I picked up Mitch Albom’s The Little Liar wondering if I needed to read another story about the Holocaust. I almost didn’t check it out. We live in a world at war. We live in a world where starvation, strife, and civilian casualties are collateral damage of those wars. Yet war continues to be waged. I am glad I checked the book out. I read it in less than twenty-four hours. A unique voice serves as narrator in The Little Liar. It is Truth. Albom masterfully uses that narrator to explore the meaning of truth and to illustrate the horror of man’s inhumanity to man. Four characters, Nico, his brother Sebastian, Fannie, and Udo pull the reader into the story and demand the reader’s attention from start to finish. In a way, their stories have been told before, but as written, they seem startlingly fresh and compelling. In the context of what’s happening in the world, their stories are more than relevant. Rather than mar the story by retelling it, I want to share what I call the wisdom of Albom. “Never be ashamed of a scar. In the end, scars tell the stories of our lives, everything that hurt us, and everything that healed us.” “But questioning a madman is like interrogating a spider. They both go on spinning their webs until someone squashes them out of existence.” “How could fishing boats keep rolling so innocently? How could the world eat when all those prisoners were starving? How could things look so terrifyingly normal here…?” Why do world leaders create scenarios where these questions still are relevant today? Read this story. Keep asking the question. Why do we still wage war?
Compound Fracture
I am not a sommelier, but I know what wines I like. I am a retired nurse with forty years of experience in Critical Care. I believe I am qualified to discuss the broken state of our health care system. It suffers a compound fracture. Early in my career, Primary Nursing, a practice in which one nurse agreed to be active in the care of a patient throughout his ICU stay, was introduced on our unit. It facilitated a holistic approach to care. At least one nurse knew more about the patient than his diagnosis and room number and helped that patient navigate the trauma of critical illness. Primary Care did not last long. It was time consuming for nurses already working short-staffed. It was costly, as Primary Care nurses spent time away from task accomplishment addressing the total patient. Now, after a recent short stay in the hospital and a more recent health jolt, I realize things certainly haven’t gotten better. I have had MS for decades and have strived to maintain the highest level of wellness. My PCP encouraged me to go to a local MS specific clinic for care. I went every year. The providers watched me walk, checked my neuro signs, assured me exacerbations declined with age thanks to an aging immune system. I was trusting. I accepted what I was told. I kept my routine appointments. When my knee began to bother me, I didn’t think about MS. I went to a knee specialist who watched me walk, did an x-ray, saw no arthritis, injected my knee, and sent me on my way. I followed up again when the pain recurred. Another x-ray, another injection. When that shot wore off, I learned to live with the pain. Then, after suffering a Closed Head Injury due to Covid induced hypotension, I switched neuro clinics and ended up at a clinic closer to my home. I saw a new MS doctor. In two visits, he changed my life. He watched me walk. I’d seen my gait in the windows as I walked into the gym. Aging I told myself. “You have footdrop,” the doctor said. Gutpunch. MS finally left its mark, less painful than my burning paresthesias, but so VISIBLE. Yet no one had told me. I bought an ankle brace online. I’ve learned to wear it on the treadmill. My knee doesn’t hurt. My leg is more stable when I walk. Where is the breakdown? The breakdown exists because there is a lack of collaborative practice. Just like the Primary Care concept in nursing, if my PCP, knee doctor, and MS doctor had even had a phone conversation, might I have learned of my footdrop sooner rather than later. Could this type of practice ever happen? I doubt it. The other part of the breakdown: Who would get reimbursed? What would the billing code be? Who would lose money if I’d just bought a brace? How much is one phone call worth to the practitioner? To the patient? Has medical specialization destroyed the healing art by disallowing the opportunity for a patient to be treated as a whole? What professional do I see to answer these questions?
Collaboration might be needed.
Touched
I am not a sommelier, but I know what wines I like. I am not a book critic. I am an avid reader and hope someone will help me understand what I felt was the brilliance of Walter Moseley’s Touched. The cover, two hands held side by side with fingers upright and a face superimposed on them, compelled me to pick the book from the “New Fiction” shelves at the library. It is a small book. The 159 pages are 5 x 7 1/4″. The story, the words, the size made it easy to read without stopping until the last page. Then, I was left in wonder.
Marty awakens from what he believes was a centuries-long sleep a changed man. He believes he has been recruited and altered to play a part in the eradication of the human race. From there, the reader faces many questions. Is the narrator reliable? A few pages in, it no longer matters. Immersed in an alternative reality, the possibilities of which include science fiction to schizophrenia, the reader confronts the quintessential questions of humanity. Is Marty/Martin/Temple the infection of or the cure for humanity? For me this dilemma expanded and applied to everyman. Are humans the destroyers or saviors of this earth? Do we, as a species, have the inner strength to resolve differences and amass the resources to save ourselves? Reminiscent of The Overstory, Touched returns more than once to the concept of the oneness of the environmental and human ecosystems.
I found the ending haunting and provocative. After being reprogrammed by Marty’s intervention, a man leaves Marty’s home to get away from the sound of a howling dog. The man fears it will keep calling for his attention. I interpreted that the man feared changing back to what he had been, a hateful, racist thug, thus positing the age-old question: are humans doomed to repeat past mistakes?
Neither expert nor editor, I’ll only mention things I found interesting about the writing. Mosley’s use of names insist I examine my own moral compass. Marty’s wife, Tessa, has had relations with a man named Truth. Marty’s last name is Just. His alter ego is Temple. Mosley describes the color of people using various shades of browns and grays. I have a mentor who talks about muscular sentences. I found Mosley’s writing sparse, yet muscular. The biggest compliment I can give any author is to say I will reread this book before returning it to the library. I have been Touched.
Quiet Horror
I am not a sommelier, but I do know what wines I like. I am not a movie critic. I have friends who critically analyze movies, their production, stories, costumes, and acting. Not me. Having said that, I do not take lightly writing about The Zone of Interest. It still haunts me. I read the novel by Martin Amis before watching the movie. Usually, books satisfy me more than the movie productions of them. Not so in this case. The opening scene portrayed a family outing. Men wore swimsuits like the one my dad wore when he took me to the local pool and taught me to swim. Women and children sat on blankets spread across the grass. A river lazed in the background. What it didn’t show, but what I knew from reading the book, was this all took place in the shadow of a death camp. It registered for me as quiet horror. No audible dialogue, just the establishment of an atmosphere that was down to earth while being obscene for someone who knew the secret of the setting. Throughout the movie, ordinary people did their jobs, followed orders, created innovative machines, even fought to remain in the penumbra of Auschwitz, with little reference to the people who suffered and died. In one scene, women quibbled over who would take what from a collection of garments confiscated from prisoners. I couldn’t help but see vultures picking over the flesh of dead animals. What gut-punched me the most was a scene, not from the 1940s, but a modern scene in which uniformed workers cleaned the floors of a what seemed to be a Holocaust Museum. Again, no dialogue, just people doing their jobs as if they either did not know or had become immune to the context. Encased in glass, a mountain of shoes stood in the background. Another quiet horror. I remember my shock and grief when I saw a similar display at the museum in Washington, D.C. It made visible and real the number of lives taken during the Holocaust. I often think of The Zone of Interest in a world at war in so many places. I must wonder if, because of our responsibility for mundane tasks and day to day survival, do we become immune to the quiet horror of man’s inhumanity to man? The Zone of Interest helps keep me from becoming so.
A Slice of the Pie
I retired from bedside nursing over five years ago. In that time, every medical journey with my body demonstrated to me how broken our health care system is. Medical specialization is one culprit in the fragmentation of care. When I go to my cardiologist, I am the heart with Sick Sinus Syndrome. When I go to my electrophysiologist, I am the dual chamber, MRI friendly, pacemaker. When I go to the dermatologist, I am skin. When I go to the joint specialist, I am the knee not wanting to have surgery, not the septuagenarian with MS who works out six days a week and walks funny. When I go to the MS doctor, nothing more need be said, except that I am blessed. For the most part, my disease is invisible. Maybe that is why it doesn’t come up often in a plan of care.
Every specialist gets a bit of me; no one cares for the “all of me,” I realized this when after working with the same Physical Therapist for several weeks, we discussed my Multiple Sclerosis, which suggested this wasn’t considered when the orthopod submitted orders to treat my bobbling knee. The therapist didn’t know I had it.
Flash back twenty years and my diagnosis of pulmonary embolism. Although I saw a hematologist, the risk of clotting problems associated with autoimmune disease was never mentioned.
I have a dream for my health care providers. Once a year, I’d like a Zoom meeting, God forbid we could do it in situ, where each one helps put the pieces of the puzzle that is my body together and makes recommendations for my health maintenance. I would come with a list of questions about what the interface of body systems and health problems means for the coming year. I would come hoping I would be recognized in toto.
I See No Women Like Me on TV
After surviving the scourge of cystic acne and seven surgeries for basal cell skin cancers on my face, I realized I don’t see women like me on television, that grand purveyor of what is stylish and acceptable. I see women portraying assassins who kill half a dozen men, are thrown against walls, break mirrors with their faces, marked only by a smudge or two of blood as badges of courage. I see talk show hosts with different hair styles every day, pristine cheeks, eyes lined and mascaraed, fashionable clothes, and manicured nails long enough to function as deadly weapons.
What I don’t see are facial scars, not invisible scars caused by rejection, bullying, lost love, not surgical scars in places that can be buried in layers of clothing. I am talking about a track in a cheek, on a nose, dividing a lip into asymmetrical halves, flaws of the flesh that detail the map of a life.
My scars began to carve their presence in young adulthood when stress, hormones, and maybe genetics, ravaged my face. I went to a dermatologist who lanced and drained and prescribed antibiotics. After a tumultuous episode of sobbing in his office, so loud and uncontrollable the doctor insisted the office assistant stay with me, I managed to get back to my dorm only to have to eat dinner with my friends with my freshly assaulted face on full display.
I felt the throbbing pain, not from needles, but from the humiliation of being on the cusp of adulthood and cursed by a disease that presented itself in such an obvious place, a place there was no way to hide. I wondered what I had done to deserve such punishment, because that is the way young people think.
Things settled down for a while. I accepted the uneven landscape my face and labeled it dimpled, like a water puddle in the street being textured by raindrops. I knew in reality my face emulated the moon.
I graduated from college, married, moved, and started my first job, all things my parents’ core values and signs of approval taught me I should accomplish if I wanted to be considered successful. My husband subsumed himself in TA responsibilities, chemistry experiments, and mastering the new tech language of the flourishing computer age, FORTRAN.
In the small, college town ICU where I worked, I nursed a man who died from burns caused by a fan belt when he fell on his tractor with the motor running. I stared at the girl, almost my age, brain dead from carbon monoxide inhalation when she and her boyfriend parked in a cornfield for privacy, left the motor running for warmth, and failed to notice the exhaust backing up into the car. I watched the drunk leap over his side rails, fly through the air, and land in the arms of a diminutive colon-rectal surgeon. My face broke out, each bump a monument to the tragedies and surprises life presented.
My co-workers, the people who watched the same horror show as I, became family. We routinely gathered at the mom-and-pop pancake house for breakfast. At night, we went to movies or drank and danced at the nearest bar, which happened to be a gay bar. It didn’t matter. We felt safe until grief from the losses we shared challenged professional distance and dissolved personal boundaries. Dancing became experiments in tongues and hips and breasts and buttocks in a place where no behavior incurred judgement. I wanted to experience as much as I could before I died, because death, sadness, loss, seemed as prevalent as an acrid cup of crappy hospital coffee. I began to explore the things that might bring me from numbness and oblivion to hyperacute being. My face rebelled. Tetracycline became as routine as a daily vitamin to calm my erupting face.
Like many health care professionals, I believed the rules of well-being didn’t apply to me. I told myself that caring for sick people provided a protective barrier against the havoc nature could impose on the body. I read pages of warnings about the side effects of Tetracycline. Photosensitivity I interpreted as intolerance of bright lights.
I forgot those warnings when, after years of taking the drug on and off, a friend and I took a summer road trip to Galveston. A move inspired by my divorce had landed me in Texas. We left Dallas on a whim. When we arrived in Galveston, all the motels were booked, so we spent the entire day on the beach, until my friend noticed my face.
“You face is as red as a stop sign. We’ve got to get you out of the sun.”
We paid a ridiculous amount to a scruffy stranger in exchange for his cheap, dilapidated beach front room. Faded pastel prints adorned the walls. The bed was made with sheets that looked like they hadn’t seen a washing machine. I made ice packs for my face.
I had learned the magic of ice therapy when I pulled an unexpectedly heavy turkey from the oven. The roasting pan slid and grazed my forearm as I maneuvered to keep the turkey, drippings and all, from hitting the floor. I watched the blush of the burn, my arm, embarrassed by the heat. I remembered learning in my anatomy class how heat caused the capillaries to dilate and fluid rushed to the site causing blisters. Ice prevented blisters. That time, my skin healed without a blister or a scar.
On the way home from Galveston, my friend and I stopped at a drug store. I alternated ice and the commercial poultice of the day. My face peeled and healed. I thought I’d invented a cheap, natural way to exfoliate and never dreamed damage from the abandoned caution of one week-end when I was twenty-eight would hibernate, only to haunt me as I aged.
In a small college town, I could ride my bike anywhere and logged one thousand miles in a year. When I moved to Dallas, my body lost its tone and stress dominated my mind. I decided to start running. I bought the cheapest pair of running shoes in case my flat feet would betray me and force me to find another form of exercise.
I discovered I loved to run, especially in the heat of the day. A slick coat of sweat made my body glisten around mile five. I memorized the contours of hills, which streets had the prettiest yards, which yards had weather worn wooden fences from which their dogs might give chase. I learned to avoid cruisers who’d slow their cars and offer me rides. Seven miles left me roasted, inside and out. When I got home, hot and content, I glugged a half a gallon of water to replace what the heat took from me.
I didn’t wear sunscreen, sun glasses, or a hat with a visor. I didn’t read about the damaging glare from the asphalt. My running became a habit as strong as nicotine. While I ran, I felt both peaceful and in total control.
One day I looked in the mirror, admiring my outrageously sun-bleached hair and the unexpected deep tan masking my usually fair skin. I saw a rough spot on my lip and scraped it with a finger nail. It pulled away leaving a perfect circle, as if I’d plucked a weed from the dirt all the way to the root. A minute bead of blood appeared. In a day the spot healed, but a dip no bigger than a pinhead remained. I made an appointment with my dermatologist, Dr. Cheek. I picked him because I liked irony.
Before the invention of the Mohs procedure, doctors cut by sight and touch. I trusted Dr. Cheek, a mild man who looked quizzical, not amused, when I asked if he’d ever received a STAT acne call. He numbed my lip, something no more painful than being given a local anesthetic by the dentist. I sat on the edge of the examination table. I sensed rather than felt the scraping begin. Time loses substance when a hand holding a sharp instrument pushes and rakes across the lip you no longer are sure is there, until the instrument hits a nerve and you shift with anxiety. “That hurt,” I said, “I felt that.”
“Not much more.”
The procedure ended not long after that. How long? I’m not sure. I left the office with a dime sized hole in my lip that made the worst cold sore seem like art. I learned basal cell tissue had a different texture compared to healthy tissue. When there was nothing left but healthy tissue, the excavation stopped. I suppose I was thankful the good Dr. Cheek hadn’t put a hole in my lip and that I had a few days off before returning to work in the high splash profession of ICU nursing. I suppose I went running the next day. I suppose I figured this would be the only time I’d have to endure such trauma.
Believers say “Make a plan and God laughs.”
What riotous glee must have echoed through Heaven.
Decades later, despite a solid marriage, a challenging job, and a new house, my plan unraveled. Had God been laughing all this time? It started with a small spot on my nose requiring a snip and a stitch. Then, a fleshy mole in the hairline of my left temple grew into a plump, textured monster taking over one side of my head. A general surgeon I worked with worked me into his schedule. I arrived for my appointment dressed in workout gear; I never dreamed of missing a workout.
Dr. Lewis numbed me and positioned me on my side. The paper covering the examination table rustled and sighed and reminded me it was my turn to be a patient. The local anesthetic given, Dr. Lewis put on his gloves and, using a scalpel, sliced away the creature claiming territory on my body. “You’re bleeding a bit, but I don’t think I’ll stitch it. I’ll bring the biopsy report over to the unit.”
Except for the wad of gauze on my head, I felt great. I knew eventually my hair would cover the scar. We shook hands. I hopped off the table and headed for the gym. Yes, I did go work out. It was a time before Dr. Google educated the general public about the community prevalence of Methicillin Resistant Staph Aureus, a time before I realized I was mortal.
By the time a rough spot appeared on my nose, Dr. Lewis had succumbed to Alzheimer’s. A colleague and fellow runner referred me to a doctor who ran a clinic like a car assembly line. Rooms with plastic flags, each a different color, lined a long corridor. I arrived for my appointment to find half a dozen other people waiting to be prepped and cut. The doctor impressed me with his efficiency, his ability to put me at ease, and, ultimately, his dismissing my surgery as no big deal. He lied.
A young woman with on-the-job training, no formal education, explained she was going to numb my nose. Nothing had ever hurt like the needle piercing and accidentally penetrating the entire thickness of the side of my nose. The woman sucked air, paled, and hurried her exit with a “I’ll let the doctor know you’re ready.”
Fortunately, I asked my husband to drive me. He ushered me to the car with a mound of gauze on my nose. I couldn’t see over the dressing. I paced around the house avoiding the bathrooms and their tempting mirrors. I paced some more. I went into our bathroom and stared at the mirror. What horror hid beneath the bulge of the dressing? I peeled back the tape as gently as I could and lifted the gauze. I don’t know what sound I made. An “oooh” or an epithet. My husband rushed in afraid I had fainted. A dark hole the size of a quarter stared back at me. Emergency reconstruction took place a few days later.
A plastic surgeon I knew and trusted did the repair. I didn’t know it would be a two-step process. The first surgery created a flap on my nose. The doctor retooled the blood supply by operating along the natural crease of my cheek. It was hardly noticeable. But the flap bloomed like the bloated cap of an earthstar mushroom. The mirror became my enemy. I was scheduled to return to work at a job positioning me up close, face-to-face, with patients.
For two months, I wore a flesh-colored oval Duoderm patch over my nose, all day, every day. Not one patient ever mentioned it. No family members ever asked me about it. People spending days in an ICU, dependent on strangers, hooked to noisy machines that alarmed, rather than reassured, rendered my trauma invisible to them.
The time came to debulk and revise the flap. After surgery, I could look in the mirror for the first time without wanting to die. My grief lingered, coupled with a twinge of shame. I longed for the face of the young woman I used to be. I was ashamed of my failure to take care of myself. And the doubter in me, the part of me who questioned the existence of a higher being, again wondered what I had done to deserve such torment.
My most recent biopsy has healed. I await another Mohs procedure. This time the diagnosis is more ominous, squamous cell. It is a frightening diagnosis, but what frightens me more is the new path that will be carved in my face. While I wait, I’ll workout, play with my cats, write, drink wine, and watch television, where I see no women like me.
The Warrior and the Mammogram
The first challenge in a writing class designed to help me find my voice involved identifying characters and setting from a memorable time in my life. Using good old pen and paper, I described the second house I lived in and my older sister, who ruled her neighborhood gang like Sheena, Queen of the Jungle, the female warrior I remember from television in the fifties. Although we were estranged later for many years, my sister influenced major life choices, from my career to my single adulthood.
I may have been only five or six, but I worshipped my sister and looked for ways I could be like her. In the process, I found ways I could not, because I didn’t have the same talents. I hoped proximity would allow me to absorb even traces of the things I admired. A five-year age gap between my sister and me, cultural mobility, and unknowns I can’t remember allowed us to drift apart.
Then my sister developed breast cancer. My yearly mammogram evolved into the most painful, degrading, frightening, “routine” exam. Her diagnosis reclassified me from normal to high risk. The dread grew exponentially every year as my appointment date neared.
Perhaps that explains why, while waiting for my mammogram this year, I developed a case of tunnel vision. Once I checked in, I sat in morgue silence. Stress percussed the beat of my heart inside my head. While others focused on their phones or tablets, the only things I noticed in my physical proximity were feet.
To my left, thin tan sandals with a jeweled strap over the instep hugged delicate feet with nails manicured a peach yogurt pink. The hem of white capri pants stopped the extension of lightly tanned skin to the ankle strap. To my right, cheap patent leather white straps arched from between the great and second toes to the back of sole of the flip-flop. Thickly applied, white acrylic nail polish made the toes look fake, like those of a doll I had when I was a child. Across from me, a “safe distance” away, two feet were ensconced in yellow hued suede ankle boots. Too hot for August. I thought.
I bent my left leg and rested my ankle on my right knee to inspect my shoes. When new, white canvas provided the background for white leather mountains capped by purple peaks. I used a skate hook to tie the purple laces tight enough to keep my right ankle from rolling outward, which it had done since 6th grade. The thick soles added an inch to my height and kept knee pain at bay. After a year of working out in these shoes, the white turned gray. The waffled tread on the soles flattened. Like a breast in the machine.
To my surprise, a man checked in for testing. He wore traditional black work shoes, laced, with the leather scuffed and bulging in places from wear. Because of his gender, I looked up, looked at his chest. He wore an ordinary light shirt with short sleeves and a button-down collar. His chest, flat as any other man’s, led me to wonder why he needed the same abuse as I or any of the other women did.
My vision expanded to body types. I’d read about the relationship between weight and different cancers. From a group of five, two were voluptuous and round as Rubens’ nudes. Two moved across the room, lean and lithe as small trees in a gentle breeze. I walked, sturdy, muscled, with a small spare tire, the middle woman, the one caught in the middle of chance, weighted by a positive family history.
A technician called my name. I navigated toward her. I thought of the day my sister beat up the boy from across the street. I remembered the day, years later, when I broke months of silence and called her. “Mom told me you had breast cancer. Tell me how I can help.” Statistics say one in ten women develop breast cancer. Had my sister intervened with Fate on my behalf? In some other dimension, had the great gamemaster in the sky pictured me and my sister in a circle with eight other women where my sister insisted “Take me”?
My mind wavers between cruelty and compassion; it replays the “what ifs” and reassures with platitudes, “Surely not you.” Because my sister is a survivor, I can imagine the worst and hope for the best. In my mind, she remains the warrior queen and gives me strength.
AOC
This week I discovered I’m not too old to embrace a new hero, Alexandria Ocasio-Cortez, after she rebuked Mr. Yoho for his misogynistic hostility. Finally, someone illuminated the subtle, accepted subjugation of women, verbal male judgement. Her speech on the floor of the House inspired this sixty-nine-year old, who gave up on modern young women having an interest in gender issues. Her words reminded me of an incident from over twenty-five years ago.
One Halloween I went to work wearing a Hillary Clinton mask. I know some reading this may think “Well that would scare anyone.” But it was during the Clinton years, a time when a sense of well-being flourished, generated by the charisma of an energetic president. Mrs. Clinton, I would never disrespect her by calling her Hillary without invitation, labored to propose a plan for universal health care. I’d read research about the cost benefits of health maintenance versus regaining health after a crisis. A study out of Cook county asserted that health maintenance was cheaper. I augmented my Clinton mask with hand printed IDs made from index cards and intended to pass them out instead of candy. I delighted in a clever costume spiced with a bit of politics. Where better to ponder the ailing condition of American health care than in a big city ICU?
In the break room, I bumped into a frequent antagonist, a short man with an arrogance matched only by a need to dominate and a skilled physician. I handed him a card. I never expected my crudely made prop to light a fuse. Our debate began. He ranted about costs and insurance and hard work; I responded with questions about the responsibility to citizens of one of the wealthiest nations in the world, with the research I had reviewed, with the concept of moral compass. At some point, my mask came off, not just the Clinton façade, but the mask of restraint I learned to wear around the ego-fragile co-habitants of my work environment. How’s that for jargon?
We steamed up the break room. An audience assembled. When we agreed to disagree, one on-looker deemed me the winner of the exchange. The crowd dispersed. The two of us remained. My opponent agreed I won the round. Then, and this is why I am writing this, he spoke.
“It’s not what you said, it was your delivery.”
How was I supposed to say it? With please and thank-you and a curtsy. With a flash of cleavage. With apology or passivity. His words suggested a certain demeanor would make challenging him more acceptable. He diminished his stature even more with the innuendo.
I will keep my eye on AOC. I will listen to what she has to say. I know the internet has lists of the “craziest” or “dumbest” things AOC has said. The time for womanspeak is now. I will listen and hope it will be heard.
TMI
I paced around the house yesterday trapped in a conundrum of my own design and complicated by the crises going on in the world. I wandered from the newspaper, to reading, to the computer, back to reading, to staring out the window, asking myself how the world devolved to a place filled with vitriol, disdain for life, and measuring greatness by wealth, not of heart, but of commerce.
Yesterday forced me to become proactive today.
First, I thirty-day-snoozed someone on FB who posted nothing but rants about her one-sided view of injustices in this world. When I mentioned the devaluing of women in our society, she responded that we had to focus on black skin. Why? If all are not afforded the same equality, where is justice? Why did I have to accept when, as a young woman, I was told my opinions were valid, but I didn’t put them politely enough? Why did I have to be warned not to jog alone because I would be asking for “it”? We all know what “it” is. Why is age discrimination less valid than any other? Every person of age, regardless of color, will face it. I’m sure if I had explained my frustration when Kaepernick took the knee for police brutality but not for the female victims of his fellow athletes’ abuse, I would have been told I didn’t understand. When is brutality not brutality? When it’s black man on black woman?
A few days previously, this same person cursed and slandered health care professionals for trying to treat her holistically, with a thorough knowledge of all possible health issues, which caused a delay in her surgery. Having worked in a law office interviewing possible clients, I am sure she would have sued if anything went wrong because those same professionals didn’t investigate, didn’t delay, just forged ahead with an incomplete history.
Yesterday, charges were upgraded for one and brought against three police officers involved in the killing of George Floyd. Today, on FB, this same person continued to spew anger, document atrocities, and stir non-productive emotions.
I don’t feel the need to snooze people very often, but when the negativity outweighs the sharing of information, when it stops me, rather than helps me see things from the other side, when I suspect the tone will never change and will damage rather than advance a cause, I must.
There is an upshot. I plan to conscientiously limit my screen time except for writing.
I am forcing myself to leave the house, with caution, of course. A combination of the emotional beating from too much information and the weight of the heat and humidity imposed on this sixty-eight-year old body is sending me to the gym. Oh, I’ll maintain my anonymity. A mask is as good a cover as a FB avatar. I’ll workout, watch L&O:SVU reruns, and give myself a break from the confines of the living room, the kitchen, the mess that is my work space, the neighborhood where I am the woman with the purple cane and the clumsy gait who figure eights around the blocks to cover ten thousand steps. I will give myself a break from death tolls, brutality, judgements, accusations, venting with no plan or purpose, pundits celebrating the Dow amid the dual threat to America, a carnival barker posing as a leader, and my own shame at not knowing what to do to facilitate change.
Has Medical Specialization and the Business Model in Health Care Given Rise to Google, MD?
As a nurse, my family sought my advice over the years. I never practiced medicine without a license and stuck mainly to my specialty, Cardiovascular Nursing. If people asked me about pregnancy, I used the line “I don’t know nothing ‘bout birthin’ no babies.” I learned more about labor and delivery from Call the Midwives than I did from a clinical rotation forty some years ago.
With time, my advice took second chair to a new pundit, the internet. My mom asked me things, I advised, she argued. She would quote something she “Googled.” When a close relative developed cancer, she prepared for long distance care at a Cancer Treatment Center she read about until I reassured her that for her type of cancer, therapy at home would be more than satisfactory.
I agreed with the doctors at work who disdained Dr. Google or Google, MD. But then I had easy access to talented professionals amenable to “curbside consults.” I felt light-headed at work one day. I mentioned it to a colleague, a cardiologist. I had a stress test within a week.
Now that I have retired, I experience patienthood in an entirely new way. It started with a little light-headedness. No. Not a little. A lot. Bad enough to call 911. The red ambulance rolled up with lights flashing. I never felt so relieved as I did when the gurney rolled into the foyer of the fitness center. By the time they did a blood pressure, a blood sugar, an O2 sat, and looked at my EKG, I felt better, well enough to go to the bathroom and drive myself home.
I did what I would have told anyone. I went to my PCP the next day. He drew labs and did an EKG. My heart rate was, hold it, take it in, thirty-six. My heart had been bradycardic for years, but a rate below forty scared me. I’d been to a cardiologist before, so I called his office to schedule an appointment. When you imagine your heart might slow to a stop, you don’t want to wait around.
This is where the fun began. Despite the fact that I had seen this doctor and had a near “syncopal” episode, I hadn’t seen him often enough, so I was considered a new patient and couldn’t get an appointment for a month. Imagine me going to sleep at night with my index finger palpating my carotid artery to make sure my heart was still beating. Yup. That was me.
Thanks to Facebook and a few good friends and the fact that health care professionals treat each other like family, my appointment got moved up. I only had to wait a few days. My heart had to behave for a little while longer. However, I was warned that the doctor was extremely busy and that sixty patients were scheduled in the office that day. Whether you’re a nurse or a lay person, when it is your heart that is thinking about quitting, retiring from the rat race, going on hiatus, you don’t give a damn about anyone else’s problems whether it’s a cold sore or an office trying to make a buck.
When the doctor with whom I had worked for years walked in, I knew he recognized me, although he wasn’t sure from where. Yeah doc, I was the one who took care of all your very sick, high risk patients who agreed to participate in the trial of the procedure that revolutionized aortic valve repair. I worked hard with the unknowns and celebrated successes that changed the horizon for cardiac interventions. Guess what? I don’t give a damn about all that. I want you to NOT diagnose me in a five-minute office visit and exam. I want you to let me know you know all of my history, my MS, my anti-phospholipid syndrome, my meningioma, my very bad reflux, my hiatal hernia, the fact I have engaged in some sort of physical training since I was six years old. not just my heart history. But he chose the five-minute route. So, I went home and chatted with Google, MD.
Dr. Google mentioned sometimes a hiatal hernia can cause the exact same symptoms I was having, which was a relief, except it made me wonder if I should visit my GI doctor. I wondered if my meningioma was getting bigger and causing increased intracranial pressure and bradycardia. See my neurosurgeon? I wondered if I had thrown a clot to my lung again. Oh, did you not know about that? It’s on the paperwork, initially labeled incorrectly with someone else’s name. Call the pulmonologist. I had already done that.
You get my drift. In a perfect world, maybe all involved in my care could conference call and coordinate a plan. Since all my health care problems reside in one body, mine, maybe it would be helpful to consider them all before proceeding. Thanks to medical specialization and the business model of medicine, that will never happen. To be the best advocate for myself, I will draw from my experience, consult Dr. Google, and hope I make the right decisions.