Tuesday, January 31, 2012

Duty and Obligation, Faith and Patriotism: A Five Year Old's Ethical Perspective

      This is the conclusion to yesterday's "Writing By Osmosis", in which my father describes how his burning desire to learn to write provided the impetus for convincing his parents to allow him to attend first grade a year early. (If you haven't read it, please click on the link below). In today's passage, Dad recounts two important life lessons he learned while innocently playing hooky and the game of Red Rover, lessons which were strongly influenced by Poland's long history of occupation, as well as the political and religious climate at the time. I find his cultural and historical recollections fascinating and relevant; they are snapshots of a time and place foreign to most of us, yet strangely familiar. Perhaps this is because we were all children once, and the honesty and inquisitiveness with which children approach life is something which, thankfully, never seems to change...

     "In the beginning, I did not know the difference between play and schoolwork. One day, I excused myself to go to the outhouse behind the school building, and on my way there, I met my playmate, Tadek, the janitor's son. He had a little frog, and we played for a short while, watching it jump. Then, we went to the river bank to see if it could swim [the Czarna Przemsza (CHAR nah PZHEM shah) river was less than a block from the school house]. I don't remember who found us there. The next thing I remember was being in our kitchen, with my father sitting on the maid's bed, and me lying face down across his knees. He applied two token, flat-hand slaps on my bottom, which were not painful at all, their symbolic significance being to impress upon me the fact that school was not "take-it-or-leave-it" play, but a duty and an obligation. This is the only time in my life that I remember being spanked by my father, or anybody else, since in the Polish school system, physical punishment was not used at any level. I had heard tales of horror from children attending other schools that some teachers were using rulers to slap their hands. But, this was illegal, a relic of the Russian school system, which was phased out in 1918.
    My second disciplinary encounter with my father took place in another context. I was taken to his office as a result of an act I committed during PE class. We were playing a game of przecinane wojsko (pzheh CHEE nah neh VOY sko), which translated into English means "cut through the army"; it is equivalent to the American game of Red Rover. I was acting in the role of the attacker. As I ran across no-man's land, I brandished a wooden toy dagger which I had concealed under my shirt, hurling myself across the enemy line, my intention being to frighten and intimidate the enemy, as opposed to using it as a weapon.
     In order to understand why I did what I did, it is necessary to know the indoctrination to which I was exposed, both at home and in school. I remember very well when there was a change of currency. A new coin was minted, bearing the Latin inscription: "Salus Rei Publiac Suprema Lex Est (the welfare of the common-wealth is the supreme law). My father had translated this to me in simple words, explaining that the sacrifice of an individual for his country or team was indeed a proper guideline for behavior. In the mid 1920s, Poland's independence was still less than ten years old, after 150 years of non-existence as a political entity. Patriotism and pride in this newly won freedom and national identity was impressed upon us while we were still in our cradles. Readiness to defend that freedom was thought of as the most desirable trait in a boy's character, and veneration of our national heroes was inculcated in our young minds, starting in first grade.
     When I was taken to my father's office, I was not awed by the place because, at one time, it had been our bedroom to which the living room was adjoined. The telephone was located in that room, so I was familiar with it from as far back as I could remember. However, the man I had to face seemed to be quite different from my daddy. The stern look in his light blue eyes cut like steel, and was enough to make me dissolve into tears. My defense was that wielding the toy dagger to intimidate my opponents on behalf of my team was right and noble. This time, my punishment came in the form of a lecture, a very long lecture which I thought would never end. When my father/principal finally finished talking, I was left with an indelible impression, a lesson to be remembered the rest of my life. I do not recall my father's exact words, but the gist of it was his admonition that "the ends do not justify the means."
     I wonder if my father suspected that all the patriotic indoctrination I was receiving might be getting out of hand, leading me to adopt a chauvinistic, narrow-minded frame of reference. Perhaps he made a conscious decision that some de-programming was in order. Shortly after this disciplinary confrontation, he took me to the Russian Orthodox church. This in itself was a shocking thing to do at a time when the vestiges of the Russian occupation were still very visible. The Cerkiew (TSER kyef) was such a vestige. It was built before the war by the German industrialist owner of a cotton-spinning mill, as a token of allegiance to the Russian government. It was considered an eyesore, and in the mid 1930s, it was torn down. First of all, the presence of the onion-shaped steeples at the intersection of the city's two main thoroughfares was especially objectionable. The other problem was that there was no Russian Orthodox congregation to speak of; the handful of remaining faithful individuals could not support such a big church.
     When my father took me to the hated Cerkiew, he did not say anything. I asked him questions, wanting to know what kind of God the Russians worshipped. His answer was that the God and the Mother of God were the same as ours (Roman Catholic), except that the way they worshipped was different. Without giving me any lectures or ecumenism, my father planted a seed in my mind, the idea that God is one. I am not sure if he knew what he was doing, but in retrospect, I think he did because before I was ten years old, he'd taken me to a Protestant church as well as a Jewish synagogue. The fact that I have never been an altar boy may have also had something to do with my father's religious convictions. I think he was, at heart, what nowadays one would call a Unitarian Universalist."

     Seventy-seven years later, my father was still asking, "Why?" and "How?" His natural, child-like curiosity about the world around him was a stable part of his personality, infecting those of us who were lucky enough to have known him. He was the epitome of a life-long learner, but his thirst for knowledge did not die with him; he imparted it to his legacy. Although Dad's physical body died a long time ago, his spirit is still very much alive, and I can't think of a better way to honor him than by sharing his extraordinary story through his own timeless and timely reflections.

Writing By Osmosis 

Monday, January 30, 2012

Writing By Osmosis

   Today, I welcome my father, Władysław Piotr Mazur, M.D. (vwah DIH swaf  pee O tur  MAH zoor), affectionately known as Bartek, not only as my first guest blogger, but a posthumous one at that. This is an excerpt from his unpublished autobiography, written sometime in the 1990s. Everyone who ever met my father and heard his tales of surviving WWII as a young man in Poland would end their conversation by saying: "You really should write a book!" In 1987, my first husband, Jim, and I gave him a book on creative writing, and encouraged him to tell his story. When my father was very young, his family moved west from his birthplace in Stary Sącz (STAH rih SOHNch), an ancient city located in a valley amidst the Tatra mountains near the confluence of the Dunajec (doon EYE ets) and Poprad (PO prahd) rivers in southern Poland, to Sosnowiec (sohs NOV yets), an industrial town in the Silesian highlands near Katowice (cat oh VEE tseh). In this passage, he describes his overwhelming desire to learn how to write, and how, at the age of five, he convinced his parents to permit him to go to school. With regard to the process of attending school and learning to write, he brilliantly and succinctly captures the inner workings of a child's mind.

     "The year of 1926 was an important one in my life, since it was in September of that year that I first went to school. Being only five years old, I was technically not old enough to go to school. At that time in Sosnowiec, there was no kindergarten, no classroom which would provide an appropriate level of education for a five year old. I was not aware of the tribulations of study, homework, or examinations which would confront me. All I knew was that I was dying to go to school so I could learn to write. I was fascinated by the ability of adults to write what they were saying by scribbling on paper, and then, to read aloud what they'd just said, word by word, using their scribbles. I tried using the same technique, but it did not work. Undefeated by these early attempts at writing, I persisted in my scribbling, and in time, my scribbles looked almost identical to those produced by my father. Unfortunately, they were not identical enough, because they were ineffective in recording my speech or my thoughts.
     On visual inspection, my scribbles presented an appearance which I would now compare to an electro-encephalogram, very similar to my father's handwriting. My parents tried to humor me at first by "reading" my scribbling, using their own imaginations in selecting the subject of the story, and initially, I was satisfied that I had succeeded in mastering the "secret method", the key to the skill of writing. In order to be sure that this was really the case, I employed the double-blind approach in verifying my conclusions. I took a sample of my handwriting, and showed it to my grandmother, who "read" it. The next day, I gave her the very same paper, but she read something entirely different. Then, I showed it to my father, and he produced yet a third version, reading the same text. I realized then that they were faking, after which I abandoned my efforts to acquire the skill of writing by osmosis or the trial-and-error method. I insisted that I must go to school. "Bugging" is the best word in the English language to describe the strategy I employed in influencing my parents, their resistance already having been lowered by my previous requests for them to read my stories, scribbled in my notebook.
     My father was the principal of a training program, or seminarjum (seh mee NAR yum), for elementary school teachers. [Note: this program had nothing to do with the seminary or theology]. Attached to the seminarjum was a four grade elementary school, where the student teachers could practice pedagogy. We lived in the same building, our apartment being on the same floor as the first grade. There are reasons why it was possible for a five year old to be admitted to the first grade, when a minimum age of six years was the prerequisite. Nowadays, I guess, it would be called nepotism. If this was true, however, it was only in relation to my admission to the school, not to the subsequent five years of education I received there. At this juncture, my father assumed a dual role: that of my daddy, and that of the supreme commander of an army of people who treated me with great deference.
     My mother's anxiety was alleviated by the fact that she could watch me during recess from our dining room window. She thus describes my first day in school: '18 September 1926--For Bartuś (BAR toosh), an important day; for the first time, he went to school. Although he has just completed his fifth year, he begged to go to school. Professor Czajkowski (chy KAWF skee) gave him encouragement to come to his class. After the first period, Mommy watched Bartuś playing in the schoolyard from a window. He appeared to be gay and pleased, and plays joyfully with his colleagues. The second period is gymnastics. He will have a lot to tell us about it...' "

     Later this week, I will post the conclusion of Dad's reflections regarding his early days in school, along with the life lessons he learned while playing hooky and Red Rover. In reading his autobiography, it is clear that our writing styles are similar, the direct result of mitosis and meiosis, and quite possibly, a little osmosis.
[About the pronunuciations...I personally like to know how to pronounce what I'm reading as I'm reading it, and this is why I include parenthesized phonetics after foreign words or phrases, instead of making multiple footnotes.]

Part Two: Duty & Obligation, Patriotism & Faith: A Five Year Old's Ethical Perspective 
My father, helping me sample my first Bloody Mary, as my maternal grandmother, Nanny, looks on (1963)


Sunday, January 29, 2012

Good Fences Make Good Neighbors

    Regardless of whether my family lived in Ohio, Kansas, or Georgia, we always had lots of interesting neighbors, mostly good ones. The first neighbors I remember were the Naegels and the Mullers. They lived on opposite sides of us in Cincinnati, and both families became good friends of ours. Tracie Naegel used to babysit Emi and me. If the weather was nice, she'd take us for long walks down Grandin Road, usually to go and visit old Mr. Ernie. Mom, Emi, and I used to visit Mrs. Naegel in the afternoons. I remember she had a special drawer in her kitchen, which she kept filled with windmill cookies, seemingly just for us. Mrs. Naegel smoked, and occasionally, Mom would join her for a cigarette. This was around 1967, when I was in first grade. The famous "Like Father, Like Son" anti-smoking public service announcement, which depicted a father and his young son doing ordinary things together, such as painting their house and washing the family car, had just hit television's airwaves. It began with the aforementioned images of togetherness and the announcer remarking, "Like father, like son." The final scene showed the two of them, sitting beneath a tree. The father lights a cigarette, carelessly tossing the almost full pack onto the ground, next to his son. The little boy reaches for the cigarettes while his father isn't looking. The scene fades out with the child contemplating whether or not to join his father for a smoke, while the announcer queries, "Like father, like son?" This was an extremely successful commercial, which I believe led to legislation making it illegal for tobacco companies to advertise on television. It was also successful in arousing a great deal of panic in me. I was secretly terrified for my mother, who technically was not a smoker. In reality, she might have had a cigarette once every six months, making her more of a social smoker, but this was a concept my five year old mind was not yet capable of grasping. One day, as she was driving me home from school, I implored her to stop smoking with Mrs. Naegel. I must have been very convincing because I don't recall ever seeing her smoke again. In 1970, my family moved to Kansas. Shortly after that, we learned Tracie had gotten killed in a car wreck, making her the first person I ever knew who died.
     The Mullers had two adopted children, Michael and his sister, Marty. Without a doubt, they had the best toys of all the other kids we knew. Michael had push-pedal cars that you could actually sit in, and they also had a Close'n'Play record player on which we'd listen to stories about Mary Baker Eddy. The Mullers were Christian Scientists, and Mrs. Eddy was the 19th century founder of that faith. This was my first exposure to a religion other than Catholicism, and I thought Michael and Marty were lucky to be able to listen to Mass on their record player, instead of having to go to church. Obviously, my understanding of how other people attended to their religious beliefs was still quite primitive in nature. After moving to Kansas, we learned that the Mullers were getting divorced because Mr. Muller was homosexual. I didn't understand that, either, but my parents explained that sometimes, men fall in love with men, instead of women, and then, it made perfect sense.
     We lived in Kansas from 1970 to 1974, and our neighborhood was an international community of state hospital employees, mostly other doctor's families. Emi and I quickly made friends with the Gonzales kids next door. Their daughter, Marcella, was a year younger than me, and she had two older brothers, Ricky and Chucho, the latter of which I had a huge crush on. We used to hang out in their basement to watch Dark Shadows. Ricky and Chucho would hide inside these giant storage crates that doubled as couches, pretending they were Barnabas Collins, asleep in his coffin. This stunt never failed to scare the living crap out of me. One afternoon, Ricky, Emi, and I took some old tomatoes and played tic-tac-toe on the side of the Garcia's house, directly across the street. I'm not sure why we chose to do this in broad daylight. It didn't take long before our parents got wind of what we'd done, and we had to apologize to the Garcias and clean up our mess.
     A couple of years later, Emi and I built a huge fort in a mud pit that was located underneath a willow tree between the Nunez's (noon YEZ) and Zubowicz's (zoo BO vich) houses. We had assembled an impressive stockpile of dirt bombs and makeshift weaponry. My brothers and sisters and I were not permitted to play with toy guns, but somehow, an air gun had come into our possession. Emi and I needed a place for target practice, and since the Nunez's were out of town for the weekend, we figured we could use the far side of their garage, it being the closest facade to our fort. After shooting multiple rounds of mud mixed with a little dog poo, we realized we had a real problem on our hands. We devised an elaborate alibi in which we'd witnessed a bunch of unruly high school kids who had circled the block in their red convertible, stopping off briefly to vandalize the Nunez's house. To our surprise, no one questioned our story, although the Nunez kids, Nerita and Julian, remained highly suspicious.
     Given our prankster propensities, we were fortunate to live in a neighborhood where everyone else had kids who had done something stupid once or twice. No one seemed to hold a grudge. When my big sister, Edina (eh DEEN ah), got married in 1972, our neighbors opened their kitchens and bedrooms, assisting in preparing and storing food for her outdoor reception, and accommodating some of her guests. Mahmoud (MAH mood), my brother-in-law, is Iranian, and we met his family for the first time, just before the wedding. Despite the language barrier, our parents communicated mutual approval of the marriage through a week of ongoing celebration; it was evident to us all that Edina and Mahmoud had cultivated a love and respect for one another that transcended time and culture. They've been married ever since. Although Mahmoud was not a Christian, much less a Catholic, Father Joe allowed him to take Holy Communion with my sister, kicking off the best wedding I've ever attended, with Polish and Persian music, dancing, and feasting that lasted the entire weekend.
     When we moved to Columbus, Georgia in 1974, we were stunned when our new neighbor, a girl named Kibby Taylor, greeted us by saying, "Hey!" In Kansas, we said "hi", instead of "hey", "you guys" instead of "y'all", and "pop" instead of "Coke." To us, "Hey!" sounded confrontational. Kibby and our neighbors across the street both had trampolines, and since none of my siblings had ever jumped on one before, we couldn't wait to get over there. Colonel and Mrs. Taylor were quite a bit older than our parents, and because Kibby had siblings that were much older than her, she was like an only child. She even had her own room. Next door to the Taylors lived a reclusive couple named the Burgesses. Kibby told us that the Burgesses didn't like kids, and this immediately prompted an entire summer of spying on them. We'd wait until it was dark, and then we'd creep into their back yard. We'd prop ourselves up on a slope where we could see Mr. and Mrs. Burgess in their den, watching TV. We made notes of our observations, speculating about their evil intentions. The Burgesses must have been wise to our efforts at espionage because one evening, as we approached their porch to play ring and run, we could see Mrs. Burgess, pressed up against the wall, peering at us through a glass panel next to the front door. After that, we left them alone. A creepy older man who called himself Jesus used to walk his dog down the court we lived on. He actually lived several blocks away. Instead of walking his little poodle, he would carry it in his arms. Jesus wasn't friendly, and there were rumors in the neighborhood that no one who entered his house ever came out. Kibby, Emi, and I tried spying on him, too, but I was so afraid of Jesus that I had to bow out of the mission.
     After I got married, my first husband and I lived in a quadraplex near Emory. Our upstairs neighbor was a nightclub DJ, named Mr. Charles Smooth. Mr. Smooth had a live-in girlfriend and a baby, although I'm not sure if it was his, and Jim and I spent countless nights, intrigued and amused by their noisy love-making. Unfortunately, Mr. Smooth had a terrible temper. One afternoon, we heard his girlfriend screaming and the baby crying, accompanied by violent thumping noises. Mr. Smooth, who appeared to be mocking the woman, was also yelling, "What about me? WHAT ABOUT ME??????" We called the police, and Mr. Smooth was promptly replaced by quieter neighbors.
     In 1988, Jim and I bought our first house. We lived in Clarkston, an Atlanta suburb that is just outside I-285. The neighbor to our right was Mrs. King, who'd lived in her house for over 40 years. We learned that the woman who'd previously owned our house had also lived there for decades, raising six children in a 900 square foot, 2 bedroom house. Mrs. King used to bring us homemade fruitcake, generously soaked in booze, as well as crocheted Kleenex box covers, the kind that have baby doll heads knitted into them. Her daughter, who was our age, developed what appeared to be crush on Jim. We caught her a few times, staring longingly at him from her mom's driveway as she was getting ready to leave for work. Our left-sided neighbors were ghastly. The woman who rented the place was running some sort of day care operation, only her clients came and went all night long, honking incessantly on their horns beginning at three in the morning. I summoned up the nerve to confront a particularly persistent honker one summer morning, but the lady just sat in her car, staring at me while chain-smoking and continuously blasting her horn. We probably should have just called the police. Thankfully, the local authorities took notice of what was really going on inside that house, and that dreadful neighbor was soon evicted.
     When I was accepted into medical school in 1997, Jim, Nick, Rory, and I moved to Macon, Georgia. We lived on a court, and there were lots of kids for the boys to play with. They befriended a mean little red-headed boy named Kevin Pope, whose parents were not shy about expressing their racist views. Kevin was in the same grade as the boys, and they went to the same elementary school. Nick and Rory developed a love-hate relationship with Kevin; they were sort of stuck with him. We didn't know it at the time, but Kevin teased Nick and Rory mercilessly about having cystic fibrosis, calling them "retards." His parents, however, were very nice to the boys. Befitting the general theme of their family, the Popes had an awful mongrel dog named Icky, who was normally corralled in a separate room when the boys came to visit. Kevin decided let Icky out one day, and he immediately bit Nick's hand. Kevin's parents were appropriately apologetic, but looking back, I'm not sure if they were genuinely concerned or whether they were afraid of being sued. We had Nick's hand examined, and since Icky's shots were up to date, we deemed the dog-biting incident a non-issue. Years later, Kevin sent the boys friend requests on Facebook. He is now a born-again Christian; hopefully, he is now emulating Jesus, instead of Icky.
     Four years later, we moved from Macon back to Atlanta. I'd just finished medical school and was beginning my surgical internship at Emory. Our first neighborly encounter was with Terry, the curmudgeonly middle-aged man who lived across the street. As Jim was backing the U-Haul truck into our carport, Terry came rushing out across his manicured lawn; we thought he was coming to welcome us to the neighborhood. He curtly introduced himself to Jim, and Jim reciprocated. Terry then admonished, "Well Jim, just make sure you keep your truck off my grass!" Apparently, our truck had brushed a two inch strip of Terry's prized grass, adjacent to the curb. We soon noticed that Terry mowed his grass every other day, frequently measuring it with a small ruler. It was ridiculous. When school started that fall, Terry began accusing our sons, who were then in the 6th grade, of depositing packages of salad dressing in his mailbox as they passed his house on their way from the bus stop. His allegations were preposterous; Nick and Rory didn't eat salad at school. Both of us were infuriated. One night, Jim and I had a few glasses of wine after the boys were in bed, and got to talking about Terry: his un-neighborliness, his permanent scowl, the constant mowing and measuring of his stupid grass, and his escalating complaints about Nick and Rory. We decided to give him a little taste of his own medicine. Donning black jackets as a disguise, we armed ourselves with a box of rock salt,  hoping to make a few brown spots in Terry's yard by sprinkling handfuls of it, close to the curb where Jim had previously violated his precious grass. The final result was disappointing, but the revenge was still sweet. Terry had crossed the line by making false accusations about our kids, officially making him the worst neighbor ever.
    In his early 20th century poem, Mending Wall, Robert Frost questions his neighbor's ongoing assertion that "good fences make good neighbors." He laments the annual springtime rebuilding of the stone wall which separates their properties, noting that neither of them own roaming livestock, only harmless apple and pine trees:
Before I built a wall I'd ask to know
What I was walling in or walling out,
And to whom I was like to give offence.
Something there is that doesn't love a wall,

That wants it down.
     Although I espouse a generalized contempt for most barriers, especially the cultural kind, I must admit that Frost's neighbor was prophetic in his assumption that good fences make good neighbors. Nowadays, we're often too busy to get to know our neighbors; it requires time and effort. Presumably due to this loss of daily interpersonal interaction, we've eroded into an increasingly litigious and paranoid society, preferring to sue our neighbors, instead of using common sense to resolve our differences. For all the brilliant advances we've made in communication technology, it seems we've forgotten how to talk to each other. Obviously, establishing boundaries is an integral part of any relationship. In the "Like Father, Like Son" commercial, we were left hoping that the father would gently discipline his young son about touching his cigarettes, and in doing so, would plant a seed of awareness that his own smoking was cheating both of them out of time spent together. Those were the days, my friends, those were the days. I feel fortunate to have grown up in a time where the crime still fit the punishment, where playing tic-tac-toe with old tomatoes on your neighbor's garage mandated a sincere apology and a thorough clean-up, not a lawsuit. Above all, I feel fortunate to have been raised in a family that embraces diversity, instead of fearing it. Brad and I are moving back to Atlanta next month. Relocating means new neighbors, a chance to be part of a new community, and already, my cautious optimism has me contemplating "where it is we do not need the wall."

Mending Wall by Robert Frost (1914)

Saturday, January 28, 2012

Goodbye, Turner McCall Boulevard

     It's Friday afternoon, January 27, 2012, and I just made my final exit from the hospital where I've worked for the last year and a half. Like Dorothy in the Land of Oz, I've reached the end of my yellow brick road. Although my traveling companions don't include scarecrows, tin men, or cowardly lions, I've been fortunate enough to meet the Wizard of Floyd Medical Center, conveniently located on Turner McCall Boulevard. The wizard's name is Sean. He's a gloriously gruff and grumpy nurse who runs the show in Emerald City, otherwise known as the Miracle Center's outpatient pre-op area. He does not believe in mincing words, and personally, I find this trait refreshing. He is a curmudgeon with a heart of gold, and you always know exactly where you stand with him; just don't stand too close, especially if you have a runny nose or a cold (love you, Sean!) Here in Emerald City, we don't have any witches, but we do have the Emilys. Emily P is Sean's right hand woman, although she's often perched at his left side at the nurses station desk. She is whip-smart and insightful, and I truly hope she will become a Mommy one day soon. Emily C, who works weekends as an ER nurse, is married to a detective, and they have a little boy who looks just like Charlie Brown. Ann, Kim, Darlene, and Cara round out the pre op crew. In order to chat with these busy gals in their cubicles, which are positioned next to the doctors' computer area, you have to peek through a wall of plastic foliage, designed specifically to keep certain annoying anesthesiologists out of sight and out of mind. We have an excellent team of recovery room/block nurses, including but not limited to, Jan, Kerin, Fayla, Sherry, Katie, Kim, and Jamie, all of whom I believe could probably perform the nerve blocks themselves. They have really made doing outpatient regional anesthesia a pleasure. The intraoperative nurses and techs, Shana, Michelle, Marcellus, Amanda, Jennifer, Chris, Tracey, Kimie, Kerry, Teresa, Megan, Tracy, Jenifer, Rachael, Regina, Phebe, Lisa, Ginger, and Stacy all demonstrate terrific compassion for our patients, as well as the warped sense of humor necessary for surviving life in the operating room. Jacklyn, Lori, Cathe, Toni, Gayle, and Susan keep our patients moving along through the recovery room. I know I've left someone out; it's a little overwhelming to mentally gather all the names and faces of people who've made this part of my job so enjoyable...I hope you all know how much I appreciate and respect you.
     I work with wonderful anesthetists, both in outpatient and inpatient. There is Ron, a German-Jewish immigrant whose parents gave him up for adoption just after WWII; he lost relatives in Mathausen, which was where my grandfather died. He lives in a log cabin with a menagerie of goats and rabbits, and is one of very few liberals in this town. He is really gifted at performing spinals. We have Wes, who charms children to sleep for their tonsillectomies and myringotomies by singing them, "Happy Birthday." I recently found out that Ann, who's especially fond of intubating with a Miller blade, was an officer in the military, giving me an entirely new perspective on her...I love it! I've always been intrigued by Stacy's wedding ring, the inscription of which looks to be Hebrew, but I've never asked her about it. She's a little spitfire of a woman, and I've enjoyed my conversations with her about kids, painting, and writing. I knew Ken in my previous life at Emory; he splits his time between Crawford Long and the Miracle Center, often riding to Rome on his motorcycle. On the inpatient side, there is Ben, who kindly offered many hours of his time to help Brad and me when we moved here. He is genuinely one of the nicest people I have ever met. He penned a witty guidebook for residents and anesthetists rotating through Cooper-Green Hospital in Birmingham, AL, which was where he did his physician's assistant training. Later, he was one of my anesthesiologist assisant students at Emory. Since he and I are both aspiring writers, we spend a lot of time discussing our craft, as well as religion and philosophy. He's been an ongoing source of support and encouragement for me. Jessica, also known as Sunshine, is jokingly referred to as our token black anesthetist. She possesses a wickedly dry sense of humor, and has a darling, precocious 3 year old son. She is truly a kindred spirit: liberal and liberated. Judy is from Kansas, like I am, and she has become a dear friend. She has a husband who's battling Parkinson's disease, and her commitment to him has been an inspiration. I hope that one day, she will finish her bathroom remodeling project. Spaghetti Joe is known for his uncanny ability to entangle every single IV line and cord that issues forth from his patients, as well as for his surgical scrub cap, the back bowtie of which magically rotates toward the front of his head as the end of his shift draws near. It's almost like a sundial. Paul has a son with autism; he and I share an understanding of what it's like to raise kids with chronic illness. He likes to deer-hunt, and last year at Christmas, he shared with all of us the most delicious venison kielbasa I've ever tasted. He's had a run of bad luck with ceiling leaks and tornado damage, and I hope 2012 is much better for him and his family. Tony amuses us with stories of his brilliant, chess-playing five year old grandson, whose family recently moved to Georgia from Australia. This kid has some of the most profound insights, and I hope Tony is writing them all down. His family is blessed with the genes for longevity, and I will miss hearing about how his stubborn, determined, 90-plus year old father is getting along. Cliff, a die-hard Packers fan, and his wife, Donna, an OR nurse, travel to the beach most weekends, and during last January's snowstorm, their sunny Facebook pix inspired an insane amount of envy amongst those of us stuck in the hospital. They are very much in love, and are not shy about PDA (public displays of affection). Cass, who is extremely slender, wears long underwear and wool socks under her scrubs all year round to ward off the chilly temperatures in the operating rooms at Floyd, which are kept unnecessarily cold. Like me, she is a fan of cottage cheese. Her commitment to keeping the schedule moving along is nothing short of impressive. Eddie, who has another life as a farmer and beekeeper, brings us raw honey and beef, entertaining us with tales from his hives and pastures. Grumpy Doug grew up in Pennsylvania, loves to work the freezing cold neuro rooms, and has "Iron Man" as his cell phone's ring tone. Michigan Doug is my age, so we have a lot of pop culture in common. His accent reminds me of my Canadian cousins, and I love that he can't wait to get home at the end of the day to "visit" with his wife, Eleanor, in front of a roaring fire. Dave and Heather are our resident married anesthetist couple; I knew both of them from Emory. Lani, whose baby was born in November, experienced the trials and tribulations of parenthood when her child had to be lifeflighted to Children's Hospital in Atlanta for repair of  twisted intestines; she's back at work, and her baby is doing just fine. Johnny and Richard both commute quite a ways to work everyday, and together with Alison, the newest addition to the group, they round out the complement of Miracle Center anesthetists.
     I haven't worked the inpatient side of the hospital too much recently, but that was the starting point of my trip down the Miracle Center's yellow brick road. Brenda is the first friend I made, after surviving a terribly long recovery room resuscitation together during one of my first nights on call. For some reason, she thought I hated her, and was shocked when I sent her a FB friend request the following day. There's a silly rule restricting nurses from the doctor's lounge, where the coffee dispenser is, and because of this, I've become Brenda's coffee bitch...she requires 4 containers of half-and-half per cup. She and her husband have become good friends of ours, and since they spend a lot of weekends in Atlanta, I know we'll see them there. From pre-op to recovery, I've come to know the Tonyas, Minnie, Kim, Jenny, Kelly, Kristy, Angie, Kandy, Holly, Vickie, Kristie, Melody, Connie, Sonya, Christy, Mike, Gia, LaDonna, Edith, Jessica, Sara, Donte, Penny, Stacy, Missy, Patrick, Shelita, Jerry, Jane, Gayla, Jennifer, Terri, Tracey, Denise, Robbie, Beth, Cathy, and Elaine. Together, we've shared many perioperative adventures, as well as a few misadventures. Again, I know I've omitted some important names; given the fact that I am terrible at remembering names, I am actually impressed that I've done this well so far! In GI Lab, there are Dawn, Scarlett, and Bobby, as well as another nurse whose name escapes me at the moment, all of whom have been of great help in getting our often incredibly sick patients prepared for their EGDs, colonoscopies, bronchoscopies, and ERCPs. I will always remember trekking up the back stairs to labor and delivery, located in the Miracle Center's Pleasure Dome, where Shelley, Ashley, Kris, Kay, Rhiannon, Maggie, Mindi, Jill, Tammy, Brandi, Kristy, Kierston, Amy, Stephanie, Connie, Alison, Jessica, Gina, Sandi, and Susan are a just few of the friendly faces who assisted me with placing epidurals, calming frantic parturients and their families, and getting through the seemingly mandatory 3 a.m. C-sections during my nights on call.
     In concluding this incomplete summary of my gratitude to all the amazing people I've had the opportunity to work with, many of whom I am proud to count among my friends, I realize that it's written in present tense. I'm guessing it won't seem real until I clean out my locker this afternoon and shred the patient lists I've kept since day one. I am hoping that I will be remembered as someone who cared deeply about doing the right thing for my patients, as well as being a relatively low-maintenance doc, someone who was maybe a little unconventional, but generally easy to get along with. I've thoroughly enjoyed my family here at Floyd Medical Center, and am especially glad for social networking right now. It has definitely revolutionized the way I keep in touch; perhaps that is why I don't view people I've known or worked with in the past tense. Once again, I'm off to see the Wizard, starting down a new yellow brick road.  I can only hope that my new traveling companions will be as personable and supportive as the ones I've gained here. The older I get, the smaller this world seems. Who knows? We may just cross paths again one day very soon.

Thursday, January 26, 2012

The Kids Are All Right...Right?

   Given the fact that finding a good babysitter is one of parenthood's most challenging tasks, my poor mother really had her work cut out for her. I am the oldest of her four biological children. My sister, Emi, and my brothers, Adam and Peter, are two, six, and eight years younger than me, respectively. I also have two older half-siblings from my father's first marriage who are ten and twelve years older than me: my brother Leszek (LEH shek), and my sister, Edina (eh DEENA).  When I was very small, Mom's sister Lynda, who is twenty years her junior, lived with us in Cincinnati,  and she, Edina, and Leszek were my first babysitters. Based on some of the stories I've heard, babysitting Emi and me was no easy job. For instance, Lynda awoke one morning to find me finger-painting my crib with my own poop. I discovered that Edina's Clearasil was also a wonderful artistic medium to work with, and one afternoon, I squeezed an entire tube of it onto a chair in our living room. Emi and I used to deliberately eat pennies when no one was looking, and it's a wonder they all passed through without getting lodged in our digestive tracts. Lynda reports that I embarrassed her one day while we were sitting in her car at a stoplight. It was a warm afternoon, and Lynda's windows were rolled down. I was just learning to talk, and began pointing excitedly at a truck passing by, exclaiming, "Look, Hattie Lynda, a FRUCK, a FRUCK!" Hearing the expurgated version without the "r", the people in the car next to us shot Lynda disapproving glances, shaking their heads in disgust at my wanton use of expletives.
     In 1970, we moved to Osawatomie, Kansas. By then, Adam was two, and Mom was pregnant with Peter. Mom was the director of psychiatric nursing at the state mental hospital across the street, where both she and Dad worked, and she recruited some of her nursing students to babysit us. Ruth was our first student nurse babysitter, and she was shy and nice. We really liked her. After Ruth graduated, there was a succession of other nursing students, and overall, I think Adam, Peter, Emi, and I were pretty well behaved with them. Oddly, the best part of babysitting nights were the kid-sized TV dinners Mom bought for us, a tradition which I later repeated with my own sons. In terms of securing a babysitter, New Year's Eve was considered a special case. For some reason, my Polish grandmother, Babcia (BOB cha), whose English was very limited, was charged with taking care of us on that particular holiday. On New Year's Eve in 1972, Emi and I barricaded ourselves in the kitchen, where we generously dotted the ceiling with wet toilet paper wads, a delightful trick which Leszek had previously demonstrated for us. We thought this would be a perfect way to ring in the new year, but Babcia felt otherwise. She immediately swept away all traces of the festive evidence with her cornstraw broom.
     In the mid 70s, there was a mass migration of families we knew in Osawatomie to Columbus, Georgia, presumably because a new state psychiatric hospital had opened down there. Our neighbors, the Yates, moved to Columbus shortly after we did. Emi and I were playmates with the Yates girls, Peekie and Buffy, both of whom I think were adopted. They had older brothers named Chuck and Rob, and Chuck was a good friend of Leszek's. Chuck was married to a Japanese girl named Keiko, and they lived in Florida. Rob, who was a few years younger than Chuck and still living at home, agreed to babysit us for several days when my parents went out of town for a medical conference. This was sometime around 1977, when I was in 7th or 8th grade. We were pretty excited about having a guy babysitter, especially one that was going to stay overnight in our house. He seemed like a normal guy. The first night my parents were gone, Rob sat Emi, Adam, Peter, and me down on the carpeted stairway in the hall, and calmly informed all four of us that we were, without a doubt, destined for hell. Unbeknownst to my parents, Rob had become some sort of wacko Christian fundamentalist and was suffering from serious religious delusions. Despite being unnerved by him, we waited until Mom and Dad came home to tell them about what he'd said. Rob's parents promptly kicked him out of their house. About a year later, another Osawatomie transplant named Vicky, was slated to babysit us one weekend. She was a nurse, and seemed like a nice lady. She never bothered to show up, and we ended up spending that weekend alone, listened out for by our neighbors at my parents' behest. It was the first time I'd ever been left in charge of my sister and brothers. Our biggest concern was that Vicky would show up and make us go to church on Sunday morning, so we devised an ingenious plan to prevent that from happening. Inspired by an episode on the Brady Bunch, where the Brady kids made a mess of the house so Alice wouldn't leave her job as their maid, we covered the living room with string, ketchup, mustard, and cornflakes, figuring that Vicky would make us clean that up instead of taking us to church. We later learned that Vicky had suffered an alcoholic nervous breakdown and had returned to Kansas, where she died shortly thereafter.
     Because I have a November birthday, I didn't get my driver's license until the 11th grade, necessitating a babysitter who could drive when Mom and Dad went out of town. Our final babysitter was a lady named Kathy, whom we secretly referred to as Pillowbutt. She was quite tall, with an attractive face, but her polyester-clad rump looked as if she'd stuffed several pillows in there, forming a wide, dimply shelf. We lived in a house on a lake, with a pool and a motor boat we used for water-skiing. Mom and Dad left explicit instructions with Pillowbutt that we were not to use the boat while they were gone, an edict which we unfortunately chose to disregard. We knew where Mom and Dad kept the key. Secure in the knowledge that Pillowbutt wouldn't arrive at our house until early evening, we decided to take the boat out for a spin. Speeding along at full throttle, we hit a stump, and lost our propeller blade, completely disabling the craft. As evening fell, we found ourselves paddling around helplessly with one oar in the middle of the lake. One of our neighbors noticed us, and came out in his boat to pull us back to our dock. That night, Mom and Dad called, and we assured them that all was well. In the meantime, we conspired to replace the propeller, but none of us had the $113.00 the boat repair technician told us it would cost. Unless we could convince Mom and Dad that the propeller had somehow just fallen off, we were screwed. Much to our chagrin, our neighbor couldn't wait to inform Mom and Dad about his daring rescue. The proverbial cat was out of the bag, and we were in big trouble. I don't remember exactly how many weeks the boat restriction lasted, but it was long enough to command our attention.
     Years later, I was a single mother of twin boys. When our beloved live-in babysitter, Ferishteh (FER ish teh), took another job, I scrambled to find her replacement. She came in the form of a morbidly obese, 22 year old girl named Alicia, who had been highly recommended by one of the neonatologists I worked with. Based on this, I figured she'd take decent care of Nick and Rory. I knew she'd had a tough life, and initially, I took pity on her. The first thing I had to do was tell her to bathe because she reeked of B.O. Not long after that, she clogged up the toilet with a huge turd so bulky I had to dislodge it with a drain snake and an hour of vigorous plunging. I never thought I'd stop retching. While she lived with us, my sons mysteriously developed a strong distaste for honeydew. They informed me that Alicia spent most of her time, smoking cigarettes on the back porch and talking on her cell phone, feeding them melon everyday at lunchtime to the point they couldn't stand the sight of it anymore. After arranging for a charitable dentist to extract her badly abscessed rear molar, I let Alicia go. Nick and Rory still hate honeydew, a residual trauma from our misadventure in babysitting with Alicia, but other than that, they emerged from the experience, unharmed and relatively unscathed. Ferishteh came back to live with us, and life was good again. Good babysitters are worth their weight in gold, and some, like Ferishteh, simply can't be replaced. If only I had known about Alicia the way I know about a good honeydew melon...

Wednesday, January 25, 2012

The Subtle Beauty of Chirality

     When I was first learning how to write in kindergarten, I labeled my drawings and schoolwork with my name: SIRK. I couldn't understand why the nuns seemed so frustrated; in my left-handed view of the world, this clearly spelled KRIS. Everything about the way I wrote made perfect sense to me. Starting from the right side of the page, and working my way over to the left, it was plain to see that SIRK spelled KRIS, and using this right-to-left approach prevented my left hand from dragging across the paper, smudging the print. The nuns did not permit the use of erasers, or even spit, to correct mistakes. I clearly remember Sister Mary Nicholas depriving me of a gold star when we were learning to make "g's" because I tried to conceal a misplaced pencil mark with a bit of saliva. Eventually, I conformed and adopted the standard left-to-right approach for English written expression.
     Sometime around the fourth grade, I became obsessed with India. My family was good friends with an Indian family, who had a daughter one year older than me, named Alia. I was so envious of Alia's pierced ears and nose that I obtained some clip-on earrings from a grocery store gumball machine, pressing the clasps as tightly as I could whenever I thought about it, in an attempt to pierce my own ears. Alarmed by this, my parents allowed me to get my ears pierced by a doctor for my 9th birthday. Alia's mother gave me one of her saris, teaching me how to fold and wrap it, and I was utterly determined to wear it to school. My mother vetoed this proposal, so I just wore my sari around the house. Alia taught me some Urdu words, but I what I really wanted to learn was how to write in Urdu; it is one of many languages which is written right-to-left. On a Big Chief tablet, Alia spelled out my name, and it looked like this:
     In 1974, my older sister, Edina (eh DEENAH) came home from Iran, where she and her husband, Mahmoud (MAH mood), were living. Mahmoud had been imprisoned as a dissident by the SAVAK, Iran's secret police, and was being brutally tortured. If there was anyone who has ever come close to being the embodiment of Jesus Christ and Buddha, all rolled up into one, it is Mahmoud. It was horrifying for me to know that he was suffering in prison so far away. Edina had flown to Poland that summer to meet our family while we were visiting our relatives there; this was the first time I'd seen my big sister since she and Mahmoud were married in 1972. She seemed strangely grown up. I now realize this was probably because of the extreme duress she'd experienced over the past year during which Mahmoud had been imprisoned. After our visit in Poland, Edina flew to Italy to visit friends and family on her way back to Iran, and while she was there, she was notified that Mahmoud was being released from jail. She was told she should return to Iran right away. When Edina called my parents to inform them of this, they were emphatic that she should immediately return to the U.S., instead of going to Iran, presumably out of fear that this was all a ploy for the SAVAK to apprehend and imprison her.  Edina flew from Italy to Kansas City, and spent the rest of the summer with us. Mahmoud was soon released from prison, but before Edina went back to Iran, she taught me how to make Adas Polo, a Persian national dish, and how to do some self-defense kicks and punches. I had forgotten how much I enjoyed being around her; she's a naturally gifted teacher. Being a linguist like our father, Edina was fluent in English, Italian, French, Spanish, and now, Farsi. That summer, she accompanied me to my Polish lessons. Because Edina and I shared a mutual fascination with language, she enthusiastically taught me a few Farsi phrases. Like Urdu, the Persian language is written from right-to-left. Edina showed me how to write my name in Persian. It looked something like this:
خنجرمردم اندونزی ومالایا
     Chirality*, which stems from chiros, the Greek word for hand, is a concept used primarily in chemistry and physics to describe an entity or object which cannot be superimposed on its mirror image; the reflections are always different. In chemistry, this is usually due to an asymmetrically positioned carbon molecule; in humans, it is a function of the brain's laterality. Human hands are a perfect example of chirality. One hand receives a disproportionate amount of the left or right hemisphere's attention; this is thought to be what determines whether we become right or left-handed. Have you ever tried shaking someone's right hand with your left hand? It feels funny, similar to putting a right-handed glove on your left hand. A distinct relationship exists between our right and left hands, which differs in comparison to other lateralized body parts, like our feet. Unless you were missing a hand, it wouldn't occur to you to use your left foot to assist your right hand in splitting open the shell of a pistachio, would it? Our hands may look identical, but they differ dramatically from one another. If you hold your right hand up to a mirror, what you'll see is a left hand, reflected back.
     Perhaps one of the earliest lessons we receive in "the right way of doing things" in life is the way in which we learn to write. Although the majority of people in the world are right-handed, not all languages are written left-to-right. As a lefty, the right-to-left approach seems much more intuitive to me. I've tried using left-handed notebooks, but they don't adequately address the awkwardness I experience, writing in the conventional manner. The same ideas can be expressed equally well using either approach, making the direction in which we write them seem relatively unimportant. No one really knows why English is left-to-right, Persian is right-to-left, or Chinese is right-to-left and vertically-oriented. There is not a right way or a wrong way to write; it's a culturally dependent variable.  If I were to look in the mirror as a fourth grader, dressed in my sari while writing a story, I would have seen a fair-skinned, blue-eyed Indian girl, furiously scribbling away about the injustice in the world with her right hand. Herein lies the subtle beauty of chirality. Like enantiomeric reflections of one another, brilliant in our asymmetry, I'd observe two girls mostly alike, yet curiously diverse, using opposite hands in different directions to articulate a commonly shared idea.

Chirality is pronounced with a hard "K"

Tuesday, January 24, 2012

Can't Hurt, May Help

     I just read a fascinating article called, "Your Brain on Psilocybin Might Be Less Depressed." The author, Nancy Shute, discussed the results of two recent brain-imaging studies which examined the effect of the hallucinogen, psilocybin (magic mushrooms) on areas within the brain thought to be involved in clinically significant depression. The researchers expected to find a hallucinogen-induced increase in activity within the thalamus and portions of the cingulate cortex. These areas coordinate and control different areas of the brain and are an integral part of the default network, an intricate neural superhighway which is thought to maintain our sense of self. What they found was the exact opposite: these areas became quiet during the volunteers' psychedelic experiences. Future research will investigate the utility of psilocybin in treating depression; it has already shown promise in treating existential anxiety and despair in terminally ill cancer patients. Psychedelics have long been utilized in religious ceremonies in other world cultures as a means of achieving spiritual awakening. They've gained popularity in our culture as experience-enhancing staples at raves and music festivals, but like any other mind-altering substance (which includes antidepressants!),  they can be dangerous in the wrong hands  Before you run out to that cow pasture for some shrooms (psilocybin mushrooms grow on cow patties), please note that psilocybin remains a Schedule I narcotic.
     In depressed patients, the posterior and medial cingulate cortices (PCC/MCC) are two of several brain regions that have been demonstrated to be hyperactive. The PCC and MCC are concerned with consciousness and ego, specifically autobiographical recall and speculation regarding the motives and intentions of others, and are postulated to serve as perceptive filters which are active while we're thinking, and suppressed when we perform cognitive tasks. Increased activity in the PCC as well as the amygdala, a structure responsible for fear conditioning, is positively correlated with rumination, an algorithmic, repetitive type of negative self-focused thought. Rumination is a known risk factor in the development and prolongation of clinical depression; it sustains, enhances and perpetuates a negative mood. People who ruminate are characteristically pessimistic or neurotic. They are unable to let things go because they devote a disproportionate amount attention to certain distressing or irrational thoughts, seemingly unaware of the fact that thoughts are just thoughts. This is what makes ruminators exceptionally vulnerable to depression.
     For most of us, thoughts come and go all the time. Some get our attention, while others are consciously or subconsciously filtered out; this cognitive equilibrium prevents our minds from becoming overwhelmed. Interestingly, those of us who daydream are more likely to become depressed. Daydreaming is associated with difficulty staying on task, and is mediated by a tendency toward rumination or poor concentration skills. When we daydream, we lose the ability to redirect our thoughts back to the present moment, and they effectively intrude on our ability to stay focused on what we're doing.
     Meditation is a form of non-judgmental awareness which is achieved by training the mind to attend to the present while simultaneously allowing background thoughts to pass. During meditation, breathing relaxation techniques or the use of a focal point, such as a mantra or a feeling, are employed to induce a state of voluntary control over one's thoughts, promoting a self-centered sense of heightened alertness and insight, as well as calm and concentration. People who meditate learn not only to control their own minds, but to regulate their vital processes, including their metabolisms, blood pressure, and heart rate. It has been found to have utility in treating chronic pain, depression, anxiety, and attention deficit disorder. Numerous studies have linked the practice of meditation with improved mental, physical, and spiritual health. My son, Nick, is a living example of this. He has cystic fibrosis, a genetic disease which affects the lungs and digestive tract. After he began practicing Kundalini meditation and yoga, his lung function increased and has remained stable. He hasn't been sick in a very long time.
     In the West, treatment of clinical depression is largely centered on the use of antidepressant therapy, with or without the use of concomitant psychotherapy. One in ten Americans is currently taking an antidepressant. The exact way in which these drugs work is poorly understood. Essentially, they alter the constitution of the brain's neurochemistry, affecting the synaptic concentration and activity of norepinephrine, serotonin, and dopamine. These drugs are associated with a host of side effects and adverse reactions, such as sexual dysfunction, nausea, impaired mental ability, sleep disturbances, and weight gain. The abrupt discontinuation of certain antidepressants can result in a severe withdrawal syndrome. The really bad news is that a recent review of literature published by the pharmaceutical companies and the FDA revealed that both parties selectively reported studies which yielded positive responses to antidepressant therapy, while omitting those which demonstrated little or no benefit. The results of the few negative studies which were published were skewed in a positive light. In an epic failure of scientific research, the pharmaceutical industry and the FDA concealed data from the American public. They hid the fact that antidepressants really don't work well at all! At best, patients taking antidepressants can expect only a partial response. Eighty-six percent of these folks will experience unpleasant side effects, and 50% will stop taking the drugs after four months. Even the positive studies demonstrated dismal success rates with antidepressants compared with placebo. Why are so many people taking these drugs and not getting better? It boils down to misinformation and complacence on the part of both the public and practitioners, and greed on behalf of the drug companies. Big pharma is cashing in on the American public, while the FDA permits this snake oil charade to continue. Insurance companies don't reimburse well for mental health, and everyone's either too poor or too busy to go see a shrink. We want a pill for everything that ails us, to suppress our symptoms instead of getting to the root of the problem. We don't want to be involved in treating, or much less, knowing ourselves. I am not criticizing those who take antidepressants, especially those who believe they are being helped by them; however, I think we as a society need to examine our dependence upon them, especially given the disappointing lack of evidence of their effectiveness.
     The brain imaging research which I addressed above raises some interesting questions in the context of treating the causes of depression, not just the symptoms. (One of Western medicine's biggest limitations is that it focuses on disease and symptom suppression, not on overall health). The brain structures which are suppressed by psilocybin have also been shown to be quieted by meditation. These areas of the brain have been elucidated as essential components in self-conceptualization, and it would follow that they are also intimately involved in the development of depression and anxiety. The beneficial effects of meditation in treating and preventing relapse in depressed patients have been studied fairly extensively, and the results are encouraging. Obviously, the drug companies would prefer that you didn't know about this; after all, your depression is important to them...cha-ching! Any initial cost incurred in learning to meditate would easily be offset by the fact that it is free of side effects and can be practiced anywhere, by anybody. (If you're lucky enough to have a Buddhist temple in your neighborhood, you can learn for free, like my son did. You don't have to become a Buddhist to participate, and they always provide great food!) Meditation requires discipline, a commitment to look deep within the self, to take 10 or 15 minutes each day to focus inwardly, permitting thoughts and apprehensions to come and go without allowing them to become intrusive. In doing this, you become well-acquainted with yourself, and you just may discover how much you honor and appreciate YOU! You may actually access the source of your depression, instead of numbing your mind with medication. There really isn't a downside to using meditation as an adjunct in treating depression. With or without antidepressants or psychotherapy, along with adequate sleep, good nutrition, and regular exercise, meditation certainly seems to be a "can't hurt, may help" modality. The pharmaceutical companies have profited from keeping us in an antidepressant-induced stupor long enough, don't you think?

Your Brain on Psilocybin Might Be Less Depressed
Turn Off, Tune In, Drop Out
Psylocibin found to ease end-of-life anxiety in a small study of patients with fatal cancer
Neural Correlates of Rumination in Depression
Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy
Why Antidepressants Don't Work for Treating Depression
This Is Your Mind on Meditation: Less Wandering, More Doing
Attending to the Present: Mindfulness Mediation Reveals Distinct Neural Modes of Self Reference

The Apple Doesn't Fall Far From The Tree

     I've often wondered what possessed me to become a physician. I detest snot and spit, two viscous bodily fluids which are virtually inescapable in the practice of anesthesiology, the sight and sounds of which I am forced to contend with on a daily basis, but which secretly nauseate me. I don't like living in hospitals or call rooms; they're full of germs and the dim-bright fluorescent lighting gives me a frontal headache. I especially dislike being on call for 24 hours, where I work all day, then have the privilege of staying up all night in the operating room, dealing with non-emergent emergencies, just because it's convenient for the surgeons. The paternalistic hierarchy of power inherent in medicine also poses an issue for me. Given the fact that I have an extreme distrust of establishments of any kind, I have a great deal of difficulty accepting that things can't, won't or shouldn't change within such an artificially-produced system, no matter how irretrievably broken it is, or the notion that I am merely a cog in the wheel. Finally, my name is NOT  "Anesthesia!" I do not have a problem with co-workers calling me by my first name, so call me Doctor or call me Kris, but please don't refer to me in the collective sense, based on my occupation.
     Obviously, I'm over-dramatizing a bit, because I do find caring for patients immensely gratifying. Medical histories aside, I love the way I'm able to learn important, intimate details about my patients in less than ten minutes of face time. We talk about their fears, dreams, and beliefs, what their spouses, kids, and grandbabies are like and what they mean to them, as well as what they'd like to eat when they wake up. It's an opportunity for me to talk to them about smoking cessation, because smokers who decide to quit around the time of a surgical procedure have been shown to have very good success rates. One theory is that general anesthesia "cleans out" the nicotine receptors and decreases the craving for a cigarette. I especially enjoy explaining the process involved in the anesthetic; it gives patients the chance to learn about what's going to happen in the operating room and to ask questions. Prior to undergoing an anesthetic, I think every patient should have a clear idea of how he or she will be monitored intraoperatively, what kinds of tubes will be placed, what we'll do if there's a problem,  and how their post operative pain will be managed, either with pain meds or the nerve block I placed preoperatively. The challenge is finding the words that fit each patient's level of understanding. I like to explain general anesthesia as a therapeutic end-point on the line of consciousness. To illustrate this, I spread my arms out, wiggling my left hand, and I tell the patient, "You are here." My left hand represents his or her current level of awareness, which is usually wide awake and a little nervous. Then, I wiggle my right hand, and say, "This is general anesthesia, and it's very different from being asleep. You and I go to sleep every night, and hopefully, we don't take drugs to do it. It's part of our natural cycle. When you're asleep, you dream, you move around, you wake up when you hear noises; under general anesthesia, you don't do that because we are controlling your level of consciousness with the drugs we give. We're going to take you from here (left hand wiggling) to here (right hand wiggling) in a matter of seconds by giving you medicine through your IV. General anesthesia is a profound state of chemically-mediated unconsciousness or a medically-induced coma, and when the surgery is finished, we stop giving our medicine. The next thing you'll remember is waking up in the recovery room, where a nurse will be with you at all times, and will give you medicine for pain or nausea, if you need it." That's my spiel, and it seems to put my patients at ease.
     I also relish my daily interactions with other physicians (well, most of them), anesthetists, perioperative nurses, scrub techs, and other operating room personnel. My job is stressful, and it's important for me to be able to laugh and decompress while I'm working. So, judging from the length of the above paragraph regarding what I like about being an anesthesiologist, compared to the first one in which I outlined what I dislike, it's fair to assume that I do appreciate most aspects of my profession. That still doesn't answer why I became a physician. I didn't grow up dreaming of following in my psychiatrist father's footsteps, nor did I have a formal calling to medicine. I went from a job in mental health into nursing and worked as a neonatal ICU nurse for seven years before going to medical school. Becoming a physician seemed to be part of a logical, natural progression. It felt right at the time and it just sort of happened, an unexplainable leap of faith where I took my ideas, inspirations, and intuition and ran with them.
     My mom receives a copy of my blog via e-mail every day, and she usually sends me a few of her thoughts regarding each one. She recently read The Beneficial Effects of Roach DNA on the Human Spirit, where I described my entry into motherhood as a physiologic awakening in response to my biological clock, and here again, the pattern repeats itself. I wasn't fond of babysitting, and I didn't seem to possess that nurturing instinct, therefore, I couldn't really picture myself being a mother. She wrote: I agree with you that a biological clock evidently seemed to pop off because you had little interest in kids and babysitting. Even when you called and said you were going to become a nurse, it stunned me momentarily because you never seemd too interested in dealing with sick people.
She's told me many times how I continually surprised her and Dad with my decisions to become a mother, a nurse, and a physician, and I have to admit, it was almost counter-intuitive. I'd always pictured myself as an artist or a chef.    
     Yesterday, I took out the autobiography my father penned in the decade before he died. He has a fascinating, almost unbelievable story, worthy of a book, and I thought it would be fun to have him as a posthumous guest blogger. I was reading about his early years in Poland, and learned that his parents kept a diary of his developmental milestones. It is hard to imagine Dad as a baby or a little boy because I've only known him as my father. Amazingly, this diary survived WWII, a trip to Australia in the hands of my father's old girlfriend, Danuta Dambrowska, and my parents' house fire in 1989. My grandmother, Babcia (BOB cha), recorded that in 1922, my father, Bartek, who was then eight months old, ate a little newspaper which resulted in inflammation of the intestines. She said that he became so ill that she and my grandfather sent their 14 year old son, my uncle Staszek (STAH shek), to fetch the doctor in a distant town, observing how Staszek later became so tired running that the next day he had to go to bed.
     Dad surmised that his parents had been more interested in recording his "intellectual and psychosocial development than the milestones of my physical/physiological progress...as there are many references to my interest in music" as well as his advanced language skills and early use of neologisms, his uncanny ability to recall distant events with great clarity,  and his mathematical dyscalculia, which eventually caused him to fail his apothecary exam in medical school. My grandfather recorded in February of 1927 that six year old Bartek inquired of his mother: Mommy, I know that God created us, but how was He created? Did He create himself? If God is so good, why does he allow people to have terrible diseases?
     Dad observes that "there are no inclinations in the diary that my parents ever dreamt of my becoming a physician or thought I might have nascent qualities of personality that someday could be useful to a doctor. Music and sculpture--yes, but medicine? No way! Except, perhaps, for frequent entries describing my empathy, compassion, and generosity." On this topic, Babcia noted: September 1926--Bartuś is very sensitive to the misfortunes of others. The other day on our way from downtown, we ran into a little boy with his father, returning from the doctor's office because the boy had an inflammation of his eyes. Bartuś took pity, and on the spot, gave him a whole box of candy which I just bought for him. He also promised to say a prayer for the boy. And, indeed in the evening, Bartuś says a prayer, and asks God to restore the health to the boy whom he met in the morning.  She adds: For the poor, Bartuś has a very merciful heart. One day, there came [to the door] a poor man. Bartuś said, "Look, Mommy, this man has such a sad look in his eyes--we should give him something." He was immensely happy when I gave the man some old clothes. Then, he asked, "Why is it that God allows [there to be] so many poor people in the world? God is so good, so why doesn't he give a lot of money to the poor, so they won't have to suffer poverty?"
     Reading through Dad's memoir, it is clear that the apple didn't fall far from the tree. I am very much like my father with regard to the reasons I went into medicine: it is a perfect vehicle for expressing compassion and empathy, similar to the way in which we convey these attributes through our music, paintings and sculptures. We both shared an altruistic desire to help people, to do the right thing, and we followed our hearts to get there.  We were inquisitive, constantly asking "Why" and "How", especially about God, which I believe made us more open-minded and receptive to the experiences of others, while freeing us from a faith-related agenda. Above all, we were both deeply committed to the art of medicine, not just the science of it. In my opinion, most physicians could benefit from developing more introspection, better listening skills, and sensitivity to the misfortunes of others, instead of the regurgitation of data, the narcissism, and the lack of empathy we've unfortunately become infamous for. Who knows? Perhaps artists just make better doctors.

Monday, January 23, 2012

The Wu-Wei of Grilled Cheese

     I've managed to burn the roof of my mouth on grilled cheese yet again. Yesterday morning, I lifted some weights, followed by a P90X interval workout with Spartacus, after which we simultaneously felt invigorated and ravenously hungry. While he showered, I meditated in front of the fridge, doors wide open, waiting for a comestible volunteer. There was leftover butternut squash soup, an apple and some fresh blueberries, nothing very exciting. A sandwich of some sort definitely seemed to be in order, but the protein choices were limited to tempeh, almond butter, or cheese. Since creamy soups lend themselves equally well to being slurped from a spoon or dipped into with hot, crusty bread, the idea of grilled cheese materialized as a splendidly viable option.
     As the soup heated over a low flame, I rooted around in the cheese drawer and defrosted a few slices of bread. I came across an unopened wedge of Red Gold Pepper Jack cheese, made by the dairy here at Berry College, as well as a brand new package of pre-sliced Swiss. The blueberries had been rinsed, and were draining in a colander on the counter. Lunch was beginning to take shape. The griddle was already heating on the stove, and I swirled it with a little coconut oil. Coconut oil is solid at room temperature, just like butter, and while it melted, I began the business of slicing up the pepper jack cheese. Cheese-slicing is an onerous task, especially if you're dealing with a soft variety; you drag your knife through it, and end up having to peel the rubbery slab from the blade. After a couple of attempts to get uniform slices, I abandoned my knife in favor of a cheese shaving tool. It did a slightly better job, but still sliced unevenly, gouging the poor defenseless wedge. With a modicum of effort, I managed to shave a few ounces' worth of pepper jack, setting it aside while I got the bread toasting on the griddle pan.
     Being both a textural and alimentary experience, grilled cheese demands good bread. I don't like the mushy white or wheat knockoffs because they taste like cardboard, as well as deflating like spent helium balloons when you mash them with your spatula. I totally understand that some people prefer their grilled cheese to resemble communion wafers. My copy of the White Trash Cookbook highly recommends the use of Wonder bread; however, I'm of the opinion that the bread in a grilled sandwich needs to stand up to the cheese, instead of submitting to it. Spartacus and I particularly like sprouted seven-grain bread. Aside from its theoretical digestive advantages, this flourless bread is absolutely delicious, and possesses a substantial crumb which transforms from pleasingly chewy to delightfully crunchy when toasted. Unfortunately for sufferers of celiac disease, it is not gluten-free. I slathered two pieces of bread with coconut oil, dropping them onto the hot griddle, and covered each with a mound of pepper jack. Thinking that the sweet crispness of an apple would complement the spice in the unctuous cheese, I arranged a few Pink Lady medallions over the jack, and covered it all with a slice of aged Swiss. The griddle hissed and popped, and the toasting bread and cheese smelled exactly like it did when I was a kid. On Saturday afternoons, Mom used to make us grilled cheese and tomato soup, which we'd get to eat in front of the TV while Kukla, Fran, and Ollie announced that week's installment of The Children's Film Festival. We were particularly fond of "Skinny and Fatty" and "The Red Balloon."
    The anticipation I begin to feel as I'm preparing a grilled cheese sandwich is an embarrassingly sensual phenomenon. There's a moment where the bread becomes perfectly golden-brown and slightly abrasive, where the cheese oozes voluptuously down the sides, hinting at the velvety abundance enveloped within; this moment heralds a fleeting window of opportunity during which the sandwich will burn if it is not immediately removed from the griddle. It literally happens in the blink of an eye, especially if I'm distracted. Over the years, I've become pretty adept at multi-tasking in the kitchen, so burned grilled cheese is rarely a problem anymore. What gets me into trouble is the contemplation of that first bite. The physics of grilled cheese are relatively simple: you have bread, which is porous, readily permitting the transfer of heat, and you have cheese, the molecules of which are more cohesive, resulting in a slower dissipation of thermal energy. It's a time-dependent exchange, and there is no hurrying it along. Waiting for the sandwich to cool is like opening a portal into a parallel universe where seconds seem like minutes, rapidly usurping any iota of willpower I have left in favor of instant gratification, predictably culminating in that synchronous instant of supreme pleasure and pain where silky hot cheese meets delicate mucous membranes. Ouch!
     According to Lao Tzu, the three greatest treasures in life are simplicity, patience, and compassion. Through the Tao Te Ching, he observes "Simple in actions and thoughts, you return to the source of being. Patient with both friends and enemies, you accord with the way things are. Compassionate toward yourself, you reconcile all beings in the world." I'm learning to be more patient, to avoid getting in my own way by looking out for the way of things, the unity which drives the system. Imposing my will onto people, objects or situations may give the illusion of being in control, but in reality, it interferes with the spontaneous, natural flow of life, obstructing progress and efficiency instead of hastening it. Easy does it, let it be: these are examples of the Tao principle of wu-wei, or not forcing. We've all invoked these concepts at some point or other, but they're easier said than done; we continue to stand in our own light while we work. Western society is impatient. We make things happen, we don't wait for them to take shape. Time flies, and time and tide wait for no one, but is time really of the essence? We really do have plenty of time. I know I wouldn't be as stressed out if I spent more time enjoying time, and less time rushing it. If only I could apply this wisdom to grilled cheese.
Second Cup Tzu-Jan (a related post) 

Sunday, January 22, 2012

Lipstick Adonis

     Am I alone in my assertion that one of the true tests of a serious relationship seems to be whether or not you can get your boyfriend to try on your lipstick at least once during the course of your romance? In my opinion, it's an indicator of how comfortable you are with each other, a barometer of your mutual playfulness. My sister, Emi, regularly subjects Carl, her husband of 25 years, to beauty treatments, like Mary Kay Satin Hands and mud masks, which leads me to believe he probably enjoys pampering himself. Outside of Halloween, I don't know if she's gotten him to put on her lipstick. At last report, Haley, my son Nick's girlfriend, has only been successful in convincing him to let her paint one of his toenails. This really didn't surprise me. Nick's dad never permitted me to glamorize him, either--the only makeup I'm aware of him ever having worn was camouflage grease paint during turkey hunting season.
     Brad initially resisted my attempts to decorate him, but after about ten months of dating, he gave in. First, he agreed to pose in a red Afro clown wig. He said the hair reminded him of a children's show he watched growing up in Michigan called Oopsy the Clown. That's when I first started affectionately referring to Brad as Oopsie (I didn't know how to spell it!). About a month later, we flew up to Columbus, Ohio so Brad could meet Emi and Carl for the first time. They live in Bexley, in a funky turn-of-the-19th century Sears catalog house with a teeny tiny room upstairs that Emi has designated as "the make-up room." It has a custom-fitted twin bed, a small closet, a window seat with storage, and a vanity chest crammed full with an impressive array of products. Brad was sitting in there with me one morning, keeping me company while I applied my mascara, when I finally convinced him to let me put some of Emi's lipstick on him. He wasn't exactly thrilled with the idea, but being a good sport, he complied. The tomato shade on his lips complemented his blue eyes, but looked startlingly grotesque in the context of his facial and chest hair. It wasn't a good look for Brad, who from now I'll refer to as Spartacus. Satisfied that Spartacus had ventured out of his comfort zone to indulge my silly whim, I handed him a box of Kleenex to wipe away the lipstick, but not before snapping a picture of his awkward glamour.
    Emi and I used to love dressing up our little brother, Peter, as a girl when he was a toddler. We sometimes needed him to play a girl in the variety shows we put on for Mom and Dad, but more often than not, it was just for the sheer pleasure of seeing him transformed into "Mona." We'd put brown leotards on his head for pigtails, outfitting him in a frilly shirt, vest, and skirt, completing the look with a pair of saddle shoes. Peter was always very cooperative; I think he liked the attention. He was a darling boy and girl. Despite the fact that much of Peter's early childhood was spent as Mona, he managed to grow up a regular guy, clearly defying the notion that "pink is for girls and blue is for boys." What a bunch of hooey! Mona, sans leotard pigtails, is immortalized in a dramatically shadowed black and white photograph taken by my older brother, Leszek (LEH shek), displayed for posterity's sake on a wall in Mom's dining room.
    As a medical student, I did a preceptorship in a pediatrician's office in Perry, Georgia. I examined the kids first and presented my findings to Dr. Dan, who would then re-examine them and prescribe any necessary treatment. One morning, I was trying to get a three year old boy to cooperate with an otoscopic exam. He was flailing and screaming, and his mother was of little help. This was back when the Telly Tubbies were popular, and in an attempt to calm him down and engage him so I could look inside his ears, I jokingly observed "Oh my, I think I see a Telly Tubby in there!" His sourpuss mother immediately informed me, "Them Telly Tubbies carry purses! They're all gay! Timmy don't watch them Telly Tubbies." With a mom like that, who needs enemies?
    Gender-bending 70s glam rockers like David Bowie, Lou Reed, and Iggy Pop made it socially acceptable for guys to wear makeup as a form of self-expression. I adored Freddie Mercury's early look: the eyeliner, the cool shag cut, the black fingernails on his left hand. These were looks emulated by boys and girls alike. I saw nothing wrong with it then, and I see nothing wrong with it now. I think our society is ridiculously hung up on sexuality, an attitude which is propagated by residual puritanical beliefs and a fear of those who are different from us, fueled by our own insecurities. What are we so afraid of? When you consider how tribal men have festooned themselves with war paint, tattoos, and piercings for millenia, and how even our forefathers adorned themselves with powdered wigs, it seems silly to equate a guy's desire to embellish his features with a problem in his gender identity. Nowadays, there is no shortage of mirror-loving manly men running around with Botoxed foreheads and chin implants. We all want to make the most of what we've got. Whether you call it vanity or self-improvement, cosmetic enhancement has never singularly been a woman's thing; our men have just gotten a lot more sneaky about it!

Brad, aka Oopsie aka Spartacus, 2008 

Lipstick Adonis, 2008, posted with Brad's permission :-)
Peter as Mona, 1972

Saturday, January 21, 2012

The Best of Both Worlds

     Yesterday afternoon was a typical January day, cold and rainy. When I arrived home from work around lunchtime, I sat in my kitchen, listening to the rain tapping outside the window. Cars made slick water-skiing noises as they went rushing by. I heard a couple of sirens, wailing in the background; someone was in trouble somewhere. Simon and Lilly, our German short-haired pointers, are afraid of rain and they were snuggled up next to each other in their beds. I could feel an afternoon nap coming on. Writing these blogs often keeps me up past midnight, and since I have to be up at five every morning to get ready for work, I'm a little sleep deprived of late. Although I'm left-handed, my right wrist and forearm have started aching from all the writing I've done. Maybe it's because I don't use an external mouse with my laptop, and I'm constantly using my right index finger on the computer's mouse pad. Sometimes, it's hell being a left-hander in a right-handed world.
     As I sat in the kitchen, eating my leftover lasagna and contemplating the rain, a familiar old feeling began worming its way into my brain. It's a melancholy which has plagued me for as long as I can remember. Without warning, this mood invades my psyche like an unwelcome subconscious squatter, daring me to try to evict it. It's a state of being in which I feel very much alone, disconnected and isolated from the world around me, where the importance of day to day minutia becomes catastrophically magnified and I'm left wondering, What's wrong with me? I've learned that the best course of action is to let it pass.
     When I was a teenager, this melancholy would typically hit me on Sunday afternoons, after my family got back from Mass. I'd go down to my room, put my favorite Incredible String Band album on the record player, and sleep in a strip of warmth on the carpet made by the sunbeam which predictably pierced a window above my bed. It's funny because the thoughts that troubled me then are the same ones which vex me now: What is my purpose here on this Earth? What is it that I am meant to be doing? I guess you could call it an introspective query into the reasons for my existence, but somehow, that doesn't really capture it. It's more of a deep longing to know myself, to honor the creative forces within me, to be in harmony with life's ebbs and flows, but most of all, to be genuine and true to myself. In high school, I read a lot of philosophy, and one of my favorite authors was Hermann Hesse. In the eleventh grade, I read his novel, Demian, a coming of age story in which the protagonist, a young man named Emil Sinclair, experiences an awakening of his consciousness as he struggles between the worlds of illusion and spiritual truth. One passage, in particular, made a profound impact on me. It reads, "I wanted only to try to live in accord with the promptings which came from my true self. Why was that so very difficult?"
     My life is in a state of flux right now. In a week, I will finish my work here in Rome, and then, Brad and I are moving back to Atlanta. He took an IT job in Dunwoody, and is now commuting over a hundred miles to work each day. I don't have another job lined up, and it's unsettling. The sequence of events which led to me leaving my job here has been unbelievable, to say the least, and it's been difficult not to feel bitter. Life never seems fair to those of us who think outside the box; we're alternately blessed and cursed. The tumult of these last three months is what propelled me into writing, and honestly, I've never been happier. Brad and my mother say I'm a different person since I've started writing, that I'm easier to get along with, less hung up about things like vacuuming, more considerate of others. As much as I've tried to deny it, there is a certain degree of narcissism involved in being a physician. Most of us aren't cognizant of this; it's an insidious process. The nature of our work takes us further and further away from knowing who we are, and eventually, we define ourselves by what we do. Idealism isn't compatible with survival in the medicine-as-business model, a system which is more about the bottom line than quality of care. Many of us feel demoralized. You'd be surprised at how many of my colleagues, most of whom haven't even been practicing for ten years, view what they do every day as "it's just my job."
     Once a decade, I seem to reinvent myself. In 1990, I graduated from nursing school. Eleven years later, I graduated from medical school. I've been a practicing anesthesiologist for almost seven years now, and I've experienced both academic and private practice anesthesia. There are advantages and disadvantages to both worlds, similar to the duality of illusion and reality which Hesse addressed in Demian. Achieving contentment within one realm or the other seems to be a function of just how much time and autonomy you're willing to compromise. I've spent the majority of my adult life, living inside the hospital microcosm. I've worked nights, holidays, and weekends for as long as I can remember. I've missed many Thanksgivings and Christmases with my sons. Aside from being positively recognized for my work by one of my patients in the local paper, I can't think of the last time I heard, "You're doing a great job. Keep up the good work!" from one of my bosses. I'm tired of hearing I need to put my big girl panties on and suck it up. I don't think I should have to suppress my ideals or cut corners on patient safety in order to receive a paycheck, yet that's the kind of pressure I am confronted with on a daily basis. Like Meg Ryan in When Harry Met Sally, I want what I want, and I know exactly what it is I don't want. What's so terribly wrong with that? I've started thinking about what it would be like to be my own boss, and I have to say, the idea is tempting. I'd like to work part-time in anesthesia, which would give me the time I need to start writing my book. It would be the best of both worlds, allowing me to continue the patient interaction which I find immensely gratifying, along with more time for channeling my creative energy into artistic pursuits. 
     The melancholy I felt yesterday has evaporated into a strange sort of gratitude. Last night, when Brad and I were at dinner, he looked at me earnestly and said, "Do you realize what I would do to have a brain like yours, to be as smart as you are?" We talked about my parents, about how opposite they were from one another, and he observed that Mom must have felt overshadowed by my father's intellectual and artistic prowess, his eccentricity, and the passion he devoted to his many interests. My father died long before Brad and I met, but he speaks of Dad as if he knew him. Maybe his familiarity with Dad stems from living with me, knowing that my father and I were kindred spirits, and that we shared many qualities including the general way in which our brains work, a strong drive to create, a compulsive need to question authority, and yes, a little bit of narcissism. Brad then told me how much he loves my mother because he recognizes that she really had a tough job. She entered into life with my father as a stepmother to my sister, Edina (eh DEENA), and my brother, Leszek (LEH shek), Dad's children from his first marriage. Several years later, his 71 year old mother came from Poland to live with us. Mom learned enough Polish to communicate with Babcia (BAB-cha, Polish for "grandmother"), and in adapting to the customs of our intercontinental family, some of her own history was lost in translation.
     Like most mothers and daughters, Mom and I have had a complicated relationship, punctuated by my co-existing needs for her approval and respect for my personal boundaries, and her desire for me both to succeed and acknowledge the help I've had along the way. Brad told me he wanted me to write about how thankful I am for the gifts my parents gave me, not just the DNA they endowed me with, but the support I've had to be me. He's wonderfully insightful like that, so incredibly genuine, and I looked at him and thought, Yes, I am very fortunate. I am grateful that, no matter how much of a jerk I've been in the past, my parents never stopped loving me. My mother doesn't always understand me, but I think she gets the essence of who I am. There is a part of me that is very much like Mom, the way in which I associate meanings and perceive an interrelatedness within life's rich parade of situations. She's given me the gifts of intuition and metaphorical thinking, and this what makes writing so enjoyable for me. Today, I'm grooving in the revelation that I'm the product of two worlds which collided in love, a love that has steered me through this crazy 49 year voyage of heartbreak, joy, and self-discovery, collectively referred to as my life.  Everywhere I go, there I am. I love you, Mom and Brad!