“Nobody Dies For Lack of Health Care”

From the “Please tell me I didn’t really hear this” files, a glimpse into the outlandish minds of the Rich And Powerful Right:

https://www.google.com/amp/www.cbsnews.com/amp/news/gop-congressman-nobody-dies-because-they-dont-have-access-to-health-care/#ampshare=http://www.cbsnews.com/news/gop-congressman-nobody-dies-because-they-dont-have-access-to-health-care/

“Just Say No.”

Ah, if only it were that easy.

Just.  Say.  No.

What couldn’t we do, if we could 

just

Close the door

Turn the page

Start over

No thanks

Don’t want

Done.  With.  That!

Like yesterday, for instance, when the Physical Therapy Assistant insisted that I lie on my back, with a hard piece of half-round foam running the length of my spine.  The idea is to open up my shoulders, which I’ve been guarding because of impingement syndrome.

I’m enthusiastic about getting more function.  I clambered onto the torture platform and lay down on top of the foam thing, expecting to open up and bliss out.

Except that didn’t happen, because the foam thing is hard as a rock.  I wiggled and squirmed trying to find the comfy spot.  There wasn’t any.  It pressed on my tender sacrum and my tender thoracic spine.

“Straighten your spine out!” The Assistant barked. That did it.

“I cannot straighten my spine because my spine…is…not…STRAIGHT!”  

Now other patients in the Physical Therapy room were interested.  A drama!

At a word from the head Physical Therapist, the assistant backed off.  After I had descended from the platform, she led me to a doorway (common PT tool, available to most people who don’t live in a van).  There she demonstrated a doorway-assisted stretch that I hope to be able to do one day, but not when I have recently fallen and can barely move at all.  Nope.  Not doing that.

“What do you MEAN, you’re not doing that?” She screeches, drawing further attention from the Peanut Gallery.

“Just what I said.  What else have you got for me?”

She crosses her arms.  Oh brother.  I’m waiting for the PT Get Tough lecture, but her boss shuts her up in time.

Now she wants to do something with my neck muscles.

“Neck is off limits.  No discussion.”

Too bad my aim was not to give this person an apoplectic fit.  If I had meant to do it, it would have been a tremendous success.  But that was not my aim.

I’m really not in bad shape at all.  Just banged up a bit.  Actually, when I think about it, most of my biffs and bangs were acquired doing things I love to do: occupational injuries due to the business of life, with a large overlay of genetic vulnerabilities.

I can’t say No to my genes.  But I can certainly say No to anyone who doesn’t listen to my concerns, who seeks to intimidate me, to use their position of petty power to try to overrule my ownership of my own person.

“But it’s for your own good!”

Maybe.  

On the other hand, what’s good for the goose isn’t necessarily good for the gander, and so on.

I’m not just “a shoulder.”

I’m a person who has lost 2 1/2″ of height over the past two years.  That’s because my spine is kind of disintegrating.  It’s getting a bit pretzel-y.  My years of spine PT are over.  So nope, PT assistant does not get to mess with my neck muscles.

We ended up with simply repeating the exercises the Head Trainer had given me last week.  Whatever.

As I write this I’m thinking about a friend who is very ill.  She’s enduring incredible invasions of her privacy, has lost every vestige of personal space.  People bossing her around from every possible angle.

She can’t “Just say no.”  She can’t Just get up and walk away.

This has to be the hardest thing: to not have the option to Just.  Say.  No.

Don’t Worry, I Only FEEL Like I’m Gonna Die

A few days ago…when?  I can’t tell.  Leave me alone.  I was camping in a Cracker Barrel parking lot.  They let you do that: good for business.  All night, revolving on the rotisserie of chills and sweats and pain and chills and sweats…happens sometimes, no one knows or cares why, so I grumbled and ate their lousy breakfast and went on.

A day of elevated mood is always welcome, so I enjoyed that one, the day after the bad night, who knows, who cares.  I do.

Then it hit me like a wall and sent me scurrying to the health food store for homeopathic remedies, Chinese herbs, bee products, healthy meats and vegetables…bargaining, I think they call it?

But no avail, the virus has a foothold, and now it’s the headache, the exhaustion, the total body crushing pain, hyperacusis, desperate thirst, irritability, sweats and chills, and…need I say more?

The Flu.

Is it the flu?  Sure feels like it.

Then I should be on that antiviral…but according to the CDC, there is no flu here.  Really?

It’s the weekend.  Doctors are closed.  The ER?  Fuck a bunch of ER, I’m not going.

It’s the heaviness in my chest that worries me a bit, but…nah, it will pass.

It’s just that I have to get to Chapel Hill on Tuesday.  My baby boy will be defending his Ph.D. dissertation and I must be there.  I must!  So this must pass.

I only feel like I’m dying.  I’m not really.

Sick Day

Wouldn’t you know it.

I have had a maintenance appointment for my van this morning, but….

I’ve been feeling weird for a few days.  Had an “upset stomach” last week, treated with Imodium and cannabis tincture, got OK in a few hours.

Past few days I’ve been seeing some blood in my stools, but that does happen now and then.  I’ve got Crohn’s Disease, after all.  Fortunately a mild case.  I’m grateful for that!

Last night I felt beat.  I chalked that up to long pleasant walks with My Girl Atina.  Had a simple dinner of soup and went to bed at eight.

I awakened at 6 with a start.  Freezing cold.  Well, it WAS freezing cold, since I am low on propane and had to triage between the gas fridge and the heater.  The fridge won.  So it was pretty damn cold this morning.

Suddenly I realized why I was awake at that ridiculous hour:  I needed the bathroom, and right now!

Fortunately my bathroom is right next to the bed, so I hopped in there….

Sorry to be gross, and I won’t be upset if you stop reading now.  In fact, I won’t even know if you stop reading now, so proceed at your own risk.

There is a certain vile stench that rises off of bloody stool.  Those who have smelled it know what I mean.

If I were not the kind of person who would rather die than puke, there would have been a terrible mess.

Imodium doesn’t stop this kind of thing.  Blood is very irritating to the digestive tract.  Imodium does seem to help the cramps and spasticity, so I use it.  I’m on my third.  Can’t take more than four a day.  As it is, after this episode has passed, my gut will be paralyzed.  I won’t crap for four or five days, at least, and then I might have a normal week or two. 

Now my belly is lying there on top of me all pooched out, full of borborygmi (oh God I love that word!  Borborygmus, singular; borborygmi, plural.  Def: bowel sounds that are audible with the naked ear)–in my case, audible across the room.

Last time, we had a little conversation about farts.  Remember?

Good.  Well, people, I know there are those among you who KNOW that dreadful feeling…is it really a fart?  Or is it…something else….

Yes, it certainly could be something else….let us get to the bathroom…quick….

Oh dear.

Let’s look on the bright side: at least I’m disabled, so I don’t have to worry about calling in sick.

But I just did call in sick to the mechanic!  Oh brother.

I’ve been halashing (that’s Jewish for “longing,” more or less) to do some volunteer work.  What I really want to do is to read aloud to little kids, homeless people, nursing home residents, people stuck in the damn hospital….anyone who wants to hear the magic of a book. 

To me, books are the most tangible evidence of humanity.  There is magic in the visual arts, but those could have been done by angels.  No angel could write a book.  They are too concrete, angels.  Come to think of it, an angel could never make good art.  You have to break the rules to make really good art.  Angels are programmed.  They can’t break the rules.

Ugh, my belly hurts.  Now I have to find my heat pack and put it in the microwave.  And burn some fucking incense.  Atina’s been licking her ass again.  The bathroom is stinking the place up.  God, I can’t wait till this blows over.

I LOVE Purple!

image

Purple is SO my favorite color.  ‘Specially when my shirt, my sweats, and the bruise from where I got blood drawn yesterday are all the same shade.

That’s not an actual bruise.  It’s more of a bleed between two layers of skin.  That’s what happens when my skin is the least bit disturbed.  I didn’t even feel the stick, so it’s not really trauma.  The really fucked up thing about these purple things is they turn into scars.  WTF?  Scars.

Now I have purple blotches coming up here and there from the deeps, very tender, with swollen blood vessels under them.  I showed all of this to the doctor I went to yesterday, who is supposed to specialize in things like that, but I guess not, because he kind of shrugged and said I ought to see a vascular surgeon, but, he added, they are hard to find in these parts.  Then he ordered a lot of blood tests, and told me to come back in two weeks to discuss the results.

If I’m still alive, that is.  These swollen veins can’t be a good thing.  If I’m not significantly better tomorrow, I will take Atina to board at the vet, and take myself to the hospital.  Surely someone ought to have an idea or two about what’s going on.  I hope.

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?

Tales From The Roadtrek #1

My favorite essayist, E.B. White, would often begin a story with a wandering tale about what he was doing at the moment of his writing: lying in bed sick, listening to the pigeons on the ledge of his New York apartment; lying in bed sick–even though he was a very active man when he was well, he was often sick, having a poor constitution–at his home in Maine, listening to the mourning doves in the tree outside his window, and so on.

I am one-and-a-half days into a two-day reservation at Hamlin Beach State Park, which is in New York State due north of Rochester, on Lake Ontario. I arrived near dark last night, having taken a bit of a tour through my old haunts here in this town of bitter sweetness. Here I did my hellish residency in Pediatrics, got divorced, got my first job as Director of a Pediatric Emergency Department on the merit of my performance as a model prisoner of the hospital known as The Gulag, where residents who were out of favor with the Powers that Were and Are Now In Their Graves–which is too bad, because I would like to give each and every one of them a piece of my mind for punishing me for being sick—were sent.

It was meant to be a punishment, and for some it was.

As for me—I was right at home.

The Gulag’s other moniker was the Knife and Gun Club. It sat right in the heart of violent gang land. Crips ‘n’ Bloods. Each with their own highly honed style of maiming and/or killing members of the opposing gang, if they could; and they did.

It felt just like Chicago to me. Many nights in my Upper Clark St. apartment, lovely and cheap, we would have to creep around on the floor lest we meet the fate of those who are struck by stray bullets during yet another gang war taking place in the park across the street.

I had been banished to the Gulag’s Emergency Department for seven months, so I simply moved in when the existing director bailed out. The Gulag was just my kind of place. I stayed and played for another two years.

The campground—we’re back to Hamlin Beach now—is at least a half-mile from the actual beach. That is just fine with me, because several weeks ago I camped at an absolutely dreadful campground on the Jersey Shore (New Jersey, not Jersey in England). The place had all of the unpleasantness of Eastern beaches, except the beach itself—for that, you had to drive twenty miles.

But no need. The campground featured plenty of coarse and painful sand that blew into everything, causing normally decent food to become dangerous to the teeth. Sand fleas, sand flies, fire ants, and, I discovered in a most unpleasant way, a medium-sized member of the spider clan that is perfectly camouflaged to look like the sand it dwells in. Well, not all of them dwell in the sand; some have moved into my camper, and now it is a game of “I squash you if I can catch you before you bite me, you little bastards.” I have no idea how to get rid of them without poisoning all of my tiny premises.

Anyhow. We return to New York State. The Lake Ontario beach is at least a half-mile from the campground, as I have already mentioned. Today I set out on foot, with my big sun hat and heavy multipurpose walking stick (the one my father, of blessed memory, cut from a rhododendron branch that had been climbed by a vine, causing the stick to be shaped in a mesmerizing spiral).

I found some pretty trails winding around toward the beach, only some of which were carpeted with poison ivy. The rest were nice dirt trails covered with pine needles. [After-note: did you know that eucalyptus oil is very effective at quelling the itch from poison ivy?  Good thing I happen to have some.]

After a delightful meander, I found myself on the strand of Lake Ontario. I mused on the fact that even though I left Rochester in 1992, Lake Ontario still lay sloshing in its glacier-carved bowl in the Earth’s crust, same as if I had never left. Fancy.

I watched the early evening swallows swooping and scree-ing together, something I have always loved to see. The gulls stood fat on the water line, gobbling the bounty of lake mussels–a bad creature imported on the hulls of the great ships that make their way from the Atlantic into the Great Lakes by way of the Saint Lawrence Seaway, which have wreaked havoc on the lakes’ ecology by way of competition for nutrients. But the gulls love them. I was struck by how many more of them—mussels, not gulls—there seemed to be, judging from the mess of them on the beach, than there were the last time I was here, so many years ago.

My eyes kept straying to the water, and every time they did, I felt the familiar nothingness come over me.   Actually I didn’t feel anything. Only in retrospect do I realize what must have happened.

The breeze picked up as the shadows lengthened, and as the chill ran down my spine I turned to walk back to the campground.

I walked and I walked and I walked, and at some point realized that I had become disoriented in the process of trail-meandering, and had wandered too far to either the East or the West, I wasn’t sure. So I kept on walking straight, figuring that since I was on the road that bisected the park, I was sure to come upon a sign eventually.

Only problem was, my legs were tuckering out. Nowadays when I walk too far my legs start feeling stiff and weird, and they hurt. Well, they were hurting, all right, and I really did not want to keep on, and was thinking of sitting down in the grass on the side of the road; but since it kept on getting dark, that did not seem like such a good idea. It is better to be lost in the daytime than at night, don’t you think?

Not one single vehicle came down that road the whole time I was dragging myself along, grateful for my walking stick, which was by now doing yeoman’s duty by way of holding me up. I prayed and prayed for a park ranger, but unlike taxis in Jerusalem, which arrive if one prays sincerely, no park ranger responded to The Call.

At last the answer to my real-time prayers came along in the form of a Border Patrol Officer in a Jeep. I flagged him down and told him that I was looking for the campground. He grinned and pointed–the entrance, which was only a quarter mile away, in the very direction in which I was hobbling, appeared out of nowhere. Perhaps he was a wizard or a saint, and he either conjured it or performed a miracle.

Or, perhaps, had I simply kept on, I would have arrived at it in a few more minutes of agony and confusion, but Heaven sent this uniformed angel to relieve my mind.

(Still, I would have taken that Jerusalem taxi. At least I wouldn’t have had to walk any more.)

I still had a mile or so to negotiate until I arrived at my campsite, so I continued to put one foot in front of the other, trying to ignore the mounting pain and stiffness, until I finally reached my little motorhome and collapsed on the bed. My legs felt as wooden as my walking stick, although not nearly as useful.

Even now, hours later, if I try to move around much my feet go into painful scrunched-up spasms. One of these days I will get around to going to some doctor about this, if I can find one who is not a dimwit. if you are a fellow doctor who is not a dimwit, then a) this does not apply to you and b) please be in touch immediately.

Two Days Later

I think I must have had a bit of a hypomanic episode the morning I left Lake Ontario and headed straight south on Rt. 15 to pick up I-86 West. At 4:30 am my eyes popped open. I wasn’t sleepy.   Odd, even though I had passed out at 8:30 the previous night after the unplanned hike. My biological clock usually has me waking up between 8 and 9.

I have managed to wean myself off the dreaded Zolpidem (Ambien), and now instead of being forced to sleep for 12 hours at a stretch, my body seems to be tentatively investigating what her normal sleep pattern actually is. It’s delightful, really, to lie in bed with the lights off, listening to whatever is around me, whether it be tree frogs and whippoorwills, or semi trailer trucks roaring in and out of the truck stops I like to lay over in, like this one, two-thirds of the way toward the Western boarder of Indiana; and drift gently off to sleep, rather than literally passing out from drugs. Takes some getting used to, though.

Day before yesterday, I drove 400 miles, and enjoyed every bit of it. Blue skies, gorgeous mountains, farmland, Amish settlements, elaborate barns, simple houses.

Bivouacked at a truck stop, and was dismayed to find that unlike most of its kind, this Flying J did not have a special overnight parking section for RVs. Even the trucks were stacked up two to a space.

There were a few “regular car” spots over in a corner by the entrance of the truck lot. One space open there, better grab it. I pulled as far in as I possibly could, because my position was just beside one of the fuel lanes.

Yeah, OK, it sucked, but I was so tired from my hike and my long drive, I was grateful for the privilege of parking overnight without the dreaded 3 am knock on the door, lights flashing in the windows–fairly predictable if you park overnight just anywhere…so I’ll put up with a noisy, stinky truck stop where my sleep is unlikely to be rudely interrupted.

All evening I drifted in and out of sleep, frequently jarred awake by the ka-BAM, ka-BAM of the trucks running over a piece of broken pavement 5 feet from my van. I had to do some emergency self-NLP in order to abort the full-fledged panic attack I felt coming on.

Fortunately, the noise settled down and finally stopped at about 11. I learned something new about trucking: there are two kinds of drivers, the day ones and the night ones, and they change shifts at about 11 pm.

I marveled at the connection.

Before I had diagnoses and meds and sleep, I used to like to do my long distance driving at night, especially if the trip involved crossing deserts or long stretches of the Mysterious Midwest flatlands. One cornfield looks about the same as another to me, friends.

At night, the highways belong to the trucks. So many trucks come out at night: in places they’re bumper to bumper at 85 mph.

In a regular car that’s terrifying. It feels as if they don’t even see you–that they will just run right over you.

When I got my big Dodge truck and 33 foot horse trailer (with full living quarters) I got started with CB radio. Suddenly the highway exploded into a whole new dimension.

“Hey J.B. (J.B. Hunt is a trucking company), keep an eye on that four-wheeler (regular car) on your left lane. Looks like he wants to pass you.”

“Thanks, good buddy. You got anything good to listen to?”

“Wellll, just a couple o’ them Jeff Foxworthy tapes. He cracks me up!”

“Yeah buddy, he do! Hey, if I see you at the Flyin’ J you want to look through my tapes and see if you wanna trade for somethin’?”

“Sure thing, good buddy. Ten-four.”

“Ten-four.”

It never crossed my mind that there might be an entire subculture hidden from those of us who drive around oblivious in our four-wheelers. And then there is the overlay of a subculture of land-bound humans who sit up all night with their CB radios talking to the truckers. They have colorful “handles,” or nicknames, and each of them has a persona—and an agenda. Luckily, CB radios have lots of frequencies, some public and some that can be rendezvou’d upon by mutual agreement. Dialing my way up the channels in order to chat privately with a friend, I’ve also come across some highly illegal activities right there in traffic.

I did merit some special treatment from the truckers when I was pulling my horse-hauler. Since I always made sure to politely introduce myself, I was graciously received by the pack of whining 18 wheelers hurtling along around me.

“Hey, good buddy, OK if I slide in in front of you? I got to get off at this exit.”

“Ten-four, little lady, you go right on ahead.”

He flashes his lights when I’m far enough ahead to safely change lanes. I flash mine twice: Thank You.

I haven’t got a CB in this little rig yet. I feel kind of funny about it, being only 22 feet long, as opposed to the 120 foot length of your average tractor-trailer combo. I’m going to have to swallow my pride, though, especially if I keep on getting up while it’s still dark.

Today I felt like crap all day long. Maybe that’s because it rained so fucking hard yesterday that I had to bail out at the first truck stop I came to in Fort Wayne, Indiana. I had wanted to travel another couple hundred miles to an actual campground, get a really good shower—my rig has a tiny shower in it, but there’s nothing like standing under a stream of hot running water for as long as you want.

I saw a couple of little baby tornadoes forming in the clouds, and the barometric pressure was bouncing all over the place. What else could make one’s ears pop on solid flat land?  But I had the SiriusXM Radio pegged on Classic Vinyl, and if The Big One had dropped down out of the sky and swooped me up–well, I guess that would have changed my channel, all right.  But it didn’t, and here I am, still.

The only place I could find to park turned out to be right over a sewer drain, which was flooding a bit because of the rain, so I spent the night inhaling noxious fumes.

Maybe that’s why I feel like crap today.

Didn’t even make 200 miles. Didn’t even get out of fucking Indiana.

I’m on U.S. Highway 24, Westbound.  Flying J again.

Oh well. Isn’t that what this journey is all about?

Roll with the punches.

Enjoy Paradise.

Enter The Black Dog

Normally I’m pretty good at cloaking my moods.  I’m trained in the art of dissembling.  One of the hidden maxims of medical training is, “Control your face.”  Don’t let the patient know that you’ve just found a….you’ve just done a……and barely got yourself out of it….your surgical assistant is the most beautiful thing in the world…you just farted.  Etc.

One thing it’s hard to conceal is The Black Dog’s visits: depression.  I’ve never been good at it.  I cry at the drop of a hat anyway.  So I’ve gotten good at noting which exam rooms are empty, so as to duck into one for a good bawl, and exit red-eyed.

“What’s wrong with your eyes?”

“Allergies.”

Yesterday I woke up feeling like somebody had clubbed me over the head.  I couldn’t tell where I was in time or space.  My brain felt like chocolate pudding, but not at all tasty.  Actually, I didn’t wake up at all.  If a friend hadn’t texted me at 1:45 pm, I would probably still be asleep.  Poor starving Noga lay next to my head, resolute.  If I had kept right on sleeping, I don’t think she would wake me up to feed her.  I don’t know if that’s good or bad.

I felt kind of like I felt when I took my bedtime medicines in the morning, except this was even worse.  I was hoping it would wear off as the day (what was left of it) wore on, but no.  At bedtime last night I resolved only to take those medications which if you do not take them you might get a seizure, which happened to be the same meds I go to sleep by.  How convenient.

I was quite sure that after a good day’s/night’s sleep, certainly whatever I had taken would have worn off, but no.  Well, it did, to some extent, but then I started feeling cross and weepy.  I yelled at my dog.  I’m very relieved that she seems to understand, and cuddled up with me for a lie-down-not-nap after I got from the grocery store.  I’m amazed that I got back, since I really, really should not be driving in this condition.

I still have not put away the groceries, six hours later.  I have not put away the enormous piles of laundry that I took to the laundromat the day before the day before.  And I just read an article about the habits of Brown Recluse spiders, that they sequester themselves in the fingers of your work gloves (!) and in piles of laundry left on the floor (!!).  Well, these are in black plastic bags, if that helps.  (The reason I was reading up on Brown Recluse spiders is that I found one uncomfortably close to where I sleep, the other day.)

Last night, the night between Days One and Two of the Feel-bads, I had one of my thankfully rare episodes of chest pain.  They occur sometime in the middle of the night, and are so intense that I can’t move.  Even if I thought it was a heart attack, I would not be able to move to call the ambulance.  So I have learned to have the attitude that if it’s my time to go, it’s my time to go, and I am a Do Not Resuscitate specimen anyway.  I toy with having that tattooed across my chest, but my religion specifically forbids tattooing.  I mean, come on, like 5,000 years ago there was a law against tattooing?  What, Moses was afraid we would all become, like, Goths?

Where was I.  Oh yes.  This episode of chest pain occurred between Days One an Two of the Feel-bads, and I was not at all sure I was going to wake up at all, but in fact my alarm did rouse me, as it hadn’t on the previous morning.  I rose, feeling hopeful, but a wave of nausea washed over me and I sat down on my bed again, uncertain, until I remembered that my mother had to go and have some tests at the hospital and I was supposed to go and sit with Dad so that the morning caregiver could go to his second job.

I managed to crawl out of the house at noon, after waking at nine.  Given that I don’t even have a shower to loiter in, which I would have done had I had one, I can’t account for the time at all.

My mother was at home already, triumphant that even though they had done the wrong test, it was negative and therefore she knows more than me.  But she needed tomatoes, so if I were going to the store, would I get her two?

I hadn’t really been planning to go anywhere, given my foggy mental condition, but I caved in to her request and got in my car, very slowly and carefully, and in that condition drove to the store, where I discovered that I needed at lot more than just her two tomatoes.

On my return to the P’s house I caught my wrist in the tailgate of the Outback as I was closing it, and my paper-like skin split over the back of my right wrist.  I didn’t notice the blood until I got home, though, which is what prompted yelling at the dog, because I was bleeding all over the place and she was blocking the passage between myself and the sink full of dishes, where I wanted to wash my wound and see how bad it was.  It could be that she knew something was up and was concerned about me.  That is probably the case.

As you see, I have diverted you from thinking about the fact that somehow or other, The Black Dog has made his way to my doorstep.  Ah, that was what Noga was bugging me about!  It was really as if it hit me right as I walked in the door: the wall of depression.  Smack.

I don’t know what triggered what, in the Feel-bads scenario.  Could have been either one, doesn’t matter.  This morning I took my meds as usual, and I think I did on The Lost Day before that.  If I don’t feel better tomorrow I’ll increase my Lamectil by 50 mg.  My shrink, who has been my shrink since 2001, he and I have protocols for everything.  Depressed?  Add more Lamectil.   Psychotic and/or manic?  Seroquel.  Anxiety?  Clonazepam or Lorazepam.  And so on.

But tomorrow is another day, and this one ain’t over yet.  My lie-down with Noga helped, and I know she’ll want to cuddle at bedtime–she always does.  She’s very predictable.  She runs on ritual, on routine.  And by default, she causes me to have a modicum of routine, which I would not otherwise have, being unemployed and an undisciplined writer.  She has just had her evening bit of obedience training–she demands this every evening at 8:30, not because she so much enjoys the training as she does the treats that accompany it.

And now it’s time for evening meds, brush the teeth etc., arrange the nighttime necessary things in the sleeping area: tissues in case of crying and its accompanying snot, bottle of seltzer (I really like my water to sparkle on the palate) bottle of Ouzo (I like a little Ouzo before sleep, if I don’t fall asleep from the meds before I have a chance to drink it), pee bottles (pee bottles?  Right.  I don’t have a toilet).  And one little fuzzy golden Lhasa Apso, who will no doubt jump up in the spot where my feet are supposed to go and give me the “Apso Look,” which is indescribable; if you have seen it you’ll know what I mean.  But what she means is: “Show me that you love me and haul my 13 pounds up to your face and give me kisses and hugs.”

Which, of course, I will be delighted to do, at the peril of soaking portions of her fur with my tears.

Daily Post Challenge: Reincarnation

I’ve journeyed through all kinds of religions.  As a teenager I hung out with Mescalero Apache shamans in New Mexico, and got to go to a peyote meeting where the group energy was channeled to help somebody in trouble.  When I finally went to college, I took courses in Anthropology with a professor who had learned witchcraft in Africa, and proved it by murdering chickens and divining the future from their guts on the floor of the classroom.  As a graduate student in Anthropology, I learned about lots and lots of religions that believed in reincarnation.

But it wasn’t until the year 2000 that I began to look into my own native religion: Judaism.  Jews are famous for being Buddhists, Hindus, anything but Jews.  And I was no different.

My motivation for exploring the religious beliefs behind my genetic heritage was simple.  Because of a confluence of influences, I lost everything I owned.  My health took a dive.  My 16 year old son was living on the streets, eating out of dumpsters, just as I had done when I was his age.  Life sucked.

A friend turned me on to a book of the Apocrypha: Christian mystical writings that didn’t make it into the Bible.  I started wondering, wow, if the New Testament is this cool, what is the Old Testament like?  So I started reading it, and came up with not much knowledge but loads of questions.  Naturally, I turned to the Internet, and typed this into Google:  “What is the meaning of life?”

The top of the search results lead me to the Meaningful Life Center, run by Rabbi Simon Jacobsen.  It would take more words than I have here to explain what is contained in there.  It’s everything Jewish, both traditional and mystical.  I went straight to the mystical.  There I discovered that Judaism teaches that we are sent into this life, these bodies, in order to fix things.  These things can be blemishes on our souls because of misdeeds in previous lives, or they can be blemishes on the collective soul (which is another topic), or they can be fixings of specific events that are destined to happen in this life, or in the world at large.

I have spent the past 13 years in further study of Jewish mysticism and concepts of reincarnation, and how I can personally work on fixing myself and my little part of the world.

Then I went to India, as a result of an event that I do not believe was random.  It was 2010, and I was very ill with something that was eluding the diagnostic prowess of Western physicians.  I have a passing familiarity and great respect for Ayurvedic medicine, so I researched the most reputable Ayurvedic hospitals in India, and one of them happened to fit my time frame and pocket book, so off I went to Tamil Nadu.

On the day that I arrived, the physician in charge was out on maternity leave, or paternity leave, I guess, since his wife had just had a baby.  The doctor who was filling in was Dr. Sundar Raman.  The moment I saw him I burst into tears.  I knew that he was somehow related to me, from a previous life.  Unlike a Western doctor, he jumped up and ran around to my side of the desk and held me while I cried.

I stayed at the Ayurvedic hospital for ten weeks, undergoing intensive treatments.  And every day, Dr. Sundar came to my cottage and we studied together for three hours.  He is a Brahmin priest.  We studied the correspondences between the Hindu Vedas (the scholarly tracts behind the religion) and the mystical backbone of the Torah, which is the parallel system of the Hebrews.  We drew diagrams and studied passages from both disciplines.

I learned that in Hinduism, the understanding of reincarnation is that we are engaged in a process of purification of the soul.  With every incarnation, we should strive to live as clean and true a life as possible, with the aim of ascending through the layers of unreality and misdeeds that are inherent in the human condition, and eventually reaching a pure state, finally merging with the Cosmic Consciousness.

And what about illness?  Where does that fit in?  Illness, says Dr. Sundar, is a pathway to salvation.  If we pay true attention to the message of illness, and realize that it is a process of cleansing from sins committed in previous lives, we can use it as a springboard to ascending in consciousness and leaving the Karmic Wheel.

I was shocked at this, and very excited, because this is exactly what Judaism says about the purification process, and the ability of illness and misfortune to cleanse and actually benefit us, even though the process can be very unpleasant.

On difficult days, I try to remember what Dr. Sundar says: Illness is the key to salvation.  And I fervently hope that in the merit of my suffering and the good deeds that I try to do, I don’t have to have a next life; and that if I do, it could be easier than this one.

Crazy People Get Sick Too

“Crazy people get sick too.” a professor of mine in medical school told me, as we walked through a crowded urban emergency room.  He firmly emphasized to his small crowd of followers that it was nothing short of criminal to instantly brand every human being who presented to the ER (or anyplace else) with a medication list that included psych drugs, or was delusional, or disoriented, or hallucinating, or even violent, as being a “crank,” and ignoring the possibility that this person might be physically ill, just like anyone else.

I took that lesson very much to heart, even though I was not officially among the mentally ill at that point.  It made all the sense in the world that mentally ill people could still get heart attacks, and strokes, and kidney stones, and life-threatening infections.  It even made sense that people who were not diagnosed with a mental illness could have conditions that might mimic conditions normally associated with, say, a psychotic break or an overdose: acute liver failure can cause hallucinations and stupor; uncontrolled diabetes can cause disorientation and lethargy progressing to coma; hypoglycemia can cause uncontrollable tremors, delusions, and hallucinations progressing to unconsciousness and sudden death; brain tumors can cause auditory and visual hallucinations, personality changes, depression, mania, paranoia, and just about anything else.

Then there was the lady who kept vomiting and vomiting for almost a year.  The gastroenterologists did every test in the world and it all came back normal, except for her serum electrolytes, which were screwed up from her constant vomiting.  They branded her a psychogenic vomiter, which means  they blamed the vomiting on something psychological and that was not their department, so they discharged her from their care.  A few months later she presented to the ER, this time vomiting up fecal matter (sorry).  Yes, it was really gross, and my heart went out to this poor lady, who had been branded a “crank” simply because the doctors did not know what was wrong with her.

This time the ER requested an acute surgical consult.  The surgeon decided to take her to the OR the next day for an exploratory laparotomy, which means they would open her up from guggle to zatch (my terminology) and wudge around in her innards to try to find the cause of her awful condition.  Luckily, I happened to be on the surgery service then, so I was pressed into service holding retractors.  (N.B. anyone who has a question about any of these terms is welcome to leave a comment and I will explain.  I figure that most people watch all these medical shows they have now, but since I don’t own a T.V. I don’t know what they have on them.)

Where was I?  Oh yes.  Holding retractors.  So.  When the surgeon got in there, he found, to his great surprise, a gigantic tumor in the middle portion of her small intestine.  Now, the small intestine is notoriously difficult to evaluate due to its extreme length (about 20 feet) so you can’t just stick a periscope down there and look around, like you can with the large intestine.  So all kinds of weird shit (excuse the pun) can hang out down there and go on with its dirty business undetected.   So when he opened this lady up and found a grapefruit size tumor like a donut surrounding the tube of her small intestine, he was shocked and amazed.  I was ecstatic.  The lady was vindicated.

The surgery turned out to be very messy.  I will not go into the particulars.  I had the immense satisfaction of bringing the news of the positive surgical findings to the attention of the arrogant asshole gastro people, who pretended that they thought something was the matter all along.

Oh, I forgot to tell you, this lady had a diagnosis of anxiety disorder and was on two or three meds for it.

One piece of good news is that since then there have been many new developments in medical imaging.  It is doubtful that things would have got that far without a CT scan, or an MRI, or both; and either of those would have revealed the weird tumor.  But given her diagnosis of anxiety disorder, would she have been taken seriously enough to even get to the point of imaging before she started throwing up shit?  I really don’t know.

Next post, I will tell you why I wrote this one.