Absolutely Nothing Novel Or Unique

2009-07-14T11:14:00.001-07:00

reprieve

An unexpected day off. Time enough to wash my hair. Dry it even. Put in product, remember that it shines. Time enough for a second (first) cup of coffee. An over-stuffed arm chair. Time enough for pages empty of words, so full up of write.

But there is no place to begin, having gone this far along. I've started something of another place, a place devoted only to that which I was intent on avoiding: mommyblogginess. It is one of the many ways in which I am salting my words, in effort to make them easier to swallow. There is much that needs to be documented, the mundane and sweet daily doings, the messy, complicated emotions, the excrutiating cliches, the insurmountable loneliness.

But it's nascent. New. Newer than she is. Not ready yet to step lightly out into the bright glare of morning.

2009-07-13T08:41:00.000-07:00

place holder
There is so much. Yes, she's here. Yes, she's perfect. Yes, I'm exhausted.

Somehow, there is no time. I don't know why I am so surprised. There are about ten thousand things that I have written, invisibly, so far. All of them lost, for now, into the recesses of my brain.

I will say this - I am newly, strangely, unexpectedly lonely. This is startling; I am no longer the easy creature of solitude I used to be. I miss my mother. I miss my friends. I am tired and bored of New Hampshire. I find myself seeking paved roads and placing to buy things. This is unexpected, too. Hurried as I was to leave the city. To live in the country.

This is the country. I'm trying.

But there is too much, so much, to get out first. But not now. Some other time. Soon.

2009-05-23T14:09:00.000-07:00

filler

A few have emailed, concerned, questioning, just wanting to make sure. Most have left. Occasionally, someone really cool stops by to say hello who I'd never met before, and that's always nice. So I'm posting this for now, a place holder, a trail of breadcrumbs, just in case I need to come back.

1. The baby has not been born yet. Best we know, everything is fine. Today is her due date in fact. Apparently she did not get the memo.

2. I am still sick but not nearly as sick or as continuously as before. Some days are almost okay. Some days I want to stick my head in a blender. It's like being in the wrong kind of Skinner Box. There's no way to predict what will happen: some times I am nauseous for hours; other times food just tastes wrong. Occasionally, mercifully, every once and a while, things are almost normal, making it all the more infuriating the next time I try to eat something and end up instead, hypersalivating and spitting up in the sink.

3. I don't know if it's lack of blood flow or volition or if I will ever return here the way I once was before. I do know that I refuse, on principle and practice and a rather unpopular aversion to all things Mommyblogger, that this will never, ever be a Mommyblog. That said, much in the way of Anne Lamott, I kind of need to chronicle things.

We'll see what happens. Once it does.

2009-04-09T16:03:00.000-07:00

village voice

I always thought I wrote to open the stop cock on the pressing, urgent overstock of inventory in my cluttered, disorderly, saturated mind. I always thought, in New York, that I wrote because I couldn't not write. My brain processed the world as a series of words, typed out onto a page. It never occurred to me that I needed the hard-pressed humanity, the the little sorrows, the accumulated enormous and tiny and bewildering moments in order to write.

Before New York I had bad boyfriends and big heart aches and an abundant, vaulting ambition. I worked long nights, late under the bright and flickering lights of blue buildings, tending to slow ailing and quick dying creatures--filled up behind their cages, eyes full of water and color--trying to breech the chaos and the calm of Emergency Veterinary Medicine.

Before New York I had a fierce and hard-beating heart full of sad ache for a boy who should have been a man, but wasn't. Before New York I'd run for miles and miles and miles along the green and golden ocean, trying to outpace my irrepressible insides. Before now there was much in my life that urged commentary, required compartmentalization, that I had to write it down,I had to place it some where else outside of me, in order to keep the sinew together, in order to quiet my unquiet mind.

What I am saying is that I am unaccustomed to such pedestrian complaints as the ones I have now. Sick from pregnancy and exhausted of the visceral constellation of maladies that seem to be unique only to me, causing incredulous speculation and vague disbelief whenever I try to explain them. Bored and tired of a job that reminds me daily that my talent and ability and ambition is disappointingly untended to. Facing the same redundant and thread bear sacrifices so many women have already suffered: careers for children, professional success for personal satisfaction. There is no new territory here, for me or for anyone. I embarrasses me almost to even give voice to it.

And yet, I still have this space. Am half-heartedly nursing it. Which is odd. This space that was so necessary to calm the chaos I urgently abandoned. This space that existed because of the hard and heavy heft of medicine and New York. And here I am now, in the quiet and the calm, empty and restless and wistful, wondering if I needed some of those small disasters to distract me from the echo and edges and dust in my heart.

2009-03-25T12:02:00.000-07:00

dyspepsic
I have nothing, I'm empty, full up of space and distance, so out of practice I barely know where to begin.

Last week we went home, to Santa Cruz, where we no longer live. I stood along the steep cliffs in the hot sun and the thick air with the seals barking and the green ocean and the tiny waves crashing and the chattering pelicans, feeling as if I will never be so complete as this, that I will always be missing an entire chamber in my heart.

I did not ever want to be a mommy blogger. I do not ever want to be a mommy blogger. Lately, as I stare vacantly at the various entries of some of the more formidable mommy bloggers who populate the momm-o-sphere I feel as if I have never been so alone in my life. As if I am certainly an alien being, as if I am certainly out of my guano mind. I can't relate. To any of them. Well, maybe this one and this one. But neither of them are mommy bloggers and both of them are equally and separately stunning. I look around and see so little that centers me, so few women who anchor me or make some kind of semblance of sense.

Lately I have been sick. Again. Almost, if not as bad, as before. My heatburn is so bad it forces the food back up again after I eat. On all fours and sobbing I crouch in front of the toilet, coughing and gagging every bit of it back up. When it stays down it hurts so much sometimes it takes my breath away. It comes on like a spasm, out of nowhere, a full frontal attack. I can feel the little bit I manage to eat in a day forcing it's way back up again, ripping up the delicate skin of my body as it works it way backwards, up and out, punishing. I feel like a mental patient, like some deranged person that no one believes, or understands. People just look at me, cross-eyed, and say still? Aren't you supposed to be done with that stuff? I makes me want to kick them in the teeth.

And I'm still nauseous. Always. Tums makes it worse. Almost nothing is worse than trying to eat Tums. Even barfing is a better alternative. Nothing tastes so foul as those little round chalk chucks from hell. I've tried Maalox but my nausea was so extreme that I gagged it right back up again, into the sink. Food is a total fucking nightmare. Nothing tastes good and everything, everything, leaves me with an aftertaste so excruciating I can't tell what's worse, the heartburn from not eating or the nauseating, hyper salivating aftertaste mixed with the heartburn from eating.

People ask me how I am doing. I am supposed to smile and glow and say, just lovely. The nursery is all done and everything is painted in garish fucking pink. I'm fucking ecstatic. That's what they want me to say, what they expect me to say and what I do not, almost ever, actually say to them. Ever. I want to say, this fucking sucks. It fucking sucks. I'm miserable and sick and every single moment of my life is consumed by the complete revolt and failure of my body to do this the way it was supposed to and I can't eat and my chest is going to cave in from being eaten inside to out and no one seems to understand or even believe me and no really, I can't "just eat" to feel better. Everything I put into my body causes me pain or makes me vomit and even water tastes like hell so no, I don't love being pregnant, fuck you very kindly.

Instead, I walk around like an escaped mental patient, clutching at my chest and mumbling, heart racing and breathless, wondering why it is my body is failing so miserably at the one thing it's supposed to do right now which is feed itself.

Andy looks at me and frowns, be nice to her, he reminds me. And I crumple and die inside, because clearly I am already an unfit parent, unable to put aside my own visceral discomfort, waiting for this mystical love to arrive, waiting for the moment, as promised, when I will recant and cave and believe, somehow, that it was all worth it.

2009-01-28T08:44:00.000-08:00

bookmark

Jesus, I still suck. I've been meaning to, and meaning to, sit down--full up of write--and do some vital space maintenance, cleaning out some of the biggest, bulkiest bits of crap in my brain. But first there were friends in town, and then it was beautiful with much snowshoeing to be done, and then there is work, which is terrifyingly real and official and I can no longer hide under the guise of student but am now, quite suddenly, trusted practicioner. And. And I lay awake at night thinking jesus fuck did I document that I saw such and such in so and so's file, good god what if the eight year old with the belly pain who got added in as my last patient of the day has some whopping intussusception and the xrays I sent her for will essentially be worth nothing but a law suit since I won't be back in the office again until the end of the week and by then she'll surely have perished or had her entire intestines emergently removed? Or oh fuck me I swear I did that PAP smear all wrong and I'm going to have to call her and tell her to come back because the lab report will essentially say You Suck at Finding The Cervix. Please Try Again.

And then again today, which is so snowy and lovely and I fell back asleep this morning in my bed, dreaming of being back in Brooklyn--when half of my days were spent in sleep, fitfully recovering from itchy, achey 36 hour shifts in that tired, old, broke down hospital--such that I woke up wanting bagels and my old neighbor to come down stairs so we could brew tea and sit in bare feet in my living room watching the snow fall and listening to the quiet and deafening roar of the city.

2009-01-14T08:57:00.000-08:00

judgemental

My, it has been a while. I've been toying with the idea of letting this space fade into oblivion. Life now is nothing if not quiet and uncomplicated; the deafening need to be here caused by the groundswell of New York is no longer and, without that, my need for catharsis is less pressing, absent, almost.

Or maybe it's just that I'm so deeply in between now that I don't even have my words yet. I was once a strident non-mommy blogger and I am unwilling, or unready, to enter into such an endeavor, despite my growing circumference.

Or perhaps its that coming here creates a nostalgia of sorts that, after a while, grows tiresome. I miss New York a great deal and occasionally. I miss all the things that were slowly choking me -- the trash, the saturated humanity, the cruelty and the beauty -- although I do not think I will ever miss the screeching screaming loud loud loudness of it.

Or perhaps its that the most pressing part of my life right now is one that I am willfully, stubbornly trying not to make an enormous to do over. I am excited and terrified and mystified by the impending probability that I will shortly become a mother. I am in awe almost daily. Yet as I begin to tip toe into the outer reaches of motherhood, namely other mothers, I am horrified and frightened and flabbergasted. I don't feel like any of them, I don't really look like too many of them and I certainly don't sound like too many of them. I haven't chosen paint yet for the nursery and for the love of god and all things holy I do not, under any circumstances, want anything pink. I worry about how I will do this, bereft as I am of any kind of operating instructions. I watch other mothers and feel silently scornful, judgmental, so quick to think you're doing it wrong. As if I know. As if I had any concept.

I go snowshoeing about my backyard with my dog for hours. In the quiet of the packed powder it's hard to imagine how infinitely changed my life is about to become. As we trudge through the snow he steps on my shoe and I tell him back and go forward. He takes three steps back and swings wide to the side, bounding ahead of me three or four steps then turning towards me, waiting. I think to myself that I have such a good dog, and know that a great deal of that is because of me. I understand dogs, the way they think, how to affect good and bad behavior, how to be consistent and kind. How to reinforce, how to discipline. I have no idea about children. People love nothing more than to tell me that dogs and children very! very! different! As if I didn't know this. And yet I still encounter women all the time with unruly ill behaved dogs and screaming mean spirited children and it's hard, I'm sorry, to not make a connection.

So I am currently trying to find where I connect and with whom. My family in New York is all nannies and baby nurses and I have to be honest when I say I still don't understand what the hell a baby nurse does for you that you can't just do yourself with a boob and your own mattress. I've looked for the natural parenting people around here and, while I share their views on wanting to at least try cloth diapering and home baby food making, I don't so much share their unironic Full Moon worshipping and placenta stewing.

I miss California so much sometimes. I miss the kind of young surf mom in Northern California, walking around in jeans and flip flops, babies in slings and running strollers, alternately talking about the merits of possibly not vaccinating their children and waxing their vaginas.

2008-12-11T05:58:00.000-08:00

cabin fever

Our driveway is made of soft grey gravel and winds a seeping, steep serpentine up the hill to our house. On one side is a wide ditch lined with smooth round river rocks, each the size of a small cantaloupe. When the rain pours down tiny raging rapids course beside us as we navigate our way home. In the summer the ferns are lush and verdant and thick, hip high and dense, they quiet everything else around them. In the fall the maples are red and orange and brazen and the white tail grow fat and easy from the green meadows behind us. Our house is lovely and warm and spacious. It's big and beautiful and more than I ever thought I'd come home to.

This is where and what I wanted. This is where I wanted to be. Worn out and weary from the city I couldn't have stayed in New York. No matter how lovely the apartment, no matter how great the view, I felt claustrophobic and imprisoned, every day was like clawing for oxygen. My preceptors all shook their heads, asked me if I was certain, reminded me how much promise I had, a calling as it were for dense and complicated pathology, the messy kinds of medicine.

So we arrived, filled with the promises of Ivy League provisions and low key country living. And it's quiet. And beautiful. And lonely. And there are no jobs for me in the enormous Ivy League hospital. And, just like that, all of that potential quickly becomes nothing of utility as I settle instead into a tiny practice to discuss hypertension and cholesterol, driving for hours on an empty interstate, counting the headlights of every passing car.

I find myself staring at women, openly wondering if we could be friends. I latch on to irrelevant signifiers: the shoes they are wearing, the kind of bag that they carry. About a week ago I saw a young mom with blonde hair in two short braids, a powder blue beanie and Uugs. She had rosey cheeks and a shoulder strap messenger bag and as she stood in line before me to order her children muffins and hot chocolate, I felt the rising urge to tap her on the shoulder, ask her name, because she was the first person I'd seen in months who wasn't twenty years older than me, wearing pleated pants or sporting a mullet.

I wanted to come here, needed to come here. It was here in Northern New England, Boston, or New York. I couldn't have stayed in the confines of all that noise and concrete any longer. I couldn't have raised children who don't know how to climb up a tree, marvel at bugs or have stood out in the undiluted darkness of night, looking up at the stars. But this is more and less than I expected and once more I am struggling to fit in. Sometimes I feel like a stubborn mistress, tenaciously tending a half-broken heart, insisting, always, on calling Santa Cruz home.

2008-12-02T08:43:00.000-08:00

some kind of gratitude

I just ate two pieces of pizza. And they tasted almost ... normal. I even added in a few sips of coke. I didn't have to run to the bathroom to furiously scrub the taste of poison out of my mouth for almost ten minutes.

I've lost all of the two pounds I'd gained last week. Hard to say if it was the in-laws, the 118 consecutive hours of cooking that took place in our kitchen, the turkey that was brined in an unholy concoction of maple syrup or the two days of undigested food I finally vomited up in the bathtub.

I want to write that I'm finally feeling brave enough to accept that I hate being pregnant, but looks on people's faces when I even allude as much stops me short in my tracks. Maybe if I were back in New York or home in California I would have the fortitude to be so bold. But here in strange and uptight New England, where most women wear sweater sets with christmas wreaths pinned to their left breasts and matching reindeer earrings, I duck away and turn my head, quietly accepting their oh pumpkin, you'll feel better any day now I just know it!

I never expected to miss my broken down little hospital so much; a place where I could turn to basically anyone and say this fucking blows and they'd be all, oooooh child, you think this is bad girl? Wait 'til you try to push that shit out your cooter. You ain't seen nothing yet.

2008-11-27T14:07:00.000-08:00

surrender

I passed the boards, got a job. Food continues to taste like poison and probably will ~~forever~~ for the next 6 months. For some reason I get heartburn every night, even on an empty stomach. I spit into hand towels in the grocery store and I may never be able to eat chocolate ever again. Fuck Dooc e. I hate her. I've gained a pound and a half and maybe, maybe, I'll be able to snowboard through January.

2008-11-19T06:02:00.000-08:00

Cope

No you may not bring any water bottles, cell phones, pagers or electronic devices into the testing center. She looks up at me over the counter, red orange streaked hair and purple cotton jumper, rearranges her papers, stares at me and waits. What if, I offer, I pour the water out and only bring in the bottle?

These are the rules, and she pushes three laminated pieces of paper in front of me. You're really supposed to have read them before arriving here.

It's 8:17 in the morning and I'm getting a little bit desperate. I've arrived for my boards, despite my better judgement and complete lack of preparation, and I am trying to explain to a women with inadvertently orange hair and a purple sweater that, well, basically, my mouth over flows with saliva every five seconds and I just need something to spit into. I put my head into my hands and sigh. Can I at least bring in an empty cup? I ask, motioning to the water cooler behind me.

These, young lady, are the rules, she is staring right at me and tapping a fingernail onto the counter. Okay, I say, I'll figure something out.

I've packed two fried eggs with beans and a tortilla and place them in the designated locker. You are required to eat in the waiting area, she tells me. If you take anything out of your locker you need to show us what it is. I hold up my toothpaste, toothbrush and water bottle filled with dilute baking soda. I need to brush my teeth before I begin, may I use the restroom? She looks at me as if I were absolutely insane. Five minutes, she tells me.

Walking down the hall I bite back the tears. I just want to be normal again. I just want my mouth to stop revolting against me, filling up with a toxic kind of saliva I could never bear to swallow, completely dehydrating me, forcing me to drink huge gulps of water that then make me wretch and gag because oh my god everything tastes like its made of poison. In the bathroom I stand in front of the sink, vigorously scrubbing out my mouth and regarding my reflection. My skin is gaunt and pale, my eyes dark, sallow. Even though I can tell how much my body is changed, my jeans hang off of me, my shirt clings only to my chest, my belt takes up more space than my quietly protruding belly. I don't yet look pregnant, just crazy.

After spitting, rinsing, spitting and rinsing I galvanize myself for the four hour exam ahead of me, take a deep breath and walk back into the door. A new woman is behind the counter, she smiles at me kindly. Do you have a moment? I nod mutely. She beckons me to the back of the office.

Do you have a medical condition that necessitates a cup? She is looking right at me and nodding vigorously.

Um, kind of?

Do you have a note? We both know that I don't.

No, no I don't.

Okay, she says. Listen, I put a call into our head quarters to ask them about this. Mostly they don't want water next to the computers. Can you at least begin the exam and I'll let you know? I nod. She touches my shoulder and smiles. I want to hug her and sob but refrain from either.

My boards, by and large, were a disaster. I felt flush and weak and nauseous, forcing myself to read the questions on the screen. Question and after question, section after section, I sat there in awe and horror. It's as if I had never trained for this, had no idea what any of the questions were, nonetheless the answers. My mouth swelled with toxic spit, I tried discretely to empty it into my non-absorbent wool sweater. My body staged a full on visceral distraction and I was losing the battle to cope. My stomach swelled and my mouth filled with the few bites of cereal I'd eaten three hours before. I looked around in panic, couldn't get up, couldn't forfeit an entire section of my exam and, without recourse, spit it out into my sleeve, biting back the tears and folding the edges over itself in effort to hide what had just happened.

At lunch I opened my little box of fried egg and beans to an overwhelming stench that made me gasp. I snapped the container shut, closed the locker and sighed. I'm starving, shaking, nauseated, defeated. The kindly woman in the yellow dress looked over at me and smiled. I'm still waiting to hear back. If you'd like something to eat we have granola bars, cookies and crackers. She motions over to a table and nods, encouraging. I smile feebly, thank her but say no thank you. How do I explain that anything with any kind of sugar i it tastes like battery acid and splenda? Instead I go back to the bathroom, trying forever to scrub the rancid taste from my body.

Driving home, hours and hours later, after several failed attempts to find anything, anything, anything to eat that doesn't involve a deep fryer and a drive-thru and missing New York more than I ever though possible, the guilt and rage and frustration unleashes itself in torrents. I have five incredibly close and lovely friends who want nothing more in their lives than to be pregnant, all of whom have high likelihoods of not getting to see that happen. Equal to, and in a case or two, almost more than the overwhelming desire to have children, they want, so badly, to be pregnant. I hear people talking about this being the most important thing we can do with a lives, the most important experience in a woman's life (period) and I swell with sorrow and frustration. If this, to be simple and essentialist about it, is the whole reason we exist, then why the hell am I failing so miserably at it? Why the hell do I hate it so much? Why is my body doing everything it possibly can to prevent me from doing the one thing I need to---eat. My previous convictions that my relationship to my pregnancy has nothing to do with my relationship to wanting children is beginning to erode and as I start the long drive home I cannot help but feel as if I am failing in an enormous, universal, evolutionary way.

2008-11-13T08:19:00.000-08:00

briefly

Quite possibly the worst part about vomiting is waking up the next day to realize you still have some left over in your nose.

It's week twelve, day five and for reasons I cannot explain or justify I have begun vomiting again. Yesterday I ran to the bathroom, threw up my chai and stayed on the floor, sobbing. Because it gets in my nose, it makes me see stars and it pulls at my stomach muscles. I haven't gained any weight, can't eat anything with sugar in it since that, to the best of my ability to ascertain, seems to make me vomit with hawklike fidelity. I am running this operation somewhere between one to two fried eggs on a flour tortilla with refried beans a day. Yesterday was a banner day. Four eggs and two tortillas.

We had our first ultrasound on Tuesday. It was crazy and strange and very surreal. The last time I was in the opposite situation, standing in the dark room with one of my patients, looking on the screen as they saw their baby for the first time, trying to capture the heart rate, trying to measure the back of the neck. It is always weird to be where I am now, patient not practitioner. But things seem fine, and I have a very uncharacteristic sense of calm in me lately. We saw five fingers on one hand and lots of jumping around, healthy movement.

I'm just waiting to be able to eat, to be able to drive again, to be able to anything more than stay close to the toilet, waiting for the inevitable onslaught of nausea to finally, finally win.

2008-11-12T07:27:00.000-08:00

purchase

The strip mall is sparse and sprawling, grey bright orange and yellow, filled up with McDonald's and Burger King, Pizza Hut and K-Mart. It is where we shop, because we have to, because these are the options and this is our life here, now. I pull across the two lane street and into a parking lot, drawing up next to an old Civic filled from roof to floor boards in boxes of clothing, empty food containers and cartons of cigarettes. My car is 4 months old, dust covered but undented. Beside me the Civic sits on three tires and a spare donut. I notice that it is missing the passenger seat. Two spaces down a girl, easily ten years younger than me, pushes a stroller, holds a toddler on her hip and ushers a young boy of about six across the lot towards the discount grocery store. I clutch my bag given to me by my mother in law a few years ago, bought at a department store in New York unimaginable today.

The Sears store is tiny, crammed with last season's items and offering only one or two selections in each of its four small departments. The salesmen lean lazily against the washing machines, the store is empty, the ring of the bell as I walk in echos and all heads turn to face me. He ambles up to help me, short and balding and cyanotic, breathing in shallow rapid breaths and leaning every few steps on a shelf, a dryer. Can? I? Help? You? Young? Lady? each word punctuated with one quick inhalation. I'm here to buy a refrigerator. A new refrigerator. An extra refrigerator. Because our family is coming up from New York for the holidays and we'll need more, we'll always need more, to prepare for it. He tries to sell me more, bigger, fancier. I watch him leaning along the aisles, gasping, ambling, trying to sell me something anything to make his commission. No, I say, just the smallest cheapest refrigerator you have, we don't need much, it's going to live in the basement. His efforts are valiant and I understand them, although I set my face into stern refusal and repeatedly rebuff him with no, what do you have that's cheaper until finally we reach the dark end of the aisle where last year's items languish in dust and discount. This, I say, pointing to the cheapest, that one. He sighs, takes the ticket and begins the slow journey back to the computer. I walk behind him, observing his gait, watching his shuffle, my face burning with guilt and confused consumerism, wondering how we are obligated to best help each other.

At the register he writes the ticket, I look at his clubbed and yellowed fingers, note the distention of his external jugular vein, the heavy weight of ascites pulling at the buttons along his belly. I want to ask him, why aren't you on oxygen? His oxygen saturation is clearly dismal, his lips are dusky purple, his chest rising in quick ascent. Broken blood vessels smatter his arms in the characteristic pattern of disease and while we make small talk about his sons in community college it is all I can do to keep up with the charade and not turn to him and shake him, ask him if he's even on Lasix, has anyone ever drained the fluid from his belly. He mentions the economy, the hardships of being a salesman, worrying about foreclosures and his kid's college tuition. I nod and smile in a gesture of silent agreement, fold the receipt for my extra refrigerator for our bounty of good fortune and walk towards the door. I turn to thank him, to wish him a good holiday, he smiles back and suppresses a cough and I walk into the cold bright outside, always and again uncertain about how we can best and ever actually help each other.

three things

2008-11-05T11:59:00.000-08:00

Thing one: OMFG President Obama. I almost* cried last night but couldn't, because my body has hijacked every molecule of water remaining left in it to make saliva. Not that I hate it or anything.

Thing two: things got better with the whole full body invasion of symptomatic side effects and then they got worse again. Guess where we are now. I've decided I'm not going to talk about it because I sense that most people find it boring and trite and possibly more than a little annoying. And then I'm likely to get onto a wooden soap box and let loose about the unrealistic and quite frankly maddening social expectation that women who are pregnant are supposed to be glowing and happy and absolutely vibrating with joy. And if you aren't, if you are, say, tired and sick and tired of being sick and tired of people looking at you weird because you have to walk through the grocery store spitting into a hand towel because lord with no mercy the freaking saliva, that somehow implies that you are going to eat your children with fries and ketchup. And you know what? I really resent that. But I'll work that one out later and spare you the diatribe. For now.

Thing three: I've been missing New York albeit in a strange and subtle way. Mostly I miss the things you can buy, purchase or have access to. Namely chinese delivery and any other place to shop besides K-Mart. Last night, however, I really missed New York. I sat in the study of our big, cozy farm house house, siting beneath the old wood and plaster beams, listening to the election on podcast radio and wishing I were in Brooklyn. Envisioning the amazed and joyful faces of everyone at my old hospital, wanting to be precisely right there in this moment in time, this incredible part of history. I wanted to be embraced by the Jamaican nurses and get another 'Sup white girl from the security guard. I wanted to squeeze Miss Adam's hand as we passed in the darkened, dirty hallways, I wanted to hug to janitor on the fourth floor with the bright eyes who always opened doors for me, say hell yeah to the cafeteria clerk with his thin dread locks and knitted cap. I wanted to be back there then, right now, today. The world is immeasurably different today than it was just yesterday and from where I am in Northern New England it feels dampened, distant. I miss the pulse, I miss the pulp and flesh and grit of it and want, for now, just for this moment, to be back in it once again.

*Upon further review I believe the word almost gravely misrepresents my emotions on the night of November 4th --- a hazy solution of elation, disbelief, immense relief, immense and unspoken fear for the life of this incredible, important person, exhaustion, extreme nausea and heartburn. Looking back on it now, when someone asks me where I was when Obama was elected President I will be able to recall vividly our little house, our little study, in the white and rural backdrop of New Hampshire. And, looking back on it even now, I wish we had made more of an effort to be with humanity in that moment, to be connected, and complete. We don't even own a television (because we are stubborn liberal intellectual elitists and aren't we sorry now). I'll go back and youtube the visuals when the world first found out but I do feel as if one of the most important parts of this election, the humanity, happened without us.

2008-10-29T07:55:00.000-07:00

sugar

The taste in my mouth is so constant, so awful, so impermeable, so maddening I find myself desperately inhaling various and edible objects in effort to mask it, ameliorate it, make it go away. Lemon sours from the health food store, hard candies, salted nuts, sour lemonade, minty gum. None of it works and, if anything, eating only makes it worse-- the food that I bite into never tastes as I remember, as I imagine it was intended. I stand in the front yard talking to the contractors about septic tanks and my stomach growls, everyone looks at me I and feel it lurching, angry and empty. I excuse myself to the other side of the house, lean forward and spit.

Half an hour later I'm standing in fuzzy slippers and a lazy tree pose, wrapped up in the warm glow of my kitchen, beating a scrambled egg and stirring hot coco, I am anxious and shaking to eat. Three bites of breakfast and one sip of chocolate finds me, yet again, hunched over the bathroom sink furiously scrubbing with toothpaste and toothbrush, marveling that so many feedback loops exist in this one body to prevent me from eating.

weakness

I went to the barn yesterday to enter in notice of my early retirement. My lesson was starting and I leaned on the rail in fleece lined boots and down jacket, exhausted and wasted and not at all interested in riding. Last week on the flat, attempting a simple pattern over white poles not even set up into jumps or standards I could barely keep my seat, panting and sweating and utterly exhausted. The high school girls smirked, my trainer's face was kind but grim. You're just too weak, she tells me. I nod and push my helmet back off my forehead, gathering my reins and pride in front of me. I'm used to running six miles in under an hour, jumping easily over grand prixe fences, effortlessly clearing expansive cross-country courses. My mind races, my ego withers. I look over to my left at the huge mirror on the long wall of the arena, pushing my shoulders back and shoving down my heels: I look the same, I think to myself, but in that moment I no longer recognize the girl looking back at me.

guilt

I spend a lot of time feeling guilty for not being a glowing, beaming, exuberant pregnant woman, bursting with happiness. I secretly worry that the intensely visceral occupation of my own body betrays an inability within me to love, as if this simple maelstrom of hormones implicates me already as a failed mother. I cannot undo the unnescessary and ingrained connection between pregnancy and mother-hood and I feel like, if I doing this part so poorly then I am surely doomed for the rest of it. I know that pregnancy for some people is an enormously important, vital, self-affirming, life altering part of our existence. I have so many friends who are trying, others who know that they will never be able to conceive and I feel terrible inside and always. Because here I am, knocked up and ungrateful, annoyed at the ptyalism and dysgeusi a, the nausea, the GERD, the weakness, more obsessed with trying to eat than colors for the nursery. I feel like I owe it, at least, to these women to not feel so flipping grumpy about a little bit of drool and heartburn.

2008-10-27T06:33:00.000-07:00

after taste

I load up my hand basket with asian pears, watermelon, navel oranges and organic grapes from

California, single handedly and exponentially increasing my carbon footprint with deft fingers and an unappealing amount of saliva. It had occurred to me earlier in the day that the only thing I could possibly consider eating was watermelon. In October. In rural New England. But my stomach sways and lurches in the fruit aisle and once again I worry that I have been lead astray, foiled by a tempestuous and mercurial body that maintains its right to revolt at any food at any time and any moment.

I bite into the soft rind of what should have been a crisp pear and spit it out immediately. In a paper bag to the right of me, piled up on the passenger seat, sits yet another failed and expensive food experiment. I open the car door, lean forward and spit like a trucker. I cannot contain the water my mouth makes and am always looking for places to (un)delicately lean forward and spit.

appetite

I don't have hyperemesis gravidum and I have an infinite amount of sympathy and respect for women who weather that storm of parity. I am probably a little bit dehydrated but otherwise well, usually the nausea prevents me from eating which prevents me from puking. Most recently, for about four days on now, I have tentatively begun eating again, marveling at the strength of both starvation and total food aversion, taking tiny bites of a syrupy pancake, sipping on instant hot coco. On Friday, in a moment made of little else than mercy and miracle, I ate half of an eggplant parmesan sandwich on my way to the barn.

apprehension

At night I lay awake and tend to my wonders, my worries, my greatest anxieties. I know far too much and all the causes of first trimester loses fume like a toxic cloud in the dark hours of morning. I get up and frown at my mostly flat stomach, worry about my painless breasts. I worry for all the speakable reasons and the unspeakable ones too. I worry in ways I cannot say out loud but that press down hard and unremitting. In the dark and tiny hours of morning I worry that if I ever lost this baby, would I have the strength to have another?

2008-10-20T06:16:00.000-07:00

change

I sit on the wooden, upholstered chairs, looking up at the patient pamphlets, staring at the exam table, the sink, taking in the strange irony to be on the other side of the medicine, the powerlessness of being a patient. The nurse has ushered me in, asked me to pee and recorded my weight. She scowls at the scale, you've lost four pounds in just over a week, she tells me and even though I have every reason to know better, I feel accused, responsible.

I'm waiting for whoever has time in their schedule to see me. I had called to ask for a simple prescription for heartburn medicine, was taking way beyond the daily maximum dose of pepcid and prilosec, although over the counter, is a class C medication. Everything I ate either hurt too much or came back up again. I have been given antibiotics (too broad spectrum for a pregnant patient with nausea and vomiting but they insisted and I conceded) for an asymptomatic urinary tract infection. Now I have an upper, and lower, complete intestinal insurrection.

No, I am not willing to take prilosec, I tell the nurse on the phone. Yes, I do know it's the same class of drugs as the others but until the FDA changes its safety profile I won't risk it. She impatiently puts me on hold. One minute later she picks up the phone again, listen you're just going to have to come in if you won't take what we're offering you.

I hear the NP outside the door, rustling her papers, reading through my chart. I have a towel to my mouth to absorb the copious amounts of saliva I can't bear to swallow. She walks in and takes me in--again I feel small and powerless, the irony of being both a practioner and a patient.

But I am good. I only answer the questions she asks, don't push or goad or insist, even though I simply want to say listen, a cephalosporin is a bit too broad spectrum, it's making me sicker than I was before, just give me some macrobid. Secondly, I'd like a script for nexium or protonix because I know they are class B and prilosec is class C and I will jump into traffic if this heartburn continues.

This is the inevitable dance, the difficulty of being both at once--capable and helpless.

In the end she writes me a script for Protonix that my insurance won't fill and changes my antibiotic. It will take days, they say, to get the authorizations in place. I consider buying it outright, at Andy's urging, but it's $250 a bottle. On stupid principle, I refuse.

-----------------

Night is coming quickly now that it's autumn. I haven't been to the barn in a week, too sick or weak or nauseated. I hadn't told my trainer yet, foolish, perhaps, but I wasn't ready for the possibility of being grounded after being horseless for so long. I would give up at four months, I told myself, once my body is too altered to keep my balance.

I groom and tack up quickly, a flashy bay gelding who is new to me and pacing. I didn't even pause or reconsider before hopping up, still lithe and nimble. We go around the arena a few times, he's hot and athletic and ready, eyeing the jumps at every bend. We get our pattern, I'm third in the sequence. The few other girls in the class are all in high school and they are today the rider I was so long ago. I bite my lip to temper my ego.

On our turn he explodes into the right lead and it occurs to me immediately that I am way too weak and he is way too strong. We haphazard the course and just as we're going over the blue vertical the nausea swells and I consider leaning over and vomiting over his right shoulder. I miss my next jump and bring him in to circle. My trainer is yelling at me from the center of the arena, the high school girls are smirking. I lean forward, drop the reigns and fight the urge to vomit as she runs up to me. She is saying something about him being strong and to do it again but when she arrives she stops, cocks her head and says what the hell?

I'm pregnant, I pant, and I think I'm going to barf on your feet.

----------------

Later, after the tack is away, the aisle swept and the buckets filled, I walk into her office.

You're on the flat from now on, she tells me. I know, I say. It's just not worth being stupid, she looks up over her entries for the up coming show. I fiddle in front of her, feeling foolish and small.

She puts her pen and paper down and regards me squarely. I rode until I was six months pregnant. It was really dumb. God forbid something happens. I, for one, wouldn't be able to forgive myself.

I nod. Okay, I say and turn to leave.

Besides, she says with a huge smile but without looking up, if you barf on my feet you'll have to buy me new boots. And these are very expensive and very Italian.

2008-10-15T08:23:00.000-07:00

symptomatic

Oh hello. Well my goodness, this is a strange thing indeed: to be sitting in my house with internet. Oh my god people, call Tom Friedman, THE INTERNET.

So here's the thing. I've got something I need to tell you and I've been trying to figure out for days how to do it. There's the, internet, we need to talk tact. Or the, here, I think you should sit down, oh! and what about a beer? Here, have a beer approach. But beer's hard to link to, so I had to eliminate that one from the list of options. It's just that, well, considering a few hours ago I had to tell a bunch of strangers just because they are working on our house and couldn't figure out why extending the project into May was SUCH A BIG DEAL ALREADY, CHRIST, I kind of can't believe I'm only talking to you about it now but, well, shit, here goes:

So, I'm pregnant.

(My god I still feel like I'm sixteen years old and still have to suppress the urge to duck because I'm fairly certain some high school guidance counselor is going to smack me with their purse, screaming what were you thinking? What about your future?)

And before we get all crazy and excited, please let me get something off my chest because MOTHER OF GOD pregnancy sucks. And yes, it's early. Earlier than the prescribed time to tell the world and all that, but it's late enough that if something went wrong this is the first place I'd come to (and you'd be all, what? What are you talking about, crazy?) So let me just tell you how much pregnancy sucks (operative word: pregnancy, not parenting) and for those of you who read Jonniker, sorry, but this is going to sound like a lot more of the same because LORD WHAT WERE YOU THINKING when you made the pregnancy package?

I'm a very symptomatic person. If you look it up and it lists the side effects you best believe I'll have 95% of them, regardless the ailment. But come on already. Really esophagus? Really? It's only the middle of the eighth week and already with the heartburn? Really? Oh, oh and the morning sickness? Oh yes, can we please talk about that? Somehow I harbored a illusion that morning sickness was made up of insurmountable urges to vomit that overtook women in an instant and hurled them towards toilets or sinks or trash cans or what have you. Meaning that there you were, out in the world, FUNCTIONING, when all of a sudden you had to vomit. I wish. With all my heart, I wish. Oh no no. It begins about 3 minutes after waking up, drags into a long, protracted, prolonged series of hours of hypersalivating, migraine inducing nausea wherein I swear to god I've been fucking POISONED until finally, finally, like five hours later, I lean over the kitchen sink (or similar) cough, gag, retch, heave and sob. All for not a lot of production, if you know what I mean. After which, though, it must be said, I feel miraculous (thereby furthering my conviction that I'm not actually pregnant rather merely being poisoned by an inch and a half long creature with fins). Once I vomit I feel like god, all is well with the world, my headache clears, I can walk and drive and think and read and it's amazing, AMAZING....for about 3 hours. And then it's wash, rinse, repeat.

And why didn't anyone just tell me: listen honey, stick your finger down your throat, I promise, you're gonna feel totally better? Why doesn't it say that anywhere? Because it's TRUE. Note to selves: don't hold back, just barf, even if it makes you feel like an afternoon special on bulimia because all of a sudden your choosing foods on the basis of what they'll be like to vomit back up again.

So much better in fact (this knowledge is a very new development, by the way. Instead I have been spending the better part of the last eight weeks GREEN, refusing to eat anything and everything made of or resembling food because, mother of god, what are you trying to do, kill me?) that I ate not one but two egg and cheese crossaints from Dunkin Donuts. Strange thing pregnancy, and let me be the first one to hold up both hands and wave the repentant white flag for thinking that I was totally going to eat a healthy, raw, organic, high protein, low carb diet when pregnant (AND run 6-7 miles a day) because HAH! In the last eight weeks, the only food I have actually thought remotely reasonable to eat has been a Bean Burrito from Taco Bell, french fries from Burger King, mashed potatoes from KFC and now Dunkin Donuts. Today I seriously considered Pizza Hut, I'm not kidding (I would never kid about Pizza Hut) but MY GOD, the heartburn.

You'll be glad to know though that I've hated myself after every single event. All were failed experiments.

So this is pretty discombobulated and inarticulate and all over the place but I'm madly trying to use up the last of my few functional minutes before I have to return to the fetal position, clutching at my heartburn, desperately sticking my finger down my throat and threatening to Andy that next time, we're adopting.

satellites

2008-10-12T13:13:00.000-07:00

Listen. Our internet died completely, fall is here and I've got a lot to tell you. But I won't be able to until next week. When we finally set up our little space station and get some kind of real internet. And then I can stop parking outside of the town library, stealing their bandwith and getting shot at by hunters.

2008-10-06T09:41:00.000-07:00

Two thousand and one

We sit on the damp concrete, backs against the wall and windows of a costume shop, knees bent, feet splayed, waiting for the theatre to open, for the show to begin. She wears converse, black, low tops, and dark jeans, a studded belt and a cardigan. Her tortoise shell glasses peek out from chunky black bangs. I wear cargo pants from the Gap, a white cotton shirt and flip flops. Her hair is short and hip, dyed deep black and messed up in the back. My hair is long and streaked in sun. Her skin is milk white and unblemished. My skin brown and thick and solarized. I call across the street for dinner while we wait, order vegetable pad thai--no shrimp--and tofu with mixed veggies--no peppers and no onions--without even pausing for consensus. I know her aversions and her favorites; there is an known and intimate familiarity to us, like an old house, like home. She is languid and calm and patient. I am wound tight and rapid and flutter. She likes television and couches and long days with movies and books and black coffee. I love the air and oxygen and atmosphere, can't stand television, can barely sit through movies.

We have been friends for years and we sit on the sidewalk, side by side, waiting for the show to begin.

Two thousand and eight

We haven't spoken in over a year. It was a long slow collapse, lengthy break up, an unnecessary end. There were all kinds of awkward, assumed, associated reasons. Accidentally missing each other, avoiding, for months, weeks, years. There was an enveloping edge, I felt uncomfortable, defensive. All at once, our endearing differences were coming us undone.

I miss her daily although I think of her less and less as time gets older. But it still happens, and often. I'll be driving in the car and will be filled with the sudden need to call her, to tell her that John Mayer is such a fucking tool or why do women wear scrunchie boots for the love of god and allah? She is the one I want to call when inappropriate comments about toothless rednecks sitting outside with their fat daschunds overwhelm me.

We haven't spoken in over a year. Sometimes, if I'm not paying attention, I'll dial the first five digits of her phone number, a muscle memory, an old habit. Thinking back to a time when our differences were slight and our friendship seemed infinite and inevitable.

2008-09-25T13:40:00.000-07:00

speech-less

I have no words for this. Please, when you get to the bit about Iraq and Afghanistan, national security and our soil (which is after the bit about Putin and his head-rearin') and tell me if little bits of your brain didn't start exploding and then tell me that you didn't fall onto the floor convulsing, wherein, after regaining consciousness, you didn't crawl immediately into the pantry and begin drinking. Heavily.

2008-09-25T04:38:00.000-07:00

occupied

I've been consumed with much in the world--tangible, terrifying, pressing--and my brain has been sluggish, slow, suspended. I listen like a furtive junkie to NPR, rifling through the virtual pages of the New York Times, devouring The Forever War, balancing one foot on the urgency to act and the other on preemptive defeat.

In my tiny town on a river in New Hampshire I drive along the water, looking at the loveliest homes, reassured by the blue Obama Biden signs cropping up like some kind of lush fall bounty. It settles me, it insulates me, it quells the panic that lives easy inside me.

When I drive to the barn though, out of town and along the lake towns, out onto the interstate and back into distant, unconnected areas, the urgent gnaw returns and the number of McCain Palin signs snake the roadways like thick vines. I keep my mouth quiet when the plumber comes by and brings up offshore drillin' and at least we'll have someone in the White House who's real people, even if she is a woman--no offense, I mean. And I cannot understand how so many of the people immediately around me, the people who will need federal assistance this winter to heat their homes, the people who cannot afford to fill their gas tanks, the people who cannot pay their medical bills, who cannot afford health insurance, people whose homes are being foreclosed --because of an administration of undersighted, myopic, unilateral greed-- the people who are most disenfranchised by the current and unbalanced powers of our country today are its staunchest supporters.

I see how Obama misses the mark in places like this. His eloquence, his manner, his intelligence, the way he says his words work against his most desperate and deserted constituency. I see how people in places like this think to themselves, well shit, Sarah Palin's husband is a hunter and I'm a hunter, and that's really good enough for me. I don't need no high-fluenting, fancy-talkin' President. I need someone who's gonna understand me. And that means, to many, shooting deer, going to church and not giving a fuck about Russia. Because, in their dire disconnect they miss Joe Biden unequivocally defending the money in their pockets, saying--under no unclear terms--that people who have more need to start paying more, not less, than those who don't. Bottom line, end of story. What they do hear is Sarah Palin--screaming, shrill, lacking all composure--proclaiming that's not patriotism. Raising taxes is about killing jobs and hurting small businesses and making things worse.

But I have to agree with Dooce. If I have more money than you and you need to heat your home or pay your medical bills or put gas in your car to drive to work because you make something barely over minimum wage then take my fucking money and goddamn you Sarah Palin for saying that's not patriotic.

I am no great political commentary. This is not a political blog, nor will it ever be. I will be the first to admit that I have checked the fuck out internally over the last eight years because paying too much attention to the country I lived in caused a kind of desperation and rage in me that was often untenable. I am, if anything, more of an anthropologist than critical analyst. Listening to our President whisper the words freedom made me want to claw my way through an eighteenth storey window and jump. Standing by, powerless and bewildered, to watch something akin to the economic Patriot Act about to be passed to the tune of seven hundred billion dollars (the weight of which will be allocated equally between the rich and the poor, thank you Sarah Palin) creating the inalienable, non-transparent right of the Fed to manage it, to save some of the world's wealthiest individuals without the time for insight, foresight or careful consideration is astounding to me. It is beyond my grasp and when the guy comes by to fill dirt into the holes in my backyard, driving his truck up with his McCain stickers and then works for something like 16 hours of hard manual labor and tells me he ruptured a disc last year but couldn't afford to go to the doctor, I want to rip out both of our eyeballs. Because I cannot pay him enough to fill holes with dirt to go to the doctor, but I am certain that if he has his way in this election, neither will his political candidates.

2008-09-20T04:44:00.000-07:00

bliss

I had a photo to put here, made up of horse ears and yellow leaves, a thick black mane and enormous feet, red maple leaves--flamboyant, gaudy, lovely--and the bluest sky, riding the ridge-line for hours in the new crisp of fall, bundled up in sweaters and gloves and an orange hunting vests, but it was lost in a glitch of uploading and battery failouts. Even still, it was every bit of bliss.

equus

I am training again--as if I were ever some kind of expert, as if my muscle memory and strength will ever return--in dusty, fenced in arenas, over rails and on the bit, on a tall, eager gelding--my aids (hands steady! legs back! heels down! hips aligned! back straight! fingers closed! elbows bent! head forward! chin level!) a humbling and messy approximation of what they once were. My body is weak and sore and unconditioned, my mind is stubborn and determined, my heart is full and as I come in around the long side one more time--asking him to bend not holding him up with our hands--turning this big brown horse into the jump, it occurs to me in rapid clear fashion that this is what joy is made from.

2008-09-10T12:09:00.000-07:00

native

The tiny, immaculate shoe store is on the corner of Via Gregoriana and Via Francesco Crispi in the Spanish Steps district of Rome. Light spills golden from all sides and I enter gingerly: feet dustied from walking in flip flops, black cotton dress damp and clingy, well worn and unwashed. We are in Rome without warning and I have not packed appropriately. We have dinner reservations in a few hours and I have to my name a see through sun dress, short cotton shorts, bikinis and flip flops. I do not even have purse, using instead a cotton mesh bag that looks as if I might be employing it to carrying fish. If reservations are required, so certainly then are shoes.

Andy sits on the supple leather couch while I pick through the choices, working in stilted dialect with the petitely glowing sales girl who picks up the shoes and lays them out before me. I try on each, walking the narrow perimeter of the floor plan. We are in a part of the city that is most like Madison Avenue and while these little shoe boxes are set off a bit from Prada and Bulgari we are still in very deep and the numbers on the bottom of each shoe reflects it.

Andy asks me which ones I like most, these, I say, but they are crazy expensive. He says, well do you like them? Yes, I nod but shrug my shoulders and say but these are cheaper pointing to an uglier pair that don't do quite so much for my draft horse ankles. But those look better, he affirms, you should get them. I wiggle nervously and bite my lip. I walk back and forth in them two more times, a small parade for an audience of two. Get them, they look fantastic, he says, hands me a silver card and walks into the back to look at a pair of Italian sneakers. I don't have my wallet on me. I don't even have a purse to put a wallet into. I take his card and hand it to the sales girl who smiles at me.

Most American women are too stubborn, she says, grinning like a cat. Most American woman want to do it all themselves, they think they are too big for a man, too important, they can do everything. They would never let a man buy them shoes, say. That is what they think, American woman. But not you, she smiles at me again, swiping the card through the reader. I can tell, you are more like us. You are more like Italian woman. She holds out her hand, palm up, fingers curled, as if she were holding a fruit that is ripe. Italian women, we think instead that we are in control of our men completely she tightens her hand ever so slightly and that we keep them around to do as we choose. Italian woman, she can always choose. She hands me the slip to sign. I stammer something about just not having a bag to carry my wallet in and it's not that it's just that I don't have a purse and and and.

She smiles again, her green eyes alight, takes the slip from my fingers and places the receipt into the crisp paper bag. I think you are like Italian woman, I think you could live here in Roma, no?

lonely planet

Until recently I never travelled. Abroad or even domestically. My mother rarely travelled (though I suspect it was on her list of things she was fated to miss out on in life), airfare from Hawaii was expensive, hotels and rental cars were often insurmountable. I left for college without even visiting. It did not matter. I had a scholarship. It was where I was going.

Until recently I had spent a miserable month in the home of Dutch family who despised me in Amsterdam, had travelled to Thailand on a lark and with the modest blessing of a tiny "inheritance" and had been to Greece. I slept in hostels and rationed food money, took trains and buses and carried the weight of my belongings strapped to my hips and back. I came back with empty bank accounts and filled up credit cards and had to wait to get my pictures developed until I had enough money. I was still using cameras with film, digital seemed too far from reach.

Until recently I could barely rent a car domestically, none the less in Costa Rica, India or Italy. Until recently there was money only to go home every few years and even then with the help of my parents. Until recently time there would pass without me, each part of my family aging in huge chunks, our lives changing without one another.

Much has changed and for it I will be forever grateful. Much has changed, the least of which being I am now some kind of professional and for once in my life am conceivably solvent. Much has changed and I pause to acknowledge it, standing at the window, looking out onto the city of Rome, in a clean bright hotel room with luggage I don't have to carry. Much has changed and it amazes me, still.

2008-09-05T07:19:00.000-07:00

lost at sea

I miss the ocean so much sometimes I think it will be the end of me.

Back from a week in the Ionian sea with an Israeli sailor and the kind of life I could only dream of ever being able to do more than peek into occasionally. En route now to Italy, where I have never been before and I want to tell you all about the biggest laundry bill I've ever seen in my life (three. hundred. dollars. oh. my. god) and all sorts of else but I am swoony and land sick and already very much miss the ocean (I know, I already said that) and can't type. I tried to keep a log but ran into a few difficulties that I'll try to revisit later, when my head is screwed back on properly.

Until then, here are some pictures (click on the albums).

on holiday

2008-08-29T06:06:00.001-07:00

There was a post about New York being the loneliest place I know of. A bit about returning to Brooklyn, walking past my old hospital, past the Pakistani fruit vendor on the corner, past the old women in orange bright Saris, ornery boys in baggy jeans, young women in wigs and dark pleated skirts, their small sons with fresh haircuts and curled peyos, Ecuadorian men on the corners in thread bare suits who drive dented, dusty black sedans for hire. A bit about the noise and rush and empty open ugliness that is to me New York. A bit about the tragedy of summering in the Hamptons and the salvation of having lived in Brooklyn. There was a bit about the colorful quiet of coming home at sunset, of road trips and dogs and summer peaches.

But it got lost to crowded up days and slow internet, to packed bags and misplaced passports, to international airports and lost luggage.

And now I am sitting on a metal rail in a corner with old chewing gum wrappers and crumbling granite, in the Athens airport, on a prepaid internet card with minutes quickly ticking, waiting to depart to a small town on a small island off the west coast of Greece, to spend a week floating at sea. Our luggage is probably lost, perhaps forever, hopefully not; I've bought a terribly ugly teal blue bikini and some certainly cringe-worthy yoga-ish pants at a kiosk in the airport to bide a week on a boat in the ocean---ever and always mindfully aware breathlessly grateful that I can do that, that the time in my life when such an unpredicted set back would empty me of my precious little completely has come, and gone. Ever and always keeping attention of the collection of moments that make up the feast of my life.

Unknown what the internet allowance will be, out there at sea. Likely absent, as one would expect. I will, however, be taking scads of pictures and some kind of log. I will post a link once it exists here. I have one favor, one vital, crucial, critical favor and that is this: please click the link, please visit, please look and come back here to say hi but please do not comment on the actual [whatever I might fashion]. Precious few in my life know of this blog and that provides me authenticity and safety and candor. I just don't want to even have to explain the existence of this and/or the content and I know I don't have to explain their existence to you.

So that's all for now, stay tuned, come back again soon....

2008-08-20T11:35:00.000-07:00

endless

It takes little. A field of ferns and wildflowers. A dirt path, good running shoes, a dog with bear bells. Tall trees and fast streams. A body of water. Sun burned skin and uninterrupted sky. A surf board to paddle to the middle of a lake. Strawberries with peaches. Fiction in hardcover. A full day in the sun.

As always, a small and quiet resident ache hums hard and hallow somewhere back in the middle of me, the white noise of my faulty wiring. At times I wonder what I miss most. The soggy earmarks of my youngerness or the youngerness itself. It is the particulars--sleeping on the bow of a sailboat, diving up deep from the ocean, walking with bare feet down sand alleys in Thailand, the sound of snow, the fog in redwoods, seals sounding off morning, steep cliffs and rocks and seaweed, boys on cruisers, golden --that run me aground.

At the lake women surround me. Organizing their children, gathering their supplies, greeting one another, eyeing my only-ness with suspicion. On the rocky beach with a big towel and a surfboard, a hardback book and flip flops, I am a strange anomaly. I try to smile, wave. They smile back half-hearted, turning away, looking back, moving forward.

But I am an easy creature of solitude. Content to find a spot in the sun, soak up what's left of it, shore up for winter.

merci, mercy

2008-08-13T17:13:00.000-07:00

Thank you, everyone. Thank you for your emails, your comments, your gentle reminders. There was more than I put down. There was how he talked about his erections in the room with a patient, volunteered that he, too, had had a vasectomy. There was how he mixed up "coat" with "clothes" when telling me he liked me better without either. There was how, in order to illustrate that he's not a complete jack ass, he reminded me that, though he wanted to say to the patient with jock itch "aren't you glad you get to have a hot chick check out your stuff!", he hadn't said it to the patient. Because that's what you call restraint.

I feel edgy, defensive. I spoke up for all the reasons, any of the reasons. I spoke up for me, I spoke up because I couldn't not speak. I spoke up because, given the privilege, the privacy, the intimacy, the vulnerability and the delicacy of helping people in their own body habitus, in their own fleshy lives, we cannot loose sight of the extraordinary power that affords us, and that we must be careful custodians of the position we keep. We see people naked. We poke and prod and slice them open. We ask them to undress, unarm themselves, speak truthfully, admit their weaknesses, admit their failings. We solemnly vow to do no harm.

Regardless, I feel guilty. He probably lost his job. In a community of limited career opportunity.

And yet, rounding the corner to get coffee this morning, coming from the other side of the hospital, my heart quickened as I drew closer to that part of the hospital, scanning the people, ready to duck or hide at the first sight of him. I did not set out to ruin his life. I have no vicious, righteous anger. I wish I did. What I have instead is a dense and messy complicated guilt.

2008-08-13T03:49:00.000-07:00

executioner

The Department Chair of Medicine is tall, tan and kind. The Internal Affairs specialist is patient, quiet, and thorough. The Internist PA has dropped her patient load, sits with me at the table. We gather in a bright office in the rain. They take notes, I tell the story. They shake their heads. I shake a little, lips trembling, every bit of my skin a little twitchy.

I know what happened. I know that it happened. I know it could have been worse, am glad that it wasn't. I know that I know intellectually, it's not my fault. I wonder, unintellectually, if anyone everyone sizes me up, measures the likelihood against my face my hair my body. I wonder if, somewhere, unwittingly, they agree or disagree, that this really happened. That it really happened. I know that it happened and I know it could have been worse, am grateful that it wasn't. What I do not know, cannot understand, hard to intellectualize are the doubts. Did it really happen? Did it? Yes my frontal lobe screams. Was it as bad as I'm telling it? The words are harsh. To expose them to true light hangs heavy, a thick rope. I am aware of the consequences.

I am retelling the story, answering the questions, yes he said that, yes he closed the door almost completely, yes there were accidental bumps, no they weren't in private, no only on my hands or arms, yes he used those words, yes that's what happened, yes he said that, yes he did that, yes there was a patient in the room, yes that's what happened. I feel the knife in my hand and I don't know quite what I'm doing with it.

They are reassuring. Professional. Kind. Supportive. I ask about protection, fall out, indemnity. I want to know, plainly, will he be able to come back into the office and tell everyone, anyone, that friggen (insert expletive of choice) said I sexually harassed her. They reassure me. They allude to the unlikely possibility that he will be back in the clinic, ever, without being escorted. I feel the rope in my hands. I don't know what I'm doing with it.

Sexual. Harassment. The words feel over used over powered underwhelming. I want something else to call it. I want another word. I want another word for creepyinappropriateimmaturestupidity. I want another word that says I got into my car and bit my lip until it bled because I felt powerless to tell him to fuck off because I want need want need want need a job here because I was afraid he'd get to whoever would hire before I would because was afraid he'd tell everyone I did it, because I was afraid of confronting him. I want another word that explains what it is to be someone who thinks she can handle it but actually couldn't. I want a word that says that without using the words sexual. Harassment.

2008-08-12T03:14:00.000-07:00

complicit

The day is over. He's called his wife, gathered his things, straightened his desk. I am writing the final note on my last patient, sitting on a chair in the corner, back against wall against plastic, pinning the distance wide. He waits. I keep writing. He waits, shifts his weight, waits some more, looks at me, staring. I am writing.

"Where's your evaluation form?"

I stop. I don't want it. Don't want an evaluation from him. I want to go home and bathe in hydrochloric acid, could give a yellow fuck about an evaluation from him. But I give it to him. Because everything is okay and everything is normal and I'm okay and I'm in control and if I ignore it then perhaps it will be over, because if I say fucking give it a rest already then confrontation intimidation alienation. And I need a job. And this is what crosses my mind, as I sit in his office alone with him, back against the wall, pushing myself into the corner, just keep your mouth shut, don't screw it up, you need a job, if you tell him to fuck off, he could ruin interfere jeopardize slander. If you make him angry you might not be working here.

"Lets see here, what does this have to say about you?" he asks.

I fast quick a fake smile, "you don't have to fill it out, really. _______ (preceptor formerly known as pervy, clearly I had no idea) can fill it out for me, really".

"No, I want to fill it out" he says, taking it with relish and reading it out loud for me.

"Relationships with clinical teams," he begins. "Willing to establish excellent relationships with team members, check, however she's unwilling to establish relationships with me".

I stare at the computer. I stare at the screen. I stare at the computer. I stare at the screen. I hate myself for not saying anything. I will myself to not say anything.

"Student is trustworthy. I doooooon't know. Are you trustworthy? Can I trust you? Hmmm, I wonder". He stops and looks long at me.

I state at the computer. I stare at the screen. .

"Student is respectful and honest in professional situations...yeah, I'd say. A little too professional if you ask me!" he guffaws.

I stare at the computer. I stare at the screen.

_________________________________

He gives me highest marks, with a half-baked anecdote about a my being good with little old lady and a complicated case. I take the evaluation from him, shove it in my bag. I will go home later and rip it to pieces, because it feels like a pay off, like an exchange, like I am complicit, like I said, for the price of an A and a job I'll keep my mouth shut and stare at the floor while you push your unwanted advances, your leering, glaring, strong arming closed door comments on to me and you'll go home to your wife, and the olympics, and everything everything will still be okay.

2008-08-11T15:55:00.000-07:00

power, less

"I heard a rumor, is it true?" he's leaning over, towards me, elbows resting on his knees, looking at me, willing me, challenging me, taunting me to look at him.

"What's that?" I say, feigning distraction, heart pounding, looking down at my laptop, not looking up, not looking at him, pretending to be reading up on our first morning patient, instead I am writing a desperate email to Andy that says jesus fucking christ, it's not even 8:00am in the morning on Monday and I'm already getting sexually harassed.

"I heard a rumor and I want to know if it's true, is it? Is it true?"

I sigh. Give in. Look up.

"What's the rumor?" forcing a natural tone, forcing normalcy. I'm not intimidated. I'm not uncomfortable. I'm not intimidated. I'm not uncomfortable. I'm not powerless. I'm not intimidated. I'm not uncomfortable.

"That you like me. Is it true? Do you like me?" He leans in, folds his hands together, his gold wedding band catches a bright, brief flash of light off the lampshade. His mottled sky blue tie hangs limp between us. I cringe, then smile, weakly, worriedly, forcing a hard harsh laugh. I hold up both my hands, my wedding band on my left, my engagement ring on my right, a physical gesture meant to underscore my legal lack of singleness. It occurs me to later, only after the fact, that is a gesture that looks a lot like surrender.

"I'm married". My tone is flat, quickly dismissive, defensive. What. The. Fuck. In a rush I feel at once ashamed and shameful, as if I am the one crossing the line, as if I am the one who made this.

"And no, I don't like you. Sorry. I mean, I think you're a nice guy" I rush to quick to interject bullshit my brain hisses, you fucking idiot, stop apologizing "but I do not" I am stammering now "I don't like you. Sorry".

_______________________________________

"Did I make you feel uncomfortable?" he says, closing the door to his office. I am eating his food. Shamed and ashamed to have accepted his offer, starving and shaking, hypoglycemic and hyperventilating, I wonder briefly, what does it say about me that I'm eating his crackers? That I accepted them? Will anyone understand that it was because I just wanted to pretend, needed to pretend, have to pretend that nothing is wrong, it's okay it's okay it's okay it's okay, I'm not powerless, I'm not intimidated, I'm not uncomfortable, this isn't happening, I am okay. It's okay.

"No, no, no. It's fine. I'm fine. So what do you want to do with this guy? Should we send his urine out for cytology? Does it need a urology referral? I think he should have a cystoscopy. Let's order him a cystoscopy, how do I do that? Show me how to do that, is there a form or something?"

"Because it's okay, you know, if you like me. I wouldn't mind. I like you. I wouldn't mind if you like me". He leans in, pushes his chair away from his desk towards mine, my back against the wall, trapped, not powerless, not intimidated, okay okay okay.

"Jesus" I push out of the chair, "get over it" I'm trying to make it a joke, trying to make it okay, trying to make it stop, trying to make it go away "I don't like you. Really" I feel like I'm defending myself I feel like I made this I feel like I'm wrong.

_______________________________________________

The day goes by like a small eternity. I force professionalism. I am okay. I am not intimidated. It's fine. Everything is fine. I'm fine. He behaves like a sixteen year old boy, writing notes behind my back, showing them to patients.

She's sooooooooo serious one of them says. I find it while leafing through the papers in the exam room, looking for the list of medications.

"What?" I say, genuinely confused.

"Oh," he laughs, "I was telling them how you don't know how to take a joke. That you don't know that I'm just joking with you. That you take me too seriously when I'm only joking around, you know."

"Oh," I say. And then, to my patient, on the table, half dressed and worried about his prostate, "are you still taking the Verapamil?" because I have to force normalcy, because it has to be okay.

_________________________________________________

"I hope I don't make you uncomfortable. Do I make you uncomfortable? You can tell me. You can trust me. I won't tell anyone if you like me. I like you too". He has just hung up the phone with his wife, asked about his children, the Olympics, the dog.

"I'm fine, it's fine. Do I need to call cardiology about scheduling this patient's echo? Should I email her doctor?"

"You did a great job with her you know," he moves in, staring, glaring, searing, "you're really good with patients. They really like you. I like you too, but you don't like me". He screws up his face in, a mock pout. If I had eaten more of them I would have thrown up his crackers.

I sigh. I've tried making jokes and making light of it. I've tried willing it to be gone, ignoring it, avoiding it, refusing to acknowledge it. I've tried asking the nurses which one of you turkeys told him I like him, I don't care who started it because I'm here to end it.

None of us told him that, they say. And I believe them.

2008-08-06T05:18:00.000-07:00

confessional

I am afraid that I do not want children. Or that I will be terrible with them. Or that they will be terrible with me. Or that I will ruin their lives, eternally, mortgaging them to a life of therapy. I am afraid that I will fail, that they will hate me, recoil, retaliate, rebel, rebuke. I am afraid that I will discipline them too strongly, too little, too late.

There was the time I scruffed one of my cats (forcefully) and pinned him to the ground, staring hard into his eyes and commanding him (loudly) to STOP FUCKING ATTACKING the other cat goddamnit and he looked up at me, shocked, alarmed, mewed one tiny, plaintive meow and I sunk into the bathroom tiles, heart pounding, clutching my hair, thinking to myself, oh my god, I am going to beat my children.

In Brooklyn I ran with Fidel, pounding the solid cement from one neighborhood to the next. We stopped at all the stop lights. I snap my fingers, he immediately sits, waits for my signal. On the green light I step forward, he follows, an inch or two behind. We run past owners being pulled down the streets, frothy mouths, pinched necks, powerless people. A woman runs up from behind me, her dog pulling mightly ahead. We stop at the light, I look at Fi, he sits. Your dog is so good, she tells me. I smile, I rule him with an iron fist. She smiles half-heartedly, backs away. Oh, she says, and runs off, being pulled being her own orange dog, before the traffic clears or the light is green.

I watch defeated moms in restaurants cower at the anarchy created around them by their children. I have to push down hard against the swell of judgement and urge to go over to her and physically intervene, enforce. I have no idea what it is like to be a mother. I can only imagine the stress, the exhaustion, the confusion, the absence of instructions. I know I verge on horrifically judgemental. It humbles and terrifies me. What kind of person am I if, were I allowed to, I would walk over to the table, smile, put my hand on her shoulder and then, instead of pleading with them for one more second to sit please sit please please please please please please sit please stop screaming please please please don't scream please for mommy, I would push them (gently) down into their little seats, physically enforce. What kind of person does that make me? What kind of arrogant asshole am I exactly, because I am certain I am one.

The honest truth is this: I (not so) secretly assume that I will end up trying to raise my children under the same tenets that I have my animals--to sit when they are told, to wait patiently for what they are asking for, to not bite or bark or scratch, to play nicely with others, to come when I call them, to eat what I feed them, to understand that I am in charge. But there is a tidal swell of anxious doubt in me every time I am witness to a parent-child interaction and I end up thinking, I'm never going to do that. Because I know that hubris is the fall of my humanity.

I have turned out calm, safe, reliable horses. I've trained sweet, well-behaved, obedient dogs. I have managed, even, to instill a semblance of law and order into cats, creatures that live lawlessly if you let them. I know how to correct badly behaved dogs, cats, horses. I know how to intuit, to anticipate, reward, reprimand. What I do not know is how I will be, how I will react, how I will respond, how will I intuit when it is no longer my dog, cat, horse but rather my flesh my heart my children. What I do not know is what makes me so certain that it won't be me, that I am never going to do that, that I won't be sitting, one day, in a restaurant, surrounded and subjugated, by the flood and anarchy of my own screaming children?

2008-07-31T03:47:00.000-07:00

morbidity

We are a strange, sad species. Heavied by the burden of our bodies, our appetites, our impulses, our thirsts. We sit on either side of the sharp line, each of us equally mortal, all of us driven by our own quiet fires.

In the conference room on the sixth floor of the east wing at the top level, down the glass halls and past the big windows, we gather in disorderly array. Along the wall there are gleaming sliver crafts of coffee, ceramic pitchers of cream, flakey pastries, sweet muffins, powdered donuts, bowls of sugar. Crowded around the bounty we fill ourselves with heavy cream and light conversation until we begin to spill over a little on the edges, insatiable.

Sitting in on the weekly Cardiology mortality report, listening to the case, viewing the real time images, clutching at my own hard beating heart, I look around through the darkness at those around me. We all sit in unison, nod our heads, dissent or agree, interjecting the supporting evidence of the obvious risk factors (he was a smoker, his cholesterol was 318, he never achieved adequate blood pressure control, his diabetes was untreated for years), dividing our attention between the screen and our bellies, casually discussing the death of a stranger while earnestly shaping our own.

mortality

I am sent to the clinic to admit my patient, a man in his late fifties, referred to us by his doctor three hours away, he has been having chest pain for days. His EKG shows some startling changes, his cardiac enzymes confirm a small attack and his medical history betrays a relatively short life of hard living. We sit in the cheery clinic room, me on the stool, he and his wife on chairs in front of me. I take them in as a contiguous unit, two humans who have shared thirty years with each other. He is a little ashen, surprisingly thin. She sits next to him, bearing the betrayal of her expansive body, weighted down by an anarchy of cells. We discuss the obvious: the smoking, the drinking, the cholesterol, the fats. He tells me he won't do needles, insulin is out. He tells me we keep giving him his blood pressure medication but he doesn't take it, he feels fine. Even now, he tells me, I feel fine. I don't have chest pain any longer, I want to go home.

She sits beside him, wheezing ever so slightly, looking up at the ceiling, at the posters behind me, anywhere, everywhere else but me. I want to turn my attention to her, now that he is safely within the parameters of our ability, on his way to broader arteries, his life extended by as little much as we can give him. I want to reach out and touch her arm, contact her, connect. Shifting herself on the small plastic chair in front of me I can taste her discomfort, feel her anxiety, her presumption that I am here to judge, scold, chastise, scoff.

There is no way that I know of yet to sometimes be good to both the body and the mind. There is no way that I know of yet to save us from our own appetites, the fire to feed. There is no way that I know of yet to explain fully, in human form, the betray that crosses from body to mind. There is no way that I know of yet to understand what it is to loose a battle brought onto you by your own cells and tissues, by your own cross-wired mind.

2008-07-28T05:55:00.000-07:00

golden

Driving home along the narrow green roads, past the white clapboard houses and the big red barns, past the tall slanted shed by the road with Blueberries For Sale and the old coffee tin filled with money, past the pond and the creek and the chickens in the road, driving home in my right now today this song comes up in the shuffle and in a rush I am lean and brown and young again, dizzy for a bad boy with good credentials who lived in a small cabin on a tall mountain in the back roads of Big Sur. And just like that I'm driving in the grey light of dawn and fog and ocean, my hair unwashed and knotted, putting my face up against my palms, pressing into the smell of his skin. And just like that I can remember everything: driving home in my little black Jetta, the sound of his mandolin, the intoxication of a terminal love affair, lying on our backs in the cold wet of March, the sting of whiskey, a million stars.

We grow so myopic so quickly so unsettlingly soon. Sometimes all it takes is the smell of pine trees or the light on the water and I am back again and suddenly someone long ago from today. Sometimes all it takes is the curve of the road, a few chords of guitar and I am 28 years old: ferociously in love with a blue eyed boy, starving to the bone, carrying enough love for both of us, going at it alone. Sometimes I wonder if everyone lives a little like this, looking backward from the freight train, scratching our heads, wondering how time goes for so long so quickly, or when we'll ever catch up.

looking glass

I stare into the mirror under the flood of hundred watts bulbs, inspecting my face, my skin, my wrinkles, my age. I can count the light brown spots now as if they were rings of bark, trace the thin skin around my eyes, the lines around my mouth, my testaments. I see myself in every elderly woman I pass, recognizing my legs or my hair or my shoulders, wondering how I, too, will age. Wondering how the insides of time work, how life ticks by, endless and instant and jumbled together.

2008-07-24T04:10:00.000-07:00

satellites

We are living off dial up, fanning the wind power of some very narrow bandwidth. I have two hours of life at home: one hour before work and one hour after, the remaining bits used up at the hospital or traveling to it. In the mornings, with coffee and milk and two lumps of sugar, I give myself 42 minutes to tend to the neglected, pixelated portions of my life. Cluttered inboxes of spam, emails to friends, unenthusiastic job queries. In the 42 minutes allotted I can usually download about 5 pages, more if I don't actually read any of them.

And so I've been left without the cantilever---reading, writing, communing, conversing in my small little community of bloggerly women---nascently assembled to steady the scales.

red

The halls are immaculate. Everything is put into place. Above and below, the whole huge hulking thing feels like a solarium, an open aviary completely devoid of fluorescence and decay. The business of medicine hums along uneventfully, a well oiled machine of laptops and templates and accessible resources. Printers are abundant and centrally located, shelves of supplies tucked away neatly, obediently, without chaos. Nothing, it seems, is left to need or neglect.

I follow him around, from room to room, for ten, sometimes eleven, hours a day. Occasionally he has me go in, talk, gather a history, perform a minor, perfunctory exam. Invariably we go back in together, me behind him, dutifully, and then I am shuttled quietly into the corner by the sink to sit in silence so he can complete the decisions. It is hard to determine if it's chauvinism, egotism, mistrust or laziness but it is, without a doubt, a most expensive and worthless use of my time. Following him around, from room to room to office, sitting behind him, watching him write a note, answer an email, occasionally privy to some varnished clinical pearls, my resentment and boredom accumulating into a thing of its own, I have mentally departed. He tells me I will never get a job in this town, nonetheless here. I keep quiet and dress conservatively, searching my closet for clothes that do not betray me, inside or out.

To be fair he is mostly the minority and I am not stuck with him exclusively. It is rare but not uncommon to be subjected to his conversations about hunting in excess and for sheer pleasure, his views on homosexuality, gender or politics. I smile and bite down, willfully silent and clearly outnumbered.

second sex

It's not that I'm so much unattractive but rather that I never quite learned how to play my sex. It's not that I'm not feminine as much as that I am headstrong and obstinate and I walk with my shoulders, not with my hips. It's not that I'm not a girl, it's just that I never quite learned how to be expectedly frilly and silly and soft and pink. It's not that I'm unkind, it's just that you would never describe me as sweet. It's not that I'm disrespectful, it's just that I never learned that I should quietly defer to men. It's not that I'm aggressive, it's just that I had to learn how to do it alone. It's not that I didn't have a father so much as it is that I never had a daddy. It's not that I'm ugly, it's just that I know that pretty is what I am not. It's not that I'm unpretty, it's just that people are often surprised to realize it.

It's not that I'm surprised to find that I can be taken seriously here as sex or intellect, it's just that I've never been told so overtly to choose.

2008-07-19T15:02:00.001-07:00

family reserve

My mom has come and gone, leaving behind a thin line of ash, smoldering a silent advance between us.

She arrives in the July heat of summer on my stoop in Brooklyn--laden with luggage, dressed in khakis and a visor--and my heart presses against the kind of dense and difficult love a now grown person has for their own, aging parents. In my apartment, inside the small structures of me, we are fine. I am still enough of the daughter she remembers, the daughter she needs me to be, the daughter she wants to keep the groundswell at bay. She eyes my dining room table, asks is this one that (my mother in law) bought you? and I say yes, it is, biting back from wanting to remind her that she’s seen the summer before. Her hands glide over it slowly and she breathes in deeply, looking up and around and I see, for a miniscule moment, the resentment wedging itself quietly in.

Later on, in the Hamptons, at my mother in law’s house, things fall apart. My mother in law is buying us furniture for our house--beautiful, stunning, priced astoundingly--and we are solidifying the order. As I sit on the phone with the office back in New York I watch my mom leafing through the pieces we are ordering, her eyes a hard mixture of envy and awe and I suck my own air in quickly, trying only to straddle the line with grace.

We fight like I am once again a child, a teenager, as she can render me fourteen again with one look. On Long Island, in the lush country of New York’s elite, she becomes sullen, quiet, pouting and passive. By the time we migrate to New Hampshire she is piecing and biting, tossing angry interjections with the deft flick of her voice--though she will admit to nothing, proclaim vehemently that it's all in my head (I’m not angry, you’re angry! I’m not upset, you’re upset!) and that nothing (nothing!) is wrong, she is fine, FINE. I’m fine. I don’t want to talk about it. I’m fine. Nothing, from my likely choice to have prenatal ultrasounds during my theoretical pregnancy to the way I fold and put away my sheets, escapes her disapproval. Willow comes two days later to save me, her own mom in tow, and we sit up late at night, toes touching, talking about the enormous and searing sadness only our moms can make in us. I am thankful for the dilution they bring into the concentration of contempt as much as I am to have another witness to the event, a ballast against the wind.

Even as it unends me I know many things and all of them at once. I know that when she comes to me like this I am not an adult of my own, I am once again fourteen and raging against my curfew, her choice to ground me, her chronic disapproval. I know that she is a human made up of much envy and regret, that she tends to see in sharp focus her own collection of dissatisfaction. I know that she always wanted the life I have stumbled into, that she always thought she would marry an Ivy League professor, have a warm wooden house, living and breathing, as she sees, so easily. I know that all she wants in life is her own house, her own yard, and that bringing her to mine is cruel in a strange and unspeakable fashion. I know that she could never admit that what she is really thinking is that she deserves more, more than what she’s capable of seeing her life as, more than she has, more more more. I know that she is grappling with sharp and untenable emotions that she is not proud of. I know that somewhere, hidden up and folded inside, she is happy for me--relieved--that I have landed on such solid footing. I know that my own, intimate insight into those darker pieces should galvanize me against some of her more caustic tendencies. I know that I should be the adult I am every elsewhere when I am with her. But instead when she is with me she will always and only be my mom, that I will always and only want to her to be proud of me, happy for me, uncomplicated, just like that. I know that I want her to not be her own, actual messy human self; that this is impossible, unfair. I know that, despite all I know, I too want more.

2008-07-15T03:08:00.000-07:00

civilized

Yesterday I drove to work. In a car. In my car. Alone. Drinking my coffee, listening to NPR. Without anyone stepping on my feet, farting behind me or leaning against my shoulder. No one pushing me into the standclearoftheclosing doors, swaying like cattle, lurching lonely through the darkness.

profiling

My preceptor is older than I expected, jocular. He has a bumper sticker at his desk for the presidential candidate I am decidedly not voting for and I am surprised to see that his car keys belong to a Japanese import. On his walls are autographed pictures two former presidents of the eighties, a calendar of ducks and several snap shots of dead animals on proud display.

We talk briefly about New York, about my new community, this quiet place; we steer clear of politics, he makes a careful comment about the "certain kinds of people" you find in places "like that" and a small, confusing anger bubbles up from below. Sitting in the clear light of morning, waiting for the day to begin, I am suddenly and at once awkward and dubious, wondering how I will pass these next few weeks, his eyes flickering slightly, subtly, repeatedly, below the neckline of my coat.

big fish

The day is benign, boring. I follow him from room to room, listening in on the discussions that ensue about osteoarthritis, degenerative joint disease. He asks little of me yet I get the distinct impression I have failed to leave a good mark. After these months of palpable pathology and extreme abnormalities I am woefully bereft in my knowledge of the mundane. And suddenly, swiftly, I feel very much a small fish in the glowing, gilded fish bowl of Ivy League medicine.

2008-07-10T04:11:00.000-07:00

stage fright

I am unaccustomed to writing for an audience--real or imagined. I have had a small collection of amazing women who have haunted these pages for the last handful of months, a scattered cropping of lurkers and an easy arena of comfort from which to dwell. These humans have brought me immeasurable joy and sanity and have often set the other side of the scale in my altogether lopsided life. At many times along the short and narrow path of this space I've reevaluated, reassessed and redefined what the F I was trying to do here in the first place. As a non-mom and a reluctant blogger usually I felt a bit like I was elbowing my way into something in which I did not fit. Reviewing the ways I've used this space myself over the last smattering of months I've often thought there is something distinctly schizophrenic about it, a sticky stack of polaroids capturing my best and worst angles. I had no idea if I would keep writing once I left the broken up anguish of New York City. I had no idea what I would say any longer, now that I've left that dirty dirty hard hard fast sharp city behind. There much inside to process I'm certain, there is much of it still stuck inside; and yet my day to day life in a loud speaker is over and part of me has always wondered what will happen here, in this pixelated place, in the aftermath. A newer, awkward, skittering part of me hopes that those who have come here recently will not then, in turn, leave disappointed.

And so, it is unnerving, reassuring, validating and terrifying to have you all here--real or imagined. Thank you, every one of you, immensely and unendingly, for your kind comments, for even coming here at all. I have been woefully remiss, stuck up in a dial up connection, a house full of boxes and a very nosey mother.

However, there is a kind of quiet here that is weathered and well worn, a space that begs a laptop and a mug of coffee; a space every bit as important and necessary as my sinking ship in the city. I am not a writer. I do not have stories to tell, dialogue in place, characters inside of me. All I can do it witness and observe, record and tabulate. New York was easy on the keyboard, hard on the heart. I wonder now, now that I am gone, what will become of this space? What will happen here now that I can finally and again breathe easily?

wherein I proclaim my utter astonishment and shamelessly beg you all to stay

2008-07-08T14:49:00.000-07:00

Oh my goodness. Oh my goodness my. And by that I mean, jesus *%$#$@*# christo, holy friggen crap. Hi guys. (!) I had no idea. I had no idea that Kristin came here much (or at all)--Kristin whose writing makes me feel like we would somehow be very good friends, Kristin who often says the very things that kick around the cluttered corners of my mind, Kristin who is inevitably the second blog I click to every morning without fail, Kristin who had dinner with Dooce Kristin--none the less that she would or did or actually has said something about this little jumble I sometimes think of as my life in typeset. But I guess she did. She has. And you all came here. And I'm so shocked and amazed and grateful and kind of mortified because this has been a real f-er of a week and I haven't written and all of my last posts have been pretty much wah me and well, I sort of feel like you caught me with my pants down, but hey, erm, welcome! Really.

Okay, now I have to go lock myself up in a closet and squeal in disbelief.

true to light

2008-07-02T17:57:00.000-07:00

For those of you who are wondering, no, this is not my hospital. And yes, I am (horrifically) not very surprised.

It is, indeed, time to go.

2008-06-30T10:06:00.000-07:00

fight or flight

Often I feel as if I live this life like an animal of prey: unsettled, tachycardic, diaphoretic, always waiting for the trap to spring. In the early light of June in the small, thread bare library on the third floor of fourth wing of my little, broke-down hospital I am sitting in sweaty disbelief. Leafing through the pages of my evaluations, a kind of praise and accolades I will never be accustom to, having just been offered a job and an award for which I was never a legitimate candidate, what occurs to me most is that I am loathe to be separated from the pack and that a fall from grace can seem very long and hard when you are afraid of heights.

When it comes to praise I am awkward and inept. I fumble at the strings of my scrubs, flush and tremulous and mutely inarticulate. I press hard against the inevitable, internal reaction of just wait, soon you will realize how little I know, how uncertain I am. I dig in against the urge to run, pressing my nails into the flesh of my palms, wondering always and again, why it was that I was given such an unusual, hard-beating heart.

stockholm syndrome

I came to New York to get my hands dirty, to be in up to my elbows in a mythical urban grittiness. It was to be all gun shot wounds and sweet old men from Russian with poorly defined illnesses from which I would surely nuance a diagnosis. It was going to be big name hospitals in the big, big apple. I would be exhausted and, occasionally, discouraged, but althogether rewarded and balanced, my sanity still neatly intact. I came instead to floors with no sinks and nurses with no mercy and patients with no money, no insurance, no education, no choice. I came to a place where everything was a struggle, a place where I learned to beg, barter and steal. A hospital that demanded I confront my own ill-defined ideas of racism and prejudice and cultural idioms. A population that demanded of me great change and, in exchange, made me infinitely better than I ever predicted.

On my way out, for the last time, through the sticky revolving entrance I turn to the security guard to say goodbye, heavy with everything I have accumulated in a year, and he smiles crookedly at me, nods. Peace out white girl, he says, stay safe. We knock our closed fists together, opening them to grasp each other's fingertips into a soft, sloppy snap (because I'm ghetto now, you see). At the bottom of the circular drive upto the enterance one of the janitor's comes up to me and says you out, mami? Si, I say, I'm done. You be blessed now, you hear? she tells me in the thick Jamaican accent I am certain to miss. You too, I say, and we part ways. She into the cool dim of those fluorescent floors, me into the bright squint of day.

And I am dirty to my elbows. And I am okay, at last, with the stains.

land locked

It's not that I'm unhappy per se, it's just that I miss the ocean. It's just that I miss diving down deep under and coming up to breathe. It's just that I've been homesick for surfing and sandy sunshine and water and ocean. It's just that lately my dreams are like this

thicker than water

2008-06-26T08:44:00.001-07:00

I have been carrying around a homesickness that is heavy and hard and hallow. It lives like a small bird in a cage, like a structure in my heart, and there are times when it is all I can do to hold on to it, contain it, keep it in situ.

I've taken the long and far road from my small home in the middle of the ocean. Sometimes I don't know if I will ever go back again, if I can, or if I will. But I've been dreaming of water, and iron woods, and muddy sandy children. I miss an entire section of the world so much sometimes I wonder if I will always live like this, walking around with a half-broken heart.

as it were

2008-06-23T02:55:00.000-07:00

It's not so much (or only) that I hate the city, it's just that, I have no idea what the point of summer is without an ocean. Or a lake. Or even a slip and slide. Driving around Brooklyn yesterday, watching kids try to come up with ways to play outside, locked in and trapped up, staring side-long at the hot, dirty faces slumped over on the stoops, I had this flash of how different my life could have been, how different I could have been, under any number of different circumstances. How easy and fragile and specific and intricate our little lives end up to become. If I had grown up here, how different would I be?

You should be a doctor. I hear that to varying degree and from time to time. I hear it more now and recently, here in my shocking and unsurprising niche of Obstetrics. You should be a doctor, they say to me and it is a dense and messy thing in me and I rarely handle it gracefully. You should be a doctor. From my mother in law it drives me bat shit crazy, from the residents and occasional Attendings, I wince and shake my head and clutch at the remnant part of me that agrees. What I should be is in ownership of my profession. What I should be is confident and secure that I would ultimately be no different, no better, as MD. What I should be is grateful that I am now finished and not looking down the barrel of six more years. What I should be is unenvious and relieved and contended. What I often am is left wondering if I should have been, could have been, would have been more.

2008-06-19T04:35:00.000-07:00

bazaar

On Friday morning, when I walk into the clinic, Leroy is standing behind his desk, wearing all white scrubs, snakeskin boots and rocking out to . Our eyes meet, he puts on arm up, one hip out, swivles in a circle and says Oooh girl, you're looking fierce today child.

In the waiting room they sit for hours. In the sweltering heat, without air conditioning, in the dark. They are waiting for us, for me, to call their names, lead them through the narrow yellow halls into small rooms, ask them about their last normal menstrual periods, measure their fundal heights, find the small, fast heart rates on the doppler monitors. They sit for hours waiting for a routine sonogram, a yearly exam, laboratory results. Without insurance there is no one to complain to. Without insurance they voiceless, powerless, stifled and sweaty. They wait to be seen by a handful of expert clinicians with swift hands and thick Russian accents but settle instead for us, a bevy of blundering students, to provide some of their most intimate care. It is to these women--dark, bright, braided and beautiful--that I am wordlessly grateful to, for allowing me access to learn on them in a most visceral, surprising way.

exposure

In the operating room there is little mercy, save the relief of anesthesia. In the operating room after the quiet rush of anesthetics, the business of surgery is swift and sterile and succinct. Patients are positioned in ways that best serve our access--exposure as it were--humility excluded. In the operating room, beneath the blue drapes and the sterile towels and the rows of glinting instruments, lay sleeping people who have come to us with hope and fear and eager trepidation that we will improve their current station, that they will, to some affect, leave us better than they were. In the operating room, beneath the hot lights and the glare of the scrub nurse, it it easy to forget who is beneath there, a full life on the wrong side of the scalpel. In the operating room, standing in sterility and in front of my patient in a most comprising position, I am reminded in a rush that this is a privilege, that I am the most fortunate one, that I have been given people, in their most intimate moments, from which to learn. In the operating room, in the clinics, in the exam rooms and on the blue floors left sinkless I am reminded that I have had the very particular privilege to to see so many so sick and it when it comes it feels something like salvation.

2008-06-10T18:10:00.001-07:00

desamparado

Because my mom is Italian women, usually older, often come up to me and address me in Spanish. ¿Hermana, hermana usted habla español?

No, I say, no. No habla espanol.

Pero necesito descubrir cómo conseguir el 38.o autobús de la calle a través de la ciudad. ¿Puede usted ayudarme? ¿Puede usted ayudarme? ¿Yo necesita conseguir al autobús, usted sabe donde está? ¿Usted sabe donde está cercano el 38.o autobús de la calle a aquí? ¿Puede usted ayudarme mi hija?

She stands in front of me in the sweltering heat, sharing the small slice of shade on the scant green hill in front of the hospital. She is hunched over, wet with perspiration, face peering down at me, hands out in the air, talking. Talking. Speaking to me in a language I do not understand, asking for something, a bus, directions, how to get home. Eventually she stops and looks long at me, believing at last no habla espanol and I am left, again and always, feeling full up of all the ways I am unable to help.

parity

My 19 year old patient does not speak English, save the words shit, ouch and no. She has been brought here by her boyfriend from the Dominican Republic, the DR, so that she could give birth to their baby in America, so that they could have some kind of chance of a life told better. She has vomited three times. She is alone behind the curtain in our triage, those are the rules and she obeys them. I come in to meet her and she grasps my hand with such strength I can only think to myself, shit, that's my right hand and she's going to break it. I admit her to the labor and delivery room--small and uncertain in such growing autonomy--holding her hand, wiping her forehead. And when she says, an hour later, after I have inserted two gloved and sterile fingers inside of her to asses her dilation, her effacement, the baby's station ella es mucho más suave que el otro doctor I know only that I have not hurt her in the process, a sure sign that I am doing it wrong.

When she finally delivers I have already gone home, exhausted and spent after the labor of a 36 hour shift. I did not get to see her daughter, or say good bye, good luck, good pushing; and yet, as my first patient in what I now know is going to be the rest of my professional life, she is indelible.

gratitude

There are so many things for which I am grateful. Bird songs, coffee with milk and with sugar, soft cat-chins, Andy. I didn't want to just write a comment response thanking each of you for your comments, for still even being here, because it means more to me than just a comment thanks. Really. Really. Thank you. Thank you for checking in and I am still amazed at those of you who haven't checked out completely. I heart you utterly, messily, fantastically.

hiatus

2008-06-03T02:22:00.000-07:00

I've never been comfortable conversing or writing or talking here as if I had some kind of audience (because really, lets be honest, I love all six of you but this isn't a sock puppet show. Additionally, I figure you all have fairly involved, riveting lives that haven't been too disrupted by my recent absence) here. I had intended and hoped only to carve out some kind of space to exfoliate the dead patches without making myself raw. Maybe--vaguely, unintentionally--I hoped to find a handful of other people, flung far across these small distances who were something kind of the same. And I have. And I'm grateful. And I love it.

I'm not sure why I haven't been writing lately. I can't quite verbalize what's changed or shifted. My brain still works the same, functioning to formulate thoughts as if they were words on a page; my daily chronology categorized in squares of words and paragraphs. I still have the compulsion to write and always. But I haven't. I have not read, I have not written. Perhaps because everything might come out a little bit like this: I hate New York City I hate New York City I hate New York City I miss Santa Cruz when do we get to move already holy fucking christ I'm about to graduate I'm not ready I don't know anything I'm going to be a terrible PA all I want to do is plant roses.

Which is only mildly interesting. And that's assuming you're on your third gallon of whiskey.

there will be moose

2008-05-18T06:13:00.000-07:00

So we bought this house in New Hampshire. And we are moving there. Soon. And it's not in the city. And it's quiet. And beautiful. And the last time anyone got shot it was by their drunk cousin Bubba with a skeet gun, not by a police officer during a routine traffic stop. And we have one store. One. It's a Country Store. The kind where you say to the guy, Earl, hey I'm looking for a lumber jack and he'll say oh yeah, call Johnson over on Wheelbarrow Road. His number is blah blah blah blah blah and the next thing you know the whole town knows two crackers from New York City have moved up country. It's the kind of place where you haul your own trash to the Transfer Station on Sunday mornings. It's the kind of place where # of cows > # of people. It's the kind of place where you wake up in the morning and all you hear are birds and the clicking of dog feet. It's the kind of place that sort of makes you need to vomit, it's so beautiful. It's the kind of place I never, in a million years, would have imagined I'd end up, yet it's exactly the place I want to be. It's the kind of place that makes a girl like me feel the need to get a Ford F-250 and some sheep.

Don't even get me started on the moose.

So anyway, to drive the point home, here are some pictures. In New York, I wake up to this:

In New Hampshire, I wake up to this:

Most of the people we know here think we are batshit crazy. I think, if I have to commute an hour on three trains just to go sit in Central Park with seven hundred thousand other people for any length of time, maybe I jump off the Empire State Building.

on further review

2008-05-16T06:24:00.000-07:00

There is always this option.

diametric

2008-05-15T05:41:00.000-07:00

In Manhattan my patients are healthy. They make their appointments in advance. They make appointments, period. They have allergies, muscle injuries and viral infections that don't require reports in triplicate to the CDC. They are all very nice. They kindly tolerate my young ineptitude. They like me, I think; they listen to me. They require astonishingly simple solutions. A prescription for Allegra, Xanax, Ambien. Felxeril for the back spasm. Cipro for the urinary tract infection. Zithromycin for the viral infection that won't respond to antibiotics but for which we dispense without pause. Because they are white? Or well enough off to....what? Write a letter to The Times? My doctor wouldn't prescribe me a drug for which I have no indication? Because it's easier?

But it is. Write, scribble, sign, satisfaction.

The nurses say good morning to me, every single day. They know everything and they steer me through the inanely simple without need for pride or humiliation. The entire office is so nice I hang half frozen, waiting for the shoe drop. They are actually urinating in my coffee. They spit in my yogurt. My challenges are now to recall the more mundane trivia about medicine. What is the name for an infection in the bed of a nail? What do you call an uncomplicated infection of the sweat gland not colonized by flesh eating bacteria? What is the ideal range for a well control diabetic's HgB-A1C? Well controlled diabetics. Uncomplicated infections.

It alternately amazes and terrifies me.

Across the water, over the bridge and into the streets of loud trash and music, just simple miles apart, I am small and white and invisible. Across the East River, down in the black streets of Brooklyn, my patients have not had their colonoscopies, do not get regular mammograms and are not well controlled diabetics. The cannot, or do not, or will not make appointments in our small clinics, waiting instead for the stroke to arrive, the foot to become gangrenous, the cancer to grow completely through the large intestine. Across the water, on the unblanched roads admist the red brick projects, I struggle to understand the words and accents of my fellows, my peers, my attendings. I am powerless in every way I can think of: there are no simple solutions, no uncomplicated infections, no well controlled diabetics; I have to wait until those who I rely on to help me feel like getting around to the task at hand; I have to decipher cryptic medical records delineating dense medical histories and differentials; I have to proceed without the benefit of typed reports or adequate information; I do not walk into a room to find instant, intact respect because I am in a white coat with a stethoscope. I have to work against my gender, my age, my skin color and my dress. I have to sift through the tangled mass of five comorbid diseases in patients no less human than those across the river.

In Manhattan I come home calm and dry. In Manhattan I come home well fed and on strong footing. In Brooklyn I come home diaphoretic and suicidal. In Brooklyn it is a struggle to stand up hard enough against everything crashing down around you. In Brooklyn I can offer very little in the way of simple solutions. In Brooklyn I am the one who needs Xanax. In Brooklyn I feel hopeless, helpless. In Manhattan I feel guilty.

And yet, at the end of the day, if given a choice, I would cross the river and take the bridge. Helpless, hopeless, pale and invisible, I am no more visible than my patients. Powerless against the enormous forces of race and culture and religion and habit. Against socioeconomics and education and regional mores. Against myself or them or the system. In Brooklyn, because there are no simple solutions, we all come out of it distinctly different humans. In a place of uneasy options and all of us messily swept up in it, we are in it together, divided as we may be.

2008-05-13T05:14:00.000-07:00

cluttered heart

I used to think that melancholy was a byproduct of being younger, leaner, less steady with our compasses, all the terrain in front of us uncharted; a direct metabolite of intentional disillusionment and green ache. I used to think I would out grow it, some day, like shoes. And I would keep it around as artifact, like a tumor taken out and put into jars, to show to myself: look, look at that, you used to carry that around with you. As if I were cured.

Driving the green miles of my new roads in New Hampshire, surrounded once more by big, empty beauty, quiet finally inside, something comes on the radio and I am suddenly, unexpectedly nostalgic. And it is a hard grasp to see that I have come so far from there, that I have already gone so long, when sometimes nothing on the inside seems changed. And just like that, in the middle of my life right now, I'm back again and younger, drunk on liquor and life and cigarettes, looking up at the sky, mending a fragile heart, counting stars.

low definition

My mother in law sends me this as a link from The New York Times and immediately I am angry. I am angry and annoyed and small childish. Because this is my life, in a nutshell, although in some ways even less glamorous and more chaotic, as this is not my hospital. My hospital does not have translators, or computers or sinks. My hospital is even more poor, even more dense, even less dazzling. To write up an article on the hospital I work in would be to outline an exercise in failure, a fall out of our humanity.

And I am angry. I am angry because never has she asked about what I do, what my day is like, since it is unattached to Important Names and Things To Brag About. Because all New York is about, at this level, is attachment to Enormously Important People and if you are not attached, well... I am angry because I have, for the past two years, bounced between both upper sides of Manhattan and the underserved in Brooklyn and the stark contrasts have made me schizophrenic. I am angry because as I share meals with them, they laugh and roll their eyes, as if we were talking about a stain on a shirt somewhere that won't come out; as if it were nothing less than a nuisance and when will I learn to choose a better cleaner? As if to say it is somehow my fault, or my patients. I can almost somehow hear the word that's what you get for working in the ghetto. And I am consumed by undifferentiated rage.

And since I am passive aggressive and an impostor of a New Yorker, I send her an email back. I want to say "goddamn you for only paying brief attention because someone finally got it together to write an article about it in The Times. Goddamn you for being so specifically clueless. And goddamn you for rubbing it in my face". But I do not. Instead I write something terse and childish like, Now you know what my life is like every single day. Minus the computers, the translators and the sinks. And yes, my patients are also very, very sick.

Because I am ill-equipped to live like this.

the beautiful people

2008-05-09T04:01:00.001-07:00

At first, in the beginning, I wore fitted, tailored pants. I added in heels and cashmere sweaters. I began my training in an enormous hospital in Manhattan, funded to the high beams with a surfeit of money. The hot, gay social workers wore Paul Smith, the receptionist had an amazing colorist, the doctors had corner offices. With doors. Bookshelves. Plants. The even the nurses wore kitten heels.

My patients were the clinically insane and woefully addicted. And, with the exception of one, exclusively male. Soft broken hungry humans living as they could in the system that kept them in place and accounted for. I had my own office, with computers, a phone, a window. These men had twice weekly meetings to complain about the discomforts of their hospital stay: the DVD player didn't work over the weekend; my roommate snores too much, I need a private bed; the pizza we ordered for pizza night wasn't from the right pizzeria how could we be so moronic, they are living in a prison here, the least we could do is order real pizza for fuckssake. I conducted psychiatric interviews, timid and bold and unaccustomed to their short attention, their stock answers, their eyes on the buttons of my shirt. Staring them down, unremitting, sweaty heart pounding inside, tailored pants still neatly creased and fitted.

In the ghetto, at my next hospital, along the blaring streets of Brooklyn, one does not wear kitten heels, cashmere or anything remotely fitted. One does not arrive for work in hand me down Prada and, if one is small and white and inept, that one in particular should not wear sparkly, glinting, gawky engagement rings because one's patients live in the projects down the street and the nurses ride the train an hour in from Queens and one will never survive if one parades down the halls clicking, coiffed, and conspicuous.

Which is why, last night, when I ended up at a Chelsea art gallery last night for the opening of a friend's latest installment and meeting Andy's friend Zac Pozen (!) I was wearing loafers.

Loafers. LOAFERS. Zac Pozen. Chelsea art gallery. Loafers.

No, no. Please. It's not okay. Really, it isn't.

*****

Addendum: thank you, Flutter, for pointing out that it's Zac Po-Sa-en, Ssssssen like Stupid Girl in Loafers Who Doesn't Watch Enough Sex In The City or Gossip Girl not PoZEN like Stella.

explanation point hang over

2008-04-29T06:42:00.000-07:00

Ever had one of those mornings when you wake up, roll over and simultaneously think "holycrapshit I'm going to vomit holycrapshit who the hell is that?" No? Just me? Hmmmf. Well that was the beginning of my day, status post writing what sits directly below this. I woke up, re-read my blog and promptly smashed my laptop into my face.

yellow bricks

2008-04-28T11:22:00.000-07:00

Hi! Oh my god! I think an anvil fell on my head while I was sleeping, at which point I died, and am now writing you from heaven. Seriously people, what the F is going on around here?

First of all (FIRST OF ALL) I didn't even have to report to my new rotation until 9:30 this morning. NINE THIRTY in the morning. That is practically the afternoon people. Why don't you just tell me to make a margarita for breakfast because that is an F-ing a VACATION that's what that is.

And then (AND THEN) I got to ride the real train, the grown up fancy train to work and OH MY GOD can I just tell you how weird that was. Weird! Look! I'm using exclamation points! That means things are REALLY CRAZY. First of all, it's completely packed. Which I'm not used to. What I am used to is sprawling out over 4 seats staring up at the ads for malpractice attorneys in Spanish trying to calculate the correct vector of force a moving vehicle would need to hit me with so that I wouldn't die or loose a limb or be incontinent but hard enough send me to the ER (but not my ER) for the day so I wouldn't have to go into work. But this morning I had to scrunch in with everyone else in their wet (and stylish! with the little belts! adorable!) trenchcoats and umbrellas all dressed up in their pointy shoes to go to their cushy offices in the financial distract and OH MY GOD can I just tell you about the diamond rings some of these woman are wearing? GI-normous! Ginormous! (look! again! the explanation points! wtf?!) I want to ask them if they tear their rotator cuffs every morning getting out of bed but I'm afraid they might hit me in the temple. And then I'd be a vegetable. Because their rings are the size of flower pots. Ginormous, everyone, ginormous.

(Which reminds me that I need to talk about The Real Housewives of New York City at some point, but not now, because I'm already diaphoretic and panting and yet another orthogonal diatribe might actually make my head explode so it's up to someone else, all six of you, to remind me. Because if you've ever seen it I've got some shit to say. Shocking. I know.)

And then. (AND THEN!) I got OUT of the train and I wasn't in the ghetto! People, I tell you what, New York ain't so bad when it's all cute cafes and narrow streets and glossy buildings and people with their pants covering their butt cracks. Really. I know it's hard to believe, but I am here to say it's true. It's so very true. I went into a little corner deli and DO YOU KNOW WHAT THEY DID? They said hello! Good morning! Can you believe it? I couldn't. I couldn't believe it. Could not. I almost jumped over the counter and made out with all three of them. Because I didn't know how else to express my awe and gratitude and figured inappropriate sexual advances are clearly the only answer. And then they asked me if I wanted my bagel toasted!! Toasted! And I did! I did want it toasted! And then THEY TOASTED IT! I cannot tell you the glory of that moment. It was sheer ecstasy and quite possibly even the rapture, without the part about god and the Apocalypse and Mel Gibson.

And then (and this is where you'll really understand why I am actually convinced that all of this is nothing but lies and fabrications and that I'm actually laying in a morgue somewhere because I've already died and I'm writing to you from the pearly gates of Jesus) I went into the hospital where I will be working for the next five weeks and promptly crapped myself. Really. No fooling. It started when the guard smiled at me (SMILED!! AT ME!! Who does that?) and asked me where I needed to go. And when I told him? He knew exactly where to send me! AND THEN HE TOLD ME TO HAVE A NICE DAY. And he MEANT it. He did. He really did. I just know it. And what he did not do was give me a sup white girl what you need? head nod nor did he fall onto the floor with full body exasperation that I would have the gall and audacity to ask him (him! the guard dude! the one you are supposed to ask these kinds of questions to!) that kind of question. Holyfriggencow are you serious?

And then (yes, AND THEN) do you know what happened? Do you know?? I got into the elevator AND IT WORKED. The little buttons, they lit up and the doors closed and it went right where it was supposed to and right then and there I almost passed out from the shock of what I saw. The tiles on the floor were clean (!) and there was no trash swept into the corners (because that's sweeping? Because that's okay with everyone? Because we're all crack addicts?) AND THEN do you know what I saw as I walked into the suite of exam rooms and offices? Wait for it people, wait for it:

A sink.

HALLELUJAH a motherloving sink!!!!!

Not just one sink either. Oh no. No no no no no no no. There are multiple sinks. All over the place. In the exam rooms. In the lab room. In the medication room. In the hallway. In the bathrooms. It's like fucking Home Depot in there. And not only that (NOT ONLY THAT!) there was soap. Soap. Real live actual soap. With paper towels. PAPER TOWELS PEOPLE. Do you have any idea what this means?? It means I have died and I have gone to heaven and yes, I can tell you, in heaven there are sinks. Because even God uses Universal Precautions.

And please, don't even get me started on the medical records. It will only make me weep with joy and disbelief. Suffice to say that it's beautiful. They exist. They are right there. IN the OFFICE. I don't have to proffer oral sex or my first born to try to get them. And I can read them! I'm SUPPOSED to read them! People even HAND THEM TO ME. I almost stuck my tongue down the throat of one of the nurses because I felt that quite possibly I had never loved anyone so much as I loved her the moment she came and gave my first chart to me. Holyfuggenshit. I have died. There is no other explanation. I have died and I have gone to heaven and in heaven there are complete medical records and computers and everywhere you look, there are sinks.

adios

2008-04-27T07:20:00.000-07:00

Sometimes life is so f-ing beautiful and lovely that it seems like the only thing you can do is stick your head in the toilet. Just to get some perspective.

On Friday Andy was being ~~a little irrational totally insane kind of complete f'er~~ particularly special kind of human such that while standing in the driveway, talking on the phone with the insurance companies, I had no other choice but to flip him off. Because I'm classy like that and really believe in communicating my feelings. Later in the afternoon I looked him in the eyes and apologized for giving him the finger. It's just that, it was because I wanted to punch him in the face.

And so is the end of our little lives in Santa Cruz. We've said our goodbyes, I've doubled my body weight in huevos rancheros and halved my Time To Full Body Face Lift. Andy got poison oak in an assortment of places that usually go along with the words: and that's when I realized it was poison oak and not, say, that barmaid in Bulgaria. And can I just say how it never ceases to amaze me how many people get poison oak in places only Bavarian barmaids and a few well trained physicians are normally privy to and that all it takes is one person to open up the conversation for everyone and before you know it you're openly discussing (in depth!) someone else's genitalia and I've just never gotten comfortable hearing the words my vagina in casual cocktail conversation?

wilder

2008-04-24T09:26:00.000-07:00

Willow comes in from San Francisco to see me. We walk around downtown in the sunny chill of April, contemplate Buying Things. We clutch cups of tea and coffee and talk about the heterogeneous ache of life, the disappointments of being human, our own small denials, our little lives in medicine. We use hard laughter, soft voices. I adore her deeply, wholly. I understand why we are friends.

Vicki, my Hawaii sister in law's sister, leaves work early and we walk the trails of Wilder. I am saying goodbye to friends and family, tracing the blueprints of my life. Every place that I go is a place I have been to so many times before, during very specific times, certain sections of my chronology. This is where I came to outrun an old heartache, that is where I used to drink too much and smoke stale cigarettes, this is where a long ago friend once lived, that is where I would go to watch the water, regain my footing. Wilder is where we are are today. It is an old farm at the base of big, open meadows and I bury my head in the tangled manes of the draft horses, slip them slices of apples, breathe in their dirt. Wilder abuts the Pacific directly; it is sharp cliffs and strong waters and from the top of it you can turn around and see the whole world in front of you, bright blue and unending.

Vicki and I sit at the top and watch the whales cross the ocean. We try to spot the babies but are only able to make out the spray. She is not my family by blood but we are bound by strong love and shared history. We are so different and so much the same and we will always be a little more than family, we will always be friends.

2008-04-22T07:56:00.000-07:00

2008-04-21T09:24:00.000-07:00

the long road

Flying tends to give me migraines. I sit there like a furtive junkie, watching seven straight hours of Bravo and Animal Precinct, unmoving, tucked up like a small fish in my standard issue leather seat. I never drink enough water. I've always eaten a really bad slice(s) of pizza at the airport and I rarely, if ever, open the Cardiology or Nephrology texts I've lugged on to allay my guilt and neglect.

Such that I return, bleary and famished and squinting, home.

Driving back late at night from San Francisco I stick my head out the window, drink it up. Suddenly and abruptly, there is sky. Stretched out and pin-pricked, thick and uninterrupted. Acutely, ceremoniously, where there was once dirtyfastloudloudscreamhonkpushtrashtrasheverywhere there is now the dark light of midnight and the unalloyed wash of moon. And instantly, unequivocally, I am better.

wind and sea

The bleached out bones of my life are here. I have not tired of Santa Cruz. I still love the wide, patch work streets, the low trees, the quiet houses, the dank redwoods, my separated life. I love it fiercely now, today, two years out and away. It is notrashnosirensnohonkingscreamingscratchingbigrigsontheexpressway.

It is quiet, it is only birds and seals--barking, scrapping, fussing over sun spots--and an occasional lawn mower. It is only open windowed sunshine and the clicking of dog feet on hard wood.

We walk out in the strong on-shore winds to the ocean, lean on the iron railing, look down at The Lane. In the mornings we go to into the redwoods, padding quietly along the paths and needles, shady cool with little sun. The afternoons are all chilled, damp air hung out to dry in the sun; the mornings are full up with kettles of tea and coffee mugs.

The minutes go so slowly, are spent so quickly and I am better already.

distance, difference

2008-04-17T15:21:00.000-07:00

The restaurant is like all the other places we go to in the city: dark, lush, quietly electric, expensive. I used to fight the urge to faint every time I sat down to order, anything, everything, it was all too much, so much, so unnecessary; now I walk in, know to greet the hostess, know to check my coat, know to kiss on the cheeks, know to wait for my napkin to be unfolded for me, my fast heart still a catch in my chest, an easy smile to compensate. At best I am ambivalent about these nascent social graces, at worst I am terrified of them, anxious about unintended implications.

They are there, my mother in law and my sister in law, leaning over their blackberries, looking up to say hello. I never know what to wear. I never feel as if I've gotten it right; something is always wrong-- my shoes, my jeans, my bag, my jacket. And I am proud and uncomfortable with this. In order to assimilate there is much to hand over.

I love them each awkwardly and individually but the sum of our parts is often too much when we are together. The table is draped in burlap, the red wine has been poured, the votive lit, the menu--which is the same menu as every other restaurant we tend in New York--considered and the blackberries placed, for the moment, down.

But I have nothing to bring to them. I have nothing to say. They don't want to hear about my life, the hospital, school. We each ask each other the requisite pleasantries, the necessary questions. How are the kids? Fine. How was your test? Fine. How was your day? Miserable. They ease into their lives in spoken format, what's to be done about the markets, are you still renting the summer house in Jackson, who's buying what pieces of art and from whom and for how much and from which dealers. The mortgage broker my sister in law referred messed up a big appointment, she was pissed and shot him a nasty email, duly noting that she was "happy" she hadn't referred him to one of her clients. Power. Money. Leverage.

I sat and watched and listened, as I so often do, surprised by my loneliness, alarmed at what comes to my mind. This is my family now. These women in Prada. Across the table, so far away. I know better. I know I should be the one to rise above this. To be grateful. To remember that my dinner costs more than I used to make an hour; to breathe; to be present and without judgement.

In this space, with the benefit of draft and edit, there are times when my internal intentions come out complete, in tact and in their entirety. It is rarely ever like that in my head. Often and in the moment I look at them and see nothing but distance and difference, allocating it to the tilt and shift of the life they live in, pushing it off of my skin to theirs. But when I am alone or reflecting I always return to me: what I could have said or done to make it easier to find connection, to make it easier to feel interesting, interested, relevant, loved.

They don't ask, but I don't push. They don't know the name of the hospital I work at (although they do know that it is not an Important Hospital and so isn't worth mentioning), don't know that there are times when I come home and sit on the cool tiles of my bathroom, clutch my shoulders and sob. They are unaware that the man who I sat with and read excerpts of Robert Kennedy's biography last week died alone in a hospital bed, his loose red beanie still lopsided on his head. They don't ask so I don't tell them that I clung to the metal rails of the supply room for five full minutes just to stay upright because this world is beautiful and cruel and we are only given so much of it. They don't want to hear about it. My sister in law won't take her kids to see Rent. She thinks it is Too Much. They don't need to Know That. I am thinking, I will tell my kids everything that I know how to. And when I cannot use words, then I will show them. I think about my mom, who bought me The Tenth Good Thing About Barney after our first dog died, who sat there with me while I ran overboard with wet and easy tears. She held my hand while I inspected the remains of our dead bunny, surprising each of us early one morning.

But they will tell me, what do I know? They will tell me, just wait, you'll see. When you have kids everything changes. They are unintentionally assuming that the miracle of childbirth will turn me into a different person. They would look at me with shock and disapproval, like when I reach for the bread, if they really knew what was inside of me.

2008-04-16T09:10:00.000-07:00

closing credits

2008-04-15T05:29:00.001-07:00

Yesterday was my last day on Geriatrics. My last day with my senile Attending, my last day on floor eight, with its green walls and lives slowly ending. My last day with the Lebanese Princess who, by no small miracle, I didn't push out a window. It's a day of goodbyes and thank yous and written evaluations. Most Attendings sit down with you, ask you how the rotation went, how they could do things better, what we liked, what we didn't. Sometimes they offer you a job or a reference or an extramarital affair.

The Princess, whom I at once loathe for reasons that betray the inner school marm in me ands slack-jaw marvel for her audacity, makes the following proclamation, "I'm not going to ask (Dr. Attending) because he doesn't like me and he won't give me an A and I need all As because I'm Going To Medical School".

Right. Medical School. I forgot. You're Doogie fucking Hauser.

She continues, "all my Attendings have given me 100% because I asked them to. I've gotten 100% on every rotation this year".

Because that's something you really want to admit in public. To someone who openly wishes a a pack of feral pigeons will peck off your earlobes. Then I stood there, with my mouth open, aghast and astonished, as she proceeds to tell the Senior Resident that he HAS to give her a 100%, the best possible evaluation you could give anyone, the kind of grade you'd give Watson or Crick or maybe that guy who wrote the program for the Human Genome or something. If you were feeling generous. Not someone who has difficultly pronouncing pancreas.

And he did it. He did it. It was really quite something actually. I was completely and utterly amazed. Astonished really.

My hospital: medical integrity at its finest.

weekend edition

2008-04-14T04:14:00.000-07:00

I went out "the country" weekend with my mother in law. Just her. This is not an unusual occurrence and proceeds a little something like this.

propriety

I do this every time. Every single time I go out to "the country" thinking that it will be, actually, in fact, just hanging out and lazing around the house no need to bring anything special we're just going to cook and enjoy ourselves and not, we're going to drive into East Hampton and I'm going to follow her around to stores that sell $25 hand soap and $350 cardigans wondering why on godsfucking earth I fell for it again and left without at least washing my hair. Such that the shitty little finicky gay boy behind the counter folding the $450 jeans with platinum inlay tissue paper will openly smirk at me with exasperation and pity and I will want to sidle up to him and say "fuck off Frenchie, I know you bought your jeans at American Eagle".

But instead I have to suffer standing in front of those full length mirrors in jeans that are too big for me a white long sleeve tee with a coffee stain on the elbow (I have no idea) and flip flops waiting for her to decide on Mustard or Mud. Or maybe both? BECAUSE WE WERE SUPPOSED TO BE HANGING OUT AT THE HOUSE. While shit head with a pompador behind me shakes his head and my mother in law, who has given me the kind of stuff that could have funded a small nation, sifts through the hangers wondering why her daughter in law can never figure out how to put together decent outfit already.

glass house

My mom calls. Often she feels left out and far away, living an entire continent and half an ocean away. She is in an unsettled place, getting ready for retirement, watching my niece and nephew grow by inches and feet, helping my father, her ex-husband, say goodbye to his parents, her ex-in-laws, over the last few months. She is resltess about life and not wanting to let anymore time without each other accumulate. So she calls. Because she knows I am out there, because she knows what I'm up against. We talk. About the kids and our plans for this summer, when will the house will done, when will the construction will even begin, when will you be in New Hampshire? All questions I don't know the answers to, and she knows it, but we talk about it anyway, because it makes her feel included in my everyday life. I hang up the phone and smile, thinking about my mom, so far away, plotting our final escape as far west as it will take us. My mother in law says:

"God, I can't believe you have to put up with someone who talks so much. I mean, she talks all the time, does she ever stop talking? I could never put up with someone who talks so much. I mean it just seems like all she does is talk and talk and talk and talk and it must have been so hard for you, you must be very scarred".

"Um, no, not reall-"

"I mean, she's so self centered, all she thinks about is herself. I would never do that to my children. I would never call them up and ask them so many questions. I mean I just think if they want to tell me they will. I'm sure it's because I had boys and your mom was never close with your brother, so she never learned these lessons, but I would never go about interacting with my children, how do you get a word in edgewise?"

"Well, actually-"

"I mean, I could just never be with anyone like that. Just the other day I had to tell _________ that I can't spend time with her anymore because all she does is talk about herself. She calls me up and just starts talking about herself and it's like and I just can't have that. I have too much going on in my own life to have to listen to everyone else's problems, you know? I mean, what with everything going on with ________ and then there was the _________ I just don't want to do it anymore. I can't see how you do it. I wouldn't do it. If it were me I woundn't do it. I mean I know you feel like you have to do it but I woundn't do it I don't know how you do it. You must be very scarred."

"Yeah, it's really not like-"

"I mean she's a lovely woman and all, but if she were my mom? Well."

"....."

stones

My husband's best friend died eight years ago. From a drug overdose. His family is a Very Big Deal. Like in a Global way. Every year people fly from all over the planet to gather at his grave and remember him. It is many things. It's a still sorrow existing in dozens of people who come, year after year, to remember their friend, their cousin, their nephew, their brother. It's a hard beauty, surrounded by so much spring. It's a lot of laughter as people gather together whose lives have otherwise splintered apart, it is a reunion, a recollection, an embodiment of joy and remorse. I have been twice now, and each time I walk away thinking it is a thing of beauty, it is an amazing feat and a testament to the strong bonds of love and sorrow.

She asked me if she could come with me this year, she hadn't been in years. I was going alone, Andy back in California tying up our loose ends. I said yes, of course, how lovely. I had no idea.

Saturday night, before leaving the next morning to the cemetary.

"God I do not want to go to this thing tomorrow"

"...?..."

"I mean, this is so fucked up. This whole thing is so fucked up. His parents killed him, they're the ones to blame, they probably want to die from the guilt. It's all their fault, if they had ever said no to him once in his entire life he'd still be alive today".

"...."

"I mean, it's so absolutely fucked up. Everyone around him is to blame. Every single one of his friends is completely to blame here. If they had just picked up the phone once, just once, and told his parents, he'd still be alive today. I will never forgive any of them for not speaking up."

"Um, actually-"

"I mean, whatever. He killed himslef. There's nothing any of us could have done. He was totally self absorbed. He thought he ruled the world. He was a little Prince and untouchable. There's nothing any of us could have done to save him. It's all his parents fault".

"...."

sunday
Driving home, at last, after its all over, all done, listening to New York NPR. There is a discussion on Fur: Couture At The Cost Of Morality? There is a man on the panel, giving out all the names of "fabulous" designers who design without fur, would never use fur, whom all the stars love and adore.

A woman interrupts him. "Yes, but David, I had this problem just the other night. I was going to the Opera and thought to wear my grandmother's fox stole. I mean, it's already dead, why waste it you know, AND BESIDES, David, if you can't wear fur WHAT WILL YOU WEAR TO THE OPERA?"

At which point I rolled down the window, unbuckled my seat belt, and jumped into traffic.

daylight saving

2008-04-11T04:28:00.000-07:00

So it was finally sunny yesterday, and warm. I mean, really warm. Like pushing 70 warm. Holyfriggencow. And really, honestly, no joke, the first thing I thought to myself was thank fucking god. I was THIS close to locking myself up and eating oven cleaner.

And now my hypothalamus is finally happy and ~~balanced~~ ~~normal~~ without searing dysfunction and order has been restored. And yesterday was one of those days that frankly make you want to punch yourself in the face. What the hell was my problem? What? What's wrong with New York? Look, its all beautiful and shit.

Ok, maybe that's a lie. But still. It really made me wonder, for a second, why I'm such an impossible cad and couldn't get suck it up and endure. Seven entire months of unremitting trash and noise and freezing cold grey. What? Like that's so hard?

maslow

2008-04-07T13:19:00.000-07:00

Uncertainty

Sometimes everything is cloudy and my mind feels like its wearing the wrong pair of glasses. Sometimes I stand there, wishing with every cell in my body for the escape hatch to materialize, for the lever to pull it, to miraculously, mercifully fall into the floor. Sometimes I have no idea what the point of these last 9 months has been, save to serve clear concern for my mental sanity. Sometimes all the information is right there, I've got it. Sometimes, usually, the paltry information fed to me on small spoons isn't enough and I take huge heaps of more, and I love it, sitting late in the lamp light of my bedroom, paging through texts. Sometimes, though, it's like I'm living in a bank of fog and I can only vaguely make out the shapes and sounds of all that I thought I'd learned so far. Sometimes all I think I've learned is how to beat the shit out of multiple choice exams, but that I know nothing in practice. Sometimes all of it is on the tip of my tongue, it's right there but not; sometimes its something I've looked at a million times before, but have only organized it in my brain as the answer to a test question, not a clinical entity in real life. Sometimes I'm certain it's because I have been taught little to nothing, except that I "need to know that". Sometimes I'm certain its because we are routinely ignored and alternately chastised but rarely instructed. Sometimes I blame it on the fact that I've yet to get my hands on a complete medical record, one with writing I can decipher or pathology/imaging results I can correlate anything to. Sometimes its so easy to blame this system, the institution. But sometimes, lots of times, sometimes I'm pretty sure its me.

Therapy

Running is the only thing that makes me feel better, so I do it. I'm no longer strong, am deeply deconditioned, and there is no peace or quietude to be found within the distances I can run to. So instead I try to outrun the static and manic, reliable pieces of this life I'm in, my head or my heart. I'm not sure. Running is the only thing that makes me feel better, so I do it, trying to quiet the quick pulses within. There is no quiet to run into and there is little space to open up and there is no dirt to pound over, but running is still the only thing that makes me feel better, so I do it. Running forward, running ahead, running away, around, before and back again. Peace through exhaustion; quiet body, unsettled brain.

Joy

In the slanted, half-empty light of spring I can still walk barefoot through the sand. It's been a long journey to come here, to my mother-in-law's house, amongst the auspicious lawns of East Hampton, but I am ever and always grateful for it. And just like that, it's still and settled. And I can wear flip flops and jeans, easy in a sweatshirt. And I can walk to the shore and bury my feet and see the ocean and look out, again, to the big wide blue. Standing, dizzy, breathing deep, happily again at the very ends of the earth.

serenity now

2008-04-04T14:12:00.000-07:00

Wading today through the new puddles of April, dutifully on my way to the train, I pass by a man in a black SUV at the exact moment that he lays on his horn. For seven full seconds. Seven. One Mississippi two Mississippi....all the way to seven. It's 6:35 in the morning.

A few feet front of me a woman is pushing a stroller, all wrapped up in plastic, through the cracks and pools of rain. She stops abruptly such that we almost collide and as I pass her she reaches out to the front of the stroller, screaming Goddamnit Johnny stop fucking with the plastic!

I am this close, I think, to buying a box set of Nature Sounds: Call of The Wild to Ocean Blue. Because the few intact shreds of my corpus callosum are about to explode.

********

I am shy. I hate attention. I fight the urge and act of fainting whenever I have to talk in front of more than one person whom I haven't known for a year, minimum. I sit in the front of class because, when I have to ask a question (because I always have to ask a question) no one can turn their heads and look back at me, face me full and frontally, make my heart pound and sweat. I am not an eye contact maker. When people compliment me ever, on anything, I am always so shocked and mortified that I invariably say something really inappropriate and aprospo of nothing. "Oh wow, thanks. I actually stole this from an old lady. HAHAHAHAHAHAH". Hands flapping uncontrollably at my sides like an encephalopathic ostrich.

And yet, I walk now--in the hospital, on the streets, along the crowded sidewalks--belligerently making eye contact, unyielding in my hellos. Especially in the hospital, always in the hospital. It is, I can see now, the only way to survive. To force contact, to create connection, to make me human, to make us collective, to make me to others tangible and real. And when I say I would never have done this a year ago, it is both that never before would I have willingly, intentionally, systematically called the attention of a stranger onto myself and also that I never lived a life like this, feeling so separate from those around me. In this way, in this wonderfully curious way, I am so very changed by this city.

*******

My patient is dying, very painfully, of metastatic prostate cancer. It was diagnosed late, as it is with so many of our patients, after it had spread to his lungs, invaded his bones. He came to us like something out a textbook: elderly man presents to ER complaining of back pain. An xray is taken and on it you see lytic lesions in the lumbar and sacral vertebrae. What's the most likely diagnosis? But he, despite this sadly generic pathology, is nothing to me most likely. He is a 79 year old man, lucky enough to have a bed by a window, spending his days slowly in pain.

We met at the beginning of the week. In a rush of informality I was assigned to him, patient is in room *** go get his history and present his case. Almost as an afterthought, distracted by his discharge papers, the resident brushes me away to him.

I read his chart, review the CT, the MRI, the series of xrays. The lab work is dismal but nothing is worse than his films. He has a 4 x 3 cm metastatic lesion in the middle lobe of his right lung. There are lytic lesions in 4 of his 5 lumbar vertebra, and they have all collapsed onto each other. His has a lesion on the 4th and 5th cervical vertebra and they are threatening to collapse. If his spinal cord becomes compressed he will be a quadriplegic. If the lesions go any farther up, it may paralyze the nerve that allows the lungs to inflate. There is much to worry about with him. The least of which seems to be his pain. The constant, unremitting, intractable pain.

We sit in the thin grey light of early morning in a room with a window. Every movement for him is agony and I have forgone the physical exam beyond any region not immediately accessible. The bones of his sternum protrude out by inches, the inappropriate invasion of a distant enemy. This, he tells me, is where it hurts more than anything. All fundamental actions: breathing, talking, shifting his weight render him breathless and panting. I have felt this so many times before, this powerlessness, this inability to ever make it better, and I am no better at it today. It is everything I can do, it is a minor miracle and a major accomplishment, to get the resident to prescribe a pain patch, to consider a pump that he can press himself for some relief.

We stand in the dark part of the hall, near the wall at the back, outside the door, looking in. He needs to get well enough so I can send him to subacute rehab, the resident frets, I don't want him dying on my floor. And in that moment I am struck by such anger and awe, and it is all I can do to keep from wondering, as I peer into the face of one of my teaching doctors, if this is the inevitable outcome for me: worrying about my monthly statistics, angry that "yet another" patient has died on my shift?

reprieve

2008-03-31T11:30:00.000-07:00

There and back again. Back and gone again. I came home, or here, or there, again briefly, shortly, just for a few days. Not enough time, but some time, some time which is more than no time. On Sunday, yesterday, we walked in the low tide onto the green rocks. Wet feet, wet sand, gritty in our toes, all tangled in sea kelp. And it was the sheer bright of noon and everything was thinly glowing and the air was thick and wet with water. The entire world was silver--shining back sharply against all that ocean and air. We sat on the hot rocks in the cool morning and I was at once hungry for everything--needing to take it all in big fists and gulps, choking on the thickness of an old life--and willfully inanimate, trying to freeze out little chunks of time, trying to settle the minutes.

Today we drove up the coast to the airport, and today the world is clear bright blue blown empty by the wind off the water. Driving through Half Moon Bay, I get it. I understand suddenly that I have lived almost all of my life in ambient beauty, lazy and passive in a world of small wonders.