Chasing Amelia

The wine: Pinot. Unless you brought something better.
The women: Me and Amelia, Beryl, Cappy...
The song: Magic Carpet Ride, by Steppenwolf.

The thing that surprised me the most was how little speed you actually need at the end of the runway to get airborne. Ninety miles an hour in a Piper Cherokee 180, full throttle, slight pull back to get the nose in the air, and you are airborne. Years of loving every moment of every plane ride, closing my eyes to feel the hum of the wheels on the runway in the center of my chest, feeling gravity push me down. Years of reading books by and about my idols: Amelia Earhart, Antoine de Saint-Exupery, Beryl Markham. Years of meeting other women pilots who haven't yet written their books, looking at their sepia-toned photographs, "first licensed woman in the state of...", hearing their stories, sharing the look, knowing yourself in the eyes of elderly women who, like me, love defying gravity at every available opportunity, love slipping the surly bonds of earth to reach out and touch the face of God, to paraphrase the oft-quoted poem "High Flight" by John Gillespie Magee.

But before I could touch the face of God, I touched every inch of that plane in pre-flight. I personally checked every bolt, aileron, wheel, rudder, gauge, oil levels, electrical and communication, brakes, gas tanks in both wings. A good, thorough pre-flight is prerequisite to a safe flight. My life, and the lives of anyone else on my plane, depend on me, and that is a responsibility I take extremely seriously. Pre-flight to me is like a good chemistry experiment or history and physical of a patient. Head to toe, same order, every time, to be sure you haven't missed anything. My chemistry experiments always worked because I knew exactly what I was doing, and I approach flying an airplane the same way. The thrill is more than devil-may-care excitement, the thrill of flying for me is similar to my other great loves: physical therapy, writing and fencing. It is about mastering a craft that is detailed, rich in history, mentally and physically demanding. In mastery there is freedom.

And before mastery will come many hours of practice, with the basics. After years of dreaming, and with a little speed and a little chutzpah, suddenly I am in the air, trying not to roll, trying to control the angle of my ascent, trying to relax. I use all four limbs together, working the rudders and wings, achieving altitude, leveling off, listening to communications flying, sorting out which ones are relevant to my altitude, destination, flight plan. The air really is like a freeway, divided into levels, directions, rules. I am confident of memorizing lists of rules and diagrams, studying for the licensure exam. This I have done before. I am confident in my flight instructor, he is comfortable, and gives the the right amount of freedom and support, direction in a way that I absorb readily.

I asked him why he started flying, thirty years ago. "I met an old crop duster, in North Dakota," he said. "He took me up. I loved the smell of the air fuel. I always wanted to be around it. What about you?" He gives a little, I give a little, we eat our fish and chips at the Bremerton Airport. It is my first lesson, and other pilots come over to our table with shy but swaggering congratulations. It's a friendly little group. Should I mention the fact that I like the smell of exhaust? My lifelong dreams of flying? Daydreams of a summer spent smoke jumping? "Freedom," I finally say, after considering. "I like take-off. I like rising above the problems on the ground. I like being alone. The sky is good for that." He smiles. It seems like enough.

I never dreamed of being chased, as I hear other people describe. I always dreamed of flying. Of running, running, never having to stop, stretching out my arms and flying. Defying gravity. Chasing Amelia.

Sounds of Silence

Not dead, Dear Readers. Just thinking. Deeply. I've been told I should do less of that, but do I listen? It's lovely down here at the bottom of my well. Quiet. I hope it's lovely and quiet and peaceful where you are too. Back soon.

Alone with Crazy

Tonight's Wine Selection: Back to the Malbec. Am I too predictable, or just too busy to stop at a respectable wine store? Organized habits, wild mind.
Tonight's Music Selection: Crazy Baby, by Joan Osborne, on One of Us

"And your hands are really shakin' somethin' awful, as your worries crawl around inside your clothes...Oh how long will you be sittin' in the darkness? Heaven knows...Oh my Crazy Baby, try to hold on tight...Oh my Crazy Baby, don't put out the light..."

Duck, Darlin', 'cause here comes a shit-pie. This is what I tell myself when I pull up new patients on my caseload who reside on a certain city avenue. I don't want to say it is predictable, but...well...it's predictable. Back in my epidemiology days I analyzed homicide and assault data for trends and hot spots and recommended initiatives for "street heat", stings and SWAT initiatives. I researched predictors and attractors (strange and otherwise) and tried to explain rudimentary predictive modeling to beat cops, rogue cops, undercover cops, police chiefs, mayors, Bureau of Justice Statistics pals, Department of Justice policy types and once or twice to Janet Reno herself. She was tall, and wore sensible shoes. I say this to back up my game; I know a hot spot when I see one. I haven't completed my calculations on this quarter's caseload, but the early results point to a finding of "Damn, Girl! You landed yo'self up in a Hot Spot of Crazy!"

So I was not at all surprised today when a patient from this area verbally abused me on the phone because I was not giving her what she wanted at the moment she considered appropriate. This area of town has a lot of users and abusers of every stripe and hue. Everyone on that street seems to be a hustler of some kind, and if I had more down time from treating their musculoskeletal and neuromuscular problems I would find it damned amusing just to sit back and watch as they try to run their games on each other.

Whenever I drive down this street I get to re-visit fond memories of this house and that house, here is where I had to discharge for drunkeness, there is where customers (men...customers...) sneak out the back, over here is where is where Jenny-from-the-Block walked up and started pounding on my car while calling me nasty names. I smiled, waved, and gave her the two thumbs up. Good times. I always make my stethoscope and medical bag very visible, and usually that gets me a pass and good treatment where ever I go. But that's just bad behavior. Crazy is different. Crazy is palpable.

Crazy is when their answers have nothing to do with your questions, when they get stuck on a thought and keep repeating it, perseverating like a record with a skip. Crazy is when they burst out in nonsensical phrases, and start telling you stories and symptoms and making requests of you that have nothing to do with reality. I've dealt with many mentally ill patients in various settings, hospitals, outpatient clinics, long term rehabilitation. But it's hard to be alone with crazy, with no back up team, no witnesses, the sole clinician as someone decompensates, spirals down. You assure safety. You try to make connection, talk them down. You make your notes, you make your calls, you do the right thing. And in the end, you save your self, because you have to, and because there are more patients to see, down the same road, in Crazy Town.

The Memory of Pain

The wine: I'm out (gasp!) And I'm taking suggestions.
The music: One Paper Kid, by Emmylou Harris and Willie Nelson, on Quarter Moon in a Ten Cent Town

"And all the time that he'd wasted wasted was his once again, it never takes too long to go where you've been...Broken hearts scattered all over the past, old bad memories tryin' to last...

When she steps down, it's like the it's first time, every time. I coach her through it, again, a little frustrated that each time we meet, we cover the same ground. After a few minutes, with my voice in her ear, she starts to loosen up. "You can do this. I've seen you do it. Full weight. Does it hurt when you do that?" With me telling her, coaching her, she walks normally. "No. It doesn't hurt now." "Well, does it hurt when I do this?" By now we are sitting, and I am open up her joint, using my body weight to manipulate her own, giving her space in new ways. "No. It feels okay." We work. She grunts. We work some more, more space, more movement. "You need to remind yourself, each time you stand, each time you walk, to put your full weight on it. You can, and you need to." "I'm afraid," she tells me. "I think I'm afraid it's going to hurt, still." "Does it hurt now?" I ask her. "Noooo..." She looks confused, befuddled. "Well..." I ease into it, rubbing her gently between her shoulder blades. "Maybe you are held back not by your pain, but by the memory of the pain you had. It's okay to let that go now." A little light bulb goes on. She walks away from me without a limp. She is surprised. I am not.

Everyone I work with has, in some way, been beaten up by life. So have I. Car wrecks. Falls. Broken bones. Surgeries that leave scars. Broken hearts that leave what feels like an eight lane freeway running through your chest. Crimes, the real kind. Threats. The real kind, pressed up against a wall with a hand across your mouth. The things that people say "I could never go through that." Suddenly, it happens to you, and you have no choice. You go through it. Because you have to. It's happening to you, right now, and suddenly you know a truth you did not know five minutes ago, back when you were happy, back when Life Was Good and We Were Us and now it's different and you're blind with rage and groping around for the bottle of ouzo that is suddenly your only trusted friend. Or you get the call, the one with Goodbye, and for ten minutes you stand there trying to feel your own lips. Or someone says that thing to you, that painfulhatefuluglythingyou'vealwaysfearedisreallytruething. Those things that change you forever, leave you afraid to breathe, afraid to think, afraid to feel. Afraid to put your weight down.

I've been there. Here's one. Twenty-three years ago in a sweltering ground floor apartment in Pittsburgh I woke up to the sound of screaming and someone pounding on my door. I was so terrified I couldn't move, I couldn't breathe. And I couldn't wake up. When the police detectives came to my door, I knew what had happened. There were two of us in ground floor apartments. She left her window open. I couldn't fall asleep alone for the next fifteen years. It was the memory of that pain that kept me from letting go, and moving on. One night, alone again justbecausethat'showlifeworksoutsometimes, exhausted and in my middle 30's, I finally found the courage to say "Fuck it. Fuck IT. I'm going to sleep. Anyone tries to bother me will get their ass kicked."

I've slept like a baby ever since, and what's more I can fall asleep damn near anywhere at the drop of a hat. I still have the memory, but it's no longer painful. I think it was because I finally decided I was worth more than that. So are you. Plus shouting FUCK at the top of my voice always makes me feel really, really good. I put my foot, and my weight, down. I was no longer going to waste any of my life on the memory of that pain.

Slather 'Em with Honey

The wine: A tall glass of cold, non-fat milk.
The song: Tupelo Honey, by Van Morrison.

A mountain of a man, really. Much too large for me to handle alone, never-the-less I do. Last week, during the first visit, he wore me out with well-worn tales of what he could not do and why. I left sad for him, wondering why so many people diminish themselves, telling themselves just-so stories of limitation and failure. A resolute refusal to dream, a mind closed to new possibility, wears me out, leaves me mute. For every suggestion, a reason why not. I know that people limit themselves in every way because of fear, and part of my job is to lead people through their fear. A good therapist keeps patients dancing on the edge of failure, without ever letting them fall, until, like Peter Pan, they fly. As I drove to my first appointment with him, my stomach tightened in anticipation. How could I convince this man to dance with me, to take a chance on something new, to give feeling better a chance?

As a child, I used to hear the phrase, "You'll catch more flies with honey than with vinegar." Congenital smart-mouth that I was, I would calmly look up from my book and say, "And why...exactly...would I want to catch...flies?" I got sent to my room a lot as a child. As I became an adult, I never really got the hang of "sweet talking" anyone into doing something they didn't want to do. It seemed like a cheat, a compromise, dishonest. Plus I never had to. I simply presented a logical argument and expected the other person to do the same. Either you agree, or you don't, no harm no foul. Don't want to participate? That's fine. There's a hundred behind you. Or, I'll do it on my own. That's fine too. A former boss of mine, whom I shall always think of lovingly as The Gentleman from Tennessee, used to drawl (as only he could), "Ms. Fuqua-Whitley, you do not suffer fools gladly." To which I replied, "Dr. X, I do not suffer fools at all." To this day I miss that man. Ah, we were a good team.

But you can't do therapy with a patient who will not participate, so in the fine wine vintage of my middle-age, I am learning to sweet-talk. Today, I surprised even myself. By the end of the session, I had this giant of a man, and his lovely, grateful wife, eating out of my hand. I anticipated needs. I led him to the dance floor. I remembered likes, dislikes. Dare I say? I wooed. He purred. He did his exercises. He implemented my safety suggestions, because they came out of his own mouth. It was a tango of therapeutic perfection. I had what I believe is colloquially called, "a little South in my mouth."

Oh, yes ma'am I did. Sweet as Tupelo Honey.

Show Me Your Teeth

The wine: A favorite smoky Malbec, that makes me think of the train ride through South America that I have been dreaming about ever since I can remember.
The music: Teeth, by Lady Gaga

A week of fencing breakthroughs. First, I have been battling a small but nagging injury in my fencing arm, and this week I have had the first pain free days I have had for at least 4 months. Pain free days. I have not had to ice. I have not had to turn my head away quickly so my patients will not see the tears when I feel the pain. I am still wearing a brace at work and while fencing, but today, a pain free day. My grip is stronger and I am not dropping cups anymore. I am ready to sing for joy.

Fencing bouts are getting much stronger, also worth singing about. A few days ago at the club, lost 10-8, down by two. Then I lost 15-14, but I came back five touches in a row. I mean, I was fierce in that bout. It felt SO good. My arms responded. My legs responded. My head responded. My touches were intentional, I had blade control. My finger control is much stronger, so my forearm extensors have to work less, which improves my lateral epicondylitis. Oh what joy! My arm is finally extending before I lunge, I am leading with my arm instead of my leg after weeks of working on it. I see more openings, mistakes my opponent is making. Footwork is getting faster. It is fresh and fun and immediate again, and I am no longer operating under a raincloud of pain.

The lesson to think about this week: Don't go searching for your opponents blade. If you can't see the tip, back up. You need to know where the threat is coming from to know how to parry. Can I take it in 6? 8? 4? 7? Free the arm and the legs will follow. Free the mind and the body will follow.

Free. Ready. En guarde. Show me your teeth.