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Make a daily wish… May 21, 2008
One of mine came true today…I was invited to read one of my essays on NPR! Listen at Weekend America archived programming here:
Pushing the Ice Cream Envelope
A Winter Meditation March 23, 2008
This was written on leap day. I might add that it is still very cold for a Kansas Easter, about 30 degrees with wind chill.
When I let the dogs out this morning, I heard a bird singing in the near-darkness. My heart leapt with joy at this first sound of spring. It’s still only late February, really, but it’s the first noise to break the still, steely grip that has been this terrible winter.
When I was a girl, we had deep snows on occasion, deep enough for Dad to tie the sled to the back of the pick-up and pull us through the fields. Looking back, the potential for tragedy was enormous, but at the time, nothing could be more exhilarating than flying over those fields at 20 mph. We had deep cold, and temperatures low enough that our breath was visible inside our unheated bedrooms, low enough so that ferny, lacy frost appeared on the inside of the windows, and a thin veneer of ice lay in the toilet bowl on particular mornings. We had ice storms: county-glazing tree-bending ice storms, often enough that my sister and I found our old Dodge Coronet in the ditch at least once a season, left behind for some passing farmer to pull out while we trudged on toward school, awaiting the neighbor that would surely drive by and pick us up. We lost power a lot, once for 10 days, so that we had to live in the kitchen with the gas oven to warm us and a kerosene lantern to read by. It was very “Laura Ingalls Wilder.”
Since I have become an adult, however, the winters here in Kansas have, by and large, been quite mild. An occasional snow before Christmas, but usually just cold and gray, with some scattered snow in January or February, deep enough to sled—if you were lucky—with a plastic toboggan, but runner sleds like our old Flyer were out of the question. One Christmas, as a poke at Jack Frost, who had apparently gone North for good, our Christmas photo pictured our daughter, then 2, all geared up and lying belly down, laughing, on her old Flyer sled. It was a vivid contrast to the green grass in our sunny backyard.
There have been occasional big snows, dangerous ice storms, and sustained cold snaps, but usually interspersed with multiple days over 45 or 50, sometimes higher, when we could all take a breather, shuck off our coats, and feel the sun on our faces. These brief respites were like manna to folks like me, who tend to take a serious nosedive when it becomes cold and gray. In fact, I’m sitting in front of my lightboxes right now, one on either side of my computer. I think they may have been what pulled me through the winter, ultimately, kept me from spiritual starvation this winter. In Wilder-speak, they’re the equivalent to an extra bag of potatoes in the root cellar during this month of the Hungry Moon, or a side of beef found buried in sawdust way at the back of the icehouse.
My desperation and hunger grew this winter, as we plunged into the deep cold round about Thanksgiving. My lower back started to spasm as if in protest, and continued to do so for a month, as the weather grew worse and snow and ice covered the ground. Calls from my parents, getting older and more frail, were daily and distressing in mid-December, during a huge storm that took out most of their trees and their power for 9 days. Roads were so treacherous and my back so tenuous that I couldn’t get to them, and we all had to rely on the good neighbors around them to help with wood, the generator, gas, and food.
My daughter moved home with her dog a couple of days after my birthday, in late December, and I confess, I felt every day of that year older as we attempted to cram another household into our modest bi-level. Back to 4 in the house, but now four adults—and two dogs—who had to come to a new agreement of living. The dogs fought, the sky snowed, and I sat in front of my lightboxes, praying for deliverance.
January brought more snow and cold, along with colds and sinus infections throughout the household. Physical therapy for my back was painful and I lived in mortal fear of falling on the ice and further injuring myself. Nearly every diversion I had planned for myself that month was cancelled due to weather conditions. Cabin fever set in, and I could relate to the Pioneer woman of Kansas who was found dead by her own hand one winter with a note next to her, “Can’t stand the wind anymore.”
February came, the month that to most is the shortest, but to those of us who are winter-intolerant, it is almost always the longest. Along with it came two colds, a severe nosebleed that landed me in the ER, and influenza. Here I am now, on February 29th, battered and beaten by winter with its cruel extra day, almost despairing of spring ever returning. And then like a benediction, that bird opened its throat and sang. And I knew that this ordeal was nearly over. I marveled at the audacity of the little bird. Arriving back in Kansas from points south in the still-deep chill of February, awakening before the sun, it sang its brave song. It could not know if another bird would be here waiting, head cocked, to answer. But still it sang, a song of hope for both of us; and a ray of light penetrated my heart.
Et tu, Flu? March 13, 2008
Ohhhh, I am so sick of the flu. I have been diagnosing people with flu for about 6 weeks. Every time I think it’s over, another new case shows up. Not to mention that the vacation that my husband and I were supposed to take in February (optimistic fools!) was spent in bed coughing, racked by fever and chills. I continued to cough for 3 more weeks, despite early treatment with an anti-flu drug.
We Americans are just not cut out for this. We like our illnesses like we like our hamburgers–fast and exactly how we expected them. A few lucky souls will get over the flu fairly quickly, on their own. But most people are coming in angry—at me—that they are still ill after 3 or 4 weeks.
In many cases, their flu symptoms were atypical, so they were either mistakenly offered an antibiotic by their health care provider or they absolutely browbeat the clinician into giving them one. Without the correct, non-antibiotic anti-flu medicine, the symptoms can drag on for weeks. So after 2-3 days on the antibiotic pills, horror of horrors, they are NOT better. Then the rage really kicks in, fueled by unmanageable schedules, thwarted plans for spring break getaways, and unreasonable leave policies that either a)keep them at the desk while they infect their coworkers b)cost them vacation time because they are sick or c) result in unpaid leave, a stressor in itself.
The office waiting room is packed with miserable, irritable, coughing folks who have, by and large, grown up in a time when many illnesses are preventable or easily and quickly treated. They believe the 5-day antibiotic they got on day 3 of their viral cold cured them (most colds go away in about 7-10 days anyway, with or without treatment) Antibiotics are seen as a panacea, and honestly, who hasn’t experienced the miracle that 24 hours on antibiotics can effect on that bladder infection or strep throat?
This is what they expect from us, and this is what we cannot deliver. The vaccine was minimally effective this year, and the extra-long winter in our region is making things worse. We’ve learned recently that the influenza virus is a wily little bugger that comes complete with its own little winter coat. http://www.medicalnewstoday.com/articles/99228.php
The older patients, the ones who lived through flu epidemics of the past, are more philosophic. They nod when I show them the quickflu test vial, with its magically appearing pink lines—a line above the blue control line means Influenza A, a line below means B. Resigned to “wearing it out,” they accept my cough syrups and anti-inflammatories and go home to drink lots of liquids and rest. They know that only time will cure this thing, and they’re glad of our care and monitoring. Some of them remember that many people used to die from the flu–some still do, though in lesser numbers. This year, with this batch of flu, we have seen more post-flu pneumonia, more of those patients going on ventilators, and more deaths than usual. Despite all this, most people will eventually recover their energy and stop coughing.
It’s the younger folks who are bewildered, the ones who can’t figure out how to carve out time to be sick, that find fault with us for not returning them instantly to the rat-race that is their lives. They are not philosophic at all, merely impatient, and slow down very little during the flu, which in turn prolongs their symptoms. Most of our world moves at a hectic, ever-quickening pace, and we are used to putting our heads down and lengthening our stride to cope. Confronting an entity such as influenza that demands our time and energy, that insists that we slow down and take time to recover naturally causes a lot of psychic discomfort. It is this discomfort that is spilling over in my exam rooms.
The flu—and once you’ve had real influenza, you realize all of those other little illnesses you used to call “the flu” were but shadows of the real thing—WILL have its way with you. Remember, it had its way with perhaps 100 million people worldwide in 1918. We are fortunate to be a more heavily armed adversary in 2008. Influenza exists. You’ve got it. So stop being angry, take your medicine, crawl in bed and rest. In all likelihood, you’ll be feeling better soon.
Super Tuesday February 7, 2008
I didn’t make it to the caucus on Super Tuesday, and to be honest, it was probably a good decision. We had record turnouts in Lawrence, KS, and people stood in line in the freezing drizzle for up to 90 minutes. Then they were packed in, shoulder to shoulder, in the midst of cold and flu season. I have been sick most of the winter, and I just couldn’t face it. I’m sorry I missed the excitement, but Obama won so overwhelmingly in KS that my vote wasn’t missed. I lay at home, snug in bed, hemmed in by 2 dogs, and switched back and forth between CNN and MSNBC. Every time CNN started fiddling with their new toy, the “point and touch zoom board,” I flipped, and every time Chris Matthews opened his mouth on MSNBC, I flipped back.
It was an interesting night, and since John Edwards dropped out of the race, I have vacillated between Hillary and Obama, finally deciding on Obama because of Hillary’s support for the war. It was great to see him racking up states, as I believe he can bring about change. At the same time, I was also very proud to see Hillary winning her share. I realize that Obama’s campaign is as much of a first as Hillary’s, but he’s still a male, and in my book therefore still has the edge. As a woman, witness to misogyny and sexism on a frequent basis, I was worried that America still wasn’t ready, still resisted the idea of a woman in charge of our country, despite the existence, past and current, of multiple female heads-of-state around the globe. But apparently, many of us have come a long way baby, and Hillary is a truly viable option. I will absolutely support her if she is the nominee, and frankly, I hope she and Barack end up on the same ticket.
I know, of course, that these results are based on my party only. The Republicans, those lovers of the barefoot and pregnant homemaker, don’t seem at all ready for a woman in the White House, although if Condi Rice–perish the thought!–were in the running, how fast would they change their tune? Hmmm, and could she get oral contraceptives on her government health plan?
By the way, that thought–Rice for President–is the best argument I can think of against anyone who would tell me it’s my duty as a woman to support a candidate simply based on gender.
My evening ended with an email from Barack, who, it seems, understands the personal, best-friends tactic incredibly well.
“Karen,” it said, and here I paraphrase: “we’ve won in Kansas, thanks to you. Michelle and I couldn’t be happier.” It was signed simply, “Barack.” I’m used to getting emails from my congressman that routinely tell me why he doesn’t give a shit about what I think, and end “God Bless You?” (I’m serious). Barack’s personal missive was a breath of fresh air.
So I snuggled down with the doggies, and nodded off to sleep in a land where new possibilities exist–the possibility of a black president, the possibility of a woman president–and I was content.
Queen-size no more?
I saw a commercial last night for Jenny Craig with Queen Latifah as their newest spokesmodel. I felt sad because she has always been completely HOT, unapologetic about her size, and a great role model for women.
Whether she has health issues, or just wants to be a different size, it is her absolute right to lose weight. I am bothered by the mixed-message aspect, though (multiple size-positive “I’m happy with my weight” articles coupled with the sudden announcement, “I’m a diet spokeperson”). I know this is probably not fair to her, but I felt she was one of the most visible holders of the “famous, full-figured, and f**k you!” banner. I would just really, really like to see a couple famous people stay happy and above a size 12–you know, to represent “the rest of us.” Selfish, maybe, but let’s face it: I get more of a kick out of adoring someone who looks like me. Adoring someone that I could never in a million years resemble smacks slightly of self-loathing.
I also wonder if Jenny Craig put the full-court press on her, or if she was even considering weight loss ’til they came knocking…after all, it behooves the diet industry to eradicate any and all women who are considered beautiful and who are comfortable with themselves and are above a size 14-16. The dearth of real-sized women keeps the rest of us anxious and eager to spend money to achieve thinness. As a health care provider, I am aware of the problems obesity can cause, but I am also acutely aware of the body image issues that plague most women in our society, both women who are large and women who are not obese by any measure. These very issues are exploited by advertisers to drive a multi- billion-dollar diet and fashion industry. So while I love Queen Latifah and feel she has a perfect right to her actions, I’m sad to know we’ll be seeing “less of her.”
The Fat of the Land January 24, 2008
I’m not a skinny gal, so forgive me if I seem unfeeling. I wanna talk fat for a minute. Yeah, fat. Not obesity; that’s so…clinical.
Obesity is closing in on a spot on the top of the list of preventable causes of death in the U.S. I get quite a few nursing and medical e-letters, and there is at least one item pertaining to obesity in each of them every single day. The malls are full of size 6 clothing on display and size 26 and above folks in the food court. Americans are fat. We know it—my god, do we know it. The media discusses it constantly, it’s an epidemic now. Every candidate discussed the obesity crisis in America. There’s a lot of talk about sedentary lifestyles, convenience foods, stress eating, and body image distortion, and then: cut to a commercial of a sugary snack. Oh, look—it’s pizza, and guess what, there’s another layer of cheese hidden between two crusts, and then topped with—that’s right—more cheese!
Why are we fat again? Let me put down this deep-fried twinkie and think about it. Okay, I’ve got it. It’s combination of three things: television, advertising, and automobiles. My god, you say, all the sacred cows of America! How could she? Relax, I didn’t hit all the cows—I left out alcohol, tobacco, and guns. So back to the causes. Do we walk anywhere real? NO. We walk on tracks, paths, and treadmills. We don’t walk to the movies, the store, or the park. How many images of fattening foods and sugary snacks do we see in 24 hours? Counting TV, radio, billboards, magazines, bathroom stall ads, and subliminal ads piped in while we sleep (“Go get a snack. Wendy’s is open all night.”)? About a thousand a day, give or take a couple hundred. Even when you don’t think you’re being solicited, you are. Now, for the worst offender: television. Television combines inactivity with advertising. A deadly combo for the fat and soon to be fat. Even the remote control is a culprit. Every time my sister made me get up and change the channel, I burned about 10 calories. When was the last time you got up to change the channel? Don’t tell me that you sat through a candy sculpting tournament on the Food Channel because you liked it, buddy. You just couldn’t find the remote.
A few brave researchers blame dieting, a multi-billion dollar industry which offers hope, time and again, for just a few dollars more. Unfortunately, studies have shown that very few programs result in long-term weight loss. Our weight loss spending has expanded along with our waistlines—we now spend tens of billions a year on diet aids and programs, yet have a greater than 50% obesity rate. One out of every five children is obese, and we all know how people treat fat kids.
We are super-size crazy. We love everything that is super-sized—except people, especially women. The trend toward giant burgers, buckets of soda, and heaping mounds of fries is the subject of some discussion, but no real blame is assigned, no solution proposed, save that of self-control. Americans and self-control don’t exactly go together. Our gambling, substance abuse, and credit card debt statistics underscore that fact. Putting aside a portion of your enormous meal is a nice idea, but multiple studies reveal that people will eat the portion given them, regardless of how hungry they are—especially when they pay 5 bucks for it and it slides down the throat like an oil slick.
Is it a surprise, then, that in our super size culture, people have super size bodies? Our children are targets from infancy, marketed unhealthy “meals with toy” while still in the crib. Snack foods and soda machines are in their schools. Physical education requirements decrease yearly. Children sell (and eat) candy and cookies for fundraisers. A local restaurant owner recalls the largest soft drink he sold in the seventies—12 ounces. Today, there are 64-ounce soft drinks available at the quick shop on the corner for 69 cents. A bottle of water, 12 ounces, costs $1.39. Which will kids buy? Juice in the college cafeteria costs $1.89; soda, 89 cents. Cheese, although nutritious, is a major source of saturated fat. Pizza companies have figured out a way to add more cheese to the pizza, by hiding it in the crust—and it comes with a fat-laden dipping sauce. Cookies are enrobed in chocolate, yogurt (yogurt!) now comes with candy sprinkles, and burgers have 3 patties, 3 kinds of cheese, and 3 strips of bacon, which will eventually get you a triple-bypass.
We’ve all heard about the obese man suing the fast food giant. It seems ridiculous on the surface, but perhaps a closer look is merited. Humans have a biological predisposition for tasty, satiety producing fat. By saturating our food with it, is the industry loading the dice? Personal responsibility is certainly an issue, but history has shown us that industry is willing to risk our health for their profits, with cigarettes, alcohol, and other substances. Marketing takes place on a conscious and unconscious level, and makes ample use of the human drive to lay down a cushy layer of fat for the coming famine. Eons ago, our ancestors experienced it once a year, during the winter. More than half of us are still waiting for the yearly famine, and adding a little bit more to our cushion every year.
Soon, we will all be feeling the pinch of the belt at our waistline. Even the thin among us will fork out more in taxes to pay for the healthcare of those of us hitting the drive-through. Paying for diabetes alone will be astronomical. The thin will speak smugly of self-control and personal responsibility, while the chubby fight 24-hour marketing aimed directly at their stomachs. Perhaps it is time to look toward prevention, something in which this country has a rather poor track record. Banning soda and junk food in schools is a start. Subsidizing healthy foods at college campuses, to make them the cheaper, faster choice would be a great idea. Bringing some pressure to bear on fast food restaurants to substantially decrease portion size and eliminate marketing to the very young is critical. Perhaps fast food chains should subsidize the installation of play areas in local health club instead of in their restaurants. Insurance companies need to pay for comprehensive coaching and lifestyle programs, rather than lap-band surgery, which works short-term but has a number of complications and, in the end, many patients gain all the weight back.
We’ve seen clearly that many companies have to be forced to do the right thing when profits may suffer—look at tobacco. As much as you’ll hate to hear me say it, our government must get involved. After all, government controls and funds the healthcare systems that will foot the bill for obesity related diseases. The Medicare End-Stage Renal Disease benefit, for example, which covers kidney dialysis, costs the government billions of dollars yearly. Diabetes and hypertension are two major causes of kidney failure requiring dialysis. Type 2 Diabetes and hypertension have both been clearly linked to obesity.
The government is beginning to take action, but in ways that will likely not change the problem—food labeling, nutrition information at restaurants, and a focus on calorie counting. These are tools used primarily by the fit, not the overweight parent and kids on the run between soccer games—they grab what looks good, and what’s fast. I certainly applaud any and all efforts, but promoting walking paths and parks, funding physical education with an emphasis on lifetime activity, and limiting marketing of sweets to children might go further in the battle. Promoting and subsidizing small family farms, Community Supported Agriculture groups, and local food businesses and restaurants are all important pieces of the puzzle.
Many ideas related to obesity prevention affect the bottom line of companies, particularly large corporate farms, and so they oppose them. I hope that this changes. It’s right to help Americans eat healthier. It’s vital to our healthcare system that we do so. We cannot continue to wring our hands about this “epidemic of obesity” and follow it with a commercial for a giant hamburger.
Sanctus Ornamentum December 11, 2007
Sometimes I run across things when I’m cleaning or sorting my stuff. Virgin of Guadalupe cards; cards for St. Jude, St. Francis of Assisi. My rosary, tucked away in a jewelry box, lying silent in a soft leather purse. I hold it to the light. Deep red stones flow like drops of blood across my palm: stigmata.
Like most packrats, my house is a reliquary of broken shards and slivers. Most are secular, some are spiritual. I hold a photo of myself, all dolled up; a tender 7-year-old bride of Christ. I rub my hand against gold-leafed picture frames and envision soaring dark spaces, quiet flickering flames of intention. I imagine that I touch the hem of Mary’s blue gown resting on her sandaled foot in the sacristy.
I left the church long ago, for a marriage that eventually ended. The lessons etched into me by the catechism of Sacred Heart Catholic Church have been washed away over time, leaving a clean smooth place. They have been replaced by a catechism of my own making, one that has evolved over time, unlike the ancient and enduring mythos of the church. But I confess that I still have a bit of a connection left, still a tiny bit of religious umbilical cord. It’s triggered when I see a bit of gilt, or a votive bearing the image of a saint. I am drawn to it as surely as I was once drawn toward the altar, mouth open like a baby bird for the body of Christ.
I run across these items in lots of places, but none more than a local Catholic bookstore. Every so often when someone I know requires a holy medal or a christening gift, I browse a little. I am distracted and then angered by what I see as propaganda—brochures about abstinence that are patently shaming to women, booklets about “The American Holocaust” of abortion, which insults both the victims of the Jewish Holocaust and the women who struggle with this decision. But then my gaze finds something—a card or medal—and I touch it, handle it with tenderness and a quick intake of breath. The holiness is there, present in the simple beauty of the object.
I shuffle through the holy cards of the saints—those gracious and concerned helpers. Who wouldn’t feel affection for these everyday assistants? St. Anthony’s my main man, keeping his eyes peeled for my car keys, a bracelet, a favorite book. I turn each totem this way and that, weighing its aesthetic appeal against my disputes with the Pope. Sometimes I buy, taking home a tiny piece of my childhood in a crinkly paper sack. These items are sanctus ornamentum; items I first associated with a state of grace.
My ornamentum is now much more diverse—trees, warm skin, flowing water, smooth stones, faint moonlight, pen and paper, rising bread, a furry black dog, the scream of a kestrel in the pasture outside of town. These things are my holy trappings now, and give me sustenance. But there remains a desire to create my own holy place, a place with just a hint of the Sacred Heart. In this place there can be no vaulted ceilings, no marble floors, and I miss them. But on the other hand, there are no hard wooden pews either. Just a humble corner filled with objects of everyday worship and a comfortable cushion upon which to sit. My confessional is a smooth white porcelain tub, where I make long-distance revelations to my sister or mother. (Or to myself.) Lying in the steamy water, I dissect my transgressions and triumphs—the latter, sadly, are ignored in the dark recesses of the church confessional. The priest behind the screen had no interest in my glories, only my sorrows, my sins. Here in my sacred space, both have equal import. I immerse myself, and then pull the plug, washing away my sins. And oh, the resurrection of the body! Naked, sinless, shining.
I once thought I left it all behind: the incense, the chanting, the myopic patriarchal dogma. But in these rituals, in these sacred and beautiful objects, I catch a glimpse of my childhood religion, and I am comforted. The black-and-white certainty of the priests and nuns has been replaced. But as I live in the messy gray area that is real life, I am on the lookout for that flash of gold. After all, there’s nothing like a little gilt to catch the eye of an old Catholic girl.
When Skeletons Walk November 30, 2007
By late summer, when the hospice nurse switched Don over to liquid morphine, his wife and kids had almost stopped tiptoeing and holding their breath. Don had always been a mean drunk and they weren’t ready to forgive and release him like the social worker said. Occasionally, as the flesh dropped away from his bones, he acted ready to bring up the subject. But by the time he had marshaled his courage the room would have emptied, everyone suddenly busy with household chores and whatnot.
The day he died was like every other day of the previous nine months except that he barely woke at all. Charlene washed his face and hands and wrestled him into a clean gown. Life went on around him. By midafternoon, he was breathing deeper, intermittently opening his eyes and staring into space. Charlene slipped the hospice pamphlet from between the pages of a romance novel and read the signs of impending death. She called the nurse.
The nurse arrived to find Don stark naked and raving out in the yard, Charlene pleading with him to come back inside, honey, come back inside. He was swinging at Charlene and screaming, wild eyed and sweating. The nurse grabbed her cell phone and dialed the pharmacist, all the while chasing Don around the yard. She lacked history with his fists, and so was willing to get close—it was her job. In twenty minutes, she had accomplished the following: Don was seated on the porch, his lap was covered by a blue hospital gown, and he was drinking a little water. Charlene sat in the kitchen and smoked a third cigarette.
When the pharmacist arrived with a syringe full of the most sedating medicine on his shelf, Don sprang to life again. It took all three sons and the pharmacist to hold him down while the nurse jabbed the syringe into his wasted thigh. In a few minutes, the same group carried Don—now a sweaty, sobbing, angry mess of regrets and confusion—into the house. Within thirty minutes, the hospice nurse had him bathed and settled into bed. Soon he was asleep. With nothing more to do, and offers of additional help—volunteers, the chaplain, social work—politely declined, the nurse left.
The family, exhausted by the afternoon and skilled in the practice of avoidance sat silently in his room while he drew his last, gasping breath. They reported to family and friends that he died at peace and that the hospice nurse was an angel.
Traversing the Midlife Minefield 
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