if you choose to walk that path you’d better have some real substantial evidence to back it up. It’s the sort of claim that can’t be undertaken in one letter to the editor.

How can we agree on a solution if I don’t agree on the problem?

Cardiomegaly Tue 27 Mar 12

It must’ve been three years ago — when I was still with my fiance, before I’d moved to Philadelphia. My brother and his wife were having a fight about God-knows-what. I think she thought he was looking at other women and he insisted he wasn’t, some similarly stupid thing that never came to any real problem in the end. My sister-in-law called to talk, so I offered to walk down the street and pick up dinner for me & my fiance so I could have the conversation along the way.

I remember her saying, “I’m speaking to you more as a friend now than a sister” — I assume because a sister would be first and foremost loyal to family, and she was speaking badly about my brother. That’s the only part of the conversation I even remember. After hanging up but before entering the restaurant, I sat on a rickety-looking set of wooden stairs with white paint chipping off them that led to somebody’s apartment in the floor above the restaurant, and I just cried for a few minutes. I returned bearing Thai food and slightly glossy eyes, and started crying again when my fiance hugged me. He told me, “You have such a big heart…”

I can’t quite pinpoint why it was I cried — or why I cry in general, ever, at all. Yes, it’s physically painful for me when people I love are hurting, and it’s frustrating that I’m powerless to stop it, but why bother crying? It doesn’t change anything. And once I start, it’s damned near impossible for me to quit. I’m like an antelope on the Serengeti — the slightest noise or movement could set me off. In the end, I get a swollen blotchy face, people around me are walking on eggshells and glancing at me uncomfortably, and the people I love are still hurting.

But I sort of like feeling this way. I can’t explain it properly, but it’s somehow satisfying to feel things so deeply. It’s a little like the wind-in-your-hair, big-breath-of-fresh-air feeling of being alive; it’s like feeling the infinite largeness of the world. If one sad thing can touch me so deeply, if it really means so much — well, then life itself must mean a whole lot.

I’ve been carrying a bit of weight the past week or so… I’ve had more headaches, and I’ve got this awful cramp in my shoulder muscles that isn’t responding to heat, massage, and prescription muscle relaxers. But I really do feel weighted; my chest literally feels expanded and heavy, like I’m carrying around an extra weight wherever I go. I have to suspect it’s my big heart.

Birthday Wishes Thu 22 Mar 12

If this sweet, innocent girl doesn’t get her birthday wish…

YOU’LL PAY.

YOU’LL ALL PAY!!!

Ch-Ch-Changes Sun 26 Feb 12

My former roommate is 23. She feels old. I suppose that’s about the age when that feeling starts setting in… Anyhow, a week or so ago she made the comment, “Oh my God, 2005 was SEVEN years ago!!” I laughed and told her that 2012 will be my 10-year high school reunion. She sighed like a proud mother and said, “Think of how far you’ve come!!”

I had no idea how pretty & skinny I was...

Of course, then I had to wonder:  Have I? In 2002 I lived entirely off my parents. I was in school but had no idea where I was going and no concept of who I was. I had a relationship that was actually pretty unhealthy, though not for lack of love. I don’t know where I thought I’d be in 10 years; I think I was so depressed, I hadn’t even considered the possibility that there was a future.  (It’s awful hard to look ahead when you only see nothingness in every direction.) So how successfully have I transitioned from adolescence to adulthood?

• Personally: I live in a studio apartment which almost never gets vacuumed and occasionally accumulates mold in the kitchen sink.
• Intellectually: I’m still a student. I sleep until noon when I can. I spend way too much time on the internet.
• Financially: I don’t have a job. All my money comes from government loans and my parents. (They insist on supplementing my monthly income so I have less debt.)
• Romantically: I have yet to start a family — or even be in the position to begin thinking of starting a family. I haven’t even found a potential boyfriend in over a year, and every day I’m only getting older. (This is slightly more painful because I actually know about how many viable ova I have still sitting in my gonads.)
• Emotionally: I’ve really come a long way in dealing with my depression — this is probably the area I’ve grown the most. I’m still medicated — I’d hoped the meds would be temporary, but things seem to get ugly when I try to go off them… It’d just be nice to have an end in sight. And of course I still have depressive episodes, and sometimes I fall into them too easily, but I don’t let them consume me like I used to.

So I suppose the big question is:  How do we measure progress? It’s always tempting to hold up my life beside those of my friends and compare the differences — people who have marriages and children and careers — but who’s to say these are the standards of adulthood? And further, who’s to say that their lives are actually as fulfilled as they seem from the outside?

I really do believe that life will bring me where I’m supposed to be. And I know that I have to be patient and not focus so much on time, I have to love myself, I have to trust, I have to keep my head up and walk my path. But I get impatient, just waiting and wanting. And I’m too vain — I see the fine age lines deepening on my face. I know my youth and looks aren’t going to last forever, and I worry that I’m not using my years as well as I could be.

Please tell me that serenity is one of those things that magically comes with age…

Mispronunciation Mon 20 Feb 12

I have a patient whose name I can’t pronounce. He never pronounced it for me because he was intubated by the time I met him. He’d been put in the hospital because he got dizzy when he stood up. Really — that’s the reason! Turns out his blood counts dropped drastically overnight, and by mid-Friday he started vomiting blood. Then came the melena (diarrhea with half-digested blood). They drugged him to calm him down & make him comfortable. They intubated him to protect his airway (in other words, to keep him from inhaling his own blood). They put a tube through his nose into his stomach to suck out the contents.

This is when they called the surgery team to see him. The guy’s 91 years old; I don’t think they actually expected us to operate, but when someone starts puking blood, you tend to call in everyone you can think of.

I happened to be in the ICU when we were consulted. I happened to be examining him when he came around, and I happened to be the only one in his room at the time. He looked right at me, trying to talk through the tubes & pools of blood in his throat; he started pulling at the tube in his nose. So I pulled his hand down, and I talked to him. I said, “You’re bleeding in your stomach. I know it’s uncomfortable, but that tube in your nose needs to stay in; it’s pulling the blood out.” He nodded.

I said, “The tube in your mouth is so you can breathe without getting blood in your lungs.” He nodded.

I said, “We called your daughter to tell her what’s happening. We’re going to take you downstairs to try and stop the bleeding.” I said, “Is that okay?” He nodded.

I said, “We’re going to give you more medicine to make you more comfortable.” He nodded emphatically. He squeezed my hand and closed his eyes. So I stayed with him, because I didn’t have anything more important to do. IR couldn’t embolize the artery. The surgery chief said, there’s no way we’re operating on this guy, most times these bleeds stop on their own anyway. The guy’s still knocked out on propofol, so I shrug and go home for the weekend.

I was happy to see he was still there Monday morning; I was disheartened to see he was still intubated. I was downright depressed to hear he was still bleeding, that nothing else could be done, and that he was counting down to the end.

We’re all going to die, and odds are it won’t be pretty. Choking on your own blood might not be the worst option. And for Christ’s sake, the guy’s 91! Maybe I’m more upset about it because I connected with him, because I could tell he was cognitively aware of what was happening.

Everything that lives, dies. It’s a necessary corollary. And yet, we fear it; we all try so hard to avoid it! It’s why my cat jumps onto the damn ceiling when he sees sudden movements. We instinctively protect our own lives as though it’s all we have. (Arguably, it is all we have — but I’m not trying to start any kind of religious or existential debate.)

Noted, as I got out of my car later this evening, a dead bird under a tree. On its back, feet in the air, as if it’d just keeled over from exhaustion or some unknown natural avian causes. And I wondered if it fought. And I wondered if it even saw it coming. Sometimes I think that’s the curse of modern medicine:  too much foresight. You’d think having foresight would help us avoid the unpleasant. But we know death is coming — sooner for some patients than others — and we still try to stall it, because we don’t know what else to do. I wish medicine didn’t make me think of death quite so often.

Listening to depressing rock from 10-20 years ago. It fits, oddly.

Update (and partial retraction) Sat 4 Feb 12

I know I was pretty gloomy yesterday… I decided to do something nice for myself. Since I actually didn’t sleep all damn day today (I was up at 8:30), I googled spas in my area. (I’m not willing to drive too terribly far, so just googling anything in Philly is tough unless the results come with a map.) Came up with this little gem. It had great reviews on yelp, so I made an appointment.

This place was NOT what I expected! It was so, so much better! (Luckily, working in the hospital has conditioned me to think nothing of naked old people, so the nudity was not an issue.) Now folks, only rarely will I allow an older Asian lady to slather my ass-naked body in warm oil, exfoliate my skin like an overzealous mother lion,  loudly slap my various muscle groups, and straddle my butt in order to work the knots out of my back with her elbows. And it was worth every second!

My regimen today: a shower, a soak in the hot tub to soften my skin, a vigorous all-over exfoliation (I basically got mugged – she took all the epidermis I had!), a rinse in the shower, 10 minutes in the dry sauna, a cucumber facial (with actual cucumbers, not scented gunk), an oiling and full body rub-down, a dousing in myrrh, and a shampoo.

If only I had a multimedia depiction of how wonderful this afternoon was…