Life’s Little Ironies

Random ironies I’ve been thinking about:

The thing you most need to do when feeling lonely or depressed is the one thing that is hardest to do: call someone, reach out to another person. Taking that step requires more energy than I can muster in those moments.

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Money makes money; the more money you have, the more you can accumulate. The system is unfair and conspires against those who don’t have it. I was struck by this, in a small way, when I went to the bank to get certified checks (bank checks?) for our closing the other day. As a perk of being a ‘privileged’ customer, I didn’t have to pay for the checks. There was a woman being served by the teller next to me who didn’t have a checking account and needed to get a bank check. She was charged – I think it was $5.00 per check. There’s an irony there. The person who could afford it wasn’t charged, the person who could least afford it was. I know why the bank does that, from a business perspective it makes sense. From an ethical perspective, perhaps another model would be better for society. What if bank customers with the financial wherewithal paid more for their services so that people with less resources paid less? Is that blasphemy in our capitalist economy?

Another example – a person with great credit and solid savings gets a low rate on a loan to buy a house. That person pays less for their house and can continue to save and build their financial resources. Another person, with a less strong credit history and less savings, gets a higher interest rate on their loan. They pay more and are likely to continue to struggle to make ends meet. What would happen if the system was reversed?

I can’t imagine the system changing given the vested interests in keeping it the way it is. And some might think it is fair the way it is – they may believe that the rich have earned their perks. I’m not so sure.

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I think she was just trying to be helpful, but she wasn’t. A woman was explaining to me how she manages her diet. She limits her carb intake, loads up on fruits and vegetables, virtually eliminates fats and makes sure she gets her 10,000 steps daily. I was nodding along. She is rail thin, I am not. When new information comes out about diet and exercise, she incorporates it into her routine. I think she was sharing her approach in hopes that I would see the light. As if I didn’t know all of that stuff.

For some of us, eating is mostly about fueling our bodies. Gary is able to approach it that way. That’s not what eating is about for me. Hunger has little to do with it. It is about comfort, boredom, frustration, grief, and joy, too.

Maybe I’m being unfair in assuming that it is easy for the rail thin woman. Maybe she is working hard – actually, I’m sure she is. But, the discipline of regulating her eating comes more naturally. Perhaps it is another of life’s little ironies – those of us who most need to separate emotions from eating, have the hardest time doing it.

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I came across a post on Facebook, from Julian Lennon, though I don’t think he wrote it himself:

Life is so ironic, it takes sadness to know what happiness is

Noise to appreciate silence and

Absence to value presence.

 

It seemed to fit with the way I’ve been looking at things lately.

High Anxiety

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I have always prided myself as someone in touch with their feelings.  I can usually pinpoint the source of my emotions. Frustration with a relationship, disappointment in an outcome, anxiety about a challenge, excitement about an upcoming new experience – I can usually identify what is going on. Lately that ability seems muddled – I’ve had more free-floating anxiety than usual.

I was driving south on the Thruway the other day, heading to New York City for something like the 5thtime in a month (I’m usually excited by the prospect of time in the city). This time I just felt nervous, my brain flitting from one thing to another, I was having a hard time concentrating.  Thankfully I was able to focus on the road – it would truly have been a really bad sign if I got lost. I can make the trip on autopilot at this point. I tried to think through what has been going on, why this unease? Why have I been feeling more overwhelmed than circumstances seem to warrant? Since I was alone in the car, I took the opportunity to try and sort it out.

I am well aware that I am very fortunate, my life is an embarrassment of riches. I try to keep gratitude in the forefront, but, oddly, I find that the more I have, the more I fear losing it. I’m not referring to things (though I do have a confusing relationship with things, I like them more than I should), but to people. Readers of this blog know that our daughter-in-law is expecting a baby any day now. I think humming along in the background of my brain has been an awareness of the risks involved for everyone. I am also well aware of the fact that I have no control over how things will go. If only I could wrap up my loved ones in a cocoon to protect them! Obviously, not an option. So, maybe one contributor to my heightened level of anxiety is anticipation of this big event.

It’s funny in some ways because we spend so much time wishing for things (both tangible things and situations/events) and then when they happen, you realize it isn’t quite what you thought. There are strings attached.

You hope that your child finds a partner in life. But when they do, it changes your relationship (in all sorts of ways, many positive, some unanticipated). You look forward to being a grandparent, but that brings new worries. You look forward to a trip, but then you deal with the aggravation of delayed flights or turbulent weather. You want the luxury of a swimming pool in your backyard, but then you have to deal with the maintenance (a seemingly never-ending source of aggravation in our case). These may seem like wildly different ‘things,’ but there is a theme. There is a cost that comes with the things we want. Perhaps that is obvious, but it makes me stop and think. There is virtue in simplicity. Maybe I should consider Buddhism! The way I understand one of its central tenets is that you shouldn’t become attached to things or ideas – you need to let go of expectations. I don’t know if I can do that.

Or maybe I need to figure out how to not let these things get to me; figure out a way to acknowledge the worry, but then set it aside, especially when there isn’t something to be done.

But, it is so easy to lose perspective. Over the last couple of months, we have been enmeshed in the process of buying a condo in NYC. That’s the reason for so many trips to the city. Filling out the paperwork for a mortgage and shepherding it through the process felt like a full-time job. How blessed am I that making this purchase is even an option? But it is also a source of anxiety. It is a huge investment, the numbers are scary. But then I would remind myself that if it fell through, there was no real loss. And, if we successfully closed on it, and it turned out to be too big a financial commitment, we could sell it. So why did it feel so stressful?

In part, I blame Trump. You may ask, what is the connection? As I was driving down the Thruway, mulling things over, I realized that another large piece of my anxiety came from worries about our country’s future. I happened to be reading a novel, Ready Player One, set in a dystopic future that was all too imaginable to me. I have no faith in Trump, he has appalling judgment and is intent on sowing seeds of hate and fear, and Congress isn’t willing to take him on. The threats of climate change, of civil unrest rooted in the growing divide in this country, of America losing its footing, are all too real. Not to mention the tragedy of gun violence. Making such a huge investment in a time like this feels like a leap of faith, but my faith is shaken.

This unsettled feeling about our future was reinforced by an experience I had on that trip. On the day I was driving, a video went viral of a white guy going on a rant in a New York deli because the employees were speaking Spanish. It is the type of thing that seems to be happening a lot more in this age of Trump and ubiquitous cellphones. One of the reasons I was making the trip was to be at the new apartment for the guy to install cable and wifi. The guy arrived, at the appointed time, and, as is often the case, it took quite a bit longer than expected for him to successfully get things running. He was there for a couple of hours. At one point, while we were waiting for technical support people (he was on hold with his office) to try and fix things on their end, his personal phone rang and he asked me if I minded if he answered it. “If I do, I will be speaking Spanish,” he explained. “Of course you can answer your phone,” I responded. He shrugged sheepishly, as he answered. I moved toward the kitchen to give him space.

As I reflect on this interaction, I realize that I would feel differently if he had been in the middle of explaining something to me, then it would be rude to take a personal call, regardless of the language he spoke. But at that point we were just waiting awkwardly. I had no problem with him taking his call. I thought it was a sad commentary that he felt the need to explain that he would be speaking Spanish. It was a personal call, it wasn’t my business to understand his end of the conversation anyway. When he got off the phone I said we had come to a sad place if he needed to ask if it was okay to speak Spanish. He gave a small smile and another shrug.

During my 2 ½ hour drive and as I continue to think about my state of mind, I have come to a better understanding of what’s been going on. Not surprisingly, most of the issues are out of my control. I decided I need to focus on what I can do to manage it.

These are the strategies I came up with:

  1. Avoid reading dystopic novels (at least for a while).
  2. Reduce the number of times I allow myself to look at Twitter and Facebook to two times per day. Look at blocking some of the more vitriolic sources from my Facebook feed.
  3. Find an organization or campaign that I can volunteer for that is in concert with my values. (Or, alternatively, assuming Dan and Beth will allow/need, help with the baby!)
  4. Devote more time to productive activities, whether it is clearing clutter in my home, doing research for my memoir or talking to friends, spend more time doing constructive things so I don’t dwell in worry.

I hope that isn’t too ambitious. It doesn’t seem like it should be.  If you have suggestions, please share. I’ll report back.

It’s that time again

Another Monday morning. Unfortunately I do not have a blog post ready yet. A combination of the business of life and a minor obsession with Downton Abbey got in the way. I found Downton Abbey on Amazon a couple of weeks ago, having not watched it when it aired originally, and it is official: I am addicted. While I am sorry that I don’t have a post ready, I have been enjoying the series. And, it actually wasn’t the only reason I am unprepared – there are those pesky details of life, too. The amount of paperwork and detail involved in a real estate transaction is beyond belief!

On a more pleasant note, two happy distractions from my writing: Happy Birthday (tomorrow), Daniel! And, mazel tov to the Goland Family!

I will post again as soon as I have something that merits sharing. Thanks for checking in.

The Week That Was

It was tough week for me – so I did not write a blog post. First and foremost, from the time I posted last week, things with Trump got much worse. Perhaps related to that, or maybe not (I shouldn’t blame Trump for everything), I had a stomach bug. Things took a turn for the better when we left for a family vacation. For all of those reasons and more, I was not able to write.

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I will be back next week! Thanks for understanding and staying with me.

Took a break

Sorry that I was not able to post my weekly essay today, but hopefully you will understand. Gary and I were in Spain this past week (!) and I had no time to write and little access to the internet. Vacations are wonderful! We took a whirlwind tour that included Barcelona, Granada, Cordoba, Ronda, Seville and Madrid – fascinating and beautiful places all.

Now if I can just figure out what day and time it is, I will be back next week with more stories. Thanks for staying with me!

Two for the Price of One: Two Views

[Note: Another foray into prose/poetry]

Boundaries and Expectations

 

September 12, 1986

Partly cloudy skies.

Driving home alone, I could barely concentrate on the road.

My eyes welled up.

 

Will I be a good mother? Can I do this?

Minutes before,

what I suspected was confirmed.

This was planned, yet I was overwhelmed.

I took a deep breath,

focused on the road and the sky, made my way home.

 

Into our little brick house.

I rush to the phone to call Gary.

He is still on rounds at the VA.

I have him paged.

It takes many minutes, seemingly forever.

 

Hello, Lin?

I’m pregnant!

Wow! This is such great news!

When do you think you’ll be home?

The usual time.

You can’t get out early?

Linda, you know I can’t.

 

I sighed and exhaled, resigned to this reality.

Okay, we’ll talk later.

I was left to my thoughts.

 

Eight months crawl by.

I was not glowing with new life.

Queasy, tired, morning, noon and night.

Ear infection, bronchitis, heartburn

I didn’t enjoy sharing my body.

 

So many rules:

No caffeine, no alcohol, drink milk

I don’t like milk.

Vitamins the size of Pluto.

Alcohol was no loss, caffeine another story.

I’m responsible for this new life!

I don’t want to screw it up!

 

The due date kept changing.

First May 2, then May 11, finally May 16

That day comes and goes.

The longest gestation in history.

I am ready! Nature has its way, though.

 

May 20 Gary travels to Long Island to take part 4 of his medical boards.

My parents come up from Brooklyn to keep me company.

At 5 pm they leave me with friends and

head back home, Gary is on his way.

I feel some contractions: Braxton-Hicks or the real thing?

 

Gary gets home by 9pm.

My water sort of breaks after midnight.

We call the doctor.

He tells us to come to the hospital.

It is before dawn on Thursday morning.

We put the garbage cans by the curb before going to Albany Med.

 

27 hours, the last 7 hard labor,

an apt description.

First, no progress, then Pitocin – a brutal treatment.

Finally, I push!

Such a relief! My body is almost my own again.

 

4:39 am, Friday, May 22, I look at my baby.

Labor was hard on me, but she is perfectly formed.

She is part of me and yet, she might well be an alien.

We are one and we are separate.

I understand her; I feel her joy, her hunger, her frustration.

But I am clueless, she is a mystery.

 

I fall in love over those first few weeks.

Her wondrous eyes, sparking with light.

Her pink, smooth skin.

She emerges into herself.

Curious, demanding, loving.

 

30 years later and

it is all still true.

 

[Note: Gary’s remembrance of that same time]

September 12, 1986.  I was on rounds when I heard my name over the VA hospital intercom for the first (and only) time in my life.  The operator put me through. Linda tells me that we are going to be parents. You could have knocked me down with a feather.  I was elated and scared and excited.  She asked me if I could get home early that day.  But the patients cannot wait.  I work as fast and furiously as I can to get out early but 10PM is the best I can do.  I remember not being able to concentrate during rounds that day which is the one and only time that ever happened.

That VA rotation was in many ways horrible.  Perhaps it was also an experience in growing up.  The VA is an underfunded, second rate health care system and, in my mind, a poor excuse to offer people who fought for our country and now are down on their luck.  And, to be sure, if you are a veteran and have other health care available to you, you are not going to the VA.  So these are the guys who things have not gone well for after they came back home.

I was an intern along with two others on that rotation.  Claude Scialdone was another intern with me and he was amazing. I can’t remember who the third intern was but it was not someone who did all that much.  Worse than that, our resident who was supposed to guide and support us was an empty suit (perhaps an empty white coat is the better medical term?).  And the attending physician came by in the morning to round, as he was supposed to do, but did nothing else.  So Claude and I were basically two guys just out of med school trying to keep 40 very sick veterans alive with basically no help.

It was frightening and it was exhausting.  On a normal day, when I was not on call, I would get there before 7AM and get home anywhere from 8PM to midnight.  When I was on call I wouldn’t get home at all.

One particular patient still sticks in my mind.  He had been there since well before I started my 6 week rotation and he was often times confused, weak and kept running fevers.  I worked him up for sources of infection again and again.  I ordered chest x-rays to look for pneumonia, urine cultures and blood cultures but they repeatedly came back negative.  I asked my resident about the guy – I told him I was certain we were missing something.  There was something going on and we were failing to identify it.  The patient was treading water at best and sooner or later we were going to lose him.

My resident responded by asking me if any of the cultures had grown anything and the answer was no.  He then explained that this means he’s fine.  He wasn’t fine.  He wasn’t close to fine and I knew that in my marrow, but I was out of ideas and had no help.

At that time, the VA closely controlled the use of the newer, broad spectrum antibiotics.  If you ordered any of them, you automatically got an infectious disease consult.  Normally that might not seem like a problem, but in the Albany VA at that time, it meant you got Dr. Aldonna Baltsch on your floor. Dr. Baltsch was as feared as any doctor I have ever known.  She was a phenomenal, dedicated, passionate physician but she was also a perfectionist with a temper.  She would come in and yell at you for all the errors she determined you were making.  I think she just wanted to make us better doctors but perhaps didn’t exactly know how to go about doing it.  In any case, nobody ever wanted to see Dr. Baltsch around.

For that reason, nobody ever called for an infectious disease consult.  And the interns and residents became experts at using combinations of older antibiotics to avoid the newer ones that came with a dreaded visit from Dr. Baltsch.  But in this moment, I realized I feared the prospect of failing and losing this patient more than I feared Dr. Baltsch.

So I ordered a new wave, broad spectrum, expensive antibiotic when my resident wasn’t looking.  I did so because I knew that, while it would bring the holy wrath of Dr. Baltsch, it would also bring her expertise.  She came up and was really, really angry.  It was as if Mount Vesuvius was going to erupt and the lava would scorch us all.  However, as it turned out, her anger was entirely directed at my resident.  She never even spoke to me – which was fine with me.

And she ordered exactly the same tests I had ordered.  But this time, after they yet again came back negative, she ordered an LP (spinal tap).  That came back negative too but she told the lab to hold onto the spinal fluid sample longer for viral cultures and they eventually came back positive for Varicella (the virus that causes Chicken Pox).  Turned out he had Varicella encephalitis, an infection of his brain caused by that virus.  This is still the only case of Varicella encephalitis I have ever seen.

He was placed on antiviral antibiotics.  His fevers ceased after a few days and he finally started to get better.  Dr. Baltsch called for a special meeting of everyone in the entire department of medicine basically to humiliate my resident.  It looked like vultures picking at a carcass as the entire faculty went after the guy.  I almost felt sorry for him.

That rotation eventually gave way to others, some nearly as hard and some not quite as tough.

But fall turned to winter and winter to spring and then I took my boards exam on Long Island.  Knowing Linda was past her due date and could go into labor at any minute, I rushed through the exam.  It was the only time in my life that I was the first person out of the room on such an exam.  That night, Linda had spontaneous rupture of membranes (her water broke).  We took out the garbage and drove reasonably calmly to Albany Medical Center where she gave birth after 27 long hours of labor.

She was an amazing trooper.  No anesthesia.  One single dose of one pain killer.  Hour after hour.  I spent much of the time with her but also left to do rounds and see patients during parts of the process.  At the end, on May 22nd, Leah emerged, perfect, beautiful, alert and brilliant.  A miracle in our lives who has been such a great joy ever since.

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Just a few hours after birth – Leah looking directly at the camera, alert and bright. Gary, on the other hand, exhausted.

Leah was a force of nature.  It is hard to explain how even in those earliest days she had a spirit and a liveliness and a curiosity.  I felt like she saw and understood the world around her in ways that most babies could not and her smile melted my heart.  Life had taken on new meaning and I fell in love with her.

Still I was torn.  I could not devote less time to my patients than what I felt I needed to.  And yet I wanted to be home; to be with Leah; to help Linda who was in some ways almost a single parent. She was exhausted and I was exhausted.  And I could not do all I wished I could do.  I could not do all Linda needed me to do.

Having already completed all of the hardest rotations in May of 1987, my last rotation of internship was scheduled to be an easy one in a community hospital very near our house.  It was going to be perfect.  I would be working a short walk from our house, the hours would be reasonable.  A long, hard winter was about to give way to a beautiful spring and hours with Leah and Linda.  It didn’t work out that way.  On the day Leah was born, an intern quit the program and the department of medicine met to determine who should cover that intern’s rotation. They decided I should cover it.  I was back in the VA hospital.