How Stigma Compromises My Medical Care

I don’t know what to do.

I can bet that most of you will say, “Just be yourself, Laura.  Fuck ’em if they can’t relate to you as the awesome human being you are.”

Well, yeah.  I appreciate that.

However.

I have this service dog, see, and she’s neither little nor cute.  Well, she’s cute to me, but a 75 pound Belgian Malinois is automatically not cute to most people, especially the uptight assholes that tend to go into “the medical field” these days.  Even my therapist does not think she’s cute.  Even when Atina climbed into her lap and gave her kisses, because she could see that the dear lady was clearly in distress, it did not help.  My poor therapist could do nothing except beg me to get the monster off of her, which I did, and Atina reluctantly obeyed but was still of the opinion that the lady needed her attention.

On the flip side, if Atina perceives that someone is potentially a threat to me, she stations herself sideways in front of me, giving the unsafe party the hard-eye, which is dog language for “come over here and make my day.”

This is why I have a Service Dog:

I have a perfect storm of Asperger Syndrome, PTSD, and Bipolar illness.  My judgement about people is shot to hell.  I lost it on April 22, 1970, the very first Earth Day, when I was drugged, dragged into a dark basement, and brutally robbed of my virginity.  That, and the prolonged months and years of running from one frying pan into another fire, robbed me of my ability to read people’s intentions.  I think it’s because I simply dissociate every time I have to interact with other people.  So now that I’m on the far side of sixty and no longer give a shit, I’ve stopped making myself do painful things, and aside from the inconveniences of not having friends, family, or a partner when I have a medical emergency, I feel much better.

Have you noticed that sometimes your fridge, washing machine, microwave, computer, and automobile all crash at the same time?  So now you have to get a ride to the Big Box store, to the bank to get quarters for the laundromat, and a ride back and forth to the laundromat, to the convenience store for ice until the new fridge comes, and while you’re on the phone with Tech Support your phone is giving your ear a second degree burn and probably giving you brain cancer as well….

This is what I call a Wear Cycle.  When everything wears out at once.  It generally falls out when you’re between jobs, or just before those gift-giving occasions, or your wedding.

So as some of you are aware, I am in the throes of a Wear Cycle of the most annoying sort.  My body is falling apart.  I thought it just needed a tune-up and maybe a brake job, but it turns out to be the transmission, the universal joints, the head gasket; and every time they fix one thing, another one turns up bad.

The result is a seemingly endless procession of doctors, PAs, Nurse Practitioners, lab techs, snotty Front Office People, sadistic MRI techs who put me in Positions Of Stress for upwards of twenty minutes while further damaging my hearing with the various hammerings and clangings of that infernal magnetic tube, being told that I need surgery for this, surgery for that, and they all worry about my blood pressure.  Surely not!

You must understand that my relationship with The Medical Field is a mine field.  The minute I leave my van in the parking lot of the doctors’ building, the hospital, the lab, I dissociate.  I am terrified.

But you’re a doctor, you say.  How could you not be comfortable in this oh-so-familiar milieu?

That’s just it.  I’m all too familiar with it.  I know exactly what goes on behind the scenes, and it disgusted me while I was in it, and it terrifies me now.

Because I am…one of those patients.

You know, the aging female with so many complaints it throws your schedule off, and she’s slight dotty, and might be amusing if you weren’t running so far behind, and of course–of course, she has to be a doctor, at least she says she is, and she does know the lingo…and she has Medicare and doesn’t seem to have a job, so she must be disabled, but for what?  She’s not saying, and if you ask, she’ll say something vague.

I know this, because I’ve been on their side of the white coat.

So imagine what the reaction would be if they walked into the exam room and there I was with my Service Wolf Dog.

The entire visit would revolve around whether the person who Works In The Medical Field was comfortable with the Doggess, and whether she thought they were Safe.

And of course she would pick up on my instant dissociation because I dissociate whenever I run into One Of Those People, because of the abuse I suffered when I was working In The Medical Field, and the abuse I have suffered as a patient dependent upon these people’s power.

And the shame of being disabled, which is, according to the ancient tenets of The Medical Field, weak; and even worse, crazy.

I just rediscovered a former mentor who was hugely influential to me when I was a medical student.  She was my supervisor in the Public Health Clinic.  We became good friends, and she helped me crystallize my medical practice world view, which is based on compassion and empowerment of the patient to take charge of her own health and well-being.

It turns out that this amazing woman had a terrible crisis, which lead to a suicide attempt.

Rather than supporting her and helping her to rebuild her life, the medical establishment brought criminal charges against her for lowering the esteem of the medical profession in the eyes of the public.

They drove her out of the profession.  It didn’t matter to them that this heinous act might push her over that very precipice she had dragged herself back from.

It didn’t matter that they were persecuting one of the finest physicians on the face of the earth, for the crime of being human.

All that mattered was that she had “failed” to complete her suicide.  If she had died, she would have been another tragic physician suicide; but since she managed to survive, she was pronounced a disgrace to the profession.

Fortunately she is a strong and resourceful woman.  She cleaned houses in order to feed her children.  She struggled her way back onto her feet, and reinvented herself.  Blessed be.

So I know very well what the result would be, even if the Doggess didn’t bite the Assistant (you hardly ever get to see The Doctor anymore):  “Did you get a load of that lady with the dog?  What a crock!”

Yes, fuck ’em.  They’ve no right, legally or otherwise, to prevent me from having my dog with me.  She’s Durable Medical Equipment, just like a wheelchair.

The only thing is…being mentally ill automatically discredits anything I say.  I’ve tried it both ways.  And unfortunately, whenever I’m honest and disclose that I have DSM diagnoses, I get my case dismissed.  No contest.  No service.  Goodbye, and put some ice on that.  It will feel better in seven to ten days.  No need for follow-up.

In awful contrast, when I have withheld my diagnoses, it’s all sympathy and MRIs.

Hell, I even got a few tramadol tablets for my torn shoulder, when I begged the doctor because my left wrist is in a brace awaiting surgery and my right shoulder is so painful that I can’t even get out of bed without fainting if I forget and try to push myself up with my right arm.  (How do I get out of bed?  By wriggling on my tummy until my feet touch the floor.)

You think she would have given me that prescription for thirty, no refills, if she knew that I’m bipolar?

Nope.  Bipolar people are categorically drug seekers.  Even though I asked for tramadol and not Percocet.  Drug seeker, no way.

I’m stuck.

I’m terrified of those places, and I need my dog.  But the presence of my dog would set off such alarms in the mind of The Medical Field Person that my actual medical issues would be eclipsed by Prejudice.  Stigma.

If I showed up in an electric wheelchair, they would be all ears.

But a crazy person with a dog?

Miss Biggess Doggess Has A New Toy!

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Flagstaff loves me.  The ball of yarn keeps getting bigger and bigger: that is to say, I am becoming more and more deeply involved with the workings of this tiny city that perches on the Coconino Plateau, at 7,000 feet above sea level, nestled among a flock of young volcanoes.

After my thirty-first medical provider visit this month, I was overcome by a sensation that something was lacking.

For one thing, I was drained to the tips of my finger and toenails from my appointment with the new Family Practice Nurse Practitioner.  I hate to think how drained she must have felt!

The purpose of this appointment was allegedly to seek a solution to my stubborn high blood pressure.  High blood pressure is bad.  It damages one’s kidneys, causes strokes and heart damage, eye damage, and basically messes you up, usually without any symptoms at all.

Having symptoms, like headaches and blurred vision, means the high blood pressure is getting to one’s brain.

God knows, I don’t need any more brain damage, so when I realized that my permanent headache and inability to read the Louis L’Amour paperback borrowed from the campground laundry room because my vision was blurry might just be high blood pressure symptoms, I went to the Walgreens and bought a fancy blood pressure machine.

The first time I tried it out, the damn thing read 165/106 (normal is about 120/75).  I ran it a couple more times and it said approximately the same thing.  I didn’t like that at all, so after a couple of hours on the phone I got the soonest primary care appointment available, which was two weeks away.  In between times I did all the things one is supposed to do to lower blood pressure, like exercise, breathing, meditation, cuddling with one’s Doggess, and fiddling with medication doses.  And hoping like hell that nothing bad would happen.

Last night my BP was dangerously high, so I took a rather large dose of my medication (don’t try this unless you’re medically qualified), and my usual dose this morning.  My BP in the office was perfectly normal, so of course I felt like a fool.

To make matters worse, I disclosed all of my psychiatric diagnoses and their respective meditations, and the NP completely unraveled.  Poor thing, who can blame her?

To her credit, she did a great job of picking out a team of specialists to help figure out what in the hell is wrong with my immune system and nervous system and skin, and whether all these are part of the same problem, or whether they are separate problems.  As for my blood pressure, she told me to keep doing whatever I did to bring it down, and gave me a script for more of that particular medicine.

Driving back from that exhausting appointment, I spied a grocery-store-cum-gas-station I’d seen before but never stopped at, because it looked down-at-heel and sad, like one of those discount groceries that appear and disappear in a matter of days like mushrooms after a good rain.  Today I needed gas, though, and the price was right, so I waited in line till a pump opened up.

After filling my gas tank, my mind returned to my own stomach.  The grocery had a Starbucks logo on the wall.  Hmmm, a green tea soy latte might perk me up!  I went in.

Have you ever had the experience of going into a drab, shabby building, and finding the inside bright, beautiful, and full of your favorite fresh fruits, veggies, and gluten free foods?  Heaven.  I got my green tea soy latte and headed for the aisles.

Half an hour into the orgy I came to the pet stuff aisle and was struck by a largish wave of guilt, since Atina had spent most of her day in the van, while I was enjoying my medical appointment and now shopping my heart out; therefore, I sprung for the $8 on sale “un-stuffed” furry critter with a squeaker at its head and tail.

I paid for my order (Jeezus Kreezus, $120 for those few things?  And this isn’t even Whole Foods!) and hauled my cart out to the van with my one good hand.  Atina glared at me from her spot on the bed.  She had good reason to be sick of being locked up!

The moment I cut the tag off the new Critter and threw it at her, all was forgotten.

She caught it.  It squeaked!  Just like the squirrels that taunt her all day around here would do if she could ever get her pearly whites on one!

Since then, the Critter has been relentlessly shaken, chewed, squeaked (my ears, my head!), and is sodden with Doggess spit.  Now she sleeps, worn out with worrying the new Critter to death.

The best $8 I’ve ever spent.

Two is too many

It seems that I have been putting off writing this post until I can’t anymore.

The reason I have procrastinated so long is…well, there are two reasons: fear, and pain.

I came to Flagstaff several weeks ago in search of a hand surgeon.  I took a nasty fall over a log, as some of you might remember, and after waiting a suitable number of days to make sure it wasn’t just sprained, sought care at an orthopedic urgent care facility. 

There I met a young, arrogant, and completely disagreeable orthopedist, who humiliated me in numerous ways until his assistant hipped him to the fact that he and I share a first name, to wit: “Doctor.”  Then he became all cozy and collegial, remarking on the skill of the last hand surgeon’s handiwork, as we gazed at my Xray together.  I was musing how overexposed the film was.  He was burbling away.  I had dissociated long since and have no idea what he said after that.

But I picked up the hand surgeon’s card on my way out, and spied the spine surgeon’s as well.

The chirpy receptionist volunteered to make me some appointments if I needed them, right there on the spot, so I took her up on it.

Let’s see, hand surgeon, since that came first.  And my poor arthritic shoulders were killing me, especially after the recent acrobatic stunts.  I’d have an appointment with the non-interventionist arthritis doctor, please. 

And then there is my spine, bane of my existence since 1985.  A couple of lumbar discs ruptured back then.  In 1987, emergency surgery for a ruptured disc in my neck.  Oh, and that rupture occurred on the first night of my internship.  I drew call my first night, of course.  “Black Cloud.” 

Over the three years of my residency I would go on to rupture at least five discs.  The spine surgeons threatened me with putting metal rods on both sides of my spine.  I demurred, and opted for a custom molded hard plastic exoskeleton type of thing that extended from armpits to groin, to be worn 23 3/4 hours per day.  Fifteen minutes to shower, then back into the Plastic Maiden.

In the intervening 30 years, my spine has had its moments of freedom from having to drag me into its consciousness.  Curiously enough, my best years were when I had horses and rode daily.  The gentle rocking motion kept my spine well oiled, and the occasional eruption of a bucking episode provided any needed adjustments.

Then I got Rolfed by the former Captain of the Venezuelan Olympic Women’s Luge Team.  She was gigantic.  She was good.  It was excruciating.

My back didn’t dare go out if it meant going back to Alejandra.

After I returned from Israel to be with my father in his last years, my neck began to bother me enough so that I went to see a Physiatrist.

For those who are unfamiliar, a Physiatrist is an M.D. or D.O. who is trained in evaluating and treating musculoskeletal disorders non-surgically, with things like hydrotherapy and massage.  Sound good?

Actually, I did not choose this person specifically because she would be the most likely to send me to a Turkish Bath; it was simply a matter of Cut vs. Not-Cut.

Dr. Not-Cut did not send me to the Turkish Bath, nor even to Physical Therapy, but packed me off to her partner who does one thing exclusively: epidural injections.

Now, while I’ve had many a needle inserted into my spine at the lumbar region, I have never permitted such an intrusion into my neck, for the simple reason that it’s easy enough to prick a blood vessel by mistake, which can be problematic in the lumbar, but catastrophic in the cervical, because there is simply no room for anything like a blood clot in the spinal canal of the neck.

I went for it, purely because I couldn’t look down to tie my shoes for the pain.  My head felt like it was going to fall off at any moment, and at times I felt like beheading myself just to get it over with.

The procedure was terrifying.  It was painful.  It didn’t work.

Fast forward through several medication trials and much condescension on the part of Dr. Non, and at last I had an appointment with her Nurse Practitioner, who wisely prescribed a muscle relaxant, voila.  And a special hardshell collar to keep my head from falling off.  A wise and practical woman…And she even snuck me a small Rx for some tramadol, miracle!

And until the tumble over the log incident, that’s been keeping my neck pain down to a barely noticeable hum. 

Post-log-jam, things started kicking notches up the Pain Scale until I was hovering in the 8 range and started using my beastly hard surgical collar again.  This thing provides a tiny bit of traction, and it gets rid of the feeling that my head is falling off, but it digs cruelly into my flesh and is no fun.

I did not wear the collar to my appointment with the Instant Ortho Clinic. 

Two things you must never do, if you go to any kind of emergency services place:  do not wear a cervical collar, and never never never reveal that you have a mental illness; otherwise you will be instantaneously branded as a drug seeker, and no one will ever listen to you or even notice the bone sticking out of your leg at a crazy angle. 

And there is a third one, I have discovered, to my dismay:

Don’t be elderly.  You won’t count.

Time passes, and I get my turn with the Arizona Spine Specialist Dude, very highly Ivy League Specialty Boarded And Fellowshipped, all very nice to know.  Confidence.

He seemed like a nice chap for a surgeon.  Asked me why I was there, seemed to listen, actually examined me and discovered, dismal dismal discovery…I have lost virtually all muscle strength in my left arm.  I have no reflexes at all in my right arm, and abnormal ones in my left.  This must be why it takes me two hands to get my coffee cup up to my face.

It is no longer an issue of mere pain management.  It is an issue of preserving what function remains to me.

I need surgery.

The MRI could have looked worse.  It also could have looked better.  What is clear, is that the degenerative disease is crunching my spine like Pac Man.

I have had two appointments with the Spine Surgery People.  The first was with the actual surgeon, whom I liked, who treated me respectfully and did a good job of hitting the diagnostic nail on its head.

The second appointment was with the Physician’s Assistant.  I have no confidence in Physician’s Assistants, for the simple reason that in my opinion, there is some difference between the education of, for instance, my new Spine Surgeon, who had (after his Bachelor’s Degree) 4 years of medical school, 5 years of residency, 3 years of spine fellowship, and assorted certificates; whereas, a Physician’s Assistant has a grand total of 26 months of post-college training: the equivalent of a Master’s Degree, very nice, but not enough to develop much clinical experience.

So, with some trepidation, I met with the PA to go over my MRI results.  How could a person with so little training interpret advanced imaging and recommend treatment?

I was relieved to find out that she is, in fact, operating as the surgeon’s assistant and not as an independent entity, as so often happens today.

She had been thoroughly briefed by the surgeon on the MRI results, conveyed them to me, and explained the recommended treatment: spinal fusion at two levels.  She explained how this was done, and showed me an example of the titanium plate that would be installed, to stabilize things.

Any questions?

Uh, well, yes…what would happen if I opted to do nothing?

Well, of course, your disease would progress and those nerves would continue to lose function….

Oh.  Yes.  Definitely.  I see.

Any questions?  She gives me the crisp smile that is the equivalent of shooting one’s cuffs to glance at one’s watch.

Not at this moment, I tell her, but I’m sure I will have.

All right then, just call and let me know what you want to do.

We rise, shake collegial hands…

Several days later I realize I remember absolutely nothing about the visit.  Except the part about Surgery, and Fusing Vertebrae, and Possible Side Effects Including Quadriplegia…shit.

I called and left a message for the PA.  Two days later, she returned my call.

Yes, what was it?  Very snappish.  It’s five o’clock, poor thing must be hungry and tired…shit, there I go again making excuses for other people’s bad behavior. 

It’s that I have some questions about the surgery.

–I explained that in the office.  We place a tube down your windpipe, pull your windpipe and food tube to one side, and…(what is going on here?  She has my chart in front of her.  Why is she using the sixth grade description garbage?)

Yes, thank you, you did explain that part.  What I want to know is where, exactly, you place the titanium plate.

Exasperated sigh.  Again, with feeling:

–I told you, we move your windpipe and food tube…

Cheezes K. Reist, woman.  I want to know whether the plate is placed LATERALLY or IN THE MIDLINE???

–Midline.

Good.  How long will I be in the rehabilitation hospital postop?

–That depends on you.  She drops the phone.  Oh sorry.

How long until I am able to drive?

–That depends entirely on you.

What does that mean, exactly, please?

–That means however long you are on pain medication.  Could be two weeks, could be six weeks, depends on you.  Each patient is different.

Ah, now I have some useful information: they give you pain medicine postop!  What a good idea.

It really was like pulling teeth.  Look, if someone is going to do violent things to my neck bones, I want to know the details.  All of them.  Not the sixth grade version: for better or worse, I am a physician, and I need DETAILS.

So now I am spooked, very spooked, by the fact that the surgeon’s right hand woman is sidestepping badly.  It’s bad enough that I have to make a decision of this magnitude, without this person giving me the power trip.

I know I need the surgery.  I’ve investigated the surgeon and he comes up kosher. 

But what about this other person on his team, who seems to have enough power vested in her that she could cause me to suffer?

It happens that there is a branch of the Mayo Clinic in Phoenix, several hours from here.  I think I’ll mosey over there and see what it’s like.  I don’t believe there will be huge changes in my condition in the near term…I hope.  Maybe they have some other, brighter ideas.

And then…there is the first appointment with the Hand Surgeon to look forward to, in a week or so.  Something is very wrong with my wrist, because of the fall.  Very wrong. 

I wish I could get someone to order the MRI of my wrist BEFORE I see the Hand Surgeon, to save time.  I think I’ll call his office tomorrow and ask.  Can’t hurt.

I have waves of feelings of futility.  What is all this for?  The wrist, yes, that’s an injury and must be repaired, if possible.  But what about the spine?  I watched my father’s spine degenerate until finally he was literally a helpless bag of bones.

I must ask this surgeon, whose opinion I respect: what am I looking forward to?  How long will it be until another unstable section of my spine needs to be fused, and another, and another?  How much of this can the body endure?  Am I really buying time with this?  What sort of quality time?  How long till the wheelchair and the nursing home?  I need to know.  I will make another appointment.

So Long, Pluto

By one of those curious twists of the state of time, space, and matter, it seemed good in my eyes on Thursday night to seek the reliable shelter of a State Park, in which to interrupt my trajectory while hurtling across the awe-inspiring hugeness of the State of Texas.
_________________________

A Texan went to visit Ireland.

He saw an Irish farmer out working in his potato field, got out of his rented Cadillac and approached the fellow, and hollered:

(Texas accent): Say, pal, is this your land?

The Irishman cuts the engine on his ancient tractor, removes his battered hat, scratches his balding red head, mops his pate with his tatty handkerchief, jams his hat back on.

(Irish accent, with pride):  Sure and it is, Mester.  Been in my family for a hunnerd years. (Beams, gap-toothed, at the Texan, who is now standing in the dirt road in his cowboy boots, dove-grey Western suit, string tie, rocking with his thumbs hooked over his tooled leather belt with its garish silver buckle.  Door of Cadillac stands open.)

Texan:  Why, that’s mighty fine, mighty fine.  How much land have you got, if you don’t mind my askin’ ? (Chews a toothpick)

Irishman, with pride:  No, I don’t mind a wee bit, sence you’re askin’.  You see that tree stump off there in the distance?  Why, our land goes all the way from that stump, back aways past the house and farmyard, barns, horse pasture, to that stoon fence, ye can just barely see it from here.  (Scratches head again.)

Texan:  I declare.  That’s a right purty leetle piece.  You know, Farmer, back in Texas where’n Ah come from, Ah kin git in mah truck an drahve from sunrise to sunset, and Ah will still be drahvin’ on mah own land.  (Air of superior self-satisfaction)

Irishman: (Shaking head sadly)  Ach!  I had a truck like that meself, once.
__________________________________

The twist of fate is made curious by a happenstance: the first Texas State Park I spied on my map happened to be full, but the sweet and adorable Mescalero Apache ranger at the park office told me that there was plenty of room at the next park down the road, which happened to be right down the road again from the famed McDonald Observatory, home of the second biggest and most scientifically unique telescope in the world.  Yowie zowie, I love space stuff!  And my knowledge base is terrible, so I got all hot and sweaty at the thought of increasing it in such a majestic way.

I scuttled down the ranchy road, reaching the park just about closing time.  Picked myself out a choice spot and settled in, nervous about the javelinas (pecaries, a nasty species of wild pig that stinks and had it in for dogs) and wild boars, that can tusk up a dog or small human faster than you can say “Old Yeller.”  We have seen a lot of their poop, fresh, in our campsite, and if they only come sniffing around of a night, that’s fine, as long as they respect the rules.

The next day I mounted Old Jenny and climbed up the twisty road to the Observatory.  They were having a program on Sun Spots, but since I regularly check the Solar Weather I wasn’t so interested in that.  I wanted Deep Space.  Wormholes, Dark Energy, you know, cool space stuff.  I wanted to see the giant telescopes, but the next available date is a couple of weeks from now and I don’t plan to be here then.  Plus it costs $115, which would be money well spent, but that’s a week’s worth of camping money, so.

But they have “Star Parties,” interpretive viewings of the heavens both aided by normal size telescopes, and with the naked eye, so that one comes away with greatly augmented knowledge of celestial bodies and visible galaxies and nebulae (one, beside the Milky Way: the Orion Nebula.  I was hoping to get a glimpse of the Horsehead Nebula, but you need a higher power telescope for that).

The McDonald Observatory is located on top of a mountain situated above the Sonoran Desert, and is one of the darkest places in the world (at night, and not a cave).  Thus, I was tremendously exited at the prospect of guided stargazing in that spectacular location.  I bought a ticket for $15 and returned to my campsite to do a bit of dog hair mitigation and await the appointed hour.

We got there early (“we,” unless otherwise noted, means my dog and I) and cooled our heels till show time.

Big tour buses pulled up.  I noted them, then blocked them out of my consciousness.

With the approach of show time, I took Atina out for a potty break and put her in the van, ignoring her rueful expression.  It’s tough being a dog.

When I entered the lobby my heart went splat on the floor, then went into a run of sinus tachycardia.  Panic attack. 

Hundreds of lovely young people wearing Texas Tech and University of Texas and Texas A&M sweatshirts milled and shouted in the lobby.

I bailed into the gift shop, which was geared toward children, with book after book after book on the constellations…fer krissake, how many books on the constellations do they need?

I perused the wall charts, the glow in the dark universes that I stuck on my erstwhile son’s ceiling, to give him something to do while he wasn’t sleeping….and noticed something odd.

There were only eight planets.

That is wrong.  There are nine.  Everyone knows there are nine planets!

Then I remembered: Pluto has been decommissioned as a planet, because it is made of frozen water and no rocks.  You have to be made of rocks to be a planet.

It’s not fair.  Other planets are made of weird shit, so why, after all this time, could they not make Pluto at least an HONORARY planet?

I bought a placemat of the Periodic Table, which has picked up a number of new elements since the last time I studied it, and bolted for my van.

The rest of the evening was devoted to doctoring my crushing panic attack.

It wasn’t merely the prospect of standing in loud lines with droves of college students.

It was the sudden realization that I, too, have been decommissioned, like Pluto, and for the same reason: lack of a solid core. 

In our last bitter conversation, my son made it clear that I am not the mother he wanted…or, in his opinion, needed.  He needed stability.  He needed a rock core, not just some object made of frozen gasses.

Pluto and I are no longer welcome in his universe.

Well.

Since I have cried all the way across the enormous state of Texas, I have very clean eyes.  It seems that tears do not simply run out.  The body just keeps making more.

And since my decommission I have had plenty of time to reflect on the universe of mistakes I have made in my life.  Mistake after mistake after mistake.

And all boiling down to what?

Well, at least I have money, for a couple more years, to pay my expenses.  That’s a plus.

See, me and Pluto just keep going around and around and around, but the end is interincluded in the beginning, so there is no getting off this particular merry-go-round.

So me and Pluto and Atina will go ’round until it all winds down and it’s time to bail out.  That’s what happens to stars before we blow up and become Something Else.

So Long, Pluto

By one of those curious twists of the state of time, space, and matter, it seemed good in my eyes on Thursday night to seek the reliable shelter of a State Park, in which to interrupt my trajectory while hurtling across the awe-inspiring hugeness of the State of Texas.
__________________________________

A Texan went to visit Ireland.

He saw an Irish farmer out working in his potato field, got out of his rented Cadillac and approached the fellow, and hollered:

(Texas accent): Say, pal, is this your land?

The Irishman cuts the engine on his ancient tractor, removes his battered hat, scratches his balding red head, mops his pate with his tatty handkerchief, jams his hat back on.

(Irish accent, with pride):  Sure and it is, Mester.  Been in my family for a hunnerd years. (Beams, gap-toothed, at the Texan, who is now standing in the dirt road in his cowboy boots, dove-grey Western suit, string tie, rocking with his thumbs hooked over his tooled leather belt with its garish silver buckle.  Door of Cadillac stands open.)

Texan:  Why, that’s mighty fine, mighty fine.  How much land have you got, if you don’t mind my askin’ ? (Chews a toothpick)

Irishman, with pride:  No, I don’t mind a wee bit, sence you’re askin’.  You see that tree stump off there in the distance?  Why, our land goes all the way from that stump, back aways past the house and farmyard, barns, horse pasture, to that stoon fence, ye can just barely see it from here.  (Scratches head again.)

Texan:  I declare.  That’s a right purty leetle piece.  You know, Farmer, back in Texas where’n Ah come from, Ah kin git in mah truck an drahve from sunrise to sunset, and Ah will still be drahvin’ on mah own land.  (Air of superior self-satisfaction)

Irishman: (Shaking head sadly)  Ach!  I had a truck like that meself, once.
__________________________________

The twist of fate is made curious by a happenstance: the first Texas State Park I spied on my map happened to be full, but the sweet and adorable Mescalero Apache ranger at the park office told me that there was plenty of room at the next park down the road, which happened to be right down the road again from the famed McDonald Observatory, home of the second biggest and most scientifically unique telescope in the world.  Yowie zowie, I love space stuff!  And my knowledge base is terrible, so I got all hot and sweaty at the thought of increasing it in such a majestic way.

I scuttled down the ranchy road, reaching the park just about closing time.  Picked myself out a choice spot and settled in, nervous about the javelinas (pecaries, a nasty species of wild pig that stinks and had it in for dogs) and wild boars, that can tusk up a dog or small human faster than you can say “Old Yeller.”  We have seen a lot of their poop, fresh, in our campsite, and if they only come sniffing around of a night, that’s fine, as long as they respect the rules.

The next day I mounted Old Jenny and climbed up the twisty road to the Observatory.  They were having a program on Sun Spots, but since I regularly check the Solar Weather I wasn’t so interested in that.  I wanted Deep Space.  Wormholes, Dark Energy, you know, cool space stuff.  I wanted to see the giant telescopes, but the next available date is a couple of weeks from now and I don’t plan to be here then.  Plus it costs $115, which would be money well spent, but that’s a week’s worth of camping money, so.

But they have “Star Parties,” interpretive viewings of the heavens both aided by normal size telescopes, and with the naked eye, so that one comes away with greatly augmented knowledge of celestial bodies and visible galaxies and nebulae (one, beside the Milky Way: the Orion Nebula.  I was hoping to get a glimpse of the Horsehead Nebula, but you need a higher power telescope for that).

The McDonald Observatory is located on top of a mountain situated above the Sonoran Desert, and is one of the darkest places in the world (at night, and not a cave).  Thus, I was tremendously exited at the prospect of guided stargazing in that spectacular location.  I bought a ticket for $15 and returned to my campsite to do a bit of dog hair mitigation and await the appointed hour.

We got there early (“we,” unless otherwise noted, means my dog and I) and cooled our heels till show time.

Big tour buses pulled up.  I noted them, then blocked them out of my consciousness.

With the approach of show time, I took Atina out for a potty break and put her in the van, ignoring her rueful expression.  It’s tough being a dog.

When I entered the lobby my heart went splat on the floor, then went into a run of sinus tachycardia.  Panic attack. 

Hundreds of lovely young people wearing Texas Tech and University of Texas and Texas A&M sweatshirts milled and shouted in the lobby.

I bailed into the gift shop, which was geared toward children, with book after book after book on the constellations…fer krissake, how many books on the constellations do they need?

I perused the wall charts, the glow in the dark universes that I stuck on my erstwhile son’s ceiling, to give him something to do while he wasn’t sleeping….and noticed something odd.

There were only eight planets.

That is wrong.  There are nine.  Everyone knows there are nine planets!

Then I remembered: Pluto has been decommissioned as a planet, because it is made of frozen water and no rocks.  You have to be made of rocks to be a planet.

It’s not fair.  Other planets are made of weird shit, so why, after all this time, could they not make Pluto at least an HONORARY planet?

I bought a placemat of the Periodic Table, which has picked up a number of new elements since the last time I studied it, and bolted for my van.

The rest of the evening was devoted to doctoring my crushing panic attack.

It wasn’t merely the prospect of standing in loud lines with droves of college students.

It was the sudden realization that I, too, have been decommissioned, like Pluto, and for the same reason: lack of a solid core. 

In our last bitter conversation, my son made it clear that I am not the mother he wanted…or, in his opinion, needed.  He needed stability.  He needed a rock core, not just some object made of frozen gasses.

Pluto and I are no longer welcome in his universe.

Well.

Since I have cried all the way across the enormous state of Texas, I have very clean eyes.  It seems that tears do not simply run out.  The body just keeps making more.

And since my decommission I have had plenty of time to reflect on the universe of mistakes I have made in my life.  Mistake after mistake after mistake.

And all boiling down to what?

Well, at least I have money, for a couple more years, to pay my expenses.  That’s a plus.

See, me and Pluto just keep going around and around and around, but the end is interincluded in the beginning, so there is no getting off this particular merry-go-round.

So me and Pluto and Atina will go ’round until it all winds down and it’s time to bail out.  That’s what happens to stars before we blow up and become Something Else.

The Carrot and the Stick

My life hangs by a frayed thread.

I am a donkey who lives by the carrot and the stick.

The carrot hangs in front of me, just out of reach.  This gives me a reason to keep reaching.  It is valuable, because it means that someone else’s life depends on mine.

I had two carrots; now I only have one.  That one is my dog, Atina.  She cannot live without me, for she is sick and depends on my care to stay alive.

Actually some other benefactor could care for her, but I love her, and she gives me the only joy I have now.  So she is my carrot.

Then there is the stick that follows me, threatening to whack me if I don’t keep trudging along under my load.

The stick is the fear that there might actually be an afterlife, reincarnation, some consequence for taking my death into my own hands.

My life has always hung by this thread, and I have clung to the thread as a mountain climber clings to the fixed ropes, the lifelines that prevent the fall into the unknown, or rather, the certainty of death.

Before the doctor rescued me by cutting me out of my mother’s hostile womb, my tiny organism was flooded by the amphetamines she took to keep from gaining weight while pregnant.

My organism did not tolerate her labor.  My heart began to fail from lack of oxygen.  No doubt my attachment to her womb, my lifeline, was marginal because of the drug that caused constriction of the blood vessels.

I was “small for dates,” four pounds, and struggling to breath, so they took me away and stuck me in an incubator with plenty of oxygen.

My lungs were bad, I suffered withdrawal from the amphetamines, I was unstable, and in those days no one was allowed to touch a fragile newborn except for feeding and changing, so I sucked my thumb and watched the white forms padding on silent feet through the dim space that surrounded my plastic bubble.  This I remember clearly.

Childhood was searing pain, alien to everything, clothes tearing at my skin, terror of my mother, clinging to my father who always had somewhere to go or something to do, only my animals for companionship and love.

Teenage hopelessness, violent rape, runaway, street life, rape, rape, rape, pregnancy, abortion, alone, alone, alone.

Finally mentors, self esteem, push push push degree degree degree, marriage, baby, fell off the balance beam, paralyzing depression, no support, head of my class, medical honor society, residency, depression, mania, no support, ruptured discs, surgery, body jacket, divorce.

Son’s father refused to see him “because it was too emotionally hard” on father.  Really?  Your son cries for you every night and day.  How can you sleep at night?  How can you look at yourself in the mirror and say, “My emotional pain is more important than my five year old son’s”?

We went on, my son and I.  Life was rough, life was rocky.  He was angry, I was numb, except for the pain always there.  Work, the drug.  Work hard, work long, work better.  A nanny in place of a father.  Angry boy, angry boy.  Can you blame him?

Angrier angrier angrier.  Treatment treatment treatment.  Drugs, legal and not.  Go and live with father finally, maybe that will help.  Bribe father to take the boy.  Father likes money, I have plenty.  Used to.

Disaster.  Thrown away, street life, homeless shelter.

Mother now disabled by mental illness, bankrupt.

Son needs help, NOW!

Therapeutic boarding school, but how to pay?  Father and his family refuse to help.  I borrow money from my parents.  They get it by mortgaging their home, to save their grandson.

I leave my career behind, to help my son, no turning back after too much time away.  I am disabled, that’s who I am, new identity.  But I helped my son to save himself, so that’s who I am now, what, a sacrifice?  No, just a disabled person.  It would have happened anyway, in my downward spiral.

Now he is a big shot, finishing his Ph.D., and his father and his father’s family have taken him back, so proud.

His first scientific paper published in the world’s premiere scientific journal.  I am so proud.

But.

We “do” Thanksgiving together, he and I, and every year has been a blast.

This year, something different.

He invites me to his apartment.  Just the two of us.  Why?

Don’t you want to invite some friends who don’t have somewhere to go?  You remember, when you were a kid, we always had students over who couldn’t go home, or were Chinese, or for some reason would be alone.

No, he said.  Everyone already has a place.

I wondered.

The night before Thanksgiving I was invited, with great pomp and circumstance, to go out with he and his friends to a bar.  I was thrilled to be included.

But when I arrived, a five hour drive from where I stay, I had a migraine and felt sick, and just wanted to smoke some flower and curl up in my van with Atina, my dog.  I would feel better tomorrow.

So I said, you guys go ahead, I’m going to sleep off this migraine.

OK, he says, eager and relieved.  And ran out the door.  I’ll leave it unlocked he says, in case you need anything.

Morning late, I feel better, he’s hung over.  Coffee, cartoons on the big screen, I’m content.  He starts cooking.  Always happy when he’s cooking!

Dinner: a roast duck, fried rice, greens, cranberry sauce.

Not much to say, and it’s getting weird.  I feel a void, ghosts at the table, who are they and why don’t they come out and play?

So the pipe goes back and forth, and he is drinking more beer and more beer.  I go to bed early, he goes out with friends.  I wonder ?

Friday morning, coffee, and I am served a spoonful of leftover rice.  He gives himself a plate, not a lot, but a plate. ?

He goes to lab to feed his cells, I shower and try to get this migraine to go away.  I’m hungry.  I take a bit more duck, rice, a bit of everything.  Thanksgiving leftovers are the best.  I wish son was here to share, but I’m hungry and my head is pounding, so I eat.

He returns from lab.  I tell him I’m sorry I couldn’t wait for him, I had to eat.  He looks angry.  I feel the old ominous storm clouds.  Why?

I guess I’d better go now.

But I feel like crap, I don’t want to drive.

He’s already holding the door open for me to go out.

Um, listen, I don’t feel so well, do you think I could hang out for a while longer?

Um, sorry Mom, I need my space, he says, with irony face.

Oh, OK, I understand.

Beggar at the door, no place for you here.

What did I do?  Did I eat too much?  Am I too burned out?

I’m not successful like his father, the famous scientist, or his father’s father, the famous whatever.

I’m just a mentally ill disabled person, a failure at life, an embarrassment.

I’m skinny, I look ill, my hair is grey and frizzy, my clothes hang loose, my dog is nervous…

Can I at least use your internet to find a place to camp?

Oh sure, Mom.  Come in.  But please leave Atina in the van.

I thought he liked dogs.  Maybe now that he’s got new clothes and new furniture, he’s afraid she will…

I find a place, guess this is it, he’s holding the door….

Love you, honey….

Love you too, Mom…mechanical doll voice.  Grim.

I drive off, numb.  Can’t feel yet, I have to get there, too much traffic.

Get there, hook up, walk dog, collapse, convulsed with grief.

There goes my carrot.

Now I know that my leaving won’t make much of a dent in his life.

I stay here for him, thinking my exit would destroy him, but not so.

He has his father now, and his father’s father, and he is their prestigious prodigal son.

In some way, relief, that cord is cut, that fixed line down.

The plan has been in place for some time, yet I have held my hand because of Carrot #1.  Now Carrot #1 has shown me the door, out of his life and into ?

Carrot #2 snuggles against me as I write.  Precious baby.  But she is sick.

She may last months, or a year or a few.

When she goes, I go too.

Will I be punished?  Will I have to come back and do it over till I get suffering “right”?  Or, to quote Lewis Carroll, do we just go “poof” like a candle, when we go?

Already I am losing the use of my body.  My shoulders are too full of arthritis to throw a ball.  My left hand no longer works well enough to play my music, which has carried me through so much suffering all my life.

Something has happened to my blood vessels.  They break and bleed under my skin so that I go around with blue lumps simply from the trauma of living.

My skin comes off in sheets if I brush up against anything harder than a pillow.  The wounds take months to heal and leave hideous scars.

The cancer that I had in the 90’s once again inhabits my innards.  I hope it grows faster this time.  No, I’m not going to treat it.  That would hasten my death, and I don’t want to leave my dog.

But some days I can’t move, my bloated belly pushes down like a rock.  Other days, not so bad.  Some days only liquids, others, soup and rice.

I had this one carrot that kept the juice of life running through my broken veins.  Now that carrot is gone, eaten up by some other entity, and the sick carrot and the stick remain.

The stick doesn’t frighten me.  I can’t do anything about the stick.

My sweet Atina will drag me along until her own candle gutters and goes out, and I will follow after, poof, and at least this life will be done with.

I can only hope that the cancer takes me before I have to take myself.

That way I don’t have to worry about the stick.

 

 

Phantom Limb Pain

There’s a crazy phenomenon that sometimes happens when a person loses a limb. The nervous system thinks the limb is still there, so that the person continues to have the sensation of having it.  I mean, to the point of the former owner freaking out because they want to put on a sock because the foot is cold, but the foot persists in not being present.  This is called a Phantom Limb.

But since the limb has really been amputated, the limb also feels the pain of that, and of the injury or disease that lead to the amputation.  This can become a terrible situation if the limb doesn’t get used to being amputated and settle down.  How can you relieve the pain of something that doesn’t exist?

I just realized that I am suffering from Phantom Limb Pain.

Some of my readers know that I am caring for my beautiful Belgian Malinois, Atina, who is dying of kidney disease.  She is now 19 months old, and starting to slow way down.  I’m enjoying her delightful self for now, and I will take care of her until it is time for her to go.

I just received the final pathology report.  It is terrible.

For those who don’t toss around medical terminology on a daily basis, let me give you your word of the day:  nephron.

A nephron is the basic operating unit of the kidney.  It has three parts, which all have different essential tasks in maintaining the balance of fluids and electrolytes (like sodium and potassium) in our bodies.  In addition, special cells called podocytes keep our serum proteins from leaking out.  These are the parts of the kidney that maintain fluid and electrolyte homeostasis, in a delicate and incredibly intelligent system of checks and balances.  Any disturbance of kidney function can lead to a disruption in the system, depending upon which area of the kidney is damaged.  And that can lead to illness and death.

Atina’s biopsy shows that 90% of her nephrons are fetal, which means that kidney development was arrested before three weeks of life.  The pathologist writes that this could be due to disease or toxins being transmitted to the pup through the mom’s milk.  The remaining 10% of normal nephrons are becoming ballooned out of shape from having to process all that pee by themselves, and their podocytes are starting to detach, which is why her urine is full of protein.  Soon those few functioning nephrons will die, and then Atina will die.

I stopped by the vet’s yesterday for another reason, and just for kicks had Atina stand on the scale.  She’s gained three more pounds…of fluid.

When I first got her, she weighed 55 pounds of skin and bones.  She looked like a sick cow.  With treatment and lots of love, she put on ten pounds and was looking and acting like a normal, healthy, happy, bratty adolescent Malinois.  I started her in Service Dog training and she was doing great.  I had this spark of hope…

Then she started looking weird and puffy.  Despite treatment, her blood pressure was sky high (another kidney function thing), and she went back to drinking gallon after gallon of water, and peeing like a waterfall many times a day, and even needing to go out at night sometimes.  And her weight keeps creeping up, and her appetite keeps slowing down…

I’m glad she’s with me, and that I’ve had the honor to be her very own human and caregiver, friend and mutual aid society.  We are passionately in love.  She’s asleep now, but if she knew that I am crying she would rush to my bed and throw herself on top of me, causing various injuries.  Since I know that they are love bites, scratches, and bruises, I take them in the spirit in which they were inflicted.  And once her initial exuberance settles down, she cuddles and kisses and lets me cry in her fur.

Aside from the love injuries, I have been injured in many ways since becoming Atina’s personal angel.

I needed a service dog to guide me through the next ten or so years of my life.  Instead I got a very sweet invalid dog, with whom I fell in love, from whom I will be parted very soon.

This beautiful sick girl of mine cost me $12,000 up front, and more than $10,000 in medical expenses so far.  I have used up most of my financial and emotional resources, and at the end of the day, I won’t have a dog, and I won’t have the money, and since even now I keep myself alive by force of will, Atina’s death may sever the thread I’m hanging on.

Everyone says, “Sue the bitch (who sold you the dog)!”  Easier said than done.

Yesterday I had a telephone consultation with an attorney from the State Bar Association’s referral service.  He listened to the “short version,” told me he had no experience with cases like this but would be happy to litigate it, outlined the essential steps, reminded me that his hourly fee is $210 (a bargain, actually), that the case would cost a minimum of $20,000 to litigate, that we would surely win, that the first thing he needs to do is to examine the purchase contact and look at some other things, and that in order to do so he needs a $5,000 retainer.

Phantom Limb Pain.

Before I became a disabled person, back in the days when I went to work every evening, relished in healing the sick, lame, and halt, and also in bringing home the bacon and frying it in the pan: if someone needed a legal spanking I had only to pick up the phone, and if my own attorney couldn’t do it, he knew someone who could.  Retainer fees?  Not a problem.  Not a question.  Not required!  Don’t even offer!  They knew I was good for it, and besides, they might need my expert witness services one day…or their kid might need to be sewed up on a Sunday… But now all I have to offer is

Phantom Limb Pain

as I am cut off from myself, and I can’t get back what is gone

I can feel it, even see it, but it’s gone

And now I have to beg some abogado, please, please

If you think my case is so straight-forward, please take it on contingency, or reduced fees, or even pro bono

I have Phantom Limb Pain, don’t you see

I’m not what I once was
I find myself in reduced

circumstances

I am among the lame and halt now
As one day you yourself might be

As odd as that might seem

No one ever dreams it will be them
Believe me, Mr. Esquire, Sir, The Hon.,

no one ever

believes that it can get worse

But it can get worse

And then it can turn into

Phantom Limb Pain

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.

 

Stigma: A Family Tradition, Part Two

I got so excited writing my last post that I forgot to mention the “family tradition” part!  So here it is, in all its sad gory.  Yes, that’s what I wrote: sad gory.

Let’s start with the unfortunate fact that the first time I heard anything whatsoever about my family’s mental health history was when my mother came to visit me during my first psychiatric hospitalization.  That’s when she chose to open up about the fact that her own mother had been hospitalized countless times for depression, and had hundreds of ECT (Electro-Convulsive Therapy) treatments, many of them AT HOME, where my mother and her sister had to hold their mother down on the bed while the doctor administered the treatments.  Apparently at that time they did not anesthetize the patient, but just let ‘er rip with the voltage.

Then poor Nana got hooked on Miltown, and after that, various barbiturates, which the doctors later switched over to benzodiazepines.  When she was put in a nursing home, her dose of Librium was limited to doctor’s orders, far less than the dose she was used to.  “They didn’t want her to become addicted.”  She already was addicted, the fools. She used to get other people to sneak her a stash, which she always put in the drawer of her bedside table, and the nurses’ aides always confiscated.  Then she would call me (I was a med student at the time) and beg me to prescribe her some more.  I always had to say the same thing: “I’m sorry, Nana, I can’t do that.  I would if I could.”

I felt bad for her, since she was really an addict, and why should they deprive a 90 year old woman of her comfort?  Benzodiazepine withdrawal is a terrible thing.   Luckily Tricyclic Antidepressants came along and saved her some suffering.

And now for my father’s side of the family.  The first to come up was my Great-Uncle Benny, who was my paternal grandmother’s brother.  He was a doctor, and the two siblings had escaped from the Ukraine just before the Bolshevik Revolution, when terrible pogroms were decimating Jewish communities.  Their parents sent them to America to escape the atrocities.  Unfortunately, Benny “had a breakdown” sometime after reaching New York, was put into Rockland State Hospital, and was never heard from again.  The family just shut the door on him and assumed that he had lived there till he died.  That’s what my mother told me, anyway.

But.  On a hunch, I looked him up in Ancestry.com and by using all the data that I had about Uncle Benny found a living son, in California.  So it seems that the man the family threw away DID get out of the hospital, and went on to have a life and a family.  But to MY family, Uncle Benny went into the black hole of the hospital and never came out.  And I don’t blame him for not getting back in touch with them!

And then there was my Grandpa on my father’s side, who married Benny’s sister.  Grandpa became overwhelmingly depressed at the age of thirty or so, and never recovered.  His doctor, who was a cousin of my grandmother’s, (and actually a urologist, if the truth be known), advised that he spend winters in Florida instead of upstate New York (where they lived), and knowing what we now know about light and its effects on depression, that was good advice.  But Grandpa was never able to work, never able to do much at all.  He had no treatment whatsoever for his depression.  He lived a miserable life until the age of 91.  I have great pity for him, having to live so long in that hell, even though he was very unpleasant to be around.

Speaking of the doctor who was a cousin of my grandmother, who would have been Uncle Benny’s, um, second cousin once removed, or something like that–anyway, one of his sons committed suicide.

So here I was, in the hospital, having felt terrible literally my entire life, and I do not exaggerate here–I cannot remember a time when I did not feel terrible, as a baseline, with episodes of euphoria that unfailingly got me into some kind of trouble–and only then was I told that the genetic cards had been stacked against me.  And I was forty-five years old.

I felt as if a closet had been opened and a whole family’s worth of skeletons came tumbling out with a crash and a shattering of bones, some of them mine.

Why had I not been told?  The impact on my life was so profound.  If I had known, then I could have sought help as a young adult, after I left home, at least–since my parents believed in psychiatry only for other people, not any of us: that was for crazy people, and they drugged you up and you were a zombie.  Well, that may have been true, for some people, because the medicines they had back then were crude.  But they certainly did have psychotherapists back then, and I sure could have used one.  At the very least I would have had some insight into why I felt terrible all the time, and not have to feel like I was some kind of freak.

But our family history was seen as an embarrassment to be hushed up and stuffed into the closet, skeleton by skeleton, and the door wallpapered over and that part of history as good as erased.  Until I came along and broke up the party.

I will never forget the shock I felt, after I had lost my medical practice and had a serious breakdown as a result, and my first hospitalization–I ran into a bevy of my mother’s friends in a parking lot, and they all started cooing about how my mother had said my practice was flourishing and how well I was doing.  I had a moment of mental white-out and then said, “Well, actually, no.  I’ve lost my practice, and just got out of the mental hospital.”   Then I turned on my heel and walked off, noting with satisfaction their jaws resting on their shoe-tops while flies flew in and out of their big mouths.  But it really wasn’t their fault.  They were just told a pack of lies.

Stigma: A Family Tradition

I think this “SAD light” is helping.  Whereas before I had it, all I could think of was classier and more refined ways of offing myself, now I find myself thinking about ways to get back on the ol’ horse and ride.

Sadly, a return to medical practice is not an option.  Too much time has elapsed since I did my last official doctoring (I say “official” because I take care of the odd mild emergency here and there, without charge).  The face of medicine has completely changed, and to tell you the truth, I want no truck with it.  Doctors now are nothing but machines.  I’m an old-fashioned country doc, and I know it’s a waste but I’m stuck with what I’ve been dealt.

But wait: I have other talents yet to be tapped!  I have a Master’s Degree in Medical Anthropology.  I have spent the past eight years studying Hebrew cosmology, in Jerusalem!  I think that gives me a set of credentials unique enough to shop myself as a visiting professor in some humanities department at some university.  I love to teach.  And what fun!

Good heavens, there’s a university practically next door to me, University of North Carolina at Asheville.  And another one in Johnson City, Tennessee, only an hour away.  It’s worth a try, anyway.  Hell’s bells, they’re still teaching the Bhagavad Gita over there, and the Epic of Gilgamesh, and no doubt Beowulf, and certainly Plato’s Republic, Sophocles, and the rest of the cast of thousands representing contrasting world views.

But I have never, ever seen Hebrew cosmology taught in any curriculum save programs in Jewish Studies, and even there, it’s not presented from an Anthropological point of view, but as pure theology.

And people, the Cosmology I’m talking about is not your Jewish Grandma’s matzo ball soup.  It’s Hebrew physics: a sophisticated body of theoretical systems that explain how the world was created as “some-thing” out of “no-thing,” and continues in its trajectory of creation even now.  In essence, it runs exactly parallel to modern wave/particle theory, and other theories in modern physics and astronomy.

So I had this chiddush (“ch” as in “Bach”), which means “brand new light-bulb-type idea,” while sipping Turkish coffee flavored with cardamom this morning.  I got addicted to the stuff in Israel, and it is one of the things I stuff a suitcase with whenever I come back to America.

So yes, I had this chiddush.  Why don’t I make an appointment with someone important in the Humanities department in Asheville, and pitch my idea to them?  I could even wear my normal everyday Israeli clothes, which do look a bit odd compared to American clothes, but they are authentic and might add a flavor of genuineness to my demeanor.

Since I always call my mother at 11 am to check on how their night was, I did so this morning.  And since I was rather hyped up by my chiddush, I told her about it (minus the Israeli clothes, since she thinks they are bizarre and wants nothing to do with them).

She oohed and aahed over the whole idea, since the fact that I have been on disability is awkward for her; when people ask what I am doing and she has to make up some lie because she doesn’t want to tell the truth.  She is embarrassed by the reason for my disability: mental illness.  She wouldn’t mind so much if it were cancer or MS, but mental illness–disgraceful.

And so it was that right in the midst of her ecstasy at the thought of my doing something “productive” again, she stopped dead and hissed, “Don’t you tell them why you haven’t been working.  You’ll shoot yourself in the foot.”

“What!  Are you telling me that you think an educated person would not hire me because I’m bipolar?” I fairly screamed.

“Yes, that’s exactly what I’m talking about!” Quoth she.

“Let’s look at this thing,” I said more calmly.  “Twenty years ago a gay person wouldn’t dare come out and say they were gay.  That’s because they were IN THE CLOSET, afraid to come out because they were afraid of losing their jobs, among other things. And now being gay is just part of who someone is.  You’re telling me now that you think that I should stay in the closet because I’m bipolar?  Bipolar is a part of who I am.  It’s me, and I’m not going to deny who I am.  Of course I’m not going to shake hands with the program director and say “Hi, I’m Laura and I’m bipolar, anymore than I would say “Hi, I’m Laura and I’m bisexual (only my mother chooses to “forget” that I’m bisexual, so she doesn’t get that part).”

But, if the interview goes well and we get down to nuts and bolts, and the director wants me to teach an 8 o’clock class, then I’ll certainly come out and tell her that I have a health issue that limits the times that I can work; and if the vibes are appropriate, I’ll tell her what it is.

If the truth be known, there’s a huge LGBT population, both in the student body and in the faculty, at UNCA, and I’m sure that like anywhere else there must be a significant percentage of people at the University with various mental illnesses.  I’m hoping that since sexual preference diversity is so much out in the open, that neurodiversity might be well accepted too.  I’m hoping.

Oh, look!  I’ve already made the assumption that they’re going to get all excited about my syllabus and hire me straight away!

“Damn the torpedoes, full steam ahead!”–Admiral David Farragut