Sunday, April 6, 2014

About A Boob

#clownmakeupselfie #selfbreastexam
Forgive me for sounding cynical, but I am SO not getting this whole no-makeup selfie for breast cancer awareness trend on Facebook. In case you're not familiar with it, it's where women post bare-faced (and in some cases looking downright haggard) photos of themselves with the hashtags "cancerawareness" and "nomakeupselfie" as a means of drawing attention to a subject which already receives a sizable amount of public awareness. I mean, seriously, it is a nice gesture, I suppose. But, if the ubiquitous pink ribbons aren't getting women to self-examine their breasts, why on earth would anyone expect a barrage of frightening au naturale mug shots to accomplish what symbolic imagery has failed to do?

People are scared of clowns for a reason. Wearing THAT much makeup is definitely unnatural, concealing what really lies beneath. Unfortunately, these no-makeup selfies come across as clownish and self-congratulatory. Hell, even the breast cancer survivors are pissed! As if masquerading publicly for a minute without makeup could ever pretend to demonstrate real empathy. I mean, if the point of this exercise is raising breast cancer awareness, why not just post a self-breast exam selfie or video instead? Oh, jeez, I forgot, we're not allowed to show our tits in public! LOLZ. (Please note that I am by no means judging the individuals who got sucked into this campaign, only the mass hysteria and collective call to conformity that fueled it).

Mom, breastfeeding me 
My mom was diagnosed with breast cancer twenty years ago at age 60. It was the first time in my life I'd ever seen Mom so sick. For weeks, she was incapacitated. She went through lumpectomy surgery, radiation, and chemo, lost all her hair, and was hospitalized once or twice for a dangerously low white blood cell count which predisposed her to a life-threatening array of normally harmless infections. Several years ago, new tumors were found in both breasts, at which point she decided to undergo bilateral mastectomies instead of more chemo or radiation. Poof! The breasts that nursed me, my sister, and my two little brothers were gone.

Spartacus, his mom, & brother Brian (1964)
Spartacus's mother died from an aggressive, untreatable form of breast cancer when he was only six. Three summers ago, his beloved stepmom died from complications following LVAD (left ventricular assist device...a heart pump) placement for end-stage congestive heart failure she'd incurred as a result of having her mitral valve severely damaged from breast cancer treatment in 2001 with the chemotherapeutic agent, herceptin. And then, there's my cousin who was diagnosed with breast cancer in her twenties. She underwent radiation, bilateral mastectomies, breast reconstruction, and chemo. Both Mom and my cousin are doing great. Clearly, I'm well acquainted with the grim reality of breast cancer.

Strategically placed tomatoes=instant boob lift!
Recently, the value of mammography has come under scrutiny, especially for women younger than 50. For a screening test to be of value, it has to be both sensitive and specific. Sensitivity identifies true positives and specificity identifies true negatives. In the case of mammography, true positives are being diagnosed along with what seems to be an unacceptably high rate of false positives. In other words, breast cancer is being overdiagnosed. Women who really don't have breast cancer risk being treated for it, as do women whose indolent breast cancers wouldn't have harmed them if left untreated. My poor younger sister, who has dense fibrocystic breasts like me, tells me she's had at least 25-30 mammograms since turning 30, along with ultrasounds, a biopsy, and titanium clip placement. Because our breasts are difficult to image, we've both been called back for further imaging after a routine mammographic exam, only to be told it's nothing again and again. Do the benefits really outweigh the risks?

I'm a less-is-more kind of gal. Coming from a 51 year old physician, especially one whose own mother had breast cancer, that may sound odd. It really isn't odd at all. Doctors make pretty lousy patients. The nature of our profession dictates that we're not allowed to be sick...ever. Who'll take care of our patients? When it comes to our own deaths, physicians tend to be minimalists. We know enough about the limitations of modern medicine to know with certainty that we don't want to die the slow, horrible, painful deaths in the ICU so many of our patients unwittingly opt for. I may not know how I'm going to die, but I sure do know how I don't want to live.

The mammography suite: "No Country For Ripe Tomatoes."
But, I digress. Back to the less-is-more thing. Until about a month ago, almost two years had elapsed since my last mammogram. In the meantime, all the media and research hullaballoo surrounding mammography's predictive value gave me pause. It's not a benign procedure and has to be approached with cautious consideration. Because my mom's breast cancer was post-menopausal, my risk for developing it isn't significantly increased. I've never smoked, have always maintained a healthy weight and been physically active, had my children when I was young and breastfed them, blah, blah blah. The idea of being exposed to any amount of radiation isn't very appealing. I'm sure I've already accumulated quite enough after years of working in the operating room with all those X-rays and fluoroscopy. Thank goodness for lead aprons and thyroid shields! And then, there's the simple fact that having my boobs squished between two pieces of hard, cold plastic totally sucks. Theoretically speaking, compressing breast tissue like that could lead to derangements in cellular integrity. So many anxiety-producing what ifs. Too many. And that's not even taking into consideration the stress of having to wait in limbo for a week to ten days to get the results.

Autonomy, self-determination, & mischief
I know my body better than anyone else. I also know what types of intervention I will and won't accept. I'm a believer in the autonomy and self-determination of each individual, as well as in self-advocacy. I don't share the same blind faith in science that many of my colleagues do; in fact, I think the acceptance of scientific facts actually requires more in the way of faith than believing in God does. As Sherlock Holmes astutely observed, "Facts are always convincing; it's the conclusions drawn from facts that are often in error." I guess I'm a bit of a skeptic, especially when it comes to being voluntarily incapacitated or disfigured. Treatment options for cancer are a highly personal thing. I don't view a person who abstains from aggressive treatment as being any less courageous than someone who chooses chemo, radiation, and radical surgery. Everyone has their limits, and I know what mine are. Were I to develop breast cancer, I'd agree to non-disfiguring surgery, but not to chemotherapy or radiation. The thought of having my boobs cut off is just too much. So is the thought of chemo drugs and X-rays indiscriminately rearranging my cellular architecture and DNA. Again, I'm not judging you, so don't judge me.

My anxiety-inducing mammogram report
Back to my most recent mammogram, I'm not sure why I scheduled it in the first place. Based on my self-breast exams, I didn't think it was indicated. My doctor certainly didn't pressure me into it. Whatever. It happened. After the boob squishing, the radiology tech assured me my results I'd received my results in three days. A week passed, and still no results. I assumed no news was good news. If something was abnormal, they would have called me, right? Ten days later, I went to have my new IUD placed. My gyn doc hadn't received the results, either, so she called over to the mammography suite to inquire about them. Here's what the report said: "There is an 8 mm mass with an indistinct margin in the left breast at 5 o'clock middle depth. Impression: Incomplete. Needs additional imaging evaluation." Well, la dee fucking da, let the goddamn needless anxiety sweatfest begin!

Me and Spartacus, deeply engaged in needless worry.
Over the ten days I had to wait to have this additional imaging, I gained about 5 pounds from a stress-eating binge that consisted of Dekalb Farmers Market candy (coconut curry cashews, dark chocolate covered almonds, and macha tea and salted chocolate caramels. Mmm-mm, good!) washed down with plenty of red wine. I felt so fat, disgusting, and horrible that I resorted to wearing scrub pants EVERYWHERE. I decided not to discuss this with anyone but Spartacus, my younger sister, and my closest friends. Until it's an issue, it's a non-issue, right? Not so much. Poor Spartacus. He barely got to know his mom before she died from breast cancer, and now, his crazy wife's personified her left breast into a creature that requests--no demands--headrubs, backscratches, and another $6.99 bottle of Protocolo tempranillo from the Candler Park Market.

Shaman chameleons we are.
I debated about whether or not to tell my children. I didn't want to worry them unnecessarily. Because my son, Nick, is studying ayurveda and happens to be a manager at a natural foods store, I decided to talk to him about what was going on. We talked about adjusting my diet. I already drink a boatload of alkaline organic green juice, laden with wheat grass, celery, dandelion, cilantro, fennel, turmeric, ginger, and lime. But, I drink way too much coffee, which is known to aggravate conditions in the fibrocystic breast. Cutting back on alcohol is easy, but caffeine...whoa! I purchased some tulsi (holy basil) tea and started my caffeine detox. I've been pleasantly surprised at how easy it's been to reduce my caffeine intake to one cup of coffee per day. The tea tastes good and it's also relaxing. My confidence was restored...or so I thought.

Hurry, let's get outta here!!!
Two days ago, I had my long-awaited additional imaging. I went to work as usual, came home early, let the dogs out, grabbed some lunch, and headed over to Piedmont Hospital. The anxiety I felt was almost unbearable. So much ado about a boob. Having been told in advance that this ordeal would take anywhere from 1-3 hours, I wanted to be prepared. I stopped at Arden's Garden and got myself a blueberry-sesame Love Bar and a bottle of pH Solution in case I got hungry or thirsty. This next part's a little embarrassing. As any woman who undergoes mammography knows, you're not supposed to wear deodorant or antiperspirant on the day of your test because it can affect the results, i.e. the aluminum in those products mimics calcifications in breast tissue. Needless to say, by the time I hiked my left arm up to position my naked, defenseless boob onto the X-ray plate, I had a raging case of B.O. At first, I thought it was the technician's breath, but no, it was me! Ugh. As soon as I was released from the spot compression imaging, I went and scrubbed my armpits. The tech informed me that, depending on those results, the radiologist might order an ultrasound. Fifteen minutes later, I was called back for an ultrasound. Being familiar with ultrasonography, I watched as the tech located and measured a radiolucent oval. I recognized it immediately as a fluid-filled cyst. Sure enough, that's all it was. Spartacus had driven through horrible traffic to get to the waiting room, and was visibly relieved when I flashed him the thumbs up. We couldn't get out of there fast enough. His feelings might change when we're billed for the $2000.00 deductible, though. Not only is reassurance anxiety-provoking, it's expensive, too.

One of my father's busty bronzes.
It'll be a looooooong time before I consider having another mammogram. For a minimalist like me, I'm not sure screening tests make a lot of sense. The information they yield isn't the problem, it's what I'd do (or not do) with it. I pretty much live life right here in the moment, and I don't go looking for problems or worries. If it ain't broke, don't fix it. Live and let live. In this day and age of prophylactic double mastectomies that are based solely on genetic testing and probability, despite the fact that with early detection the 5 year survival rate for Stage 0-I breast cancers is 100% while stage II is 93%, it seems that perhaps we've entered into a realm of breast cancer hyperawareness. I don't view my tits as unnecessary or expendable. In fact, I'm quite attached to them. Spartacus enjoys them, too. Bottom line is, I'm not sure I'd want to live without them. Once again, making such decisions is highly personal, whether it's undergoing genetic testing and prophylactic mastectomy because of a strong family history of breast or ovarian cancer, deciding whether or not to have chemo, radiation, or surgery if cancer is found, or submitting to routine mammographic screening in the first place. It's a matter of quality versus quantity of life, and quality is something that defies analysis or explanation. It's strictly a perceptual experience. And being held captive by screening tests and all their what ifs doesn't feel like quality to me. I think I'll just stick with my own intuitive version of health and breast awareness. It hasn't failed me yet.

Sunday, March 16, 2014

The Optimist

Brothers from other mothers (L-->R) Willie, Nick, Chad, Rory
Last week, I had an odd exchange on FB with a friend of a friend, a young guy named Tim in his early 20s. Our mutual friend, Willie, had posted this blurb: "So someone OD'd in the Jack's parking lot yesterday morning .... Again smh I'm about to eat [an] orange and ride my bike on that one." Willie and his brother, Chad, happen to be my sons' best friends. They're my sons from another mother. Willie is the lead singer for their band, BearKnuckle, and Chad works at Jack's. I guess Chad told Willie about the OD. Anyhow, the rest of the conversation went like this:

Brittanie: "OMG!"
Me: "Did the person survive?"
Fred: "Surviving an OD is pretty terrible."
Me: "It's better than being dead, though."
Tim: "If you haven't died then how do you know if anything else is better? And the word better is so subjective."
Me: "Tim, if you think being dead is better than being alive, you've got some serious living to do. Just sayin'."
Tim: "But you've never been dead. Don't try and get philosophical on me. I just asked a question. Geez (reattaching my head after it has been bitten off)."

Tim had a valid point about the word "better" being subjective. Some people believe they're better off dead. And some people consider other people's lives to be a waste. I guess it all depends on your outlook. My outlook is heavily influenced by text messages like this one that I'd just received from my son, Rory, who along with his identical twin brother, Nick, suffers from cystic fibrosis.

For me, motherhood's been tainted by the cruelty of this terrible disease. There's nothing subjective or philosophical about the painful awareness that I am watching my children die or the fear that I may outlive them. There's nothing subjective or philosophical about the helplessness I feel. I can't fix them. I can't make their cystic fibrosis go away.

Rory (L) & his yellow-gowned hospital visitors, Chad & Nick
Rory spent a week in the hospital back in January for a course of intravenous antibiotics, followed by a couple more weeks of home infusion therapy and a burst of steroids to reduce the inflammation raging inside his lungs. His pulmonary functions didn't improve at all. Now, he's going to have a fiberoptic scope shoved down his windpipe to examine deep inside his lung passages, a procedure that requires sedation. Believe it or not, Rory was hoping to go to work after his bronchoscopy. For him and Nick, life goes on. To quote my aphorist-writing friend, Marty Rubin (aka nothingprofound): "Morning will come, it has no choice." Cystic fibrosis is a part of their lives, not the center of their existence. I'm gonna go out on a limb and say that my boys have a pretty good idea of what life-threatening physical decline feels like. Yet, I don't know two people more fully alive than they are.

If death is the end of all experience, then Tim's argument that you'd have to experience being dead to confidently assert that it's better to be alive was pretty lame. And, he was the one getting philosophical, presumptive, and touchy. I knew responding to him any further was a waste of time and energy, but I decided to play along anyway. Yeah, sometimes, I can be an asshole.

Me: "No one's bitten your head off. Why so sensitive?"
Tim: "Can't talk now! Reattaching my back after these messages. Sensitive? I don't give a shit, dude! lol"

Me, Walt Whitman, and Chet the Jet
Ugh. I deplore being called "dude." In my book,  "dude" is about as unisex as the word "broad." It was pretty clear that this guy wasn't up for any sort of meaningful exchange. He seemed...angry. And cynical. But, I was curious and a bit bored. I was waiting to meet up for lunch with Chester, my fellow free spirit, and I had some time to kill, so I continued.

Me: "Have you ever spoken to someone who's had a near-death experience? I have, and though they say death isn't scary, they all agree it's much better to be alive. It's a matter of one's attitude toward dealing with reality. After you reattach your head, consider brushing away that chip on your shoulder :-D"

I'm sure a few eyes are rolling heavenward right about now. Near-death experience? LOL. Well, considering the fact that I give anesthesia for a living, and that general anesthesia is basically a controlled near-death experience, my response isn't so far-fetched.

And yes, I've interviewed a number of patients who've reported near death experiences following traumatic injury or cardiac arrest. One of my former partners, Steve, a middle-aged heavy smoker, had such an experience at work. We had a super stressful call schedule that involved at least 24 full hours of little or no sleep, e.g. once things quieted down in the operating room, you were up all night placing epidurals on labor and delivery.

In anesthesia, we welcome dull moments like having lunch together!
After finishing his 24 hour shift, Steve decided to enjoy a little breakfast with our colleagues in the anesthesia lounge before driving home. A few bites into his sausage biscuit, he developed severe, crushing chest pain. As our colleagues watched in disbelief and horror, Steve collapsed on the sofa, having sustained a massive myocardial infarction. One of the scrub techs, a huge muscle-bound guy, scooped lifeless, clinically dead Steve up into his arms, threw him onto a stretcher, and rushed him into the recovery room for resuscitation, flanked by a number of anesthesiologists, anesthetists, and surgeons.

What Steve told me about that experience still gives me chills. He says he remembers being in the recovery room, standing off to the side, watching our colleagues diligently gathered around a stretcher, frantically giving CPR to someone. He didn't know who they were working on, and no one was paying any attention to him. Despite all the adrenaline-fueled commotion surrounding him, he felt a sense of absolute calm and peace, accompanied by a complete lack of fear. It wasn't religious or spiritual, just a profound sense of well-being. Instantaneously, he was hovering over himself, looking down at himself on that stretcher, and apparently, that's the moment his heart started spontaneously beating again. He then underwent emergent cardiac catheterization and stenting of his occluded coronary artery. He even quit smoking for awhile. After that experience, one thing Steve's sure of is that death no longer frightens him.

Tim: "Chips are great! Who doesn't like dip and chips!! Your not living life. Buddy!!!"
Tim: "And just to be real. If there is another side to our reality, who is to say it is good or bad or any human emotion. Just thinking further than planet earth and all us humans man."
Me: "Well, that's why we have the arts, poetry, philosophy, and practical common sense

My new favorite restaurant!
Reality isn't all that complicated. It's less a matter of perception or conceptualization than lived experience and applied common sense.* We're born and we die. What goes up (usually) comes back down. Cut yourself, and you will bleed. Stand in the rain, and you'll get wet. If you drop your glass onto a concrete floor, it will shatter. Those are examples of realityOverthinking it is what makes reality seem so complicated and unbearable.

Lao-tzu wrote: "See the world as your self. Have faith in the way things are. Love the world as your self; then you can care for all things." His writings are imbued with a sense of optimism: "Stop thinking and end your your natural responses and everything will fall into place."

My conversation with Tim stopped there. My 21 year old nephew, Evan, "liked" my last comment, and that was pretty much that. Maybe I'll run into Tim someday...he buses tables at one of my favorite neighborhood restaurants. Small world, huh?

My thoughts were with Rory the rest of that day, wishing that I could somehow relieve his burden. But, I don't think either of us spends too much time wishing away his disease. In fact, it's acceptance of it that brings both relief and life-enhancing innovation. The things we can't change don't negate the abundance of what we've got to work with. They give rise to creative solutions. Maybe it's no coincidence that Spartacus and I ended up having dinner Friday night at a joint called "The Optimist."

"Confidence is high!"
I spent the afternoon with Chester, celebrating life in the moment. When Chester was a teenager, he was diagnosed with bone cancer. His doctors actually told him not to plan on starting a family because he wouldn't be around to enjoy them. Chester said, "Fuck it. I'm gonna hitchhike around the country then." He regales me with stories of his pan-American travels, living in hippie communes, picking coffee in Belize, and defying the odds that were prescribed for him. Not only did he survive to father his own children and become a kickass ultimate Frisbee player and bearded wizard of electricity, he's now a grandparent. No wonder Chester's favorite saying is "Confidence is high."

Cat on a hot tin roof. Meow!
After lunch, we walked down to see the magnificent labor of love that he and his brother have been working on for nearly 40 years. It's an amazing cathedral-like structure sitting atop a hill in the Virginia Highland area, built with hand cut marble bricks, intricately designed wooden beamwork and ceilings, and even a round moon door. It was such a beautiful day outside, sunny and warm enough for a T-shirt and flip flops. We ended up spending most of our time on the roof, perched amidst the budding treetops of live oaks and pink tulip magnolias, cracking each other up and talking about life. Here's what we concluded. Both of us have endured some major shitstorms in our lives, stuff that could have left us broken, disillusioned, and cynical. But, we just rolled with it, and now, here we are, chilling out on a rooftop, fully present and drinking it all in with nary a drop of wine between us. No, there ain't no doubt about it. Life. Is. Good.

*A loosely paraphrased summation of a discussion on BlogCatalog by Marty Rubin aka nothingprofound): "Do you think it's possible to live without illusions?"

Sunday, February 9, 2014

Life Over Easy

This photo has all the makings of an omelet...
Eggs. They're pretty much a staple food in most people's refrigerators, always on hand but oft forgotten as you're standing there with the door wide open, muttering to yourself that there's nothing good to eat. For the past several months, I haven't been doing much weekend breakfast cooking. Once Spartacus and I discovered that Ria's Bluebird Cafe, the funky Grant Park diner across the street from Oakland Cemetery where Margaret Mitchell is buried, happens to have the world's most excellent buttermilk pancakes, we've become regulars there nearly every Saturday morning.

Ria's eggnog pancakes with torched marshmallow...mmm!
On the weekends, Ria's does specialty pancakes. Regardless of whether I'm having eggnog flapjacks with toasted house-made marshmallow or strawberry-laced ones topped with Chantilly cream, I always order a single poached egg. Poached eggs are a SUCH a pain in the ass to make at home. I've tried every method known to man, including the addition of vinegar as well as the purchase of silicone egg cups that you submerge in simmering water so the eggs hold their shape without the white spewing out everywhere, but it's just not the same as when the egg is prepared special, just for you. In my book, you just can't beat the simple glamor of a perfectly poached egg, adorned only with salt and pepper. 

Well, this morning was a little different, and I'm really not sure why. Both of us got up pretty early, which means we could have easily beaten the crowd at Ria's, but for some reason, I was motivated to cook. Maybe it's because I had an entire carton of eggs that was about to expire. Usually, I just hard boil eggs that are getting close to their expiration date, but since I also had a chunk of smoked gouda that was on the verge of going moldy, I decided I'd make an omelet. I had spinach, green onions, and grape tomatoes that needed to be used up, too, so into the pan they went. Man oh man, our kitchen smelled so good! As I stood there, flipping the omelet around in my trusty old non-stick pan, I felt strangely reassured. I was thinking to myself, "Nope, I haven't lost it," when it dawned on me egg-xactly where this sudden burst of culinary mania was coming from. 

Me & Julie, celebrating our friendship & 5-7 years of no more periods.
Last week, I went to see a gynecologist for the first time in seven years. The last time I saw one was to have my now-expired Mirena IUD inserted. Here in the US, the Mirena is considered effective for five years, but in France, it's been demonstrated to retain its contraceptive efficacy for closer to seven years. Since I was 44 at the time I had it placed, I pretty much banked on being menopausal by the time it was ready to remove. Back then, I was single. Aside from the fact that I was, uh, quite sexually active, and hated using condoms, I really couldn't stand having menstrual periods interfere with my life. There was nothing quite as sucky as being caught on call with blood-stained panties and no tampons, and don't even get me started on the grossness of sex whilst menstruating. My girlfriend, Julie, told me she loved her Mirena. I mean, what's not to love about no fuss, no muss contraception with the added benefit of no monthly period? I was quickly convinced that the IUD was definitely for me. One afternoon, while I was having lunch in the physicians' lunchroom at work, I bumped into a colleague who happened to be one of the head honchos in Emory's department of gynecology. He's a fatherly figure, a real good egg, and since I'd developed a pretty friendly relationship with him during my GYN rotation as a surgery resident six years before, I felt perfectly comfortable telling him about my situation. He got me into his clinic, and within a week, I had my IUD. (Since then, my well-woman exams and Pap tests have been performed by my internal medicine doc, just because it's easier than scheduling separate appointments).

Pregnant me at my nursing school graduation
When I made this most recent gynecologist appointment, it was basically to find out where I was in my hormonal cycle. I mean, hell, I'm 51. I'd convinced myself that I was in some early stage of menopause, based on the fact that I keep having these horrible acne breakouts on my chin. For me, one pimple constitutes a full on breakout; don't judge. I suppose I'm a little vain, but since I never had zits as a teenager, dealing with them over age 50 is somewhat traumatic. When the subject of my ancient IUD came up, the doc said she'd check my hormone levels, and that we'd go from there. Later that evening, Spartacus and I were joking about how weird it would be to have a baby at our age. Since I work in an infertility clinic, giving anesthesia to women who are having their eggs harvested for in vitro fertilization or cryopreserved for later use, and men who are having their vasectomies reversed or their testes biopsied because of low sperm counts, I am constantly reminded of how difficult it is for some couples to get pregnant. If Nature had a cruel side, it would be definitely be infertility. For me, conception was easy. I got pregnant two months after stopping birth control pills, and at sixteen weeks, we learned I was carrying twins. By the time I was 28-30 weeks along, I was as big as a house! In 1990, pregnant belly photos weren't yet in style, so the only known pregnancy photo of me is the one shown here, taken during my nursing school graduation ceremony. Talk about hormonal! I could never imagine going through that again, which is why I'm very lucky to have had twins. It still amazes me that two people came from one of my eggs.

How can Spartacus sleep at a time like this?
Late Friday afternoon, I got a call from my gynecologist. I wasn't expecting to hear from her so soon after my appointment, and I was momentarily struck with terror that she was delivering really bad news. My life flashed before my eyes. A lump rose in my throat. My heart started having palpitations. The pause between me answering the phone and her telling me she'd reviewed my lab results was immeasurably long. Spartacus was napping on the couch, and there I was, a complete basket case about to learn that I had some sort of gynecologic cancer. I was totally unprepared for what came next. "Kristyna, we're going to need to replace that IUD. You've got some verrrrry young-looking ovaries, and you still need protection. You're not going into menopause any time soon." She sounded so upbeat and happy. Relieved but also in disbelief, I nearly shouted into the phone. "Are you kidding me? I could still get pregnant at this age?!" WTF?! I guess the yolk's on me. All along, I thought I was on the verge of being over Hormone Hill, that this freakin' acne would resolve, and that my body would soon be free of implanted devices. Not so much. 

Me and my huevos
I have to admit, as shocked as I was to hear the egg-ceptional news about my youthful ovaries, I'm secretly a little turned on by it. My libido's raw, as in sunny side up. It's as if I've regained several years of my life. I've always looked and felt younger than my actual age, and maybe these raging hormones have had something to do with that. Who knows, maybe there is power in suggestion? I thought my eggs were poached, but my gonads have kept right on crackin'. No, I haven't lost it. After enjoying my luscious spinach-tomato-smoked gouda omelet, I called myself in some prescription strength acne gel to combat yet another zit that's popped up. (That's one of the few perks of being a doctor). I'm getting a new IUD on Tuesday. As for me and my huevos, we're scrambling to stay as deviled as possible while taking life over easy ;-)

Sunday, February 2, 2014

Everyone Loves Meat Loaf

Puddin' Thighs adjusted her hairnet, giving the elastic waistband of her suffocating pantyhose a determined yank.

Sucking a final drag from the filterless cigarette clenched tightly between her teeth, she averted her gaze from the puke-green cinder block wall behind the stained wooden chopping block onto the ketchupy splotches besmirching her clunky lunchlady shoes.

Smiling coyly, she dumped another plastic bucketful of greasy mystery meat into the trusty old Hobart mixer.

"Everyone loves meat loaf," she murmured, clearly pleased at how ridding herself of yet another rotten ex-husband permitted her to remain within the school's annual cafeteria budget.

Saturday, January 18, 2014

An Egregious Violation of Convenience

The only thing crazier than these hats is who's wearing them.
Wanna hear something crazy? After decades of baking my own homemade bread, I did the unthinkable. I got myself a breadmaker. It's a nice one that, if you're using rapid-rising yeast, will crank out a fragrant, perfectly browned, two pound loaf of bread in just two hours and eight minutes. Nothing crazy about that, right? I mean, what could possibly be more logical than employing this efficient little machine that's designed for the sole purpose of making my life easier? I'll tell you what's crazy about it. Me. Yeah, me. 

In case you were wondering, this here's a table top
After two years of neglect, I wrestled said machine out from the lonely corner it occupied under the stainless steel worktable, the top of which my husband had labeled, along with every other appliance in our kitchen. He'd gotten hold of a label-maker at work and just went to town.  I'm guessing it was his sincere desire that there'd be no confusion about whether or not that shiny thing you step on when you want to throw something away was indeed a trash can. Thanks to his efforts, I now know that the concave rectangle with the attached faucet is actually a kitchen sink.

Anyway, this was right after Thanksgiving. I had a ton of leftover mashed sweet potatoes that I needed to use, and since I hate throwing perfectly good food away, I made the obvious choice: soup. But, I still had about a cup or so of the sweet potatoes to repurpose. They were seasoned with salt and pepper, so I couldn't use them to make pancakes. Wait a minute...pancakes are a kind of about some bread? I googled "breadmaker," "potato," and "whole wheat," and found a simple recipe that, based on my extensive (if amateur) baking experience, would produce excellent results. It took less than 10 minutes to assemble all the ingredients. We were two hours and eight minutes away from crusty butter-slathered bread and piping hot soup. Man, I was on a roll.

"No Mommy, I didn't take the screwdriver." :-D
What happened next amounts to an egregious violation of convenience. After programming the breadmaker, closing the lid, and pressing "on," which under normal circumstances signals "Step away from the machine," I stood there, frozen. Watching. Monitoring. Calculating. And, most dangerous of all, thinking. It was just like when I was 7 and got my Suzy Homemaker electric oven for Christmas, the one I tried to pry open with a screwdriver whilst baking an impossibly tiny cake. I wanted to be a part of what was going on in there. I wanted control. Fortunately, for me and my parents, I managed to avoid electrocution. 

OK, back to the remote present. Once those beater blades started rotating, I grabbed a spatula, flipped open the lid, and began assisting the dough in its transfigurational journey. I guess part of me just didn't trust that the specified proportions were correct or that the flour would be adequately hydrated since I store it in the freezer or that those goddamn tiny flippers could knead four and two-thirds cups of flour into a workable dough without my help.

The irresistibly doughy inner sanctum...hurry, close the lid!
So, I poked and prodded and scraped. I became concerned that the dough was too dry, so I started adding water, which turned it into a gloppy goo, which then prompted me to add more flour. This went on for a good twenty minutes. Given all these additions, I fretted that the dough still wasn't properly kneaded, so I reset the machine to repeat the mixing cycle. I might have been hallucinating, but I sensed the machine was heaving with every well-intended intervention, struggling under the weight of my oppression. In retrospect, there's no doubt about it...that ungrateful, good-for-nothing breadmaker was resisting me! And, it had the audacity to do so at the inception of my homemade soup and bread kick.

This next paragraph is going to seem oddly out of place. Please bear with me. I've been dealing with a family situation; my 17 year old nephew's been acting out at home and school, getting into trouble with Johnny Law, and his father (my youngest brother) is exasperated and exhausted. I understand how both of them are feeling right now. Been there, done that. Both adolescence and (segments of) my parenting experience have resembled Mr. Toad's Wild Ride. Why did I have to be such a non-conformist? Why couldn't I just follow the rules? Be respectful of authority like everyone else? Was it karma that my sons didn't follow the rules, either? Was flying under the radar too much to ask?

Gleefully molesting the forbidden med cart while the charge nurse was away
It finally occurred to me that flying under the radar had never been presented to them as a possibility, although it had become a way of life for me. You might say it was silently acknowledged, but never actively discussed. What exactly do I mean by flying under the radar? It means living life on your own terms, without seeking society's approval or drawing unnecessary attention to yourself. Keeping it on the down low. Doing what you want to do without harming yourself or anyone else. It's more about following your heart and being true to yourself than it is about not getting caught. To a conformist, this is the equivalent of dishonesty and subversion. It's unthinkable. So many what ifs. But, to someone who's not driven by pleasing authority, it's the closest you can get to realizing your freedom within the constructs of a society that was forged by the desire for individuality, but no longer values it. You do what you gotta do. 

Me and my boys, keeping our noses clean...
So, with all the focus on my nephew's situation over the past few days, I've relived some of my own excruciating moments in parenthood. There are no easy answers. What I do know is this. Our children are autonomous individuals. They are not extensions of us, nor are they receptacles for our projected fears and expectations. We cannot presume to know what's best for them. We cannot assume that what's right for us is also going to be right for them. The best we can do is share our own experiences honestly and support them as they're navigating through those of their own, without taking their chosen path personally. That's perhaps the toughest (but most rewarding) lesson I've learned as a parent.

Instead of eating out last night, Spartacus and I decided to stay in. The refrigerator was empty and the cupboards were bare, except for a one liter box of organic carrot-cashew-ginger soup. And a can of sweet potato puree. Hmm. Reaching back into the dark recess beneath the stainless steel tabletop, I pried the breadmaker from its niche. I swear I could feel it shuddering. She's baaaaack....nooooooo! Don't worry, I thought, reassuringly. Tonight's gonna be a good good night. 

Love at first bite.
And good it was. Different. Because I've made this bread soooo many times in the last few weeks, I measured out the ingredients from memory: sprouted whole wheat flour, sea salt, instant yeast, coconut oil, filtered water, raw honey, organic sweet potato puree, and vital wheat gluten. Once I got it all dumped inside the bread mixer, I closed the lid, and let it do its thing. OK, I have to be honest, I peeked inside once at the beginning of the knead cycle to scrape the clumped up flour from the edges. Other than those minor infractions, I successfully resisted the urge to micromanage my breadmaker. In return, I was rewarded with time to sit down and write this blog post as well as a delicious, hands-free loaf of bread. It was a true Lao-tzu moment. There's a quote of his that I've always liked, something to the effect of "leave people alone and they will do the right thing." Maybe that's what convenience is really all about. Let it be. Trust in the way things are as Nature takes its course. Trust yourself and you'll never be dependent upon authority.

Labeling Spartacus
So, to recap. My asshole breadmaker ended up being a metaphor for simplicity, individuality, discretion, and trust. I'm pretty sure the damn thing was flying under the radar the entire time I thought I was providing expert guidance. When left to its own devices, that machine managed to exceed my expectations. Imagine that. My sons demonstrated the same propensity years before, once I quit meddling in their affairs. Supervising a breadmaking machine seems pretty benign, doesn't it? But, the same unwillingness to leave well enough alone is what fuels the moral busybodying that continues to divide the human race. Just like all of my kitchen appliances, we end up being labeled. I don't know about you, but the only label I've willingly worn is a Chiquita Banana sticker. It peeled right off. In my experience, defiance only becomes problematic in the absence of accountability. Keep your nose clean, and people will stay out of your hair.

Sunday, December 29, 2013


The ambient silence smolders heavily,
cocooning them in a sticky lonely fog,
separating them even further
in the separateness they'd long ago mistaken for independence,
both of them living some version of the truth.

Aftermathing is such an exhausting affair.
Trampled and Trampled Upon stumble alongside each other,
circumnavigating their elegantly crafted minefield of eggshells,
carefully sidestepping resentment's timebombs,
treading ever so lightly
until the suffocating fog lifts,
leaving them spent and exposed,
each of them wondering,
"Are we the only ones who 'do' this?"

Why is communication so easy for some
and so difficult for others?
Humility, honesty, and assertiveness
don't come naturally to everyone,
I suppose.
In the interim,
Time intervenes,
softening the blows
delivered by love that still stands a fighting chance.

Wednesday, December 4, 2013

The Girl The Boys Wanted To Kiss

     Even though it ain't all that cold outside fer December, my bones've got that deep down chill inside, an' for the life of me, I caint seem ta get warm. So many regretful thangs done happened in the last coupla weeks, I don't even know whar ta begin. Maybe the Good Lord ain'tsa good after all. I know I'll probly be damned to eternal hellfire fer sayin' that, but I caint hep it. Blessed Savior of Mankind, my ass. Whatsoever He done giveth, He gets even bigger kicks from takethin' away.

     Poor Luella. Nineteen years old and settin' in prison. Got 'erself in a terrible fix a coupla years back, drivin' drunk. Killed a woman who was drivin' without a license, not wearin' a seatbelt, an' had 'er brake line held together with a pair a pliers, but none a that made no differnce ta the judge. Neither did the fact that Luella was a straight A student all through high school and her first two years a college. He intended ta make an example outta her. Ta make matters even worse, the victim's family was goin' after her mama, Roxie, in a civil suit. As if that was gonna bring their mama back.

     Me an' Roxie started workin' together down at the county clinic right aroun' two years ago. She knew just about ever'one in town. Usually had a story or two to tell about 'em all, too. I didn't know 'er growin' up, but my ex-husband did. They was in elementary school together, an' Roxie was his acrosst-the-street neighbor's girlfriend. From what I hear, she was a real tomboy. Loved fishin' and gettin' 'erself dirty. Baited 'er own hooks an' gutted 'er own fish, but at the end of the day, she was still the girl the boys wanted to kiss.

     The time leadin' up to Luella's trial was real hard on Roxie, but she hid her feelins sa darn good. I come ta think a her as an original steel magnolia. Bein' a mama myself, I could only imagine the worry an' despair she musta felt, waitin' and wonderin' 'bout what was gonna happen to Luella, knowin' how crooked the so-called justice system was in that stinkin' county.

     There was times at work that Roxie didn't look or feel sa good. Me an' her was about the same age, an' there weren't no reason ta think there was nothing serious wrong with 'er. As far as we knew, she didn't have no health problems. Made sense that whatever was goin' on with 'er was because've all the stress she was goin' through.

     Luella's trial commenced two weeks afore Thanksgivin'. Instead of havin' a jury trial, she plea-bargained an' ended up gettin' three years in a soft prison 'bout a hunnert miles north a here. I guess they was all worried that a jury mighta dealt her an even harsher sentence. Hard to tell. We all done heard about a similar case a few counties south which didn't involve no prison time. I thank that person got house arrest, community service, an' lifetime public speakin' engagements instead. None've us thunk prison was necessary or just in Luella's case. The prisons are overflowin' with them non-violent offenders, but the courts keep stuffin' 'em in there. It don't make no sense. Prison must be makin' the powers that be a whole lotta money. Seems like the powers that be is more innerested in makin' criminals outta people than servin' them real justice.

     Roxie come back ta work a coupla days after the trial. She looked a little worse fer wear an' tear, but she seemed ta be holdin' 'erself together perty well. I hadn't never talked ta her 'bout Luella's legal troubles afore, but since I got me a brother who's done been in and outta prison, I thunk it couldn't hurt, and might help. Now, I'm glad I done it. We had a real good talk, an' I told her I was gonna write to Luella, once she got moved from the county jail over to the state prison. We cried and hugged an' said "See ya next week." I had no ideer that Wednesday'd be the last time I'd ever seen 'er.

     Thursday, Roxie called out sick ta work. Friday, she come inta work, lookin' white as a ghost, sayin' she didn't have no feelin' in 'er fingers or toes. She didn't wanna go to the hospital; she wanted ta drive 'erself home. Long story short, poor thing was et up with cancer.  Ovarian cancer had done spread all up  into 'er liver and lungs. Had she knowed she was so sick? None've us'll ever know. Judgin' from how my own mama's neglected her needs what with all my brother's problems, it's easy ta see how Roxie could've waved off any symptoms she might've been havin' as stress.

     The cancer was sa far gone that the doctors done give Roxie right about six weeks to live. None a the treatment she got that weekend was helpin', in fact, it made 'er worse. She ended up on life support on Sunday, an' later that afternoon, her mama an' daddy made the decision to take 'er off. It was the right thing ta do. Roxie died peacefully on Monday, surrounded by love. It's right fittin' that her remains is being kept inside a tackle box. She wouldn't of had it no other way.

     Thank the Lord, the court allowed Luella outta jail on an ankle monitor so she could be with her mama during her last hours an' attend her funeral. Made me sa mad to hear that her bein' outta jail had to be kept on the down low, so's the victim's family wouldn't get upset. Now, I'm not one ta blame a victim. No sir. But somethin' tells me that family don't care as much about justice as they do about cashin' in. Hope I'm wrong about that.

     Luella is the spittin' image of her mama. Besides bein' smart and perty, she's got 'erself a strong will an' a good heart. Her family loves 'er to pieces, an' they'll be there fer her, come hell or high water. Caint get no more solid than that. She's gonna do just fine.

     As for the rest of us, the suddenness a Roxie's passin' still has us all in shock. I hadn't been back ta work yet, and it don't quite seem real that I ain't gonna hear Roxie tellin' jokes or belly-laughin' no more. Losin' a friend ain't never easy, but when yer the same age, it's real damn hard. Reminds you just how precious each drop a life really is. Maybe Roxie knew she was sick. Maybe she didn't want to be a sick person. Maybe she wanted to be the girl the boys wanted to kiss fer just a little while longer.