Sunday, April 12, 2015

Special Just for Me

Me & Chester, contemplating the medicinal value of these 'shrooms.
Did you know that springtime weather actually has medicinal properties? I'm emerging from a very serious and humbling bout of influenza, trying to regain my former level of physical strength after losing about 8 or 9 pounds, and still struggling with the aftermath of being treated with antibiotics for a secondary bacterial sinus infection, bronchitis, and laryngitis. This is the sickest I've been since the night my boys were born at 32 weeks because I had full on Listeria sepsis. Whew! In the process I've discovered that Atlanta's beautiful sunny blue skies and crisp morning air are the best remedy for lifting my spirits. It's as if each day since my illness is being served up by Mother Nature, special just for me. Even the rainy days are spectacular. Maybe I'm more acutely aware of Nature's offerings right now because of having recently been so sick. Regardless, I've certainly enjoyed being active outside, taking in all the amazingly colorful and fragrant blooms.

Birds do it, bees do it. Apparently, lady bugs do it, too.
Yesterday, I think I must have walked about 7 or 8 miles. After breakfast with Spartacus at Radial Café, I walked over to Chester's house, about half a mile down the road. Chester has very short legs and I'm a fast walker, so we sort of had to find our mutual pace. He knows pretty much every nook and cranny of Kirkwood, and our walk turned into more of an exploration. We ended up in the Kirkwood Urban Forest, which was marshy and swamp-like after the previous day's torrential rain. Both of us got quite dirty and muddy. We saw billowy white puffball shrubs, tiny purple ice flowers, canopies of lavender wisteria, strangely knotted tree trunks, and these two ladybugs getting it on. As we walked, we talked about so many things. The topics we covered went from mental illness to our relationships with our parents to parenting adult children, and ended with a discussion of what it means to be empathetic. In the meantime, Spartacus texted to say he was picking up some sandwiches at the neighborhood deli. I asked him to please pick up a turkey reuben on rye for Chester and a green veggie wrap with sriracha veganaise for me. Yum!

What a day for a daydream, custom-made for these daydreamin' boys.
Famished and a little sweaty after our long morning of exploration and conversation, Chester and I high-tailed it back to my house for a picnic lunch in the park. While waiting for Spartacus, Chester and I sipped cold cucumber mint water, munched on grapes, and continued our conversation. He is excited about a new lady friend, and I couldn't be happier for him. She lives out of state, in the town where they both grew up, and he's going to be visiting her soon. Hopefully, she'll come down here and I'll get to meet her in person. 

Spartacus arrived with the sandwiches, a bag of blue corn chips, and some cold drinks. I packed those into a cooler, along with the rest of the grapes and some lemon hummus, grabbed a big blanket, and we all walked down to the park across the street to enjoy our little feast. I found a shady spot for us to sit, but after lunch, we decided the shade was a little too cool. So, Chester pulled our blanket beneath the gently shining sun and a lazily soaring hawk, and we stretched ourselves out for a post-prandial nap. It was positively heavenly.

As I mentioned a few paragraphs back, the day before yesterday was one massive thunderstorm. In the evening, the rain was so bad that the Atlanta airport was closed to all incoming flights, which meant that our dinner plans with my friend, Bryan, who was flying in from Chicago for a weekend conference, were off because his plane was diverted to Birmingham. Quel dommage! 

Jerney & Mom, staying dry inside the aquarium
Earlier that morning, my mom and my niece, Jerney, made the perilous trek from Acworth to Atlanta so we could visit the Georgia Aquarium. It started out a little rough. Because of the storms, Mom's drive had been treacherous and slow, and we were over an hour late for our scheduled ticket time. We'd forgotten about the fact that this week was spring break. Needless to say, the aquarium was literally a sardine can, packed full of throngs of people, making it difficult to navigate and quite anxiety-producing to boot. Mom's had bilateral knee replacements and now walks with a cane.  I was surprised that there really wasn't any decent handicapped parking close to the facility, so Mom did a lot more walking than she's used to. Getting a wheelchair would have been an option, but the place was so crowded and frenetic, we decided to see a few exhibits, and then return to my neighborhood for a quiet lunch. Initally, Jerney wasn't enthralled with the idea of anything other than fast food. But, by the time we got to the little café, the rain had stopped and the sun was beginning to peek out from the clouds, so we got a table outside. I'm pleased to report that Jerney ate every bite of her grilled cheese sandwich. 

I've thought a lot about my mom since then. For the past several years now, her life has revolved around the care of this sweet little girl because my brother, Jerney's father, has been in and out of prison. Jerney adores her grandma and is extremely attached to her. In many ways, my mom has been the only real constant in her life. She is definitely Jerney's primary source of stability. Mom doesn't have to do the things she's done for Jerney, my brother, or Jerney's mother. I think it's what she wants to do, and maybe also what she feels she needs to do. Personally, I think she qualifies for sainthood. 

My mom, the first love of my life (L: me, center, my sister, Emi)
Last weekend, which happened to be Easter, Mom expressed feeling disappointed that she hadn't been invited by any of us for Easter dinner. Because Spartacus and I aren't religious, we don't celebrate Easter. In fact, I had completely forgotten that it was Easter. In her email, Mom said she needs to feel special sometimes. In other words, she needs to be reminded of it. This is something I don't really struggle with in life, because my sense of feeling special is internally generated as opposed to coming from an external source. Anyway, after observing Mom and Jerney during our time together on Friday, admiring how tenderly and spontaneously she kissed Jerney's head and bare shoulder, it was very clear to me just how special she is. I remember Mom's kisses, too, and how I reveled in her undivided attention. I wish she could fully realize the impact she's made, but I can certainly help in reminding her. She was, and still is, the first love of my life, special just for me. 

Saturday, February 7, 2015

Freedom, My Ass!

It isn't just Texas that's crazy,  Mr. Hastings.
Just as Alcee Hastings, that Florida congressman who recently (and quite awesomely, I might add) messed directly with Texas by referring to it in a House Rules Committee meeting as "a crazy state," I'd argue that anyone who thinks our current profit-driven, multiple insurance payer system of American healthcare is working well is equally crazy.

Hell, it's worse than crazy or inefficient: it's downright uncivilized. Such blasphemy, coming from an American physician, right?

Fear not, though, I'm not going to bore you with my opinions on why the good old US of A would be far better off with a single-payer system like Canada, France, or the UK, you know those uncivilized countries that actually provide universal healthcare coverage for their citizens, paid for through the tax base (which is something we could easily implement if American medicine wasn't all about the $). Oops, I just said and totally meant that. Guess that makes me a socialist, LOL.

But seriously, anyone who can't admit we've got some glaring problems to fix has clearly never had to care for a sick family member.

Me and my handsome rock star sons.
Those of you who know me or have read my blog know that my twin sons both suffer from cystic fibrosis, an inherited disease that affects primarily the lungs and pancreas, the median life expectancy for which is currently around 40 years of age. Daily treatment for this disease consists of multiple inhaled and oral medications, inhaled and intravenous antibiotics, chest physiotherapy, a nutritionally dense high calorie diet, exercise, and hospitalization for pulmonary exacerbations. In other words, treatment ain't cheap or easy. Their medications alone cost thousands of dollars each month, an expense which is mostly covered by our insurance.

Fortunately, we're insured through my husband's employer, who pays 100% of all employee's premiums and provides significant reimbursement for our deductibles. That's all well and good, but what's going to happen when Nick and Rory turn 26 and can no longer be covered by our insurance? Patriotic Americans proudly refer to our country as the land of the free. Here's a question for ya. How free a society are we when job and career choices for so many of us, including my musician sons, are limited by whether or not we can afford insurance coverage?

Yep, that's my unretouched ass.
Freedom, my ass! Let me tell you a little story about how it's taken nearly a year for Humana, our insurer, to approve a standard of care chest physiotherapy device for my sons.

Our journey begins in early spring of 2014. That's when we first learned of the Afflovest, a completely self-contained, battery-operated chest physiotherapy vest which permits unrestricted freedom of ambulation whilst one is actively using it. What an amazing technological breakthrough!

Given that Nick and Rory have spent years of their lives, tethered to an older model vest and a chair for at least an hour per day, the Afflovest presented a real quality of life-enhancing opportunity. Being able to do other things during chest physiotherapy, like walking, eating, and grooming, not to mention the fact that the Afflovest can be used and charged in a car, would permit a little more time for restorative sleep, convenience while traveling and camping, and improved compliance with treatments. Wait a minute...eating while doing treatments? That would be amazeballs, given that the old vests routinely made Nick and Rory vomit if used within 2 hours following a meal.

After reading rave reviews of the Afflovest on other CFer's blogs, I checked to see if the device was covered under our Humana plan. Although it was covered, the only Afflovest provider in our region was considered out-of network. According to Humana, the provider would have to waive its out-of-network reimbursement. Why Humana couldn't have just designated the only regional provider for Afflovests as in-network is beyond me.

Nick's instrumental angry tweet
Anyhow, I contacted Scott, the Afflovest rep, and was delighted to learn that the waiver had been approved. I figured it'd all be downhill from there. In late spring, Nick and Rory's pulmonologist and respiratory therapist submitted a request for the Afflovests, the first of many. Humana repeatedly denied these requests, asserting that the Afflovest was a convenience, not a necessity, as well as being a duplicate device.

I gotta be honest...this kind of crap makes my blood boil. The people denying such claims aren't physicians; they're uneducated flunkies, armed with algorithms. Maybe a little negative publicity would help things along? #inhumana #unethical, #humanasucks, anyone?

Having recently discovered that large companies really do pay attention to their Twitter feeds, I launched an angry tweet campaign against Humana. At first, it was like magic! One minute I'd be tweeting my health insurance-related discontent, and the next, a very apologetic customer service would contact me, promising to thoroughly review and investigate our case. In the meantime, Nick and Rory's pulmonologist and respiratory therapist forwarded letters of medical necessity to Humana on their behalf. Confidence was high, but dwindled as each successive interaction hit the brick wall of rejection. Three weeks before Christmas, I was about to throw in the tweet towel. And then, Nick--who rarely even uses Twitter--chirped up and tweeted his rage against the healthcare machine. This time, Humana listened.

Spartacus & Jerney, toasting Christmas with green juice.
A Humana customer service rep contacted me, advising me to construct a letter of appeal that would "tug at the reviewer's heartstrings" and assuring me that no further documentation or letters of medical necessity would be needed. Say whaaat? This struck me as odd, especially coming from someone employed by Humana. He basically spoon-fed me every detail I needed to include in my letter, from addressing quality of life issues to the specific problems Nick and Rory encounter with their current vests to reminding Humana of its advertised goals to provide patient-centered care and improve community health by 20 percent by 2020. Naturally, I was in the midst of holiday shopping madness at IKEA during this conversation. I'm sure everyone in lighting and textiles heard me groaning at the very thought of having to compose such a letter.

On December 20, I sent my thoughtfully composed, evidence-based letter--complete with research references to support my position that the Afflovest is a necessity, not a convenience--to Humana via certified mail. It wasn't an easy letter to write, especially paragraphs like this that most parents can't imagine having to draft:

Optimal lung function in cystic fibrosis doesn’t just impact quality of life, it factors significantly into quantity of life. In other words, initiating therapy with the Afflovest means my sons would no longer have to choose between quality of life and quantity of life: they’d be afforded a fighting chance for enhancing both. 

The Afflovests are here!!!!
On January 5, I received a call from Scott. After so many prior disappointments, I was afraid to answer. "Humana has approved the vests," he said. My heart literally skipped a beat, and I was overcome by a rush of accomplishment and relief: a palpable decompression. Needless to say, Nick and Rory were equally thrilled with the news. 

Since the vests were on back order, we had to wait about a month for them to ship out. One thing CF teaches you is patience. I mean, we've spent the boys' lifetime, waiting for better treatment and hoping for a cure, so what's a month in the scheme of things, right?

Last Wednesday, as I was driving home from work, I got a text message from Rory, who works at The UPS Store. There was a photo of some boxes. I was like, "Huh, why is he taking photos of boxes at work?" The text box that followed read: "vests." Duh! I'd totally forgotten that we'd specified the vests should be shipped to his workplace since no one at our houses would be home to sign for them.

And there it was, in living color, the bright blue and yellow vest we'd fought so hard for.

Rory, rockin' his Afflovest.

This morning, the first thing I saw on Facebook was Rory's status update: "The new Afflovest rocks!" Then, I noticed that Nick had messaged me late last night, telling me, "The Afflovest is so cool. It's like freedom!"

Ah, yes, freedom...

Clearly, Nick and Rory don't take their freedom for granted. Being liberated from their clunky and restrictive old vests has got to feel pretty damn liberating.

But, the hands of time keep moving forward. Soon, they'll be 26 and too old to remain on our insurance plan. That'll be another battle for another day, and believe me, I'm prepared to go to war for them.

In the land of the free, being a musician and having health care coverage shouldn't be mutually exclusive, but unfortunately, they are.

So, until some real freedom happens, and by that I mean single-payer, publicly funded, universal health coverage for all American citizens, I'll proudly just keep baring my unpatriotic lily-white ass.

Sunday, December 14, 2014


Spontaneity or life out of balance?
So, in case you haven't noticed, I've been TBTB (Too Busy To Blog) lately. Those are definitely four words I never thought I'd hear myself say, especially that cringe-inducing B word: busy. Unlike the majority of the rest of the world, I don't harbor mad love for the chronically busy. Personally, I find them transparent, boring, and predictable. When every aspect of your day's been planned down to the last detail, it really doesn't leave much room for spontaneity. And that's not very appealing to a free spirit like me.

My three year blogaversary has just passed. When I started blogging, my life was seriously koyaanisqatsi. Despite the fact that I'm a physician, I've never been one of those who lives to work. Work doesn't define me, and though it didn't back then, I'd allowed it to consume nearly every moment of my time because I felt I had no choice in the matter. Working to live didn't seem like an option. The gravid incongruity of my free spirit vs chronically busy situation finally got my attention, and fortunately, spontaneity won out.

Initially, blogging provided a much-needed outlet, a serious means of catharsis. It gradually evolved into what it is today, a fun way to connect with other people all over the world. For the first few months, I blogged every day. When Spartacus and I moved back to Atlanta from Rome, GA, it dropped down to every other day, then once a week. After I started working again, this time only three days a week, I found that once a month sufficed.

Working to live, not living to work
The last couple of months have been a blur. I'm transitioning into my new job by covering interventional pain clinic several days a month, so I've pretty much been back to working full-time. Shifting from anesthesia to pain medicine is accompanied by a significant learning curve, necessitating a fair amount of independent study. It's a bit like being in residency again. My current job finishes at the end of December, and in January, I'll be working four days a week instead of three. Can't argue with that. So, these major changes in my professional life, as well as the long-awaited closing on my house last month, have occupied a big chunk of my time. And I am breathing a huge sigh of relief. 2014 has been a tough year for lots of reasons I won't go into, which is why I'm glad I'm an optimist. Optimism is just as legitimate a reality as pessimism is. It's a matter of distinguishing what you do and don't have control over and rolling with it. Being adaptable and flexible, instead of schedule-driven. That's the beauty of spontaneity. There's always a workaround.

The stuff that matters...
Similarly to how my blogposts have naturally occurred a little less frequently over time, I too have been attenuating. And I'm not referring to the fact that Spartacus and I now have only one mortgage, instead of three. I'm talking about my attitude, how I deal with stress. I've learned not to take things personally. I've quit taking myself and others so seriously. I introspect less and do what I want more. I'm pretty good at living in the moment and following my heart without worry, regret, or expectation. Most importantly, I've realized that my happiness is my decision. Making a few small adjustments in perspective has allowed me to dial down my emotional responses, appreciate just how noncatastrophic most problems really are, and conserve my energy for the stuff that really matters. Three years ago, I would have thought being TBTB was a sure sign of failure. It's actually just a sign that I'm AALL (alive and loving life).

Tuesday, November 4, 2014

It's About Time

The early bird gets the worm, er, blueberry pie.
It's 4:30 a.m. in early November on my day off, and I'm asking myself "WTF am I doing awake right now???" This ridiculously antiquated daylight savings thingy has messed with my circadian rhythms so much so that for the past few days, I've been hitting the hay at 8:30 pm and rolling out of bed eight hours later. The crazy thing about changing time is that we don't even understand what time itself is. We've developed super-precise atomic clocks that are accurate to 0.0000000000000001 second, but scientists can only offer theories about time because guess why? Time isn't a natural phenomenon. It's a human invention that's morphed into a tool of social control. Sort of puts a new spin on hurrying and procrastination, doesn't it?

It's only been a little over a month since I published my last blog post. It's not that I haven't had anything to write about. I haven't had the time, and that's sort of shaken my world a bit. For the past 2 1/2 years, I've had a pretty light schedule, giving anesthesia three days a week and having the rest of my time to do with as I pleased. Having a schedule like this isn't normal in my line of work.

Being a physician is such hard work!
 "Lazy" and "physician" typically aren't words you'd use together in a sentence, but the compromise I worked out with my burned out self so I wouldn't quit medicine altogether did indeed involve me becoming just that: a lazy physician. Laziness has definitely had its perks. I no longer work in a hospital. I don't take call. I don't work on weekends or holidays. I sleep in my own bed at night, instead of a call room. I have days off during the week where I can sleep late and do whatever I want. It's really been a best-of-both worlds situation. The only thing that's really been challenging has been learning to survive on half of my previous income, especially since I've been paying two mortgages this entire time.

Six months ago, I decided I'd had enough of being a landlord, so I put my rental house back on the market. The loss of rental income has been incredibly painful. Living paycheck to paycheck has sucked, and it's a position I never thought I'd see myself in when I first became a practicing physician.

No explanation needed.
Since I wrote about my rental house ordeal pretty extensively in my last blogpost, I won't bore you with those details again. I do have some awesome news, though. My house went under contract on October 7, and is set to close in nine days. Free at last! Aside from one minor hiccup with the inspection (which cost me $900), everything's been moving along nicely. The final mortgage payment's been made, and I'm like a little kid at Christmas, counting the days before Santa's arrival.
The only bugaboo here is that I have to bring money to the closing table. Because I don't want to borrow against a credit card, I've had to shift gears from being lazy to modestly busy.

My light morning reading. Coffee is mandatory.
I won't lie. The past couple of weeks have been pretty intense. Not only have I started orienting in clinic for my upcoming new gig in interventional pain management, I've been working more at my regular job. I'm temporarily back to working five days a week, but surprisingly, it really hasn't been too terrible. I've been able to accumulate the funds I need for closing without having to go into debt. Acclimating to my new job has necessitated some case study and textbook reading, so I'm back on the learning curve. Thank goodness I didn't get rid of my old iPad. Instead of purchasing unwieldy hard copy textbooks, I downloaded cloud-based Kindle versions from, so I can access them via my laptop, iPhone, or iPad. It's made reading, a task that I truly don't enjoy, much more convenient and even somewhat pleasurable.

I'm feeling excited about the work-related changes going on in my life, despite the stressful and time-consuming logistics of securing malpractice insurance. My current job contract specifies that I must secure tail insurance coverage upon leaving the practice. With tail insurance running around $28,000, I've been engaged in negotiations with my new employer to cover my tail on their policy so I won't have to pay the premium.

Chester, rescuing his fallen lens from a giant burrito.
Yesterday, I received confirmation that I was approved for prior acts coverage, obviating the need for separate tail insurance. Hallelujah!! Now I can finally sign my contract. I'll finish my current job in mid-December, and then, I'll drop back down to four days a week in my new position. That means I'll still have plenty of time for hanging out with my favorite people during the week.

After months of upheaval and barely scraping by, I feel like I can exhale again. The weight of my domicile and malpractice albatrosses have been lifted. I've successfully avoided foreclosure, which at one point was a serious consideration. I'm entering a new phase in my career, one that will eventually lead to board-certification in pain medicine. My professional tail is covered. Even though I'll be working one extra day a week at my new job, my income is going up considerably, so I'll be able to splurge on a few of the little luxuries I've been missing, like pedicures and massages. My feet resemble those of a yeti. My shoulders and back are constantly knotted up from weight-lifting. My 52nd birthday's coming up on Friday, so I'll be giving myself a spa day this weekend for sure. Woot! Like the autumn leaves falling from the trees right now, everything's relaxing into place. It's about time.

Tuesday, September 30, 2014

Lost In Tune

Spartacus looking about as concerned as he was in my driverless dream.
I just woke up from the most bizarre dream. In it, Spartacus and I were retrieving our car from a valet parking service. I was sitting in the passenger seat, fiddling around with my phone, trying to find some music to channel through the car stereo. Spartacus appeared to be rooting around in the trunk for something, and as I turned my head to see what he was up to, I noticed a giant pair of speakers perched in the back seat of the car. Some really awesome music suddenly started blasting out of them. I can't recall what it was, but it definitely needed to be cranked up. Lost in tune, I didn't notice the car was moving or realize that Spartacus was sitting in the trunk until we hit top speed out on the freeway. I could only see his head and part of his face, and he didn't seem concerned at all about what was going on. He had this placid look, like he was enjoying the breeze blowing his hair back or something. Meanwhile, I'm panicking and yelling at him in complete disbelief about what I was seeing in the rear view mirror, frantically undoing my seatbelt, scooting my ass over to take control of the wheel, completely astonished that we hadn't collided with anyone yet.

That driverless car dream is a perfect metaphor for how life's been feeling recently: kinda crazy and a little out of control. Where to begin?

My house, my albatross. But, hey, the yard looks great!
Back in May, Spartacus and I decided to put our rental houses on the market. We never wanted to be landlords in the first place...Wall Street, the mortgage financiers, the investment bankers and whoever else was involved in orchestrating the crash of 2008 decided our fate for us. Thanks a pantload, assholes! I'm still trying to get my head around how the banks all got bailed out, while our house values are simultaneously plummeting without a corresponding reduction in mortgage balance. After trying without success to sell my house between 2010 and 2012, I had no choice but to rent it out. Sure, having renters provides income. But, that income gets taxed, and the way things have worked out over the last couple of years, being a landlord has been more of a tax liability than an asset. Just like the poor bastard in the Rime of the Ancient Mariner, that house has become my albatross. God knows, I've fantasized about burning the damn thing down. (Oops, should I have said that out loud? Wouldn't surprise me at all if the insurance adjusters were monitoring my computer along with the NSA).

Chester & I helped rescue this bird yesterday. I need such luck!
Fortunately, Spartacus's house sold almost overnight. I still can't believe his house sold before mine. After having mine listed for a couple of months with the same realtor who managed the property while my tenants lived there, I decided to switch agents. My listing wasn't getting any action. I was constantly having to pull teeth with the guy regarding showings. He really didn't seem to care about getting the place sold. I'd admired how aggressive and responsive Spartacus's agent was while his house was on the market, so I listed the house with her. Definitely a wise decision. We determined that the house would show better a) if it was staged and b) if the yard was shored up, so I employed the services of an interior decorator and Spartacus and I worked on the landscaping ourselves. So far, we've had decent traffic, but no offers. Last week, we reduced the price considerably, and I learned last night that there's a buyer who's very interested in the house. Maybe this'll be my lucky break. One less albatross.

Lunch with Naureen turned out to be more than just soup and nuts.
Two weeks ago, I resigned from my job, so there's that. I really hadn't been looking to change jobs. Back in July, I was having lunch with my girlfriend, Naureen. She completed her anesthesiology pain fellowship several years ago and is currently in practice with a mutual friend of ours from residency. I was reminiscing about how much I'd enjoyed my time on Emory's Acute Pain Service when I was on faculty there. She was like, "You should come work for us!" A couple of weeks later, I got a call from her practice's COO, went in for an interview, and was pretty much offered a position on the spot. It's somewhat of a departure from my current work as an anesthesiologist. Right now, I'm either giving anesthesia myself or supervising anesthetists. In this new job, I'll divide my time equally between evaluating pain clinic patients for interventional procedures and giving sedation for those procedures. I'm looking forward to being back in the pain management arena. Chronic pain patients are an especially challenging lot, so I've got my work cut out for me. What's really great about this job is that it will afford me an opportunity to board-certify in pain medicine without having to go the fellowship route. Once I get settled in, I'm going to enroll in that acupuncture for physicians course I had hoped to have completed by this stage in my career. Who knows, maybe one day, I'll be my own boss?

Everyone's much happier when I'm minding my own business.
Back to my dream. The most difficult aspect of my day to day reality is the fact that my sons have cystic fibrosis (CF) and there's nothing I can do to fix it for them. I try not to let it nag me, but it's always in the back of my mind, an albatross of a different feather. The news from their latest clinic visits hasn't exactly been cheery. Rory recently had to undergo a "tune up" because his lung functions were down. When he texted me from the clinic to let me know he was going on IV antibiotics, I sort of lost it, expressing my frustration over being so helpless with regard to his disease. He responded back, "Your sense of helplessness smothers me at times." Wow. Clearly, he needed to get that off his chest and I guess I needed to hear it. I spent the rest of that morning in tears, feeling like an ass, feeling sorry for myself, but mostly just feeling overwhelmed. I'm his mom. And, moms are supposed to fix everything, right? Not to mention the fact that I'm also a physician who's responsible for fixing people's health problems. It's exceedingly hard to acknowledge my limitations. I wish it were me that had CF instead of my sons. But, Rory is an adult. He wants to navigate the waters of chronic disease management for himself, without my well-intended parental interference. Stepping back from this interaction with him, I realized just how insidious and intrusive worrying about things over which I have no control can be for everyone involved. I'm glad Rory was able to be so brutally honest with me.

Nick & Rory, in their element.
Like the driverless car in my dream, I'm not sure where I'm going with this post. What's felt like veering off course over the last few months may very well be unrecognized plasticity, righting myself by relinquishing the wheel. The time and effort I put into fretting over houses and jobs and health is better spent lost in tune, enjoying the ride, and trusting in life's mystery. I know my house will eventually sell. Since the overgrown ivy in the backyard is the only real reservation the most recent interested buyer expressed about purchasing my house, I've got a yard guy lined up to clear it away. Hopefully, that will appease her. I'm filling out mountains of credentialing paperwork for my new job, which I should be starting in the next few weeks. In the meantime, I've been reacquainting myself with the focused physical exam for evaluating chronic pain, reviewing the neurochemistry and pathophysiology of different pain syndromes, and refreshing my working knowledge of various diagnostic and therapeutic nerve blocks and interventions. No matter how much I prepare, negotiating the learning curve that lies ahead is still going to be a matter of getting my feet wet on the job. Rory is feeling better after his IV antibiotics, although his lung functions didn't improve that much. His doc is going to keep him on the antibiotics for another week. Maybe it'll make a difference. What's important is that he and Nick are living life on their own terms, making amazing music together and independently managing their health issues. They're so lucky to be musicians. I think music's probably been more therapeutic for their bodies and spirits than any other available treatment. Can't argue with that.

I'll leave you with their latest song, "Asklepieion Hiss." This is the first time Rory's composed music around lyrics. The lyrics are actually a poem that my ex-husband--Nick and Rory's father--wrote. In the poem, he's imploring Asklepius, the ancient Greek god of medicine, to heal his sons' cystic fibrosis. It's absolutely beautiful. I hope you'll have a listen, and maybe even find yourself lost in tune.

Prayer to the Solar Storm
by Jim Landt

Awake, awake my golden snake
Coiled tight, deep sleeping in my Soul
Let in thy light, with healing bite
To airtight pathways clogged with coal
Awake and kiss, asklepieion hiss
Thy strike breeds fear in submerged swarms
Connect above, Apollo's love
Streaming down to cleanse my forms
Speak truth to right my Earthqueen's blight.
Bring order to my chaos deep.
Thy photon spray and cosmic ray
Yield healing dreams in each night's sleep.

Friday, August 29, 2014

Beyond These Walls

Bridesmaiding at my sister's 1986 wedding.

As a newly engaged 24 year old, you'd have thunk I'd be immersing myself in typical bride-to-be behavior: selecting a venue, shopping for a dress, poring over china patterns and crystal stemware, and most importantly, deciding what flavor of wedding cake I wanted. I'll be honest, cake is really the only reason I go to weddings. God, how I love wedding cake! Or really just cake of any kind, especially yellow cake with chocolate fudge frosting, or salted caramel with true buttercream, the kind that's made with eggs and butter, not powdered sugar and Crisco. Wait, what was I just talking about?

Oh yes, back to being 24. Welp, that was waaaaaay back in 1986, the year Oprah Winfrey got her talk show on national TV. I was living on Briarcliff Road in the roach-infested basement of this crazy middle-aged Spandex-wearing divorcée's house. She augmented the fortune she made in alimony from her ex-husband by giving high colonic irrigations right inside her freakin' domicile. How gross is that?? I knew this because as soon as I signed the lease, she supplied me with brochures and booklets extolling the virtues of colonic irrigation while in the same breath admonishing me that I was to have no overnight guests. Yeah, right! 

Hardly working while wearing my fiancé's shirt.
I liked living alone, without a roommate. At the time, I was working as a mental health assistant in a private psychiatric hospital, a job which paid $5.85 per hour and provided me with full health care and profit sharing benefits as well as 2 weeks of vacation. I'd never felt so independent. Although I'd started college at Auburn in 1980--studying visual art--I dropped out three years later with a GPA of 1.2, mostly because of partying, but also because of raging insecurities, a complete lack of self-confidence, and lots of inner turmoil and self-loathing. Basically, I didn't trust myself or my abilities. I was too worried about what everyone else thought of me. 

That job at the psych hospital may not have sounded like much, but it was just what I needed to restore my confidence and get back into school. So, while I was working full-time, I was also attending community college as a full-time student. And boy, did I enjoy being a student. I wasn't worried about deciding on a major...I just took classes that appealed to me: music appreciation, French, German, biology, psychology. I ended up getting an associate's degree that was inconsequential. But, the experience of plunging headfirst back into school, doing it strictly for myself and raising my GPA to 3.9ish, was exhilarating. I felt like I could do anything I wanted to.

Sorry girls, I'm a man magnet, even for men made of bronze.

One afternoon, I was hanging around my apartment, daydreaming about life with my future husband whilst watching Oprah Winfrey. I'd just finished washing and drying my clothes at the laundromat, and was about to commence folding them when the craziest thing happened. Oprah was interviewing people who found out later in life that they were gay. 

Immediately, I was struck with panic. "What if I'm gay and don't know it?" I became so obsessed with this completely irrational thought that it nearly destroyed every shred of happiness and pleasure I'd permitted myself up till then. I couldn't get this thought out of my mind. It felt foreign, like it was originating from a source outside myself. I mean, I'd never been attracted to women before. Why would I all of a sudden turn gay, especially when I adored men so much? Wait, do people turn gay or are they born that way? It was pretty clear that I was tormenting myself, pulling the rug out from beneath my own feet. Cognitively, I knew this was insane, but I didn't know how to stop. It was as if I had a built in radar detector of self-defeat, ready to crush my happiness into smithereens.

Feigning happiness while wearing itchy tights

Overwhelmed by the unsettling fear that I didn't really know myself, which quickly segued into a disturbing sense of helplessness and lack of control, I went into therapy. I can't say that therapy did much for me. After months of rehashing old issues about my sexuality (yeah, I'd been around the block only about a zillion times by the time I was 20), which only served to stir up feelings of frustration and anger toward my parents, I called it quits. The thoughts were still there and showed no sign of budging. Everything felt mechanical. What was supposed to be the happiest time in my life was painful. Ruined. Why was I so different from everyone else? Why couldn't I just be happy

Well, the problem turned out to be that I didn't feel deserving of happiness in the first place. Somehow, I'd gotten this idea that happiness was something you had to earn, that if you worked hard enough and struggled long enough, eventually you'd be rewarded with everlasting happiness. In other words, I didn't perceive myself as the source from which my own personal happiness could spring. Not surprising when you consider that we're ingrained from an early age to believe that something or someone outside of us is responsible for our attitudes and actions. "Look what you made me do!" and "Johnny hurt my feelings!" are two perfect examples of this blame-gaming. By the same token, taking credit for our success is viewed as pretentious. We owe it all to someone else, right? Whereas Gallant might say, "My bones are growing," Goofus would declare, "I'm growing my bones." It's a matter of perspective, really. If we're not the ones controlling ourselves, then who is? 

Babies...all action, no talk. No talk, no thoughts. We sure had it easy!

Long story short, by ignoring those troublesome thoughts and feelings, I quit thinking about them. Pretty cool, huh? Instead of thinking my thoughts were being thunk, I determined that since I was the one thinking them in the first place, I could just as easily not think them. I'd been making myself miserable for no reason. Actions do speak louder than words. Thoughts are the mind's words, so they can only get the best of us if we let them. If you want to change your attitude, your feelings, or your thoughts, then change what you're doing. 

Hmmm, is Mom the victim of my full diaper here?

We are not helpless victims of circumstance, genetics, or biochemistry, regardless of what the medical establishment, the pharmaceutical industry, the justice system, and society would have us believe. I'm well aware that this contradicts popular opinion, but human emotion and behavior are not diseases, except perhaps in the metaphorical sense. Attributing worry and unhappiness to genetics or biochemistry is basically just an updated version of "the devil made me do it." The good news is that just as helplessness is learned, it can be unlearned. Why give power to self-defeating thoughts and feelings? Seriously, it's about as necessary as drinking one's own urine (Is It Necessary For Me To Drink My Own Urine?), a matter of choice. (If you're offended by this, that's your choice as well). It is we who are responsible for our attitudes and our actions, not anything or anyone else. 

Chester & me, exercising our free will & self-determination in public

Because of my opinions on the subject of mental illness, especially with regard to biopsychiatry, I've been accused of being unempathetic and uncompassionate, of having never suffered through major depression myself, of being narrow-minded, and a host of other criticisms, none of which I take personally. Oh, the stories I could tell. People are free to think whatever they want to think, and what other people think of me is none of my business. The irony here is that people can and do think themselves into unhappiness, despair, and disability, as if they're not capable of thinking freely for themselves in the first place. Maybe it's a matter of whether or not a person believes he or she has free will. Self-determination, which is the essence of free will, means just that: making choices, solving problems, and taking control of and responsibility for one's own life, as well as accepting the consequences of one's attitudes and actions. As for compassion, this quote says it all for me: "Give a man a fish and you feed him for a day. Teach a man to fish and you feed him for a lifetime." Helping people help themselves to become independent is the highest form of compassion, IMO. 

Being silly is just one of  my special skills.

Without going into detail, it's taken me quite a few years and a lot of life experience to find my happy place. And, by no means does that mean I'm always ha-ha happy. Anyone who knows me knows I have a few things I could choose to be very sad about. Like sad-all-the-time-majorly-depressed-life-is-so-unfair about. At 24, I fixated on a single irrational and devastating thought that today, I wouldn't have given a second thought. It would have slid right on by. Being happy is an attitude, an approach to life that comes from a deep enthusiasm for life itself as well as the ability to keep moving on. It's impossible to be self-absorbed, imprisoned by your thoughts and fears, when you're immersed in the sensual wonders of each moment. My favorite Lao-tzu quote is "Stop thinking, and end your problems." The less I've thought about my problems, the more I've acted to change either the problem itself or my attitude about it. This aphorism by my friend, Marty Rubin, is also apropos: "We are the mountains we must cross." No doubt about it, we're our own worst enemies. Being at odds with ourselves--even on a frenemy level--is sad and wholly unnecessary, seeing as how we're stuck with ourselves for an entire lifetime.  Kind of pointless, really, when we can just as easily befriend ourselves. It's not rocket science. It's simply a matter of action.

We don't think about ice cream, we scream for it!

On a lighter note, the best part about not spending all my time thinking about my problems means I have lots more time for things I enjoy, like running. Lately, it's been so hot and humid that I've been running inside on the treadmill. Although I've watched all sorts of interesting documentaries and programs about cute puppies and kittens, I'll be glad when it cools off enough for me to get back to running outside. So much to see and experience beyond these walls. I do have one small problem, though, and it's the reason I've got to keep running. The problem is the ice cream shop that recently opened up down the street. Now I'm being confronted with the deep contemplation that invariably accompanies 24 flavors of soft serve and a dozen kinds of Philadelphia style water ice. The place has only been open 10 days, and already, I've been there four times! Less thinking means more running, and more running means more ice cream. Yeah! 

Saturday, July 26, 2014

Our Biggest Issue

Boris, in his comfy chair
Last weekend, amidst all the turmoil in this world, Boris--our beloved little 18 year old cat--died. We woke up early last Saturday morning, fully expecting to be greeted by Boris's usual "where's my breakfast?" meows, followed by him ignoring our dogs while boldly drinking from their water bowl, and then sauntering over to his comfy brown chair for a nap. Instead, we awoke to find him lethargic, confused, and very weak. Thinking Boris might have suffered a stroke, we immediately took him to the vet. The news wasn't reassuring. Although Boris hadn't had a stroke, he was severely dehydrated; his labwork revealed that he was in renal failure. The vet recommended a trial of intravenous hydration. Feeling this was a reasonable course of action, and knowing that either Boris would respond or he wouldn't, we left Little Buddy in the doctor's capable hands.

Ria's peach pancakes=pure comfort
Funked out and in dire need of some comforting familiarity, Spartacus and I hit Ria's, our usual Saturday morning breakfast spot. In between talking about Boris and guzzling strong coffee, we discussed a conversation I was involved in on Blog Catalog (BC). BC is a worldwide blogging community with an active discussion forum. I've befriended people from all over the world there, several of whom are kindred spirits that I'd love to meet in person someday. I've shared some of the most intimate details of my life on BC, things that most people don't know about me. The topics of discussion are endless. We talk about our blogs, personal lives, culture, nature, religion, politics, philosophy, history, technology, art, poetry, music, pets, travel, name it. Occasionally, the discussions get heated or trolls stop by to visit, but fortunately, the forum moderates itself pretty well. In my three years of involvement on BC, I've learned a tremendous amount about communication, how to talk open-mindedly with other people about complex or emotionally charged issues and perhaps most importantly, how not to take things too personally or myself too seriously.  

Anyhow, back to the discussion. It was centered on the observation that no one on the forum was talking about the current turmoil in the world, namely the bombing of that Malaysian Air passenger plane over the Ukraine or the Israeli-Palestine conflict in Gaza, the question being whether this lack of interest was an isolated phenomenon or reflective of society at large. In other words, were the world's big issues somehow less significant than our personal lives? Shouldn't we be more focused on things bigger than ourselves?

Visiting with Boris
Later that afternoon, we visited Boris at the vet. A tech brought him into the visitation room, swaddled in a wooly green blanket. He didn't seem seem bothered by the IV line above his paw. He meowed in recognition when he saw us, and we took that as a sign he was responding favorably to the hydration. He surprised us by wriggling out of his blanket to explore the room. I took lots of pictures of him and Spartacus. It was a very good 45 minutes. Feeling somewhat reassured, we went out for dinner, both of us thinking Boris would be coming home the next day.

At 7 o'clock the next morning, the vet called. Boris's condition had deteriorated overnight and he was now minimally responsive. He wasn't going to make it. We jumped out of bed and headed over there, hoping that Boris could hang on long enough for us to cuddle him one last time before saying goodbye. 

Anguish and letting go
They brought him out, wrapped in the same green blanket, but this time he looked terrible. Ragged. Worn out. Breathing hard with his mouth wide open. It was awful. Spartacus and I both wept inconsolably. Even though Boris was very old and we knew this day would eventually come, we still weren't prepared for it. What a profound experience it was to cradle this majestic, fiercely independent living creature who'd brought so much joy into our lives as he breathed his last few breaths. Boris lived a good life and died a gentle death. I'm grateful that he didn't suffer through a prolonged, painful illness and that we were able to comfort him in his final moments. 

I'll be honest. The only big issues in my life concern the people (and pets) I know and love. I am much more interested in sharing experiences and connecting with other people than worrying about what's going on in the world. That doesn't mean I deem war and suffering as insignificant or that I lack compassion. It means I understand that the only control I have is over myself and my own actions in life. Kind of like that old TV commercial which went something like, "We don't want to change the world, we just want to change your oil." Being an agent of change isn't about changing other people anyway. We're all constantly changing the world through our own spheres of interaction and influence, just by being here and living life. Nearly all of the problems in the world result from fear generated by people minding other people's business instead of tending to their own. Human behavior hasn't really changed much throughout the millennia. There has always been war, hatred, famine, torture, and poverty. It's just that now there's no escaping the nosy neighbor media. 24/7, it's there in your face, like Gladys Kravitz on steroids. As long as people concern themselves with what everyone else should be doing, instead of focusing on doing what good they can in their own lives, there will be fear and judgment and conflict and injustice.

L-->R: Me, Nick, Jim, & Rory
Monday, the day after Boris died, was my sons' 24th birthday. Back in May, Nick bagged his first wild turkey on a hunting trip with his dad, Jim. This was the first time Nick had hunted since high school, and his birthday wish was for us to have Thanksgiving in July with roast wild turkey and all the trimmings. By us, I mean his twin brother, Rory, Jim and his girlfriend, Glenda, his friends, Chad and Tiberius Funk, Spartacus, and me. Quite a crowd, huh? Coincidentally, Nick's been struggling with a lung infection that hasn't responded to oral antibiotics, pretty typical for someone with cystic fibrosis. So, on Monday, while I was baking birthday cake and roasting his gorgeous 15 pound bird, Nick was at Emory, getting a special catheter placed in his arm for a couple weeks' worth of home intravenous antibiotic therapy. Such is life. That evening, amidst all the turmoil in the world, Nick and Rory celebrated their birthday, surrounded by family and friends whose only goal was to thoroughly enjoy ourselves and each other, our biggest issue being whether or not to have a tiny sliver or a bigass slice of German chocolate cake.