Just a Hunch

I take care of Dad on Mondays and Wednesdays, from 11:30 till 5.  I give him lunch.  He always has something good in mind for me to construct for him (like sardines, ugh).  It makes my heart full to do anything at all to make his life easier, these days.

On Mondays the Hospice nurses visit.  They are certainly angels come to minister in a bleak and terrifying landscape.  Dad tries to tell her how Mom bullies him, he’s afraid of her.  Now that he’s helpless, he can’t do anything to hold her in check when she explodes.

I see it all the time: the way he looks up, terrified, when his barely-functional hands betray him and he drops food in his lap.  He says “Damn,” as if to let her know he knows he’s been bad; and he scrambles as fast as he can to pick the food up off his bib or his lap, wherever it’s landed.  He can no longer bend over from his wheelchair to pick things up off the floor.  Whenever something eludes him completely and ends up on the floor, he is near to panic.

I miss the obscenely obese old dog they used to have, who eagerly waited under the table for dropped treats.  He became incontinent and my mother had him put down.  I understand that she couldn’t handle my dad and the sick dog at the same time, but it makes me sad, and I miss the dog’s function.

But getting back to the hospice nurse who visits on Mondays.  She always checks Dad’s feet, since he is diabetic and feet are sitting ducks for getting ulcers and ultimately needing to be amputated.  We don’t want that.

He had sandals on, with Velcro straps that had been put on way too tight, probably by the untrained helper who gets him out of bed, showered, and dressed in the morning.  He does mean well, but he doesn’t understand certain things.  One is that Dad’s feet and legs are tremendously vulnerable, not only because of the diabetes but because his heart is failing, and that means his circulation in his lower legs and feet is even worse than usual.

On Monday, when we got his sandals and socks off, his feet were black.  I mean black.

The nurse was emphatic that he see a doctor about his feet ASAP; I didn’t need any convincing.

Since Mom was out, the nurse asked me to convey this to Mom as soon as she returned.

However, I know what happens whenever I do anything like that: “You make a big deal out of everything.  You’re always overreacting.”

I asked the nurse if she would please call my mother and tell her.  Mom would take her word of authority.  The nurse did that.

After the nurse left, I got Dad settled with his feet up on a cushioned chair, where he fell asleep.  I inspected his feet further, and as I did, I got a whiff of an odor I have smelled many times before: the sickly-sweet smell of dying flesh.  Tears wet my cheeks, made their way into my mouth, and I had to run for a tissue to catch the snot.  I always snot a lot when I cry.

After the nurse’s phone call, Mom did scramble to get an appointment with the podiatrist.  It’s now Wednesday, and he saw the podiatrist this morning.  A fungal infection, he said, and prescribed some cream.  I took a look at the feet today, and there are some bubbles; somehow I don’t think it’s fungus, but I will be very happy if I am indeed over-reacting.  I guess I have seen too much, and amputated too many feet during my time in practice.

Monday night I got take-out Chinese food for them.  I made an exception to my strictly Kosher diet, and ate some vegetarian fried rice.

Dad has been having dreadful, painful coughing fits, especially when eating (which takes more effort than you would think), and coughing up clear and/or frothy fluid: congestive heart failure.  The heart does not have the strength to pump the blood through the lungs and out to the body, so the blood stagnates in the lungs.  Fluid from the blood makes its way into the airway, causing cough and shortness of breath.  The person is literally drowning in their own fluids.

Dinner on Monday night was dicey.  He was coughing and eating fried rice, and I was afraid he would inhale it.  He was afraid he would drop something in his lap.

Although Tuesday is supposedly my day to catch up on errands, etc., I had a hunch I’d better stop by the house.  They were having lunch when I arrived.  Dad was really having trouble eating.  It seemed as if every bite he took cost him a coughing fit.  Finally the coughing overcame his will, and he succumbed to it.  He couldn’t catch his breath at all, and turned absolutely blue.

Hospice has provided us with an emergency med box, containing everything from Tylenol suppositories to morphine drops, to, frighteningly, drops to put under the tongue of a dying person to thin the agonal secretions and relieve air hunger.

Fortunately, the box also contains a few tablets of Lasix, a diuretic (water pill) that magically sends extra fluids to the kidneys, where they leave the body as urine.  That’s what was needed, to get the fluid out, and fast.

I rummaged in the box, found the Lasix, and then felt that I should at least call Hospice and let them know that I had pillaged the box.  Most Hospice family members are not doctors, and I thought it would at least be courteous to let them know I was going to use one of the contents of the box.

The nurse on call was not one I knew, and she didn’t know who I am.  She disagreed with my plan, and suggested I give him some morphine for comfort.  I explained that he had been on Lasix previously for his heart, but it had been discontinued because he was incontinent of urine, which made my mother mad.  Now she’s used to it, especially since other people change his bed and diapers, for the most part.

At that the nurse agreed.  I gave him the pill, and half an hour later he peed the fluid out.  He’s been mostly OK in the respiratory department since then, although I notice today that he’s starting up again.  I had our regular nurse call us in a prescription, so we’ll have a supply of Lasix for when we need it.

It’s Wednesday, and I spent the day with Dad as usual.  He’s been hallucinating a lot, and was pretty scared.  His feet were swollen again, so I wheeled him over where he could put his feet up on his hospital bed.  He took a nap for a while, and I read, until 3 o’clock when he woke up a bit restless.  He wanted the Westerns channel on TV.  I put that on for him, and suggested a l’chaim.  He lit up at that.  So I got us each a Scotch, and we toasted each other’s happiness, wherever our paths might lead.  Then we drank likker and made a running commentary on Bat Masterson and Wyatt Earp, he with his feet up and me sitting on his bed, happy as a couple of cackling crows.

I’m really, really going to miss him when he goes.

Making Hay

I met him in a cowboy bar in Lima, Ohio.  I needed a dance partner for the two-steps and waltzes.  The hostess got me Dale.  He was newly divorced and still smarting, didn’t want anything to do with women–guaranteed–but he also needed a dance partner.  I was safe.  We were married the next year.

He was a trackman on the railroad.  I was the director of a pediatric emergency department.  That gave us an interesting socioeconomic dichotomy.  I didn’t care; he was my savage gamekeeper, and I his Lady Chatterley.  ‘Nuff said.

One night a colleague at work said to me, “Don’t drive down Slabtown Road.  There’s a horse farm for sale there.  If you go down there, you’ll surely buy it so don’t go down there.

I went down there the next day.  I bought it.

When I was shit-poor, playing the banjo on the streets in Boston to make rent money, throwing rent parties when it didn’t pan out, I promised myself three things if I ever got rich:

I would have nice underwear.

I would learn to fly.

I would have a horse.

It was a 40 acre farm with two barns and a brick ranch house.  There were 32 stalls with 32 horses in them.  13 of the stalls were filled with the outgoing owner’s own horses, which would come with the deal; the other stalls were boarders.  So instead of “a” horse, I suddenly had thirteen!

It was a “turn-key operation.”  That meant the owners wanted out, Right Now, and wanted rid of the place and everything on it.  Suited me fine.

There was a wonderful 4 wheel drive John Deere tractor with a backhoe, front end loader, snow blade, brush cutter, power take off (PTO), PTO powered John Deere hay baler, a powered manure spreader (very important when you have 32 horses!), a 1949 Allis Chalmers tractor, hay mower, a couple of wheel-powered hay rakes, and everything else you’d need to manage and bale five cuttings a year of 25 acres of prime alfalfa.

That was the only time in my life I’ve ever watched TV.  If you’re going to make hay in Ohio, you’d better be adept at gauging the weather patterns from the Pacific Northwest to the Upper Midwest, during haying time.  That’s the way the jet stream flows in summer, and that’s the path the storms take.  It takes about three days for a storm system to travel from Seattle to Lima.  Like it says, you have to make hay when the sun shines!

Timing is critical when making hay.  First off, you have to know when to cut it.  The alfalfa plant is highest in protein–up to 28%–right before it blooms.  If you cut it right then, you will have soft, fragrant green hay that is loaded with protein, vitamins, and minerals, and there is little chance for toxic molds to settle in.  If you miss this tiny window of time–only a few days–what you’ll have is coarse, tough, not-very-nutritious hay, good for cows at $1 a bale but not suitable for horse feed at $5 a pop.

Now, the absolute minimum time frame for making a crop of hay is three sunny days: day one to cut, day two to turn it over and dry it on the other side, and day three to bale and put it away in the haymow.

So the art of it all was to pinpoint the exact three-day window between rain storms, coordinated with the ideal growth stage of the alfalfa.  It was exciting.  Heart-pounding.

To make it all more interesting, those three-day windows always seemed to occur when the temperature was over 90 degrees Fahrenheit.

The upshot of the torrid temperatures was that we could never manage to bribe the local high school boys who lolled around during summer break doing nothing but getting into trouble–we could never get them to help us put up hay, even for good money.  So it fell out that Dale and I did all of the cutting and raking ourselves.

He would go out first, as soon as the dew dried off the hay.  That was another obstacle–you can’t just get up with the birds and expect to go cut hay.  If you do anything to hay while it’s wet, it will do something bad to you, like turn directly into mold. And worse, if you put wet hay in your haymow, it creates so much heat in the process of fermentation that many a good barn has burned down due to hay fires, and many a good animal lost!  So you had to pat your foot and drink cup after cup of coffee until the sun had dried the standing hay.

As soon as the sun was full on, beating down like brimstone, Dale would jump on the John Deere with the mower on, and cut hay for dear life.  If we were lucky, it was so damn hot that I could give him an hour’s head start and follow right after him with the old Allis Chalmers, with a wheel-drive rake on the back.  The sun was so hot, the hay dried enough to turn over in just an hour!  So we’d get the whole 25 acres cut and turned over in a day.  But most of the time it was a two-day process before we were set to bale.  Cut the first day, and the second day I’d go out with one rake on the Chalmers and turn over the front field while he did the back field with the Deere.

Driving the Chalmers was an adventure in itself.  It had all kinds of convenient features, like a dead-man’s switch.  That’s a metal button on the floor that you have to keep your foot on at all times, otherwise it cuts the engine off.  Obviously, because it’s called a dead-man’s switch, if you died while driving tractor it would most likely cut off.  If you are five feet tall and have to drive the tractor half-standing, half hanging onto the steering wheel, it’s damned hard to keep your weight on that stupid switch.  Of course, if you fell off the tractor it would be handy to have it stop automatically, saving you from getting run over or having to run like hell to catch up with an escaped tractor.

The Allis had no brakes.

Therefore, I had to devise a strategy for what to do when I came to the corner of the field and had to make a turn.  Luckily the Allis tolerated letting the engine idle down real slow, since it only had two gears: fast, and faster.  But it would throttle down to a creeping crawl before it stalled.  That was good in another way: the starter was on the floor too, and required a good stomp to fire it up.  I must have looked like a monkey on a string hopping up and down trying to get that damn tractor started.

On the third morning, after the horses were fed and watered and the stalls mucked out, and after four or five more cups of coffee, Dale would hitch the baler to the Deere.  If we were lucky, and school was out, we’d have our two boys (his and mine) as slave labor.  When you live on a farm, there are certain realities of life, like barn chores and baling hay.  Let’s face it: none of us woke up in the morning shouting, “Yaaay!  Let’s go fry our ass, get good and sweaty and covered with itchy hay dust, and totally dehydrated because there isn’t time to stop to drink!  Yaaaay!”

Nope.  So it was on Baling Day that I drove the John Deere tractor with a baler on the PTO and a 14 foot flatbed wagon hitched behind, no automatic balers that shoot the bales into a tall stake wagon for us: we had the old-fashioned kind that plops the bales down in the field.  So Dale would horse the 60-to-70 pound bales up to the wagon, one of the boys would grab it from him, and the other boy would stack it on the wagon.  As the wagon filled up, it got harder and harder……but those boys could sometimes load that wagon five bales high.  Then we’d unhitch from the Deere and one of the boys would get the Allis, and haul the load to the barn.

Without the boys to help, it was just me driving tractor and Dale working the wagon like a madman with rabies.  I had to stop a lot to let him catch up on the stacking.  Sometimes I’d hop off the tractor and help stack, then we’d have another go at it till we were ready to put the bales in the barn.

If we hadn’t had a powered hay conveyer, I don’t know what we would have done.  This looked like a playground slide with a conveyer belt going up to the haymow.  We’d generally have the two kids (did I mention that they were ages 8 (mine) and 10 (his) when we started doing this?) up in the haymow stacking, and I’d be on the wagon heaving the bales down to Dale, who heaved them onto the conveyer.

And then we’d go out to the field and do it again, until it was done.  It was a race against the evening dew, or the coming rain, whichever came first.

Sometimes something exciting would happen: I always drove tractor with my head cocked over my left shoulder, one eye on the windrow and one ear on the baler, in case somebody got in some kind of trouble.

So when I heard shrieks coming from the direction of the wagon, I shut the whole works down and leaped out of the tractor seat.  (The dead-man’s switch on the Deere was conveniently located under the spring-loaded seat, so all you had to do was stand up and the tractor shut down.)

Son of a gun, if we hadn’t baled up a smallish rattlesnake; and before anyone noticed, it had been tossed up on the wagon, its head sticking out and snapping for all it was worth!  Dale whacked it with something or other, and threw that bale back into the field.  Reject!  We laughed over that for years.

After the last bale was put away in the mow, there was a mad rush for the Gatorade and the shower.  Then barn chores, which never wait till tomorrow.  And the blessed coolth of the evening.  Let the dew fall where it may; the hay is safe, and so are we, until time to bale again!

Postscript: although at the time my son thought he was being abused by being forced to do what all farm kids do, he now remembers those years as the best in his life. 

The Dinner Guest

I went to a dinner party at my parents’ house tonight.

I wasn’t invited.

Only big deal art collectors and a big deal artist were invited.

My parents live one minute away from my rude yet adequate dwelling–my father’s former studio, just a pole building really.

The way I found out about the dinner party was that my mother was whining on the phone about having to cook again, after having had a dinner party last night, to which I also was not invited.  The guests were the same art collectors.  They bought a lot of stuff, you know.

She was having ribs tonight.  I don’t eat pork.  Maybe that’s why she didn’t invite me.

I decided to make an appearance anyway.  I didn’t dress up: I wasn’t an invited guest.  Jeans and a clean shirt, good enough for a “just dropped in.”

There was a moment of uncomfortable silence when I walked through the door.  They were just sitting down.  The big deal art collectors offered to make me a place at the table.  No thank you, I smiled, I’ve just come by to say hi. The female art collector hugged me.  So did her husband.  The big deal local artist who can’t stand me and makes no bones about it, didn’t want to hug me but I hugged her just to piss her off.  Don’t ask me why she can’t stand me.  I don’t know and I don’t care.

My mother flew at me to try to hug me for the benefit of her invited guests: pretending to be glad to see me, as if I had just blown in from far away instead of down the dirt path.  I sidestepped her.

My dad, of course, was ecstatic to see me, and showed it.  That’s all I wanted.  That’s all I came for.  That, and to let Boo Radley make a public appearance.

And–I admit it–to make a small, silent statement: there is a daughter.  She lives one minute down the path, but we don’t invite her…or speak about her.  She’s disabled…..but we can’t say how, so we just don’t mention her.  And we certainly don’t invite her.

I stayed three-quarters of an hour, enough to be polite.  For table talk, my mother announced she had booked a massage with the new massage therapist in town.  Big deal artist said she’d already been (of course).  I asked her the details, what it cost.  A dollar a minute.  Maybe I could trade her, I said.  Lots of massage therapists are happy to trade with me.

My mother snorted audibly(cringe).  “What have you got to trade?”  Acid dripping on the floor.  Sssssssssss………

“Acupuncture,” I answered.

“What?”  As if she hadn’t heard me the first time.

“Acupuncture, or a custom perfume.”  My voice sounded hollow in my ears.  The noises of the dinner party pounded.  The woman rich art collector looked up sharply.  She had heard.  How could she not have?  My mother’s voice is famous for its booming quality.  She does not need a microphone.

I sat silent in my chair, which I had pulled up outside the inner circle of diners.  Images flashed: little girl circulating the loud and laughing room with trays of hors d’oeuvre,  smiling politely, speaking when spoken to and shutting up at the hard glance across the room.  Back to the kitchen to reload the tray, careful to make an artful arrangement for the guests to dismantle one by one, or maybe by twos and threes if it was caviar on cream cheese.

Then help serve the meal, and sit quietly (“children are to be seen and not heard”) unless there happened to be one of my special adult friends present, in which case I was allowed to sit next to them and talk for a little while, as long as I was not “monopolizing” them. It’s important that children learn how to conduct themselves at dinner parties, especially when there are honored guests, so that they don’t embarrass their parents.

After clearing the table (“Thank you, dear”) I was expected to disappear to my room, which is where I wanted to be, while the adults repaired to the living room to get drunk.

I stood, carefully replaced my chair where I had found it, and put on my wraps.  It’s still a bit chilly here, nights.

“Oh, are you leaving us?” cries the big deal art collector woman.

“You’re leaving?” says dad, tearing up.  I can’t kiss the top of his bald head because my mother is swinging at me, trying for a fake hug, and he’s stuck on the other side of her.   Leave it for tomorrow.

I smile and say goodbye, hope to see you again soon, making eye contact with the big deal art collectors.  Fuck the big deal artist, she can’t stand me anyway.  And she’s parked her gently ostentatious new car in an impossible place in the driveway.  I have to make a 5-point turn to get around her.

Back in my pole barn, I feel like having a drink or two or three or four, but I know it will only give me a bigger headache.  What about organizing some of this unbelievable clutter instead?  Do something constructive, shake it off.

Leave it for tomorrow.

Pass the hors d’oeuvres, please.

 

Ending the Toxic Relationship and Giving Yourself Time and Space to Find Yourself

An amazing article from an amazing blog. For those of us who are adult survivors of childhood abuse, this site can be a lifesaver, filled with resources. It was only after reading this site that I felt validated in my knowledge that I am an ACoN–an Adult Child of a Narcissist. Even though I can’t move back to the other side of the world right now, and even though the reason for that is that I’m helping my parents in their old age (thereby soaking in the stinking soup of bad relationships), I still find The Invisible Scar to be reassuring and comforting. At last, someone who understands, and has good advice! (And if my therapist is reading this: Yes, B, I know you tried to tell me all this, ten years ago. I’m a slow learner;-)

The Invisible Scar

photo credit: AmyJanelle

Some relationships are deeply damaging and unhealthy for the people within the relationship. Unlike healthy relationships, which have peaks and lows, which have struggles now and then, a toxic relationship is poison to the people involved.

But what happens if the toxic relationship is within the family sphere?

Imagine your daughter telling you that every time she was with her boyfriend, he insulted her, gaslit her, made her feel small and insignificant, mocked her interests, tried to change her personality, deprived her of what she loved, cut her off when she was speaking, demanded her to always agree with him, ignored her when she differed in opinion, expected only adoration, and left her feeling stressed-out, sick to her stomach, and emotionally wounded.

Would you tell that daughter to continue seeing that boyfriend?

No. Absolutely not. No one would. However, what if the people involved was a friend…

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Vascular Surgery

WARNING:  NOT FOR THE FAINT OF HEART!

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Vascular Surgery

There’s a good reason women make the best surgeons, she thought.

Quick, deft hands, single-pointed concentration, focus.

She thought of the women jet engine mechanics she had met in the Air Force.

Not that she had been in the Air Force; but in the course of her duties as a civilian surgeon under contract, she had met them. Now, reining in her reverie, she was intent on the task at hand.

Drat this light, she thought. She really needed a more direct light source, but one has to work with what one has at hand.

Slowly, painstakingly, she drew the outlines with a surgical marker: carotid triangle; carotid vein; carotid artery. This, the artery, was what she wanted.

She steadied the syringe she had readied with an oh-so-fine 27-gauge needle.

2% lidocaine with epinephrine should be enough analgesia for comfort, and enough epinephrine to ensure a relatively bloodless field. She couldn’t help chuckling: bloodless indeed.

Squinting in the insufficient light, she injected the layers: first the skin, then the loose fascia of the neck; lastly, the layer surrounding the vessels of the neck, careful to avoid direct injection into the wall of the vessel, which might cause a spasm.

Now it was time to cut. She picked up the number 11 scalpel and steadied her hand. Carefully, carefully she opened the delicate skin of the neck, noting with satisfaction that the epinephrine had done its job. There was no need for the tiny hemostats she had ready in case of superficial bleeders.

The next layer, the loose fascia, pulsated bluish, overlying the great vessels of the neck. These she would blunt dissect with the larger curved hemostats.

She injected a bit more of the anesthetic, just to be sure. No need to cause discomfort, which might result in unwanted movement.

At last the artery was exposed. She marveled at its pulsations, at the tiny arteries that nourished the big one itself, and the minuscule veins that issued from it, carrying its waste into the larger system of veins, to be cleansed by the liver and kidneys downstream.

Holding her breath, she slid the first hemostat, jaws open, under the artery. Clamp. The vessel, trapped in the jaws of the hemostat, stopped pulsing abruptly. There was no going back now.

Now the second hemostat, exactly one and a half centimeters below the first: clamp. She raised the surgical scissors, poised for the definitive cut between the clamps.

Tilting her head to see better in the mirror, she cursed the dim light in that bathroom again.

And then, the definitive cut!

In a single motion, she swiftly removed the two clamps and was instantly drenched in red liquid. A scream of agony split the night as she sat bolt upright in the bed, heart pounding, drenched in sweat, clutching the sodden bedclothes as she struggled, locked in the arms of the Angel of Death like biblical Jacob.

Frantically clutching her throat, she rushed to the bathroom, the very same bathroom, and strained toward the mirror in the same dim light.

Nothing.

Her throat, graceful and bluish white as ever, shone back at her from the reflection. Sucking in a deep gulp of air, letting it out in a sigh that brought the dog running, she splashed water on her face and neck, toweling off the sweat.

“It’s OK, buddy,” she whispered to her whining canine companion. “Just another nightmare.”

The dog smiled anxiously, wagged his tail tentatively, and licked her calf. She reached down and patted his faithful head.

“Good thing I have you, she murmured. Stripping off her sweat-soaked nightgown, she rinsed off in the shower before throwing on a fresh one. She sank into the recliner with a book: sleep would not visit again, not tonight.

 

Sleep, Precious Sleep

Yesterday morning my phone rang way too early.  It was a friend who probably though I get up at a normal time for a human being; but I don’t.

You see, my meds last twelve hours, and I have to sleep them off if I want to be functional the next day.

More than that.

If I don’t get the right amount of sleep, I turn manic.  Pretty simple, eh?  Meds>sleep>functional.  Not enough sleep (even with meds)>manic.

I needed to get up earlier than usual today, because there is a lot to do in preparation for Passover, and I needed a full day in which to do it.  This can usually be engineered by taking my night-time meds early.

So I did.

But nothing happened.  I didn’t get sleepy.  Instead I started feeling wired.

Uh-oh.

I thought, maybe I actually forgot to take my meds.  I looked in my pill box: tonight’s meds gone.  So I did take them, after all.

So I did what my shrink tells me to do under those circumstances: I took an extra Seroquel.  That usually knocks me down.

But not last night.  May as well have taken a sugar pill.

I took another, and a milligram of Ativan to keep it company.

Nothing.

By the way, in case you’re wondering, I left an hour between doses, sufficient to feel the effects of the drugs.

I was getting very concerned by this time.

So I took yet another Seroquel, an Ativan, and another Ambien (those are in my usual bedtime hammer cocktail).

Not one fucking bit of “sleepy” coming my way.

So I got out of bed, where I had been passing the time by watching Betty Boop flicks on Youtube, and began doing my Passover chores, since it was clear that I was going to have a short and shit day.  I got everything ready for cooking, chopped mountains of veggies, did all my prep work so all I would have to do is throw the brisket in the slow-cooker, throw the veggies on top, and not worry about it.

Finally the sledge-hammer anti-mania drugs took effect (oh for a few milligrams of Haldol, for quick knock-down) and I managed to get in bed before the blessed drugged sleep overcame me.

I still had to wake up earlier than usual this morning, to call the clinic and cancel my 11 am appointment for ER follow-up with my primary care doc.  I woke to my alarm, made the call, and lay back down to go back to sleep for a couple hours, since I’d already done my prep work and had the time for a longer sleep.

Nothing.

Not gonna happen.

So I got up, feeling cross and speedy, and made my oat matzah (gluten free), singed the meat, sauteed the veggies, made a sauce, threw it all in the slow cooker and sat down to write this.

I really want a beer, but now they’re assur, forbidden, because of being made with yeast.  Anything leavened is forbidden for one week.  Damn.  Oh well, maybe I’ll get up and clean.

 

Get Me The Hell Out Of Egypt

No, not Eretz Mitzra’im, which is the Land of Egypt.

Had I been there, I most likely would have been thrown out in one of the many exiles of my people who came there seeking asylum from the Spanish and Portuguese, long about 1492.  All but a handful of Hebrews have been ejected from that land.

But.

In Genesis 15:13-14, it is said:

And He said to Abram, “Know with certainty that your offspring shall be aliens in a land not their own–and they will serve them, and they will oppress them–four hundred years.  But also the nation that they will serve, I shall judge, and afterwards they will leave with great wealth.  (Emphasis mine)

There was, in fact, a cordial relationship between the Hebrews and the Mitzrim (Egyptians).   They traded together, and the Mitzrim gladly allowed the Hebrews to come to Mitzra’im in times of famine in the land of Canaan, where the Hebrews dwelt (now called the Land of Israel), to buy food and water.

For the Nile waters the land of Mitzra’im, but the Land of Canaan is dependent upon seasonal rains for sustenance.

Years and generations passed, and Jacob, whose Godly name was Yisrael (Israel), had twelve sons and a daughter.  His favorite son Yosef (Joseph) angered his brothers, who sold him to a Midianite caravan, who sold him to an Ishmaelite caravan, who sold him to Poti-Fera (Potiphar), who was the Egyptian Chief over the Pharaoh’s butchers.  (Gen. 37:27, 37:36, 39:1)

Yosef did well there, and was promoted to be the supervisor of all Potiphar’s household.  But bad luck for him:

After all these things, his master’s wife cast her eyes upon Yosef and she said, “Lie with me.”  But he adamantly refused…” (39:7-8)

And she kept after him.  One day she actually grabbed hold of his garment and tried to pull him to her, but he escaped and fled, leaving his garment in her hand.  She screamed “Rape!” and Yosef, who was found outside the house with nothing on, was cast into prison.

You can see from this unfortunate turn of events that even when we are doing our best and thinking things are going well, even the greatest among us may have characteristics that unwittingly trip us up and lead to a fall.

Yosef is called Ha’Tzaddik, The Righteous One, because everything he did was in honor of G-d, and he was able to overcome the most natural of urges–the sex drive–even when freely offered by Potiphar’s Wife, who was said to be the most beautiful in the land.

But it is said that Yosef had one flaw: he was beautiful and he knew it.   He would spend time putting on makeup (as was normal for Egyptian men at the time) and gazing at himself in a mirror of burnished bronze.  Thus, all the women in Mitzra’im longed to be with Yosef.  Indeed, why should Eshet Poti-fera (Potiphar’s Wife) not have him?

Yosef had told her that he was free to partake of anything in his master’s household, with the exception of Potiphar’s Wife! (39:9)

But woe to him, he was thrown into prison; but Yosef had G-d’s favor, and even this turned into a good thing, although not for a while.

Yosef found favor in the jailor’s eyes, and he was made supervisor over the prison (even though he was a prisoner himself) (39:21).  There happened to be two other prisoners there, courtiers of the King of Egypt (for in this verse he is not named).  They were the royal baker and the royal cup-bearer, and they had each displeased the King.

One morning Yosef found them distressed, for they had both had disturbing dreams. (40:6)  Yosef correctly interpreted those dreams, and the outcome was that one servant was reinstated, while the other was beheaded.  Yosef asked the reinstated one to put in a word for him with Pharaoh, for that was his boss, but the man forgot, and Yosef was stuck in prison for two more years.

Nothing happens in vain, and everything is G-d’s plan.

Pharaoh had a disturbing dream, and called all of his wise men, magicians, and necromancers to try to interpret it, but none could.  This jogged the afore-mentioned servant’s memory, and he recalled Yosef, and told Pharaoh, who commanded that Yosef be brought before him.  Yosef was given a bath and a shave and new clothes (41:14), and brought before Pharaoh.

Pharaoh told him his dream (41:17-25) and Yosef correctly interpreted it for him (go and read the dream for yourselves–it’s worth it!); and Pharaoh mad Yosef his viceroy over all the land.

Because of the content of the dream, Yaacov (Jacob, Israel), who is Yosef’s father, remember, brought his whole family, who now numbered 70 souls, down to the land of Goshen which is in the northern part of Egypt, a fertile grassy land perfect for grazing flocks, for the Hebrews have always been shepherds.

There was a time of peace, and Yisrael (Jacob) died, and then Yosef died, and the Hebrews grew to be a large and prosperous nation in Goshen.  But:

A new king arose over Egypt, who did not know of Yosef.  He said to his people, “Behold! the people, the Children of Israel, are more numerous and stronger than we.  Come, let us outsmart it lest it become numerous and it may be that if a war will occur, it, too, may join our enemies, and wage war against us and go up from the land. (Exodus 1:8-10)

 

Nationwide Recall of Antidepressant Issued

Nationwide Recall of Antidepressant Issued.

via Nationwide Recall of Antidepressant Issued.

 

Heads up, Effexor XR users.  Pfizer has recalled lot numbers V130142 and V130140, and Greenstone lot number V130014, because they may contain a heart medicine that could potentially be life threatening.  In case you can’t access the above linked article without a password, I will quote the relevant passage from the Medscape article here:

A voluntary nationwide recall of 3 different lots of the antidepressant venlafaxine (Effexor, Pfizer Inc) has been issued by the drug’s manufacturer owing to possible contamination with a heart drug and subsequent potentially fatal consequences.

As a precaution, Pfizer Inc is recalling 1 lot of 30-count Effexor XR (venlafaxine HCI) 150 mg extended-release capsules, 1 lot of 90-count Effexor XR (venlafaxine HCl) 150 mg extended-release capsules, and 1 lot of 90-count Greenstone LLC-branded venlafaxine HCl 150 mg extended-release capsules.

According to Pfizer, the action is being taken because 1 bottle of Effexor XR contained a single capsule of dofetilide (Tikosyn, Pfizer Inc) 0.25 mg, an antiarrhythimic medication used to treat atrial fibrillation/atrial flutter and maintain normal sinus rhythm.

Pfizer says the probability that other bottles of Effexor XR have been similarly contaminated is low but that it has issued the recall as a precaution.

This recall involves Pfizer lot numbers V130142 and V130140, which both expire in October 2015, and Greenstone lot number V130014, which expires in August 2015.

“Although Pfizer has not received any other such reports, these 3 lots are being voluntarily recalled as a precaution because they were packaged on the same line,” the company said in a release.

“The use of Tikosyn by an Effexor XR/Venlafaxine HCl patient, where the contraindications and drug-drug interactions with Tikosyn have not been considered by the prescribing physician, could cause serious adverse health consequences that could be fatal,” the company notes.

I hope no one is taking these lots of Effexor XR/Venlafaxine HCl, but if you are, stop taking it immediately and call your prescribing provider.

Tongue In Cheek

Guess what I did yesterday?  I had a life-threatening attack of Angioedema.  My tongue swelled to the point where I couldn’t talk.  The left side of my tongue was severely effected, the right side less so.  I could still breathe through my nose, thankfully.

It came on rather suddenly, as I was sitting on my deck watching a comely young man hauling fish after fish out of the river, taking the hook out, and holding it up in the direction of the East.  He then put the fish back into the river.  Imagine the experience of the fish!

And as I was watching this curious fish ritual, I became aware that my tongue hurt.  I looked at it in the mirror and it just looked a little swollen, and thickly coated.  I use oral inhaled steroids for asthma, and thrush is always a concern.

But I know how to handle thrush, so I went for my baggie of medical grade myrrh resin that I bought at Manny’s homeopathic pharmacy on Yaffo Street in Jerusalem.  I picked a nice clear chunk and lodged it between teeth and gum, and went about my business.

But it quickly became apparent that this was not thrush.  The left side of my tongue was jammed against the roof of my mouth.  The right side was starting to swell too.

I pondered what to do.

Would you believe, one of the things I was pondering was that this was the death ordained for me on Rosh Ha’Shanah, the Jewish New Year where everyone’s fate is decided, who shall live and who shall die, and if you are condemned to die then there are different ways to die, and one of them is by strangling.  Maybe this was it, and I should just sit down in my recliner and let the decree take me away.

Then I thought, who will take care of Noga if I die somewhat suddenly?

I went to the medicine cupboard and got out the Benedryl, and took the proper 50 milligrams.  Then I got Noga’s Predisone (she has allergies) and took a couple of the 5 mg tablets.  I silently (since I could no longer produce understandable speech sounds) cursed that I did not have any epinephrine.  I used to keep a whole emergency formulary at home, but now I don’t even have a prescription pad, even though I still hold my license.

Should I call 911?  Well, if I definitely wanted to die, then yes.  First of all, I wouldn’t be able to talk to the dispatcher except in grunts, and she would probably think I was a prank caller and hang up on me.

Even if I managed to give her my address, the Keystone Cops that they call the EMS here would never find it.  It’s not on any map, being a mile and a half down an “unimproved” road and up a dirt driveway that looks like it goes to nowhere in particular.   Giving directions in my present state was definitely not a possibility.

Not only that, but the last several times that Dad has fallen and needed emergency medical services to put him on a backboard and take him the the skunkworks they call a hospital here, the EMS has not showed up any sooner than 30 minutes after being called, even when he was unconscious. Calling the EMS was a quick ticket to the next life.

So I hopped in my car and drove the 15 minutes to the hospital.  I remembered to say Shma Yisrael, the prayer we Jews are supposed to say before we die, and asked the Creator if s/he would please spare other people when I passed out from lack of oxygen and ran off the road.  I was pretty sure that I got a positive answer.  That made me feel better, because if I was destined to die along the road I really didn’t want to take anyone with me, although it also occurred to me that they, too, might be destined to die right now and I would simply be the agent of their death by sudden impact, which is the equivalent of the punishment of stoning.

Miraculously, I made it to the hospital, parked in the wrong lot, amazed myself by navigating the path to the Emergency Room, and walked to the Registration cubicle.  The young clerk was sitting there chatting with her friends.  I approached and put out my tongue, hoping that she would see that I was walking wounded and get me inside quick.  She gestured for me to take a seat.  I did no such thing, but made urgent guttural sounds, like some sort of primate.  This time she said, “OK, I’ve called the nurse.  She’ll be here soon.”  I felt sort of better.  At least when I passed out, someone qualified would find me.

The nurse appeared right quick, and I put out my tongue for her.  She exclaimed and whisked me away to a monitored room.  The air conditioning ate through my fleece jacket, fleece vest, and two layers of silk turtlenecks.  This thing had made me really cold.  So she holds up this thin hospital gown and says cheerfully, “Everything off, now, and put this on.”

I pantomimed freezing, hugging myself and jumping up and down a bit, to make it clear I was not about to abandon my layers of warm clothing for a barely-there schmatta.  She turned the thermostat up,  the air went off, and she brought me some warm blankets.  Monitors of all kinds were applied, and a wave of panic washed over me.  Trapped.  Tied down.  Wanna run, but probably would die, and I had decided not to die this time.

An aide came in and sat down at the computer and asked me a question.  “Uuuh!”  I answered.  This reiterated several times before she got the clue that I could not talk.

A pair of nurses appeared, carrying the tools of the Intravenous Line trade.  Panic attack.  I have a disease that has destroyed my veins, making them very fragile.  They often bleed for no reason at all.  Last time I was hospitalized I went through seven IVs in one day.

But they got it on the first try, even though one of them had to hold the vein down to keep it from rolling.  I’ve done that.  Works pretty well.

The doctor brisked through the door, asking questions as she came.  Must be busy, I thought.  She’s in hyperdrive.

I tried to talk and that told her what she wanted to know.  She asked me a series of intelligent questions to which one could nod or shake one’s head.  She rose in my esteem.

Medicines went into the IV.  A respiratory therapist came and gave me a breathing treatment to prevent spasms of the bronchial tubes.

The doctor popped in from time to time, and when the medicines started working and I could speak after a fashion, we of course started exchanging war stories.  Doctors are incorrigible when it comes to war stories.  I am certain that if there were two physicians and one of them was on their death bed, the two of them would be talking about this or that horrendous case, and trying to one-up each other, just for the fun of it.

Little by little my tongue went down, but the left side was being a bit stubborn.

The doctor came in and announced that they were going to admit me for overnight observation.

I secretly thought that was a good idea, but there were several factors that argued against it.  One was that my little Noga was home all by herself and would not have enough water or food to keep her in good shape.  Another is that I take exotic medicines that hospitals usually don’t have, and I must have them.  Third, although I am something of a heretic and no good at all at certain things, I am still an observant Jew and I cannot eat anything from that hospital.  The joy of being hospitalized in Israel is that the hospital food is kosher and served in accordance with Jewish law.

But this hospital is Baptist, and Baptists love their pork.  Three times a day, pork.  It’s amazing.  But I wouldn’t even be able to eat green beans here, because they are seasoned with pork fat, and the mashed potatoes are served with utensils that have also served pork.  In summary, the place is non-Kosher and I would not be able to eat anything there.

So we negotiated that I would stay 6 hours in the ER for observation.  That was all right with me.

It was a very boring 6 hours, since I had no reading material, and the medicines they gave me made me too wired to sleep.  So I amused myself by trying to count the slats in a Venetian blind that covered a window in the room.

Seven o’clock arrived and so did “change of shift.”  I was impressed how smoothly the nurses navigated the change.  Usually change of shift means you don’t have a nurse while they are in “Report,” and you could lie there and die in the meantime.  I soon discovered that the reason the change happened so swiftly is that they had pretty much dispensed with Report, because my new nurse didn’t know anything about me.  That was too bad because she had no idea how desperate my case was when I came in, and said I “didn’t look so bad.”  I thanked her.

Likewise the doctor, whom I happen to know both from my old doctoring days, and because she has taken care of my dad during his last two hospitalizations.  She was very hassled, and rightly so, since she had to run from room to room taking histories and doing physicals.  And I came to understand that there were many cases more serious than mine.  I should say so; it is an Emergency Room.

She of course had not seen my tongue in its supersized phase, but the first doctor had briefed her on my case, and suddenly the 6 hour observation turned into an 8 hour observation, and she said she would not let me go even then if my tongue had not returned entirely to normal dimensions.

She roared out of the room, and I really hoped she was using the waterless hand cleanser units that lined the walls in the ER, because she sure did not stop to wash her hands before exiting my room.  I am a stickler about washing hands, especially in places where sick people come on purpose.

At that moment I realized I have a Tikun Klalli booklet in my wallet.  I always have a Tikun Klalli on me.  The Tikun Klalli is a set of 10 Psalms selected by Rebbi Nachman of Breslev, and is said to be the Universal Cure.  So I got it out and settled down to read the introduction, which I had never read before.  I didn’t actually read the Tikun itself, because once you start it you shouldn’t stop, and there was a big risk of interruption, of course, where I was.

The time flew past as I crawled through the easy yet esoteric Hebrew of the Introduction.  Often the Introduction of Kabbalistic books is the key to understanding the book itself.  So it was gratifying to be using my time in a productive way.  And my tongue went entirely back to normal, except for a huge blood blister on the bottom of my tongue where it had been stuck on my teeth.

The doctor flew in, looked at my tongue, asked me how I felt, and announced that she would indeed let me go, and only had to do the requisite paperwork.  I would have jumped up and down if I wasn’t attached to so many monitoring gadgets.  It was now after one o’clock in the morning.  I was sorely feeling the absence of my evening meds.

So what had provoked this gruesome tongue-swelling?  The consensus was that my blood pressure med was the culprit.  Seems that any blood pressure med ending in -pril, such as Captopril, Ramapril (which is what I was taking) and others, have a small but present chance of causing angioedema.

At last I was released and drove home.  Noga turned herself inside out with joy.  I was pretty happy myself.

But.  I was filled with apprehension: what if it came back?  I made a plan.  If it came back, that meant that I was destined to die.  I would somehow get plenty of my sleep meds down, so I might be able to pass out pretty quick and not feel the minute or two of choking before lack of oxygen shut down the brainwaves.  I took a large syringe full of insulin (my dad’s) and prepared it to inject, just in case I couldn’t get the sleepers down.  I found a manilla folder and wrote a note explaining what had happened, saying goodbye to all, how to find my will, what to do with Noga.  And between every line I wrote DO NOT RESUSCITATE.  I took a black marker and wrote it on my chest.  It’s still there: DNR.  That’s what I want.

I filled three large bowls with water for Noga in case it took a long time to find me.  I put her bag of food on the floor where she could get it.

Then I went to bed, choking down all my usual pills plus an extra clonazepam to ensure sleep.

And as you can see, I also woke up.

I Am Alien

 

alien woman head

The first thing I remember, after they left me, was waking up in a box.  The sides of the box were clear, and I could see, through the half-dark, two white shapes gliding on padded feet to and fro, with stiff white headdresses. 

Scratchy wrappings smelling of something that made my eyes water bound me tight and I grew very afraid. Then I found that I could wriggle one hand free, and soothe myself by sucking the largest one of the digits.  This took away some of the fear.

After the half-light memories, I remember no more until much time had passed.

They had told me that I would not remember them, when they dropped my astral body into this receptacle, this mobile vessel that the natives here call “human.”  But I do have faint recollections of my real people, mostly in the form of feelings of kinship, and an understanding that surpasses words.

Although my memories of what happened after I left the box have been erased, I have seen a home movie of my first steps at the age of nine months post-emergence.  The movie shows a small native female running away down a sidewalk, falling, picking herself up, and running further away, until the large native identified as “my mother” runs and picks up the small one, carries it back to the starting point, and sets it down; whereupon the small female commences running away again.  The natives surrounding the movie camera are heard “laughing.”  The small female was me: trying, as soon as I attained locomotion, to run home.

Several years later they took me to a building full of native children, and a large female overseer gave each one a paper covered with shapes, and color sticks, and commanded all to fill the shapes with color.  I saw no point in this meaningless exercise and turned the paper over, so that I could draw a picture of my real parents.  The overseer objected strongly to this, and made me stand in a corner; this was a relief, as that way I did not have to participate in their ridiculous activities.  From then on I learned the ways of achieving the corner, and did spend most of my time there, dreaming of home.

At night I sat by my window for hours, pleading with my parents to come and get me, explaining to them that they had left me on the wrong planet for too long.  I heard them from afar:  Not yet, not yet.  Your job is not finished.  Not yet.

My native “parents” did not know what to do with me, since I refused to associate with the native children, whose language was simple and crude, whose games ridiculous, and who, at the age of six, could read nothing more complicated than “Dick and Jane.”  By that time I had read a good deal of my parents’ library:  Herman Hesse, Gunter Grass, Franz Kafka, which was my favorite, especially Metamorphosis.  This was by far the best thing about this world: books, because they took me away, for a time.

The animals were a relief from loneliness. They have great wisdom and do not require speech to explain their thoughts and wishes, which are many and subtle.  The natives have terrible misconceptions regarding the animals: they think that because the animals cannot speak as they do, that they must be an inferior race.  This is wrong.

In my readings I discovered that there are special doctors for people whose minds work differently from those of the rest of the natives.  In these times they are called “Psychiatrists,” but in earlier times they were called “Alienists,” because those who do not conform to the norms of this world are considered “strange,” or “alien.”  I also learned that beings originating from other planets, like myself, are called “Aliens” as well, because we are strangers in this world.

Upon a time, there were great houses called “Alien Asylums,” where Aliens were sent for safety.  I thought, perhaps, that in an Alien Asylum I might find some one like myself, from my own planet.  I wanted to learn all I could about these places, and to see if there was one nearby.  So I got out the great book called “Encyclopedia” and looked up “Alien Asylum,” and was shocked at what I found there.

The Aliens were tortured in a ghastly fashion, with straitjackets and cold sheet wrappings and electric shocks.  I decided that I would not go there; in fact I decided to try to mimic the natives so that they would not know that I am an Alien.

I did so by spending all of my time at my studies, or in reading famous books, or in working with the animals, so that they could see that I was a very good native.

Many years passed in this fashion, but then something—I do not know what–happened that damaged my gyroscope, and I found myself one moment flying toward the sky and my home planet, and the next moment crashing to the ground.  I was unable to right this malfunction, and soon it became known to the natives, who carried me against my will to an Alien Asylum.

Fortunately the Asylum was not like the ones in the Encyclopedia.

In fact, it reminded me markedly of my first days at school, where I was given the papers with shapes and the color sticks, and told to color inside the lines, if I wanted to get out.  I refused to participate in this absurd activity, and they gave a bad report of me to the Alienist.  He ordered them to make me swallow pills, many pills every day, that made me feel weak and dizzy.  But then I was no longer expected to color either inside or outside of lines.

When they released me from the Asylum, the Alienist sent me to be “Tested.”  A kind native woman asked me many questions and gave me puzzles to solve.  I solved many puzzles, until there were no more left.  Then she asked me to look at pictures of native faces, and tell her what the people in the pictures were feeling.  This I could not do, because I am not a native and I do not use their modes of communication.

After we finished all the tests, I returned to the Alienist for his report on their outcome.  He told me that I had Asperger Syndrome and Bipolar Disorder.  He explained to me what those things mean; but it was nothing that I did not already know.

I am Alien.

Alien spaceship