Thursday, June 23, 2011

The Masks We Wear

The wine: Pinot Grigio, over ice, with raspberries. Light, white, and priced right.
The music: Before You Accuse Me (Take a Look at Yourself) and Layla, Eric Clapton (unplugged versions, Clapton Chronicles)

She was angry when she hit the door. I was only in the way, the latest in a string of people in her day who had let her down. Brother upstairs, crazy brother, lazy brother, the one in the window who pretends he doesn't hear the doorbell when it rings. She had to interrupt herself, and who wants to do that? Damn, here comes another one. 'Nother damn do-gooder, smiling the "I'm here to help you" smile, small in those khakis, 5'5" of uppity white girl ass and here she comes, askin' questions.

Sometimes all you have to do is walk in the room, and breathe, to be considered a threat. I have made this mistake so many times, walking in rooms, and breathing. Oh, and here's a tip. Explaining that you are a doctor of your profession, and need to take a thorough history to treat the patient properly, will not help your case. It will not calm people down when they hate you on sight. When she said she was going to call my supervisor and report me, I dialed the number myself and handed her the phone.

In fencing, before the first en guarde, you take off your mask so your opponent can see your eyes. You look at each other, then you salute, bell guard to forehead and slash to the side. You honor each other before you kill each other. I like that. She never took off her mask. I suppose I didn't either. Not really. Doctor is a mask. White is mask. Thinner and smaller and whiter and more educated than you? That's a mask too.

Tomorrow I fence. Tomorrow I put on my fencing whites, my body cord, my glove, my beloved mask that covers my whole head and makes me anonymous and not small and not female and not white and not anything but a fencer with my weapon to my forehead, ready to honor you, ready to challenge you, ready to win. Ready to defend myself with everything I have, including my wits and my speed and my agility and my strength. And it is relaxing like nothing else, except maybe writing, because you would expect nothing less, because you are the same, under your mask.

Tuesday, June 21, 2011

Jacko Says Yes, and I Believe Him

The Wine:
A smoky Malbec from Argentina. Smells like a campfire, tastes like solitude
The Music:
The Guess Who, No Sugar Tonight/New Mother Nature/Hand me Down World

Warning: Writer's Block Ramble dead ahead. Stop reading now if you don't want to hunker down and sweat it out with me, I won't think less of you. For a writer, this is the equivalent of a bad head cold. It's been a week since I wrote anything of note, pieced together thoughts into a cohesive whole. The blank page grows large and accusatory. Random thoughts come and go. I feel at loose ends, cross with my lack of production, lack of creation. My process is disrupted, none of my usual tricks have worked to unlock my thoughts on the page. A thousand ideas just under the surface, not one emerges. My process has always been the same, since I was very young. Music unlocks me, my thoughts, my pen, anything from Beethoven to The Pixies, to tonight's selection, The Guess Who.

"Don't give me down no hand-me-down shoes, Don't give me no hand-me-down love, Don't give me no hand-me-down world..."

The music plays, under my fingers or in my head or my stereo, and I start to zero in. One song emerges, I play it on loop and enter the zone. I don't subject anyone else to the process, the creative process would drive a companion crazy, one song playing over, everything falling away except the melody, the pen, and the thoughts start to arrange themselves in my mind. I start mumbling, talking to myself, looking a little touched to others. Words roll around in my mouth, I start hearing sentences. They order themselves, one lead sentence emerges and I know what the piece will be about, my theme emerges. Once I've got my lead sentence, I'm home free. Oh, there is still the matter of wrestling it to the page. The music I am listening to knows what I am thinking before I do.

"In the silence...of her mind...quiet movements I can find...grabbin' for me, with her eyes...now I've fallen...from her skies..."

This week, nothing. No dreams. No writing. No sentences. Silence. Excruciating. This is why writers drink. Back on the horse. Mechanical writing. Maintenance writing. Writing you look at and try to love. No heat. Showing up to the page anyway. Walking through a desert alone. No sugar tonight.

Wednesday, June 15, 2011

Can't Get Over All Y'all Down Under!

I'd like to take a moment to give a brief shout out and thank you to all you great Aussie Readers, who are now outpacing my readers in the US by a margin of 3 to 1. I would also like to thank Sarah, at Ah! The Possibilities! for listing me as a "Fabulous Blog", and Suz, at SWheatley Speaking for listing me on her "Blogs I Dig". Thanks Ladies! I dig you too. These hits in the triple digits make my little writer heart just beat wildly.

If you find yourself returning to read, let me extend a personal invitation to become a "follower" by clicking the Google Follow Button at the right of the blog. Of course if you don't, the obvious answer is it's not your cup of tea, and that's okay - thanks for stopping by and enjoy your lovely parting gift. And some of you are "following privately", and that's okay too. But don't be shy! I'd love to see your pretty face and squeeze your cheeks and say, "OOOOh, what a CHA-CHA!" I'd do it, too. You know I would. :)

Monday, June 13, 2011

Your Secrets are Safe with the FBI

"Well we know where we're goin', but we don't know where we've been. And we know what what we're knowin', but we can't say what we've seen." - Road to Nowhere, Talking Heads

As I sat at the red light at the corner of Frustration and Fatigue, and vigorously sucked my chocolate milkshake that wasn't really chocolaty but did have the saving grace of whipped cream and a maraschino cherry, I tapped my foot on the gas pedal to The Talking Heads singing "Road to Nowhere" and thought about adrenaline. My caseload right now is not as physical as I would like. I don't have many neurological patients on my schedule right now, with whom I can use my body as a Total Gym, or integrate yoga and PNF (proprioceptive neuromuscular facilitation) into their plan of care. Nor do I have as many manual or lumbar manipulation patients as on previous caseloads. Maybe it's all this lovely patience I've been developing lately, but I suddenly found myself needing to drive really fast, buy a drum kit, sign up for skydiving. Feel the wind on my face as I pick up speed, feel the divine exhaustion after the adrenaline has had it's way with me and all that is left is an empty husk and an evil little satisfied smile.

I hit the Atlanta highway, felt the hum, turned up David Byrne. I thought about my "FBI days". Oh, just a little. I sometimes miss working with the police detectives, the gang unit, the gun unit, homicide. I miss the occasional fun of going to the shooting range and improving my skill, ride-alongs with my cop buddies, wearing a bullet-proof vest, chatting away and sharing my data about crime patterns. I don't miss watching the evening news, seeing people I care about burst out of a SWAT van, hearing "man down" and patterns of siren calls and knowing what it all means.

Going to Quantico, Virginia to the FBI Training Academy for conferences of the Homicide Research Working Group was a fun highlight. Quantico was different than what I expected. And yes, I walked around the campus, and yes, I felt just like Clarice Starling when I did it. It was a fascinating place, but much more work-a-day and government issue than you might imagine. There were no locks on the dormitory doors, for one thing, which was mighty disconcerting after a day of graphic presentations on serial killers and psychological investigation. I slept very little at Quantico.

On a tour given by our host, one of the psychologists there, we were all surprised to find out that indeed, no inmates were kept in the basement. Nary a cell, however there was a very interesting firearms investigation lab, and 1950's-style offices where Agent Mulder might hang out. There were names of investigations, countries, projects on the doors. They were largely dusty, deserted and unlocked. "Your secrets are safe with the FBI", our host called out as we trundled down the hall, laughing. I fell behind the group, per usual, opened a few doors and peered in, just to be bad-ass. Of course, that was all years ago, years and years and forever ago. And if I've said anything here I shouldn't have, just add it to my file, won't you, boys? Just add it to my file.

Saturday, June 11, 2011

The Art of Patience in War

"This ain't no party, this ain't no disco, this ain't no foolin' around! No time for dancin', or lovey-dovin', I ain't got time for that now...- Life During Wartime, Talking Heads

He can't sit up by himself yet, that's going to take a long, long time. He was unconscious for weeks, with his wife and daughter by his bedside. They are here now, as I begin to move this giant of a man in ways he cannot yet move himself. Little by little, I raise the head of the hospital bed, for a minute, then two, then lower it. Managing orthostatic hypotension is dancing with a diva, you must watch it closely and cater to its every quixotic need. I watch his pupillary reaction, and take his blood pressure at regular intervals. I talk him through diaphragmatic breathing, explaining the effect on the aorta and blood pressure. "Open your eyes. Squeeze my fingers. There we go, there's that Brown-Eyed Handsome Man." I wink at his wife over the bed. "Stay with me. Talk to me. Breathe." Little by little, with every treatment, I acclimate him to vertical, and feel his muscles initiate more of the movements we are making together. "This is where it starts," I tell him, and the two beautiful women who have been so worried about him for so long. "This is where we begin."

"She's the one," his wife says. "She's the one gonna get you back up on your feet and walking again." I feel the warmth of their faith in me, and return it. The weight of expectation, rather than pulling us down, creates a buoyancy under us all, like water. Knowing it is going to take a long time allows us to relax into the commitment. It creates a space for patience, a contentment, and joy in the work of learning to walk again. It is flow, and we are in it.

After I see my last patient, I have my first fencing lesson in over a month. Lifting my fencing arm in the first en guarde, I feel the nagging ping of an ongoing overuse injury in my elbow. Still, it feels good, restful under my mask. I haven't lost ground through rest, but gained it, as my understanding mellows and deepens. John and I talk about war, about staring your opponent down, waiting them out. The art of fencing is the art of patience, and the art of patience is the art of war. We work on foot work tempo; I match him, he matches me, and we manipulate each other from a distance. I feel how relaxing it is to simply wait for my opening, and ultimately how vulnerable aggressive tactics leave you.

I could do this all day, I think. I can wait, play with it, make my opponent come to me. I can remise, reprise, play with distance, tactics, timing. I don't have to make anything happen. I just have to relax, be patient and wait for my opportunity. I'm not going anywhere. It's just you, and me, and the strip, and the conversation of the blades. "It's your move," I think now, as I watch my opponent advance. "I've got all day." And that's how I win.

Wednesday, June 8, 2011

Hallowed Ground

"Baby I've been here before, I know this room, I've walked this floor, you know I used to live alone before I knew you. I've seen your flag on the marble arch, and love is not a victory march, it's a cold and it's a broken Hallelujah." - Leonard Cohen, "Hallelujah"

As I reached into my treatment bag, I felt her eyes on me. Her daughter and son were detailing the events of the night, medications gone bad, lost sleep. Her breathing was fast. "I think she has a fever." I quickly took my stethoscope, thermometer, alcohol wipes, disposable covers and blood pressure cuff from my bag and laid it out. With what I hope are always soothing hands, I felt the patient. "She's hot, that's for sure. Has she been in and out of alertness?" I mentally rehearsed the phone call to the patient's attending physician, or assistant, knowing that it is often hard to explain from the field that gut feeling that a patient is worsening and may need to be transported.

"Ma'am, your vital signs indicate your infection may be returning," I said to my patient, who by now had pulled the covers over her head. "Your temperature is elevated, your respiration is fast, and some of the hallucinations your daughter is reporting may mean that your infection has worsened and you need another course of antibiotics. You'll need to be seen at the ER, as soon as possible." "I'm not going back to the hospital. I'm not." "I'm sorry ma'am. You can't take that chance. If for no other reason than I've gotten attached to you." I tried to inject some humor into the situation. She was having none of it. And with that, I swabbed my equipment, re-packed, gave instructions to the family, and slipped out. Signs and symptoms evaluated, reported, decision made, life saved. For now.

When I got to my car, I took a sharp deep breath in, hoped for the best, and reviewed the email I had received yesterday, from the daughter of a former patient. He had passed over the weekend. Driving down the road to my next patient, I cried. Then I got it together before I walked in the door. That's the prime directive in health care: Get it together before you shake the next patient's hand. They need you, and they need you strong. In that moment, nothing else matters. Solve the problem in front of you.

I am learning to take time, because what else is there? These back bedrooms of the dying that I am in, these incredibly intimate spaces of people who were last week strangers, where nothing is hidden and there is nothing left to hide and shame is discarded because it no longer fits. This is hallowed ground. When I clasped her hand and said goodbye and touched her cheek because it felt good to her and I could do no more, she said, "I love you." "I love you, too," I said, and meant it. And this is Hallelujah.

Friday, June 3, 2011

Mind Over Matter

I've always loved the phrase, "Aging is mind over matter. If you don't mind, it don't matter." In a culture that worships perfect faces and bodies and seems to spend much of it's time figuring out how to better promote itself, I get to spend my work days in the hot back bedrooms of ordinary people whose bodies are bent, broken, battered and disintegrating. I feel like the luckiest person alive. Together, we grunt and sweat and stand and cheer, fall back exhausted and share high fives, laughing at Brother Ass. Everyone, from 8 to 98, loves a pat on the back and an "Up top, sir!" even if I have to help them lift their hand to do it. I want to show these beautiful faces I see to the world, to capture the important moments of their lives in amber. The luminosity of the faces I see takes my breath away, and it never fails to move me to watch how a face can change over the course of an hour. How it can grow young again, how the mind comes alive and the years fall away.

Today, breakthroughs. Improvements that even I wasn't expecting so soon. The regenerative capacity of the body and the brain are so amazing, that I sometimes feel like I have simply grabbed the tale of a comet, and am just along for the ride. This afternoon, a stroke patient I am working with said "Thank You" and "I appreciate you" clear as a bell, when one week ago he could only sigh. He stood and lifted both feet, we marched together, a week ago he could not stand. The body is so hopeful, the mind impossible to contain. In sweltering back rooms of unassuming homes in neighborhoods that have no name, miracles are taking place. The water we walk on is a river of human sweat, and we are baptized in tears of frustration and joy. Everyday I learn from my patients that every face is beautiful, that age is just a number, and that the next step we take is the only one that matters.

Thursday, June 2, 2011

Bad-Ass and Bare-Necked As I Wanna Be

The heat in this city is unbelievable, and as the thermometer rises, so does my hairline. For the first time in a year or more, the nape of my neck is completely bare and open to every passing breeze. It feels fantastic. Most men know this feeling, but somewhat fewer women, which I think is a shame. As I ran my hand up my neck this afternoon and thought about the possibility of a fleur de lis tattoo at my C7 vertebra, I suddenly remembered another hand that ran up my neck, years ago, in a tiny desert town in New Mexico.

I was standing in the aisle of an auto parts store picking out something completely innocuous: air freshener. I had a pixie cut then, short everywhere on purpose, faded Levi 501s and a t-shirt. Oh, and earrings. Perhaps he missed the earrings. Out of the corner of my eye I vaguely saw a tall, sunburned, skinny man in a dirty white cowboy shirt walking toward me. Thinking nothing, I stepped forward to let him pass, and tried to decide between a pine-scented and an orange-scented air freshener. Then I smelled stale alcohol and sweat and felt his right hand grab my arm. His grimy left hand ran up my bare-neck and his fingers ran through my hair. I felt his hot, coppery breath on my ear as he slurred, "What you need is a real man to show you what you are missing." I wriggled away and walked straight out to my car, locked the door, and drove away, very, very fast. Eventually the nausea passed. I took three hot showers that night.

I grew as much hair as I could and tried to forget. For a time, I gave up an experience I loved because how I expressed myself artistically put me in physical danger, and then I submerged the memory. When I remembered it again today, I was angry. And then I remembered other red-necked bastards in other towns, and the more I remembered, the angrier I became. The last time I flipped someone off in traffic because a car full of drunk men tried to run me off the road. The last time I beeped my horn at someone in front of me because of the man who got out of his truck and came back and threatened me. Luckily, I was able to roll my window up quickly and flip him the bird. The last time I waved away cigarette smoke because of the misogynistic college student who turned around and started pushing me toward the edge of a bridge.

I'm not saying these were good driving habits, or polite actions. What I am saying is that what is considered polite behavior for women is narrow and confining, and that long hair may just be the American woman's burqa. If that is what you want, c'est la vie. In France, the back of a woman's neck is considered quite feminine and sexy. Think Audrey Hepburn, or Audrey Tatou. Unfortunately, American men have not gotten the memo. Years later, it hit me: Holy Mary, Mother of God, I think that son-of-a-bitch red-necked bastard in the New Mexico auto parts store gay-bashed me. Me, a straight woman. Apparently, in their tiny...minds...short hair and strong opinions becomes confused with sexual preference. If they are this confused, I strongly suspect they are getting very little. Maybe that is why they are so angry.