I was 29 the first time I should have died. A century ago, childbirth killed more women than any other single cause. Broadly speaking, childbed death ranked third behind all infectious diseases and all chronic diseases but ahead of injury. Not only would I have died before modern medicine, but my baby would have. My pelvis wasn’t wide enough to allow him through. He was three weeks late and weighed more than eight and a half pounds, and I was in labor and fully dilated for several hours when the baby went into what they called “distress.” I know it’s medical jargon, but I can’t help but wonder what isn’t distressing about the birth process.
Caesarians weren’t done very often until the mid-20th century. In ancient Rome, India, and China, fetuses were cut from the wombs of dead or dying women in hopes that the child would survive. More than a millennium later, the Jewish philosopher Maimonides and a Persian epic poem separately recorded that babies were sometimes delivered surgically, but doing so was rare and survival of the mother even rarer. If she did live, she would have no more children. In 1500, a Swiss veterinarian named Jacob Nufer claimed to have performed a successful caesarian on his wife. She allegedly delivered five more children naturally.
Once sterilization and handwashing became more commonplace, surgeons refined the procedure, and more women survived. With the 20th-century discovery of antibiotics to combat infections, caesareans happened more often. By 1991, they were routine. Thank you, modern medicine, for saving two lives with my first abdominal surgery. Modern antibiotics also cured both of us of the staph infections we contracted during the birth experience.
Of course, had it not been for modern medicine, I wouldn’t have been pregnant in the first place, so there’s that.
I was 32 the second time I should have died. My doctor explained what carcinoma in situ meant, and I came out of my second abdominal surgery without a cervix or most of the rest of my reproductive organs. The “in situ” covered a more extensive area than my doctor initially thought. Cancerous cells in my uterus and cysts encrusting my ovaries spelled doom for them, although the doctor scraped the cysts off my left ovary and left it in place so as not to trigger early menopause. Years later, I read The Immortal Life of Henrietta Lacks and was grateful for her unwitting contribution in the 1950s to my survival in 1994.
At 38, I should have died again. At a regular visit for migraine management, my neurologist asked if anyone had ever told me I had a freckle in my eye. A few months later, my optometrist asked if, beyond my usual myopia, I was having trouble seeing. I told him no but mentioned my neurologist’s comment. He picked up the phone in the examination room, called an ophthalmologist friend, and said I needed an appointment immediately, preferably that day. Three hours later, that ophthalmologist told me I would lose my eye and that we could only hope the tumor had not spread into my brain.
I was still traumatized by the first cancer diagnosis. The second utterly froze me. My sister sprang into action and found that the University of Tennessee hoped to pioneer an experimental laser surgery to excise choroidal melanomas. I was the first patient in its new program. Today, I have a blind spot and a lot of floaters, but I still have a functional right eye and the satisfaction of knowing I survived a rare cancer relatively unscathed.
My paternal grandmother, whom everyone said I strongly resembled, died at 39, three months after being diagnosed with leukemia. Medicine came a long way between 1952 and the 1980s when her brother was diagnosed with the same disease. He lived to die of something else years later. Nevertheless, when I passed my 40th birthday, I sighed with relief to still be breathing.
I might have died again at 50, but I definitely would have at 52. My first bout of diverticulitis, which felled me at my nephew’s high school graduation, resolved after a brief hospital stay and a hefty dose of antibiotics. A year later, the second episode perforated my bowel. I failed outpatient antibiotic treatment and ended up back in the emergency room. After another hospital stay, another dose of hefty antibiotics, and yet another hospital admission, I underwent my third life-saving abdominal surgery. Four days later, the spot where the surgeon reconnected the healthy parts of my bowel failed. Partially digested food seeped into my abdominal cavity. I remember screaming, screaming incoherently with the intense, burning pain, and nurses trying to restrain me.
Peritonitis, which inevitably causes sepsis within 24-48 hours, killed all its victims before modern surgical techniques and antibiotics. It killed my 24-year-old great-grand-aunt Kate Reinhardt a month after her 1902 wedding. Had I not still been in the hospital, it would have killed me in March 2014.
A week later, I woke up in the ICU after my fourth life-saving abdominal surgery. The surgeon had split my abdomen in a jagged line from the old caesarian scar to a point several inches north of my belly button. I did not leave the hospital for five weeks.
The surgeon had not stitched or stapled me back together. I had to heal “from the inside out.” In addition to a colostomy bag, I had a wound vac. My surgeon told me he didn’t know whether I had enough of a colon left to reverse the colostomy. Regardless, I would not be strong enough to survive another surgery for months.
Several weeks later, my son and I walked around our neighborhood as I tried to build strength. As we climbed Oak Street toward Hill Road, I felt something pop in my abdomen just above the bag that hung from my left side. I made an appointment to see my surgeon. Despite what was evident to me, he seemed mystified that I suspected the soft protrusion from that spot might be a hernia. Yes, I had a stoma and a still-unhealed surgical incision running most of the length of my torso, but surely the integrity of my abdominal wall had not been breached. He shrugged, pronounced me mistaken, and sent me home.
I resent gaslighting. There was no way I would allow that jackass to cut into me again. I found a different surgeon to reverse the colostomy. He assured me he would repair the hernia at the same time. I was relieved to wake up from my fifth abdominal surgery without a bag. I was disappointed that the surgeon had neglected to repair the hernia, which protruded from my belly like a cantaloupe when I stood. When I asked why, he shrugged. Doctors seem to enjoy shrugging.
I hired a personal trainer. I worked to regain core strength. Another enormous hernia popped out from the lower right side of my abdomen. Eventually, it grew to the size of a honeydew. I asked my doctor about surgery to repair them both. I was uncomfortable and limited in movement because “melons” clung to my midsection. The last thing I wanted was another abdominal surgery, but this was ridiculous. “Lose weight,” my doctor told me, and shrugged. Oddly, I could find no evidence to support weight loss as a cure for hernias. Perhaps my Google-fu was insufficient for the task.
Two years later, my gallbladder had to come out. The surgery typically takes about half an hour. Because of the extensive scarring and adhesions from the third, fourth, and fifth abdominal surgeries, my sixth abdominal surgery took over three hours.
I’ve lost weight, although I still have virtually no core strength because of these impeding hernias. I haven’t tried to die recently, and I’ve been cancer-free for over 20 years. Plus, I have a new doctor who doesn’t gaslight or fat-shame me. Last week, she ordered a CT scan of my abdomen to pave the way for a referral to a surgeon to repair three hernias – I added a third one last summer. Yesterday morning, she called me with the scan results.
I’m not going to be able to have the hernias repaired yet. First, a gynecological oncologist will have to remove the three-inch tumor the scan discovered on my remaining ovary. I wish I had endured early menopause instead, but hindsight and all that.
I’m glad I got the scan. Otherwise, it might have been too late before I learned that I had unlocked the cancer trifecta achievement and that I needed that seventh abdominal surgery to save my life for the fifth (or is it the sixth?) time.
“Good thing you’re a cat person,” my sister told me earlier this year. “You need to borrow all their extra lives.”
Pardon me while I bitch. This is not a political rant. This has nothing to do with social justice or a better word for humanity. This rant is all about me me me. So, if you aren’t interested in the self-absorbed ravings of a cranky middle-aged white woman, this post is not for you. Frankly, I can’t imagine that anyone would be interested, but it’s cathartic to write it out, so here goes:
I am sick of waking up every morning with a migraine. Today is day 57. Consecutive day 57 with no break. Every day between 4 a.m. and 6:30 a.m. I wake with a pounding skull.
Sure, the drugs usually knock it out, but it takes at least an hour for them to work – if they work – and they work best if I go back to sleep for at least 30 minutes while they’re taking effect. Since I can’t go to sleep on command, especially with a jackhammer or icepick working my skull, it’s not like I can set an alarm – half the time I wake up two hours later. This is really cutting into my day and what little productivity I can actually eke out between browsing Reddit and clicking links on Facebook. (Which, of course, are the prime reasons to get out of bed to begin with, right? Except I have a laptop and an iPad, not to mention a phone, so I could do that from under the covers…)
I have a job – although I’m self-employed because who would hire someone with more sick days than good days? I volunteer. I have clients and people and organizations I’ve made commitments to, and it’s getting harder and harder to meet those commitments. I only take cases without crushing deadlines.
I make those commitments because I care passionately about the world I live in, and I want to make it better. That’s why I became a lawyer to begin with – to help improve the world. It’s why I volunteer with some of the organizations I volunteer with. (I volunteer with the others just because I love history.)
Some days I can’t get out of bed. Some days I have to stay under the covers in a dark room with my handy barf bowl within reach. Sometimes I have multiple days in a row like that.
Life with Migraine
I’ve had migraines all my life. I was diagnosed in fourth grade when my mother and teacher became concerned. My vision faded and blurred during class when I had tremendous, pounding headaches. The really bad headaches came only occasionally, usually just three or four times a year. I had smaller ones frequently, though. The pace of my most severe headaches increased as I got older. I’d have bad ones as often as six or eight times a year throughout the decade of my 20s. I had a small sofa in my office so that when they hit, I could take a nap until the painkillers worked. Back then, there were no such things as triptans, and I didn’t want to go home if I could possibly remain functional. I had too much to do. Over-the-counter medications had virtually no impact. I tried them all. The only things that got rid of the worst headaches were narcotics, sleep, and time.
Three or four times a year, only time cured them. I would spend two or three days in blinding pain, vomit uncontrollably, and long for something as soft as it was cool. My pillow was too hard. Rolling over in bed meant torpedoes homed in on my cranium, unleashing their fury. But these bad headaches only happened three or four times a year. They were definitely inconvenient, but I could deal with them.
The Tipping Point
In 1997 I was in an auto accident that resulted in severe whiplash. Within a year, I was having severe headaches weekly. Then the time between headaches narrowed to the point that I would have only three or four days between attacks. The attacks themselves lasted two or three days.
I had a client who was a doctor. “Is this stress-related?” I asked him one day. “Probably,” he answered, and wrote me a prescription for a tranquilizer. It didn’t help, except to help me sleep when the headaches came.
I went to a clinic that specialized in headaches. “Live with it,” the neurologist there told me. “There’s nothing we can do but manage the pain, and we’ll do that without painkilling narcotics.”
How do you “manage” pain if there’s no way to treat the underlying cause and painkillers aren’t an option? I didn’t go back.
When one migraine had already lasted for two days and I couldn’t stop throwing up, my husband took me to my regular doctor. They gave me shot of Imitrex. It didn’t work. “It’s not a migraine if Imitrex doesn’t work,” I was told. It was bad information, but that was typical of what I had already encountered. Even the doctors had no clue.
Finally, a friend of my sister’s who worked in the ER of a teaching university got me in to see one of the top neurologists at the medical school. I met Lee Archer. He is not just my doctor; over the last 15 years, he has become my friend.
The first thing he did was prescribe Imitrex. I told him about the time I was given a shot of it that didn’t work. He shrugged. “If you wait too long, and if the headache is too far progressed, you really do have to ride it out,” he told me. “Take the pills when you sense the aura, or, if there’s no aura, as soon as you feel it coming on.”
Imitrex is a miracle drug.
I don’t mean “miracle” in the sense that it has supernatural, non-understandable properties. I mean that it really does stop a migraine in its tracks, and it does so without significant side effects. Imitrex gave me a semblance of a life back. That, to me, is miraculous. I don’t know who stumbled upon the formula for Imitrex, or who found that it worked for migraines, but they are a hero.
But the headaches still came too often – I was limited by insurance to nine of these precious doses a month. Since some headaches required two doses, we had to find some way to prevent them from happening as frequently.
I’ve tried every prophylactic out there over the last 15 years, from beta-blockers to botox to butterbur. (That’s just some stuff I’ve tried that starts with B. I’ve been through the rest of the alphabet, too, including A, which included acupuncture, which … don’t even ask. Yes, I am desperate enough to try powdered horn of tiger testicle at this point if some witch doctor hints to me that it might work.)
Add to that, I saw a Huffington Post report a couple of days ago that included an appearance by the mother of Melissa Dwyer, a 22-year-old with daily migraines who finally killed herself this past summer because she could get no relief from any medications anymore. At 22, her life was effectively over, so she ended it. I understand it, but I don’t have to like it.
When the last of the meds stop working, I won’t have any desire to continue living in constant debilitating pain, either. What will be the point? I will be of no use to anyone, and I will have no quality of life. Already I can’t take care of myself when the headaches are bad. I don’t know that I could get out of a burning house, or even dial 911 and coherently ask for help. My migraines are often accompanied by transient aphasia. Yes. Me. A woman who talks and writes and wields words for her vocation and her avocation has aphasia. The worse the headache, the worse the aphasia.
I long ago passed the tipping point. Since 1997 I have had more migraine days than pain-free days. That’s 16 years.
When I don’t feel well, I get cranky. I avoid people because I know how miserable it is to be around me. Just ask Jane. She was my paralegal for more than 15 years, and she’s still my best friend. She has seen me deteriorate over the last (almost) 20 years. She’s seen me fall into a deep depression and she’s been there to cover my ass and to prop me up when things have been worst. No one else has ever done for me what she has – not anyone in my family and not any other friends. Now that we aren’t working together I miss her tremendously. Without her, I’ll be dead, and the cats will have picked my bones clean a month before anyone discovers my body.
Plus, I’m an organ donor, dammit; suicide’s just not an option under these circumstances.
Prior to finding my current neurologist in the late 1990s, relief only came from narcotics and Phenergan, both of which are still in my diminishing chemical arsenal – diminishing, because after a while, drugs just stop working and for some insane reason doctors just won’t increase the dosage to toxic or lethal levels. (I know. I don’t understand, either. If Westley could develop an immunity to iocane powder, then surely by now I am immune to poppies.) The neurologists before my present one told me I’d just have to live with the headaches and good luck with that.
There is nothing worse than a doctor giving up on you – and telling you to give up, too.
Lawyering with Migraines
I’ve quit practicing law twice, the first time in 2001. The headaches were awful then, but I had enough of a financial cushion that when Jane’s son was born we decided to scale back the law practice and work from home, only taking the cases we really wanted. That was a good decision, but significant necessary cost overruns on a home remodel coupled with the financial crisis in 2008 torpedoed my portfolio. I no longer had a choice, so I went back to work full-time.
I quickly realized I wasn’t up for extended litigation or stressful cases. Despite that, the following year I foolishly created a law firm with two other lawyers. By the fall of 2010, I had to completely stop going to court on contested cases. I couldn’t – and still can’t – reliably know if I’ll be able to function well enough to advocate for a client, and the anxiety over being able to function is as debilitating as the migraines themselves. I didn’t tell my law partners. I was afraid to. I just got our associate to go to court with or for me when I couldn’t settle a case to a client’s satisfaction. I called it “training.”
Did I mention that depression and anxiety are byproducts of chronic migraines? Depression is crippling. Anxiety is eviscerating. Of the two, my anxiety is far worse.
Here’s a fun fact: migraines exacerbate anxiety, which in turn exacerbates migraines. It’s a never-ending feedback loop that intensifies with each completed circuit, and at some point should equal and then exceed the electromagnetic strength of CERN’s Large Hadron Collider, at which time I expect a black hole of misery to singularity itself into existence. Maybe a new boson will be discovered when the whole thing implodes. Let’s hope so, for science.
Here’s another fun fact: in the throes of a migraine, movement hurts. Every doctor I’ve ever been to tells me to exercise. Sometimes I can’t even turn my head without feeling the whole world ripple, and they want me to exercise. I tried. I paid a personal trainer for several years. Cardio workouts invariably gave me a headache. If I was using enough weight in resistance exercises to do me any good, the effort made the blood pound in my brain. I did it as long as I could, and finally, I gave up. Some days I can’t even walk up the stairs in my own house. It’s not my knees or my back that object – although they do. It’s my throbbing head. That much effort is just beyond me some days. Sometimes just walking across the room takes herculean effort.
Crisis
In the summer of 2011, things fell completely apart. There were damaging forces undermining me other than my deteriorating health, although I wouldn’t know that for another six months. I kept trying, like Sisyphus with that impossible boulder, not knowing that those other elements were working against me. I knew about the health issues and knew I was pushing that rock uphill. I just didn’t know that there was no way ever to get the rock to the top.
The feedback loop grew worse. I was working eighteen-hour days and accomplishing virtually nothing. I couldn’t sleep, because the lack of accomplishment made me extra anxious. I was at the office before 7 a.m. Except on nights when Socrates Cafe met, I didn’t leave until after 10 p.m. and often didn’t leave until after midnight. Even on weekends.
The lack of sleep showed in the quality of my work, and in my ability to work. I fell asleep during meetings. I fell asleep during telephone conversations at the office. I fell asleep mid-sentence, then would wake with a jerk. And the migraines just got worse. Instead of taking me off them, when I complained to my doctor that one of my six daily meds for migraine/depression/anxiety was contributing to the lack of sleep, he actually increased the dose. I stopped sleeping at all except for an hour or two a night when I would doze fitfully as I lay, frustrated at my inability to really sleep, in my bed. Night lasted forever, every single night.
Guess what happens when someone doesn’t sleep? Well, when a migraineur doesn’t sleep, her migraines get worse. I was giving myself shots of Imitrex at least once a week, and saving the shots for only the worst of the headaches. The worst came that often. And when anyone doesn’t sleep for a long enough period of time, she starts hallucinating. “Long enough” in this context was just a few weeks – at least, that’s when it finally dawned on me that shit was seriously fucked up.
My hallucinations weren’t the surreal technicolor movie we’ve been told happens with psychedelic drugs. They were subtle. Out of the corner of my eye, I’d see a shadow. It was a beaver-shaped shadow, maybe a nutria or groundhog. It sat on its hind legs and teased me from the periphery of my vision. I knew it wasn’t there, I knew it wasn’t real, but I kept seeing it. After a couple of weeks of this, it was joined by a crab-walking kind of prehistoric hominid figure.
The paleo-geek in me wanted nothing more than to get a really good look at this new creature. I knew it existed only as a result of sleep deprivation. I knew full well it wasn’t really there. Intellectually, I knew I was hallucinating. But the opportunity to observe an ancient hominid was about the coolest thing ever. Frustratingly, he stayed just in the corner of my vision, too, so I couldn’t get a good look at him. When I tried to look directly at any of these nutria or hominid-shaped shadows, they’d skate even further to the periphery, or they’d disappear entirely.
These critters never darted in front of me, they never stood where I could take a good, long look at them, and they were never more than shadows. This went on for about two months.
I finally gave up when things at work got so bad that I missed the third paycheck in a row. For about a year my paychecks had been spotty, and as a result, my finances were in a disastrous state. I had humbled myself to ask for help from my mother – at 49 I felt like a complete failure asking my mother for money. I was working 18-hour days, migraining almost constantly, not sleeping, seeing shadows that I knew weren’t there, and I couldn’t pay my mortgage. I was in a constant and frantic state of panic about money. And in early September 2011, the bottom officially fell out.
Without a bottom, there’s no limit to how far one can fall.
In early September 2011, I had my first panic attack. It was the first of many to come. Very few people knew that, and of those who did, none cared. They thought I was being silly. Heart palpitations, escalating circular thoughts spiraling upward in intensity, cold sweats, shortness of breath, and the inability to stop crying are not silly histrionics. No one chooses to experience these things, and no one wants to experience them in public. Certainly, I did not want to experience them in front of people who looked at me with narrowed eyes and a curtly dismissive attitude.
They told me to stop crying all the damn time. They wanted me to get over it, whatever “it” was.
I didn’t have these attacks because I wanted attention. I wanted anything but the attention they garnered me. I wanted to be able to interact normally. I wanted to laugh. I wanted to enjoy life. I wanted to enjoy my son’s company, revel in my nephew’s accomplishments, and interact with members of my family normally.
I wanted to stop crying all the damn time.
I would have if I could have.
Mental health crises are very poorly understood by most people in general. Someone having a “nervous breakdown” is scary to those who see it. It’s not nearly as scary to them as it is to the person experiencing it, though.
I went into an intensive therapy program. My family supported me going into therapy but had the impression that when the intense program was over, I’d be “fixed,” back to being the old me, and things would return to normal. They had absolutely no appreciation for how hard it was just to get up in the morning – not because I was depressed, but because I was sick.
Practicing law full-time was off the table, so I needed to create an entirely new career for myself out of thin air. And this new career, whatever it might be, had to provide me with enough income to be able to support myself while allowing me the luxury of having chronic, debilitating, disabling migraines more days than not. This crisis was a crisis of physical and mental health, sure, but there was a hell of a lot more to it.
For more than a month, the migraines grew measurably worse. I had to have shots of Imitrex every day for four solid weeks. I dropped everything: work, the activities I enjoyed, the friends I had, and even Socrates Cafe, which was by then the only thing I still did for pleasure.
I didn’t recognize myself anymore. I used to be competent, intelligent, organized, articulate, practical, strong, and forthright. A driving force. A hard worker. Diligent. Steadfast. Calm. I had never become part of any organization that didn’t then make me its leader. Sure, I procrastinated a lot, but I got stuff done. Now? Now I was a shell. I was fragile and tender. I couldn’t hold a thought in my head.
My family usually saw me in tears when they saw me at all, which was rarely. They were disgusted with me. They had absolutely no understanding of what was happening to me physically, fiscally, emotionally, or psychologically. They treated me like I was an addict who just needed to get my shit together. Tough love would take care of the problem I had become. In fact, they used the same methods and phrases on me that families of addicts are taught to use with their addicted loved ones. (There are addicts in my family, but I’m not one of them except when it comes to complex carbohydrates.)
Their criticism and their judgment and their lack of sympathy cut me to my core. They never asked how I was doing. They ignored me except when I had to reach out to them because I needed something from them I couldn’t get elsewhere.
I’ve always had social anxiety, but it was a lot worse during this period. They were completely clueless, and I knew of no way to clue them in. I doubt they even wanted to be clued in. As best I could tell, they believed they knew what was going on with me. I just needed more therapy. I just had to pull myself up by my bootstraps, after first designing the bootstraps and attaching them to my heels, of course.
When one has to put one’s face deep into quicksand to even figure out if there are bootstraps hidden somewhere down there to tug on, such an attitude from the people we need support from is hardly “supportive.” Furthermore, I didn’t need talk therapy. I needed practical solutions to very concrete problems, and I was fresh out of ideas. I needed a plan. I was expected to come up with it on my own, out of thin air. I couldn’t possibly do that, in the midst of a crisis and alone.
I had never worried much about other people’s opinions of me, but suddenly I was acutely aware:
I had been weighed. I had been measured. And I had been found wanting.
When the people I needed support from the most made it clear that they were not sympathetic, the impact hit me as forcefully as Ademar’s fist hit William’s gut.
I reached for someone, anyone, who might be. One couple who I had considered to be close friends reacted awkwardly when I told them what was happening. They backed away nervously, and our friendship never recovered. Another friend was sympathetic but had problems of their own. Another wanted to be supportive, but our relationship had never been one of sharing intensely personal stuff, so I dropped it. It just didn’t feel right. (In mid-November 2011, at Skepticon IV, that friend and I sat next to each other in the second row with tears streaming down our faces as we listened to JT Eberhard talk about his own breakdown. JT’s words didn’t just hit close to home, they bombed me like a Blitz.) Another friend I reached out to told me that they’d been there and done that, lost everything, and moved on. I felt guilty burdening them when I couldn’t figure out how to move on.
In the summer of 2011, an old romance started to flare back up when an ex-boyfriend and I encountered each other at Socrates Cafe. We didn’t see each other daily but talked regularly. During the period of intensive therapy, he was the only person who made sure to talk to me every day to check on me. He had a crisis of another nature during that time, though. He hung on gamely until Thanksgiving, at which point it was way beyond time for me to give him permission to say goodbye. He was a champ as long as he could be, and loyal to his own detriment. He was the only unselfishly supportive voice that spoke to me regularly and consistently during the worst of that time, and I will forever be grateful to him for that. Once we said goodbye, I had no one.
I was afraid of being isolated, but I was more afraid that I would spiral downward emotionally if I didn’t interact with people. I made an effort to reclaim the positive parts of my life. Things still weren’t good, by a long shot. I had days at a time when I could not make myself get out of bed. There was no one there to care. I stopped trying to make meals. I didn’t have the energy to plan and cook them. There was no pleasure in the effort – and I used to love kitchen chemistry. I gave up on dating. Sharing the mess I had become with someone else would not be fair, right, or kind. It certainly wouldn’t be loving.
For the next nine months, I had no bottom. There was no light to show me how I might get out of the situation I was in. My ragged fingernails clung to a single strand of rope that barely held me above a yawning chasm. It was a very spongy and porous rope that sometimes dissipated almost entirely. Mostly I dangled from it, but occasionally, on rare good days, I was able to climb up and stand on it like a tightrope walker. Standing on it and stretching, I couldn’t reach up far enough to grasp the edges of the bottom I knew had to be somewhere above me. But the source that provided the tightrope regularly threatened to take even that away. Despair consumed me. I made futile stabs at reorganizing my life, none of which were realistic given my limitations and my needs. I had no hope.
Deus ex machina.
A year after that day in September, a light finally broke through. I looked up. There was an end in sight to at least part of my problems. I suddenly had something I could sell to ease the financial stress, and then, with that part of the burden lifted, I could focus on healing. The migraines didn’t go away, but the rope I was dangling from slowly started rising. The pain-free days started looking a little brighter.
In December 2012, things got measurably better. I closed on the sale of two investments, which finally allowed me to breathe financially. I now have a bottom, and instead of it being somewhere over my head in the ether, I’m at least sitting on it. I can touch it. Of course, December 2012 was when I was held at gunpoint for half an hour in my own bedroom, so there’s that.
Finding that bottom made things better. I still have days at a time when I can’t get out of bed. I rarely cook. I still can’t imagine anyone being willing to share their life with me. Some days I still can’t think straight. It’s as though someone has played a bad game of golf in my head and left gaping divots where important parts of my brain should be. I feel the bruises from the ricocheting balls.
Unless it’s so bad I can’t get out of bed, even when I have a migraine I force myself to get out of the house to do the things I still can. The two hours a week spent at Socrates Cafe is still my favorite activity, but more and more often those two hours are more than I can handle. I go to gatherings with my friends and drink soda water because alcohol triggers migraines. (Hell, everything triggers migraines.) I host parties because I can’t drive with a migraine. More than a few of those parties have lasted longer than I needed them to, and seeing the last guest leave has been a relief. I don’t want anyone to know when that happens.
I hide my headaches from other people. Only a few people know that I have them so often. I doubt most have any idea that I’m often on painkillers when they see me. Instead of incapacitating me, like narcotics tend to do to people who don’t have to take them often, they are what allow me to function. I don’t take them freely; I hoard them and dole them out stingily to myself. I am not addicted, but I do rely on them. Thankfully, because of the reduced financial stress, I have to rely on them less and less.
Life is not done with me. I have things I want to do. I have goals and plans and projects and ideas. I have books to write, things to make, places to go, dreams to fulfill, and things to build. I have a son I adore, even if he doesn’t need me as much as he did when he was a kid. I have a dream that I might even, someday, have a man to share my life with. That’s probably a pipe dream, but every once in a while I take that dream out and fondle it so that I remember how.
Working full-time isn’t an option. I used to think I didn’t need disability insurance – even a blind lawyer can dictate contracts, right? Before I was 35, I never imagined that any health problem would prevent me from earning a living on a long-term basis. Now I know differently.
In a fit of hope, I bought a bike. I can glide when the pace gets too rough, right? Take things slowly and coast. Except, every time I’ve ridden the damn thing, I’ve ended up out of commission for at least a day. I still can’t exercise. Migraines still rule me.
Dr. Kermit Gosnell is currently on trial in Pennsylvania on murder charges (among others) because of practices at his abortion clinic. In January 2011, Gosnell charged with eight counts of murder resulting from gross medical malpractice in treatment of patients at his clinics. The eight victims of his alleged murders were seven infants said to have been killed after being born alive during attempted abortions, and one adult patient who was administered an overdose of painkillers during an abortion.
Medical malpractice is the action of medical providers that intentionally or negligently injure or kill a person in that medical professional’s care. From all accounts I have found and read, Dr. Gosnell is at the very least guilty of egregious and frequent medical malpractice.
Dr. Kermit Gosnell is a real-life horror story.
The mistreatment and maltreatment reported by patients and even his own staff is hair-raising. Patients who change their minds about having an abortion, even if their feet are already in the stirrups, must be respected and treated with dignity. Unless the procedure has already progressed beyond a point of no return, it should stop immediately. This is true of any elective procedure, whether it is wart removal, plastic surgery, abortion, or hip replacement.
When I hear of patients infected with STDs because a doctor used unsterilized instruments on them, I am appalled.
When I hear that of bags containing at least 47 aborted fetuses were stuffed into a refrigerator, my stomach lurches. What the hell was the point of that?
My anger rages when I hear a 15 year old girl who changed her mind on the table was physically restrained and the abortion performed anyway. That is abuse. Assault. Battery.
When I think of a live baby’s spine snipped with a pair of scissors, my fury explodes.
Dr. Gosnell has been accused of all of these things. If they are true, he should never be allowed to practice medicine again. Ever. And he should go to jail.
I am not appalled that he was performing abortions. Women need a safe place to have abortions. But Gosnell’s clinic was not safe. Not for them, and not for the babies apparently born there after botched abortions. According to Philadelphia District Attorney Seth Williams, “The grand jury went to the scene wearing Hazmat suits.” The scene was littered with animal feces and stray cats had apparently had their run of the clinic.
Why Kermit Gosnell had Patients
Over the past 24 hours hours, the anti-choice media has been bewailing the fact that the case has not gotten much media coverage. I have seen it in my news feed daily over the last month, so until I investigated further, I didn’t understand why they claimed there was no coverage. Seems that the pro-choice media has covered it thoroughly – because Gosnell’s clinic is a harbinger of what will come if abortion is made illegal everywhere. The anti-abortion crowd has not covered it, because of the focus the case trains on illegal and unsafe abortions, which they know will happen with hyper-regulation and limited abortion access through safe, mainstream healthcare channels. Unfortunately, in today’s anti-choice climate, places like Gosnell’s clinic will become more common, not less. When abortions become illegal, vultures like him will be able to prey on more women.
The anti-choice advocates do not want this story covered, because this story will become more commonplace the harder abortions are to come by.
Women determined to abort the fetuses they are carrying will do so, one way or another. They should be able to do it in a safe, sterile environment that will prevent their own death or incapacity. This was where Dr. Gosnell failed. The women who sought treatment from him got rid of their unwanted pregnancies, but apparently often did so at the cost of their own health and safety.
Why should only the rich be entitled to safe health services? Why should abortion be readily available to wealthy patients, but not to poor ones? In one respect, Dr. Gosnell did indeed provide a necessary and desirable service. His method of purveying it, though, was devastating to his patients.
Gosnell is a symptom of a broken health care system. He is the poster child for why abortion services need to be safe, sterile, and sensibly regulated – not over-regulated so that only wealthy women can afford them.
Late Term Abortions for the Poor
When abortion is too expensive for a woman to be able to afford early in her pregnancy – when it takes her too much time to come up with the expense of resolving the problem of an unwanted pregnancy, she is forced to wait to abort the pregnancy. The longer she has to wait, the closer to viability or even to term she must have that abortion. By making abortion difficult to come by and expensive, we ensure that poor women must wait longer than wealthy ones to have abortions. We create the problem that a viper like Gosnell can take advantage of.
Elective late term abortions are not unheard of, even if they are rare. Late term abortions happen because women are either denied earlier access or because of medical reasons affecting wither the mother or the fetus. If a woman has to wait beyond the point of viability, but is still determined to end her pregnancy, she will still do so. And as long as it remains difficult and illegal for her to do so, she will accomplish her goal illegally. Outlawing late term abortions will not stop them. They are rare even without the legal restrictions. Women who are able to end unwanted pregnancies as soon as they can. They don’t wait for the opportunity to kill a baby.
If his patients had had the chance to go to a clean and safe clinic, Kermit Gosnell would not have had a practice. As someone I spoke with said recently, Gosnell’s clinic was “the template for underground and illegal abortion [mills]. As abortion rights get more restrictive, as people seek to find ways to make them even harder to come by, people looking to make money off this human suffering will find a fertile grounds on which to thrive.”
When a “Baby” is not a Baby
A pregnant woman talks about her baby in the present tense, but she has no offspring yet. We refer to saving the lives of babies when we talk about prenatal health care. The anti-choice crowd talks about saving babies’ lives when they talk about not aborting pregnancies. So when is a baby a baby, and when is it not?
A fetus is the unborn or unhatched offspring of non-marsupial mammals – any non-marsupial mammal, including a human, a goat, a bear, or a platypus. (Marsupials do not have a fetal stage. They go from embryo to joey instead of from embryo to fetus.) A fetus is dependent on its mother for oxygenation, which is essential to life.
Viability, or the ability of the fetus to live outside the womb, is the measure the Supreme Court uses to determine the point at which the states may restrict abortions. Prior to viability the fetus cannot survive without its natural life support system: a woman. The point of viability is not a clear, bright line for every developing fetus. Some fetuses delivered earlier may live, while some delivered later may not. Medical advances have made it more likely that younger, smaller fetuses can live if their families choose to exercise those so-called heroic measures.
Until living tissue can oxygenate itself, it is dependent upon its mother and is not a baby. It is living tissue, but it lives a parasitic existence. As long as it lives a parasitic existence, its host may either accept it or reject it. We take steps to reject other parasitic lives dependent upon us, whether the parasite is a hookworm or a paramecium. The difference between these parasites and a fetus is that the fetus is a developmental stage of our own species, made with its host’s own DNA. We are more reluctant to reject our own species than we are to reject another. Once a fetus is born it becomes a baby that any other human can care for. After the umbilical cord is cut and the baby draws its first independent breath, it can be given to a wet nurse, it can be held by any other person or set aside in a crib away from other people completely. It is still dependent, but not for each moment of life. Its sustenance can come from anyone, not only from its mother.
Furthermore, after a fetus is born alive – that is, after it becomes a baby at the magic moment of birth – certain rules go into effect. Those rules allow us to remove terminally ill, dying, doomed, and comatose from the medical interventions keeping them alive. There is no legal requirement that heroic measures be taken for anyone, regardless of how long they have been breathing.
Why should there be a legal requirement that life support systems must stay in place simply because of the short length of time since conception? And why should anyone be legally compelled to provide life support for another person at the expense of her own body?
Someone pointed out McFall v. Shimp in a discussion today. In that case, McFall needed a bone marrow transplant and Shimp was the only suitable donor found. When Shimp refused to donate bone marrow, McFall sued. The court famously found that while Shimp’s refusal was morally indefensible, the court had no authority to order him to submit to personal, physical harm and bodily intrusion in order to save McFall’s life, and would not do so. Personal ethics are one thing. Demanding that another person put himself in harm’s way is yet another.
A pregnant woman unwilling to sustain the developing life within her own body is analogous. Every pregnancy has adverse health effects on every woman, Increased heart rate, edema, sepsis, increased blood pressure, hormonal surges…the list of physical systems challenged and even compromised by pregnancy is long and frightening. Then there’s death. Every woman fears death as a result of pregnancy. A woman may be under a moral obligation to provide healthy conditions for the tissue in her womb that has the potential to develop into a human being; however, she is under no legal compulsion to do so.
That is why women who use drugs and alcohol during their pregnancies are not incarcerated.
A fetus becomes a baby when it is born – when the umbilical cord is cut and it takes its first breath of air. At that moment, it is no longer dependent upon another creature’s continued life in order for it to exist. If a pregnant woman dies, the nonviable fetus inside her also dies, as does a viable fetus not immediately removed surgically.
Too often the terms “fetus” and “baby” are used interchangeably. I’m guilty of this, too. It’s the colloquial vernacular. These are not interchangeable terms, though. One means a creature that has not yet been born; the other means a creature that has been born.
A fetus does not become a baby until it is separated from its mother and living on its own, even if “living on its own” means that some degree of medical intervention is necessary. No one condones severing the spinal cord of an already-born baby who otherwise is healthy and able to survive. If the news reports of the testimony at Kermit Gosnell’s trial is accurate, he may have killed at least seven healthy babies – not fetuses.
There is a difference.
Valuing Human Life and Dignity
Valuing human life and dignity takes many forms. Personally, I value the life in existence more than the potential life. I certainly value the dignity of an existing person capable of feeling indignity more than that of a theoretical one.
The inherent point about abortion is that a woman who is determined to end her pregnancy will do so, no matter how much it costs, no matter what lengths she has to go to, and no matter if it may kill her.
I have witnessed abortion. The life, health, and future of my friend having that abortion while I held her hand was more important than the potential life that was then unable to live outside her womb. To this day, nearly 32 years later, she does not regret her choice, and I do not regret making sure she was able to have that abortion safely. I called home from college and asked my dad for the money. My friend could not ask her parents, but I knew my father would help me without hesitation and he did. I don’t know if he believed me when I said it was for a friend, but it did not make any difference to him. A young woman’s future was on the line.
I have also seen ultrasounds. I’ve seen different stages of healthy fetal development, and I have seen severely malformed fetuses in ultrasound after 20 weeks. One such fetus was also aborted. Less than a year later, performing that abortion would have made a felon out of the very humane and humanitarian doctor who performed it.
The fetal human being suffers no more and considerably less than the animals we humans routinely slaughter to eat, and does so with significantly less fear and trauma. It suffers less than a living human being whose artificial life support must be withdrawn because of health care directives. It suffers for a shorter period of time, too, and its death in safe, sterile surroundings does not compromise anyone else’s life or quality of life.
Abortion opponents want us to believe that abortions will stop if they are made illegal. They won’t. More people will suffer at the hands of butchers like Kermit Gosnel is reputed to be.
Butchers like Kermit Gosnell are the reason Roe v. Wade became necessary.
Butchers like Kermit Gosnell are the reason pro-choice proponents despair of ever-restrictive abortion laws.
Trees are trying to screw me. During a weekend spent dipping oak squigglies out of my pool, airborne jizz of various tree varieties has invaded every one of my exposed orifices, spewed onto my delicate skin, and now has me scratching and sneezing and using up yet another tree’s worth of Kleenex.
My migraines have never responded to prophylactic treatment for very long, but Dr. Robert Lee Archer always has another suggestion. I appreciate his dogged determination to find some way of helping me, and his kind patience when I express my frustration.
His manner is wonderful – it is something I wish all doctors had. If it is possible to teach “personality” to medical students, they should all be required to emulate Dr. Archer’s personality or not pass the course in “bedside manner.”
I have the utmost respect and admiration for Dr. Archer. I’ve been his patient for about 15 years, and he is unfailingly attentive and thoughtful. Some doctors don’t seem to hear what their patients say, but Dr. Archer not only hears, he understands and remembers. I think the world of him, and I wish I could clone him and put him in every doctor’s office I ever have to visit.
Because someone mentioned it in comments on my Facebook link to a recent blog post, I am now compelled to discuss the pros and cons of Twinkies, that sweet treat adored by stoners and other kids everywhere.
The Twinkies Legend ramped up a few years ago when the fried Twinkie was introduced to thronging sophisticates of fair fare. People drove for hours just to taste it, and the initial purveyors of this particular fine food sold 26,000 fried Twinkies in just 18 days. The magic was not obvious to those watching from the sidelines, but no one can deny the faithful. We, personally, have never tried this delicacy. According to reports, the famous creamy filling melts and soaks into the cake, giving it a souffle or pudding-like texture. It was an instant hit.
Deep-frying isn’t the only way to get Twinkies into your family’s diet. There’s an entire cookbook, 112 pages long, containing more than 50 recipes with Twinkies as an ingredient.
Disaster struck again in March of 2000, when the teamsters’ strike closed bakeries all over the Northeast. The Internet came to the rescue during this “Great Twinkie Famine of 2000.” eBay made out like a bandit, selling 20 batches of Twinkies for over $5,000.
Twinkies are popular, no doubt about it. According to Hostess Foods, 500,000,000 Twinkies are produced annually. In case you got cross-eyed counting zeroes, that’s half a billion, with a B. America’s population today is a little over 3.14 hundred million; America is pi, and Twinkie is the ubiquitous cake that radiates among us.
You might think that with popularity like this, the company that concocts Twinkies would be sitting on a big pile of money. Not so. Just this January, Hostess Brands filed for bankruptcy protection – the second time it has done so in the last ten years. Yesterday we learned that negotiations with its unionized employees might result in the employees owning a piece of the action. Twinkies lovers everywhere hope that out of these bankruptcy negotiations will come the ingredients for Twinkies’ success.
Like so many of our favorite mass-produced foods, the ingredients of Twinkies cannot be identified by the common consumer. In fact, they are so mysterious that a guy named Steve Ettlinger wrote an entire book about these ingredients. It turns out that Twinkies come from mines. That’s right. Twinkies ingredients are mined (limestone, gypsum), drilled (petroleum), refined, and synthesized into those tongue-twisting polysyllabic compounds that are printed on the package.
That’s right. He said it. Food doesn’t actually have to be made of food to taste good.
Science has weighed in on the Twinkies question. The T.W.I.N.K.I.E.S. Project at Rice University subjected Twinkies to a series of strenuous tests to determine their properties. T.W.I.N.K.I.E.S. is an acronym for Tests With Inorganic Noxious Kakes In Extreme Situations. Dedicated researchers jolted Twinkies with electricity, dropped Twinkies from staggering heights to replicate Galileo’s experiment, exposed Twinkies to radiation, plumbed the depths of Twinkies intelligence, subjected Twinkies to rapid oxidation, tested the density of Twinkies, and more.
We were not able to find peer reviews of these experiments, so we cannot herein vouch for them.
At this point, we are hard-pressed to find anything positive about Twinkies except their taste. We thought that perhaps the nutritional value would be positive, since we heard rumors a couple of years ago that someone once went on a Twinkie Diet and actually lost weight. It turns out that what the guy essentially did was starve, so don’t replace your amphetamines with Hostess products just yet. If you want a hypoglycemic rush, Twinkies are your tool.
So what about the rumors of the eternal shelf-life of Twinkies? Turns out this is in error, too. We can attest to the lie. When we helped our teenage son empty the trunk of his car once, we found a box of Twinkies that had been bouncing around back there for quite some time. “In case I need a snack,” he explained. Sure. Boys get hungry. We understand. So we removed one of those delicious golden snack cakes from the box. It felt funny. It was hard. Like, brick-hard.
“How long have these been back here?” we asked.
Our progeny shrugged. “A few months, maybe.”
We were glad he hadn’t been on a crime spree. Had he needed to use the Twinkie Defense, he’d’ve broken a tooth.
I wake up; the pounding in my head forces me to. I drag my sandy eyelids up and try to focus on the clock. 4:45 a.m. My mouth tastes like dirty socks and my stomach wants to heave. I make myself sit up and the room reels. The telltale rush of saliva into my dry mouth warns me that I don’t have much time. When the room stops moving I put my legs over the side of the bed. Somehow I’m vertical and staggering toward the bathroom.
I keep the shots of Imitrex ready to go. Finding the injector in the dark is not a problem. The container is on the bottom shelf of the bathroom cabinet, right where it’s supposed to be. My fingers fumble and pry up the lid on one of the twin ampules. The only reason I can do this now is years of practice. When my doctor first gave me the shots I was slower. The novelty meant I sometimes couldn’t prime the injection device properly and a spray of precious triptan would shoot across the room instead of into my flesh. When the headaches are really bad, sometimes that still happens. Migraines steal fine motor coordination. Gross motor skills are pretty much out the window, too, but it’s the fine motor I need now. And the dismay of seeing an injection that costs over a hundred dollars wasted into thin air has no equal. This morning I manage to load the syringe and press it to my flesh. My thumb hits the button on the end of the device and I can’t help but hiss as the sting of the medication hits my intramuscular tissue. It takes a couple of tries, but I manage to cram the injector into its holder and prime it for the next shot. Then I stagger a couple of steps to the sink.
Surely I will feel better if I get those nasty gym socks off my teeth. My hands tremble as I load my toothbrush. Applying toothpaste to my toothbrush takes extra time and effort. It’s hard. I turn the water on and wet the brush, then bring it to my objecting mouth. No sensation is good, because every sensation is amplified with a migraine. The sharp taste of minty-fresh explodes in my mouth and I rinse the brush again. I just want to peel off the cotton that coats my mouth, not breathe on anyone. I don’t want to sanitize myself yet. I just need to get rid of the grimness of first waking up.
Afterward, I grip the sink with both hands. The Imitrex still isn’t working, and even the slightest head movement is agony. Maybe if I lean here for a moment the drug will kick in. But not yet. The jack hammer in my skull subsides with stillness. When I think I can bear it, I move tentatively toward the toilet. Whether or not I really need to go, I need to sit down, and, at a distance of twenty feet, my bed is too far away. I miss the three-foot-tall stacked cube shelf that I used to have in my bathroom. I could sit on the toilet, pull it close, and rest on it, my head lying on my folded arms. Sometimes I would drift into unconsciousness that way and my husband would call to me, asking me if I was all right. If I had assumed that position, I was never all right. Now, though, the shelf lives at his house and the twelve-inch distance to the tiled wall is to far to lean, no matter how good the cold tiles might feel on my skin. I sway as I sit there.
My eyes are closed. I lose track of the minutes. I beg the drug to start working. I wait for the sensation at the back of my neck that signals its effectiveness. Nothing happens.
Eventually, I think I can make it back to bed. The nausea is a reminder that the meds aren’t working, and I know that on my way I need to get the Phenergan. Dr. Archer has prescribed it in a cream. Philip at the Drug Store compounds it and puts one dose into a syringe without a needle. A plastic cap at the tip of the syringe keeps the cream from drying out. It’s hard to get those caps off. I dread the effort, but I know it is necessary. If I start throwing up, I won’t stop. Vomiting with a migraine doesn’t make anything better.
I stand before the door of the medicine cabinet again, reach into the Ziplock bag that contains the Phenergan cream syringes, pull out a syringe, and start wrestling with the cap. Not only do I lose coordination with migraines, I lose strength. It takes me more than a minute to pry the cap off. With a grateful sigh I push the plunger and spread the cool cream on my wrists. I aim the syringe at the trash can and let it go. Of course I miss. I’ll pick it up later. Now it’s time to stagger back to bed and hope that the combination of drugs will stave off the nausea.
Too late, I forget that I have a bead of blood on my skin from the Imitrex injection. I know I smear the sheets with red as I lie down. I hope it has dried and I can brush off the crumbs of blood easily. I washed and changed the sheets just yesterday, using strong spot remover on the blood stains from last week’s migraines. They never seem to come out completely unless I use bleach. I care, but not enough to do anything but pull myself into a fetal position. My pillow is too hard. There’s nothing I can do about it except keep very, very still. My body is covered in a sheen of sweat from the nausea. I don’t want under covers yet. Warmth amplifies the pain. When the Phenergan kicks in, the sweat turns clammy, then evaporates, leaving a salty residue. Once my skin is dry, I find the coolest spot on the smooth sheets. I tug the top sheet over me, and a few minutes later pull up the quilt, too. The Imitrex still isn’t working. I am grateful for Phenergan’s fortunate side effect of drowsiness. I lie there, waiting for the Imitrex, and waiting for sleep.
Sleep evidently came. I am wake again. It’s 7:40 now, and the Imitrex has only dented the migraine pain. The nausea is mercifully gone, but even though every shift of my head doesn’t bring waves of agony, a full-blown migraine still actively assaults my head. I try to sleep again, lying still and letting my mind drift hypnotically. It’s no use. I’m awake and alert, pain and all.
I can dose myself with Imitrex again. After two hours, if I don’t have relief I can take one of the tablets. I carefully leave my bed and make for the bathroom. The blackout curtains in my bedroom don’t close completely, and the shaft of daylight stabs my eyes as I pass through it. I need a ladder to reattach the last drapery hook to the rod. Not now, though. I can barely walk steadily. Climbing a ladder is out of the question.
Imitrex’s packaging is intended to be impossible to open. Insurance only pays for nine pills a month, and they come in paper and foil-backed blister packs. Normally I take all the pills out of the blister packs and transfer them to a pill case as soon as I get home from the pharmacy. Stupidly, I neglected to do so this time. It’s a new box of pills, and I fumble even to tear away the box top to get at the blister pack. I still have no fine motor coordination, and tearing away the paper and foil backing is beyond me. Finally I stab the back of the pack with tweezers to get it open. The pill breaks as I extract it. It will leave a horrible taste in my mouth because of that. I swallow it anyway, and take a long drink of water to wash away as much of the residue as I can. Now for the other weapon in my migraine arsenal.
Hydrocodone. I hate it. I love it. I hoard it. Dr. Archer allows me twenty pills a month, but I rarely use them all. It scares me. The last thing I need is an opiate addiction. My tolerance to it is high. For all I know, I’m already addicted. I don’t know. What I do know is that hydrocodone is an extra lifeline for when the triptans don’t work. Today, I need it. Maybe I can go back to sleep. It will be an hour before either it or the Imitrex tablet will take effect. I shake the fat tablet into my palm and wash it down with water. I go back to bed.
I doze, but I don’t go back to sleep completely. After an hour, there is no change. I am tired of my bed. The cats have been anxiously head-butting the door and crying. They’re hungry. Their water dish is probably empty, too. I debate taking another hydrocodone tablet, but decide to wait. I want to see how the effort of climbing the stairs affects me, and if I take one now it will make me itch. Of course, I can always take Benedryl with it. The antihistamine will help with the itching and make me drowsy again. No, I’ll wait.
I should have taken the second pill. In my kitchen, I sink onto a stool at the breakfast bar and lay by head on my arms. The cool granite of the counter feels wonderful. The pounding in my skull does not. When it subsides, I reach for the bottle of hydrocodone I keep on my lazy Susan. The cats are sitting next to their empty food bowls, expectant. “Just a minute, guys,” I whisper. I run water into a dirty glass sitting in the sink and swallow the pill. I stand at the sink for a moment, waiting for the pounding to start again because of the movement. Thankfully, it does not.
The cats’ food dishes are on the floor. I squat slowly, not wanting to bend or even tilt my head for fear that blood will rush into it and the throbbing will begin again in earnest. I nearly lose my balance, but I’ve thought to hold the edge of the counter to ease myself down, so I have a lifeline. I’m shaky as I rise. The three steps to the bin of cat food in the pantry go well. I scoop food into one of the bowls. No wet food this morning, kitties. Sorry. I can’t bend over to get the can, and the smell of it would destroy me. I can smell the litter box across the room, and I know it needs attention, too. There’s no way. Not now. Not yet. Please understand and don’t do your business in the house plants, I beg them silently.
I sit on the stool again to recover from this round of activity. I need to eat something. Lack of food will only make things worse in the long run. I keep coffee in the fridge. Caffeine sometimes helps, sometimes hurts. As bad as this headache is, I decide to give it a try. Iced coffee with a bit of hazelnut-flavored sweetener and a dollop of milk. It isn’t as sweet as Starbucks, but then nothing really needs to be. My sister says those sweet coffee drinks from Starbucks are “a candy bar in a cup.” She’s not far wrong. I sit and drink. It tastes good. I feel stronger after sustenance. I mix myself another iced coffee, and munch on a few strawberries. The carbs will give me strength and energy.
It’s 8:25 now. I move to my computer, which sits in an alcove off the kitchen. I bring my coffee with me. I can sit relatively still, reading blogs and news, and wait for the hydrocodone to do its magic. Eventually, the itching starts. I keep a back scratcher next to the computer because my perpetually dry skin always itches. Itching from too much opioid is not satisfied as easily. I read. I sit. When I get up to forage for more food, my head reminds me that I need to stay still. I return to my computer chair with a small chunk of Havarti cheese and rice crackers.
A little after eleven, my phone rings. It’s Jan, wanting to go to The Full Monty at the Weekend Theater. She’s not sure we can get tickets. Tonight is the last night. Even though I tell her I am not up for it, she is determined to go. She will have to drive in from Hot Springs, so if the show is sold out then she’ll have a wasted trip and an hour’s drive home. I turn down the volume on the phone, because the conversation is unnaturally loud. I tell her I’m not feeling well, but that she is welcome to come by if she can’t get a ticket. I hope the show is not sold out. I hope she can go. I realize I need to go back to my bed. We hang up, and I take a deep, slow breath to steady myself. The phone call has brought back the raging throb.
I get a glass of ice water before descending the stairs to my bedroom again. I climb into bed. The sheets are smooth and cool, and I think again that I need to rehang that drapery hook so the curtains close completely. The shaft of midday sun coming through the opening stabs my eyes. My head hurts too much for me to turn my back to the windows. Besides, the light bounces off the wall; it doesn’t really go away if my back is to it. I close my eyes and hope for sleep.
I haven’t yet started to doze when I hear the garage door open. Jack is home. Lora is with him. They’re going to hang out in the basement. He brings me an icepack. I’m glad he’s come home, because I can really use that icepack. I drape it over my forehead, pressing its ends to my temples. The kids go to the basement. They know to be quiet when I have a migraine. Poor Jack. His whole life, his mother has been sick. Sometimes, she’s sicker. Like today. He has told me that by the time he was eight, he could read the labels on my meds and even spell hydrocodone. I don’t doubt it. I sent him to get them from the cabinet often enough.
I doze, and finally I sleep. It’s almost 5:00. The migraine has receded to the back of my brain. It’s still there, but right now it’s not attacking me. It doesn’t hurt. I go upstairs again. If I don’t eat a meal, I’ll suffer for it. I need protein, vegetables. I make a sandwich and chew it slowly. I don’t really want it. I’m not hungry. The consequences of not eating will be worse than forcing myself to eat now. I sit at the kitchen counter and read a magazine while I take unenthusiastic bites. I hear the kids come upstairs. They’re leaving. They chat cheerfully. Their good moods and the sandwich have combined to lift me up. Lora tells me she’s reading The Princess Bride, and I am delighted. It has been my favorite book since I was sixteen. I refused for years to see the movie, because I was so afraid that Hollywood would ruin it. I shouldn’t have worried. William Goldman wrote the screenplay for his own great book, so everything was as it should have been. Miracle Max and Valerie. Fezzik and Inigo Montoya. The Man in Black. Buttercup. Prince Humperdink. The Six-Fingered Count. Talking about it with Lora, I feel animated for the first time today.
The kids leave and I return to the computer. I need to sit still. If Jan comes tonight, I need to be functional. I’m functional now, but I don’t know how long it will last. I start writing this blog post. I feel myself tiring, but Jan calls at 7:30 to say she could not get a ticket to the play. For the last hour I have been checking the clock, wondering if she will call. About fifteen minutes ago I had decided that she must have gotten in, or I would have heard from her. “No, no, it’s fine,” I tell her. “Come on by.” I go downstairs to get the skirts I need to alter for my niece’s school uniform. They are hand-me-downs from her sister, who is shaped differently. As Jan and I visit, I rip out the hems. By 9:30, she says she’s tired and is going to get back on the road. I’m glad, because I’m fading, too. The headache isn’t back, but it’s skulking in the recesses of my skull, waiting to strike. And all those meds exhaust me. I’m happy to have seen Jan, though.
After Jan leaves, I rip the hem out of the last skirt, and I head downstairs with a fresh glass of ice water.
I read a little inSacré Bleu, the newest book by Christopher Moore. I’ve had it since its greatly anticipated release, and I keep getting distracted from it. I love Chris Moore’s books. I wish I had his wild imagination. I want to keep reading, but my brain won’t let me. I’m too tired.
As a lawyer, I know that people get harmed through no fault of their own by other’s people’s negligence and failure to pay attention to what is important. Whether it’s a car accident, a doctor who ignores symptoms, or a vicious dog who attacks a child, the person who is hurt should not have to pay the price for the injury. The court system cannot give back the things these people have lost: time away from work which leads to the loss of their careers, the pretty face that existed before the dog mauled the four year old girl, the mother who was killed by a drunk driver, living without constant pain caused by the injuries in the accident, the cheerful contributions to her family that the coma patient used to make before the doctor ignored the pulmonary thrombosis that led to her vegetative state.
When lawyers screw up a case, clients want to sue them and recover their losses. And they should. They should also be able to sue doctors, negligent drivers, and other people whose failure to pay attention has hurt them.
Unfortunately, “tort reform” usually means “medical malpractice lawsuit reform.” People think that lawyers are mean to doctors, who are just doing their best to heal people who probably can’t be healed in the first place.
That is not the case.
Look at the statistics in a recent Huffington Post article. Only 2-3% of ALL medical malpractice results in a lawsuit. That’s not 2-3% of medical care cases; that’s 2-3% of actual malpractice situations. Is such a number of lawsuits really excessive?
Caps on punitive damages is the issue Obama is expected to embrace, though. Punitive damages don’t reimburse someone for money they are out. Compensatory damages cover that. Punitive damages are intended as punishment – hence, the name “punitive.”
Why would someone require punishment for a screw-up? Think about how we decide how and whether to punish our children for negligence. Let’s say that Susie and Jenny are at a birthday party for one of their classmates and it’s cake and ice cream time. Susie gets excited explaining something and throws her arms wide, knocking over Jenny’s glass of punch, spilling it on her and ruining her party dress. Of course, Susie has to apologize to Jenny, and she has to get Jenny another glass of punch. She has to help clean up the mess, and if Jenny’s party dress is expensive Susie’s mom might offer to pay for it to be cleaned. These actions are compensatory in nature. They compensate Jenny for the loss of her glass of punch, her clean and dry dress, and her hurt feelings.
If Susie knocks the punch over because she was dancing on the table, though, Susie will be punished. Punitive action will be taken to ensure she doesn’t dance on the table and spill someone’s punch again.
Maybe we put Susie in time-out. Maybe Susie gets a spanking. Maybe Susie is grounded from her Barbies, or she is not allowed to go to any parties for the next month.
The point is not that Susie is being punished for doing something intentionally. She did not. She did spill the punch while being grossly negligent, though. She should have known that if she danced on the table where Jenny’s punch sat, the punch would spill.
Punitive damages in these cases are intended to stop gross negligence. They are not appropriate where there is no gross negligence – where the punch spills accidentally due to something unforeseen or where the negligence was minor. Punitive damages are for those egregious cases where the doctor ignored clear warning signs of his patient’s impending doom and did nothing.
Punitive damages are not awarded lightly by any jury. If a jury awards an amount in the millions, it is because the defendant in those medical malpractice actions has the resources to pay such an amount, even if it hurts. Punishment is not intended to kill, and punitive damages that bankrupt a company or a doctor aren’t appropriate. Punitive damages are supposed to hurt, though – just like being grounded from birthday parties hurts. And just like Susie, the idea is that punitive damages will hurt for a little while, but the defendant will get over it – hopefully to go forth more carefully in the future.
Did you hear? I had a softball-sized tumor removed from my neck three weeks ago.
I noticed it about a year ago and shrugged it off, thinking it was a little lipoma that wasn’t any big deal. Then I began having trouble turning my head. The lump was getting bigger – about the size of a golf ball – and I couldn’t comfortably wear turtlenecks or even mock neck shirts. I named my lump Esmeralda and patiently waited for her to gain sentience.
When Esmeralda started aching, I decided to go to the doctor. I hate going to the doctor, especially if I think I’m going to get bad news. I’ve had cancer twice, so having a tumor made me think that number three was here. If I pretended it didn’t exist, it would go away. I’m a very bright girl in these matters. I knew exactly what I was doing when I ignored the wretched thing for so long. Really.
My doctor looked at it and said that there was no question that it needed to come out. Clearly, it was causing me trouble. Even if it was probably just a lipoma and not something devastating, it was in a bad place. And, he said, even for a lipoma it was, well, kind of big. There was definitely an asymmetry to my non-gazelle-like neck. A bump about the size of half a golf ball hung off the side it.
I knew all this before he told me. I knew he’d have to refer me to a surgeon. That’s why I was there, right? So, deep breath, I got the referral and made the appointment and went the next week to see when I could divorce myself from dear Esmeralda, who I was beginning to think of as my dicephalic parapagus conjoined twin.
He sent me to an otolaryngology clinic. Otolaryngologists cut on people’s necks when the spine isn’t involved. I was glad my spine wasn’t involved, although I did wonder if that was because I simply didn’t have one. What kind of person, being possessed of a spine, was afraid of what was probably just a harmless little lipoma?
At the otolaryngology clinic, I got a CT scan of my neck. Back in the examination room, the surgeon pulled up the scan on the computer screen. “Wow, it’s really big!” he exclaimed. He showed me what to look at. The difference in the two sides of my neck was obvious. One side of the screen looked like what you’d think a neck should look like on a CT scan. By that I mean it had not much flesh and a big amount of bone. At least, that one side did. The other side? Well, it was different. Waaaay different.
There was a vast blackness that took up a lot of space on the right half of my neck. It looked as though Darth Vader himself had taken up residence there and his helmet was pushing things around.
The doctor pointed out how my muscle was stretched over this dark growth, how my nerves and blood vessels were pushed out of place, and how much space the thing took up.
“It’s sooo biiiig,” he said again. And again. And yet another time, just in case I hadn’t heard him before. That’s right. Only I could have a freakishly large tumor in a place with as little flesh as my neck and not notice it for years on end. Evidently, I can’t see a damn thing with my eyes full of sand.
Lipomas usually grow just right under the skin and are fairly simple to remove. Unless they become bothersome, it’s not necessary to remove them at all. Mine was different. It was under the muscle, which, the doctor graciously postulated, was probably the reason I had never realized it had been growing there for so long. It was also pressing on important nerves and blood vessels. There just isn’t a lot of room in a neck, and there’s a lot of important stuff there. Like, say, the carotid artery, which feeds blood to the brain. Which my lipoma had shoved out of place. In fact, it had shoved things so far out of place that I was in danger of soon looking like the Elephant Man.
Surgery wasn’t just an option; it was necessary due to both the size and the location. If Esmeralda really did get large enough to become sentient, state law would forbid me from removing her. I mean, I could already forget about using federal funds. Her presence could no longer be disguised with loose clothing or makeup. I had to act, and act quickly.
The problem was, the size and location of the tumor meant that a different doctor needed to do the surgery. Someone who specialized in cancers of the head and neck. Swell. The”C” word again. Fortunately, I liked the new surgeon. I liked the old one, too, but the new one was quick-witted, funny, and personable. And probably married. (sigh)
My family rallied around me. My sister went with me to the pre-surgery appointment. My mom took me to her house after the surgery so I could be pampered. Jack came to see me that night. I felt pretty raw, and my throat, complete with a drainage tube, wasn’t pretty either.
Wanna see?
Three weeks later, I’m still a little tired, but I’m fine. Some mornings it’s harder to shake off the latent effects of the anesthesia than others. Of course, staying up until 1 a.m. to finish a novel I can’t put down sort of contributes to the problem, but I’m gonna do what I’m gonna do. (The books are really good. Brent Weeks is a new, young author and he has time to grow. I can’t wait for his next offering.)
My son, Jack, has demanded credit for cajoling me into reading this series. Here you go, son.
I have an awe-inspiring scar on my throat. I can come up with plenty of tales to explain its presence.
I’ve told the story of Jack the Ripper to my wide-eyed nieces and youngest nephew (they’re 11, 8, and 6). I have the scar to prove that I narrowly escaped him.
Next, I plan to work up a tale of the Bride of Frankenstein for their entertainment. I’ve already got the white hair at the temples going on, so between that and the scar, I’m not going to have to spend a lot on costuming.
The surgeon said that the tumor had to have been there for a very, very long time to be as large as it was. How the hell does a softball manage to hide in a neck for years and only show up as a golf-ball sized bulge?
The size of the thing was apparently really impressive. Every time I call his office his nurse exclaims, “Oh, you’re the one with that really huge lipoma!” Every time. Every stinkin’ time. I’m beginning to wonder if I ought not to have saved the damn thing and taken it on the road. I could have made a living in the sideshow as the girl with the softball in her neck.
Maybe I should have had the thing cut in two and used it for a boob job. Next time, if there is a next time, I’m going to think that through carefully.
In response to the blog post of a friend who is understandably bemoaning the state of the nation, I got a wee bit windy.
I know, I know – it’s hard for anyone to believe that I – moi – would spew opinions unrestrained against the drums of ears attached to mouths that were asking rhetoricals, not practicals. Nevertheless, I have the answer, and if the president would only sit down and pay attention to me, all the country’s problems – yea, even all the world’s! – would be solved.
The economy is not going to be fixed overnight, and right now Obama is listening to the experts who advise throwing more money at the economy in all the wrong places – at least IMHO. But, in response to those who are nodding sagely, saying “We told you that Obama would bring socialism and liberalism to the country, but did you listen? Nooooo,” I say that (ahem) this started on the Republican watch. Obama inherited this disaster; he did not create it. And since no one has ever dealt with such a staggering world-wide economic crisis before, that means he is inventing this wheel as he goes along. Will he get it all right? Of course not. But he won’t be likely to get it all wrong, either.
From what I hear and read, the economy isn’t going to start upward on any consistent basis until at least next year, and maybe not until 2011. Whenever in history the economy has tanked as suddenly and as severely as it did last summer and fall, the recovery has always been slow. That’s why they call them “depressions.”
Consumer confidence is badly shaken, and as more and more jobs are lost and more and more foreclosure notices are mailed, it’s not as if Dick and Jane are suddenly going to decide to splurge on that vacation home, lavish gifts for their status-conscious kids, or a pricey new automobile. Their businesses aren’t going to be hell-bent to hire new employees, either, because if sales are down, and no one is getting the services they offer, the employers simply can’t justify it.
The economy is, believe it or not, depressed. And Economic Abilify has not yet been invented.
My opinion (and one or two of you might possibly be aware that I have one or two opinions, even though I rarely mention them in polite company) is that Obama would be better off to give stimulus money to the people and entities that are best in a position to turn this thing around, i.e., all of us, but in different ways.
Money should go to the homeowners trying to stave off foreclosure as a condition of and part of the debt renegotiation with the lenders – that way the lenders get paid directly by the government on behalf of the homeowners, the homeowners and their children aren’t sleeping on the streets, and the banks don’t own homes they can’t sell.
If a home is undervalued for the debt the homeowner has against it, the government should pay the difference as soon as new terms for the remainder are worked out between the borrower and the lender. If the borrower can’t afford to continue making the original payments – not the juiced-up interest payments – then there can be a second tier of incentives for the lenders to extend the debts to a 40 year amortization as opposed to the customary 30 year schedule.
And NO MORE INTEREST-ONLY long term debt! Whose idiotic notion was that, anyway? “Here, Joe Bob and Sally Sue, take this money that you never have to pay back. Just pay us interest and we’ll all be happy.” The hell, they say! Morons.
Next, apply stimulus funds to the remaking of the American infrastructure, especially rural and smaller urban areas without reasonable public transit. Make light rail, high speed rail, and buses reach more places and serve more people on better schedules. One of the worst things we ever did was allow our railroads to be dismantled in favor of three cars in every driveway and five lanes on every freeway. Refurbishing and improving our infrastructure will employ hundreds of thousands of people in various positions throughout the country. From engineers to draftsmen to laborers to porters, we can get this country moving at a much more economical rate, and faster, if we’ll commit the funds to do it. And those jobs won’t go away when the projects are complete – they will need to be maintained, too.
Simultaneously, pour money into scientific research and development of alternative energy as well as into to cleaning up and maintain the environment. I’m not talking about just reducing greenhouse gases, although that is certainly a big concern, but (for example) about making reasonable accommodations for heavy metals that are the by-product of mining and drilling. A rocket laden with nuclear waste, arsenic, mercury and lead headed for the dark side of the moon might not be a bad use of NASA’s funding.
Put people to work cleaning up the environmental damage we’ve done to the planet, and making sure we’ve still got a planet to leave to our great-grandchildren. Clean water, clean air, and fewer chemicals artificially enhancing the soil and crops will go a long way toward making us all healthier – not to mention the possibility that our grandchildren might be able to play with frogs in their back yards some day.
And while we’re at it, quit giving chickens and cows all those damn hormones! I have yet to meet a teenage girl whose double-D’s don’t put my paltry gifts to shame. Why are their adolescent mammaries the size of a Holstein’s udders? Hormones!
Reduce the employer’s share of employment taxes. With the matching amounts that employers pay for health insurance, medicaid, unemployment, and social security, the cost of hiring an employee is a lot more than just what the employee sees in his check. This would be a real, dollar amount of savings for employers and would probably allow businesses to hire more workers across the board and at all levels.
Nationalized health care? Bring it on. Insurance companies will always provide coverage to people who choose to pay more for less care. Those of us who have survived cancer (twice, thankyouverymuch) or who are on certain costly medications can’t get health insurance without staggering pre-existing conditions clauses that make our health insurance worthless and excruciatingly expensive – if we can get it at all.
When health insurance benefits dictate whether a parent can open a business of his or her own or must stay with an employer who provides health coverage the family can’t get elsewhere, entrepreneurialism is stifled. This country is dependent on small business and entrepreneurs. We absolutely must break down the barriers that prevent people from making an attempt to achieve their dreams. I don’t know about you, but I work a lot harder for myself than I do for someone else. I don’t think failed businesses should be propped up by the government (Detroit, are you listening?), but when something like paying for childbirth determines whether a family can start a small business, there’s something desperately wrong.
Where, O Where will the money come from to do all this?
(clearing my throat)
The same place the last two trillion dollars came from. And the next trillion will actually make a difference. It will put people to work, shore up the foundation of the country, and stabilize the economy. It will also have the added benefit of making the world a better place. And if any of you out there are thinking there won’t be more stimulus money forthcoming, you just hide and watch. It’ll come, I promise, whether the president takes my incontrovertible advice or not.
Now that I have solved the problems of the environment, the economy, health care, and reliance on fossil fuels, are there any other problems you’d like me to take a look at? My rates are reasonable, and I’m in a spewing mood.
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