Black And White And Blurry All Over

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There it was. The second pink line.

Pregnant.

My heart sank.

I stood outside the exam room and took a deep breath. She was thirteen. 

She knew as soon as she saw my face when I entered after knocking softly. She started sobbing uncontrollably. Her mother sat in the corner and looked sea sick. She was holding onto the edge of her chair for dear life, knuckles white, waiting for the world to turn upside down and topple her over.

“You are pregnant.”

Her mother dissolved into angry shouts about her whore of a daughter. 

Not an auspicious beginning at all. Babies should be greeted with joy and love and excitement. My heart hurt.

“I know it seems unfair for me to ask, but have you thought about what you want to do with this pregnancy?”

Her mother spoke up before the patient could, her voice charged with bitterness. “She will have this baby and put it up for adoption. She made her bed, now she has to lie in it. We don’t believe in abortion.”

The girl glanced over at her mother then back at me, helplessness in her eyes. Any discussion about other options was met with a stoney glare from her mother. 

She died during the childbirth.

Should she have had an abortion? I don’t know. It is not my place to decide. 

The world used to be a stark black and white for me before medical school and residency. Everyone is welcome to their own personal opinions about abortion. I respect and will defend your right to believe any way you wish. But before you make decisions for anyone else about their access, I implore you to walk with me for a while in the blurry fringes where the gray resides. 

It is such a polarizing subject and it makes me very nervous to speak up on it but I am bothered by some of the political rhetoric of late. I hear the hate spewing forth from both sides of the fence and wonder if and when love will ever win.

Threadbare

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I am sneezing and wheezing again as I pull out old Nancy Drew volumes from the shelves and plunk them into a musty cardboard box. 

Why didn’t I bring my asthma inhaler?

The dust hangs heavily all around me, dust that has lain here for decades. It was not how I envisioned spending Easter but my mother had begged me. I squint and blink as I read titles, as much to keep the dust out of my eyes as to keep the tears at bay. There is a reason I have been avoiding it for so long.

This room used to be mine.

I grew up here, shed more tears than I care to remember within these walls. I cried out to God so many times when I just wanted to die. There was no hope left for me here.

Please. Take me away.

There is a different bed but everything else, including the ancient fraying pastel curtains, used to be mine. Now it is called the guest room but no one has ever been brave enough to spend the night here, not since my last night in 1997, the night before I eloped.

I wanted to escape.

“We have three bathrooms but when it rains only one toilet works…” My father thinks it is funny that the toilet overflowed on a high school friend of mine. He likes to tell the story over and over again. I don’t remember it, truthfully, but why argue? He will not remember next time I come.

The walls of an ancient box are crumbling down around my old drawings. “You used to be so artistic,” my mother says wistfully as I stuff sheafs of paper into a new box. My kids might get a good laugh out of them now. They are truly awful…

No more crying. Not here. Not in this room. Not now. This is not me anymore, is it?

Old stuffed animals are still strewn about, untouched except by the unrelenting hands of time. My precious giant pink hippo that I bought from the Goodwill store with money from hours and hours of pulling weeds in the garden in 100 degree heat now has a giant hole that stuffing is pouring out of. How does that happen when you are not looking? The threads that hold you to your childhood just decay away.

“Maybe you can sew up the hole?” my mother says.

“It’s, OK. Just throw them all out…” I try to act as if I don’t care.

There are holes in the walls from pipe work done when I was a teenager. They wanted to keep the holes in case they needed more work done on the plumbing at some point, work that was never needed. I covered up the holes with posters of an F-16 fighter jet and Faberge eggs.

Plugging the holes with strength and beauty. I understand it now.

Out the window I can see the lawn hasn’t been mowed in months and the grass now stands knee high due to the early spring. My father says he is afraid to mow when there is any wind because the clippings might land in neighboring yards and upset someone. Not that anyone has ever complained about clippings. They will complain about the unsightly yard soon enough, I bet. He shouldn’t be mowing anyway, though.

Financially they are in a great place now. They could pay to have all of this fixed. Hell, they could demolish everything and build anew three times over. But they won’t. Instead, my mother complains about the lettering on her Pyrex measuring cup wearing off too soon. She has had it since I was a child.

“How much do they cost? And how long should one last, anyway, mother? Just buy a new one!”

This place is a mausoleum. When I am away I can choose to remember how I want to remember, what I want to remember. Here, the memories are forced upon me whether I want them or not. 

I will not do this to my children. I will redecorate their rooms as soon as they leave for college.

I know I should visit more often but when I go, the place fills me with grief. I still want to run away, to save myself. I still want to escape that little girl’s despair. And yet…. I think the thread is unraveling bit by bit. The hold is getting weaker, I can feel it. 

Someday, this place will no longer exist for me.  

Exposed

Wearing a bathing suit in public is tough. I have never felt comfortable with myself in a bathing suit even when I weighed 110lbs soaking wet.

Truthfully, I would rather stand in front of you completely naked than while wearing a bathing suit.

This weekend as I stood in the wave pool with my kids, I watched everyone else walking about seemingly not self-concious in the least bit despite their cellulite and stomach folds and leg hair and I started to wonder:

What is wrong with me? Why can’t I just get over myself and take this dress off? Or at the very least, why can’t I be a better actress? 

I had on my long skirted swim suit with a tank dress cover up. My daughter was begging me to, “Take it off, mommy! Please, take it off…” She wanted me to look like the other moms around us.

To be honest, I felt terribly guilty. What am I demonstrating for my daughter? Body loathing? Am I teaching her to be ashamed of herself? Will I give her a complex? Are other people judging me?

But I just could not take off that coverup, even on the water slides, even in the deep water.

I simply could not do it.

I realized that I was not enjoying this experience because of all of the pressure I was feeling. That pressure was making me recount in my head all of the things I hated about myself. A never ending broken record.

I hate my thighs. I hate the extra bit around my middle after kids. I hate my shrinking boobs and my upper arms flapping. I hate my hair when it is wet. I hate my face without make up. I hate my big butt. I hate my teeth. I hate my smile. I hate my toes. 

Just as a forty something woman with amazing abs walked by with her seven year old twin boys, it occured to me that I really was terribly ugly. Not a bit of flab was on her and I hated that woman. I hated her because I hated myself. She was everything I wanted to be. I have run marathons. I have worked out like crazy, starved myself…. But I am fighting a losing battle against the genes. My genes. AND, I am a forty something mother. Why can’t I just accept and embrace this?

How do I learn to love this body of mine? Maybe I need a self help book. Or two. Or three. Maybe even a seminar?

The answer, I have come to realize, is that I won’t ever love myself. Spare me the platatudes about all of that. I will never love myself. Oh, maybe from time to time I will like how I look in something, at least until I see the pictures, but I will likely never reach a point where I truly love and accept my body. Having peace about that is a huge step for me.

I will never love myself and that is OK! Is that such a terribly wrong thing to say? Does it make you feel uncomfortable? Maybe I seem like a sell out of sorts?

Why do I have to love myself anyway?

Why do I have to wear a terribly revealing bathing suit and strut around like I belong in it just to prove something? Why can’t I just do what makes me feel comfortable without feeling judged by it? Can’t I teach my daughter how to protect herself emotionally, to stand up for what makes her feel good about her body, even if it does not fit the norm? Maybe that is a more important lesson here than “loving” yourself.

Loving yourself…

Does that even exist, anyway? Truly loving yourself?

I don’t think so.

I think it is a lie, just another way to make us feel inadequate about ourselves. Rather than having my daughter waste away years of her life worrying about how inadequate her inadequancies make her feel, maybe the best thing I can teach her is to just accept that it is normal to feel this way and to move on.

Acceptance IS a form of courage, isn’t it? Acceptance is maybe even a way to love yourself? Regardless, I am done with worrying about it.

I had a great time once I let go of the coverup angst. So did my kids, and that is what matters.

A Doc-ument

A few weeks ago I met an intriguing physician, an oncologist with an unusual story. She had told that story to Craig S. Boyack and his newest novel, The Playground, was born. I invited her here while I am traveling to let you all get to know her…

Thanks for having me over Victo. My name is Dr. Gina Greybill. At the beginning of this story, I really am a broken person. Who expects an oncologist to get cancer herself? It hit me hard, and took a family member from me too. So I left oncology. My heart was just not in it any longer. 

Instead, I started working in end-of-life care at a wage somewhat lower than I was used to. These people need someone who understands, and I understand more than most. I travelled from one place to the next living with and helping hospice patients as they died. My next assignment took me into a world I never knew existed.

There are some interesting medical issues in this story, not the least of which is my encounter with a parasite. This parasite enhances my abilities and let’s me see into a world nobody else has access too. Angels, Devils, fairies, and monsters are all out there. This is a big part of my journey.

I even have a struggle with my medical oath, but desperate times do call for desperate measures…

As far as other interesting tidbits, your readers might be interested in the old medical cane. Nearly everyone knows what a sword cane is, but very few know that canes were made for other uses too. In the days of house-calls, a doctor might travel with a hollowed out cane that contained a few professional items. There might be a tincture or two, some paper envelopes of powders, maybe even a lancet depending on the era.

There is a very special ear trumpet in the story. It looks so absurd that everyone would post pictures of me on Twitter. We found an interesting way of using it that keeps it from being a magnet to the social media crowd.

A deadly infection makes an appearance. It’s marks a major turning point for one character. There is also a brutal thug who has an alternate use for tampons. Another interesting situation uses the topical application of opium as a pain killer.

If this sounds like an intriguing story, your fans might like to pick up a copy of The Playground here.

There are some interesting medical bits in this book, but Craig wants me to tell everyone that he’s an author, not a doctor. His job is to do enough research to make it believable within the context of the story. I think he’s done a good job of that, but the readers will be the ultimate judge.

Victo, thank you for having me over today.

***
Truthfully, I don’t know what genre to classify this book. There are historical fiction elements, the paranormal, good bits of violence, medicine, technology, horror, suspense, and plenty of death. I guarantee it will make you think.

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Screened Out

  

My finger hovers over the smoking history tab…

Do I click current smoker?

I could lie. Maybe I “accidentally” forgot to hit the right button?

No one would ever know.

Except it does not acurately convey his risk factors. It would not trigger me to ask about if he was ready to quit yet at his subsequent appointments. Not to mention the fact that it is a LIE. 

But…

I don’t want this to count against me! It isn’t my fault. I didn’t light up that cig and hand it to him, you understand.

“Are you ready to try quitting again?”

I don’t get credit for asking, though. I don’t even get credit for recommending cessation. I only get credit for clicking the nonsmoker status.

Why did he have to start smoking again, damn it?

Today I found myself looking at another patient’s hemoglobin A1C (a measure of diabetes control) when I was deciding about firing her for a completely unrelated issue. What should that have to do with it you may ask? I realized I was more likely to fire her if she had a bad A1C. 

Because of those numbers the suits are tracking….

You know what?

I don’t want to be like this. It is not why I got into medicine. This isn’t helping people. 

And I don’t want lies to ever come easily for me.

If there is one thing that blogging has taught me, it is that when I think I am alone in something, I am not. Even when it comes to pulling on my eyebrow hairs when I am stressed out. So how many other physicians out there are feeling the same pressures? How many others are finding themselves faced now with these moral/ethical delimmas?

More importantly, what about patients? Faced with rabid physicians trying to keep their numbers up, are they being less truthful with their doctors? Did they really get that immunization? That colonoscopy? The mammo? Or do they say yes just to shut us up? 

If they lie about it, I’m off the hook, right?

And why can’t patients make their own decisions about what is right for them? What makes ME or any other doctor absolutely right in all things? (Particularly when we keep changing our own guidelines?)

What about the patients that are fired for not getting their screenings done? Who is going to take care of them? Don’t they deserve the same access to care as anyone else?

Humans have the right to make bad choices.

I should be able to make the screening suggestion and facilitate getting it addressed but beyond that, I don’t want to feel like I am wrestling a patient to the ground and punching them in the face until they give in to keep my scores up. I can be *very* persuasive, but my oath was first to do no harm. Harm comes in many forms, something not reflected in those numbers.

Ultimately, this is the way of medicine right now. I don’t see it changing any time soon. That won’t stop me from mounting my own mini rebellion, though. I won’t let them change me into something I detest…

My mind turns back to the computer screen. I click the current smoker option and carry on with the visit…

Gifted

  

She told him once that she wanted a gift. Something tangible, that she could hold onto when he wasn’t there. Something that showed she meant something to someone. That she meant something to him, after all of those intimate moments together.

Her body and her love.

Valuable.

“We are no longer compatible,” he said. 

There would be no gift. 

Only emptiness. 

She wanted to die.

She clung to his memory, holding it dear, keeping him close to her heart.

Now all these years later she has this bit of him eating a hole through her soul, its fingers reaching into all of her secret places. Places where he had once been and apparently never actually left.

His gift to her.

This cancer.

Her life.

We are no longer compatible. 

Only now, she wants to live. She finally understands he is not worth dying for. 

Except now, she has no choice.

For all of the women suffering from cervical cancer.

Jagged

  
“Hey! Are you Dr. Victo?”

“Yes….” I looked up to see a tall slender woman staring at me curiously. I was sitting with my daughter in the lobby, waiting for the church service to end so I could trade my homemade sourdough bread for farm eggs.

“I thought so!” Her voice warmed. “I used to be your patient before you moved. I sure do miss having you for a doctor. Are you still in that new place?”

“Yes. Yes, I am. It’s been almost seven years now, actually…” I struggled to place her face as I quickly distracted my daughter with a smart phone app. I knew from experience where this was heading.

“Oh.” There was an awkward silence. She took a step back. “Well I am NOT going to drive that far. My friend says she does, but I won’t.”

“I understand,” I told her. “I am not sure I would that far for me…”

I shrugged and smiled as she walked away, even though it stung. Almost every time I am out and about in town something like this happens. 

The grocery store. 

The park. 

At a restaurant. 

People still remember me, which is remarkable in itself, but I wonder what my kids will take away from these encounters…

Cycling

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My baby girl is turning five soon.

It is bitter sweet. On the one hand, I love watching her grow up, becoming her own woman. Sure, she has already formulated detailed plans to marginalized me and cut me from her life but for now she is still dependent upon me. We have fun together.

On the more sinister side of things, though, now momma needs a new IUD.

(insert groan of agony)

I have dreaded this day since the IUD was placed. I have enjoyed not having periods and not having to worry about pregnancy, having sex whenever I want. 

BUT….

Insurance changes say I cannot see the woman who placed my last IUD (she did a terrific job) and delivered my last baby. I am only allowed to see someone that is employed directly by the corporation I work for. Aside from the fact my patients are not particularly fond of the OB/Gyn’s employed by the system and the fact that I run into these people at meetings, the records will be in the EHR that I and everyone else in the system use every day. 

This makes me exceedingly uncomfortable. 

Intellectually I know that anyone who is messing with my hoo-hah in a clinical setting is not going to remember what it looks like when they run into me at a meeting. They are not going to care if the area is hairy or smooth or if the hair color matches what is on my head, or if I have stretch marks from babies. I also know that, in theory, anyone accessing my chart will be documented and recorded and will have to account for why they are there.

Still. 

How many sexual partners have I had? You can be dang well sure that I am not going to be honest about that question, no matter what the real number is. Am I engaging in risky sexual behavior? If I was, I sure as hell am not going to tell them. What about screening for STD’s? If I were in a situation where that needed to be done, would I be honest about THAT? No frickin’ way.

So, I continue to agonize daily over which physician I will end up have to spread my legs for. 

Decisions, decisions.

At least I have choices. Many women do not. 

Moist

 white flower with water drops on the petals 

She glanced away sheepishly.

“You haven’t been checking your blood sugars?” This surprised me. She always checked. She was one of those patients you wished you could clone.

“Nah…”

“What about your blood pressure?”

“No. But I have been taking all of my medications.”

I looked at her vital signs. Her weight had gone up 6 pounds. She had lost 39 pounds over the past year and now she was gaining.

“Are you exercising?”

“Not for the past couple of months.”

“How has your diet been?”

“Crappy.”

“Well, we’ll check your bloodwork and see where those numbers are. You know what to do from a diet and exercise standpoint, so try to get back to it. I’d rather not increase your meds if we can help it, OK?”

“Sure.” She shrugged. “Ok.”

I stood up to go. 

There was a nagging feeling that she was hiding something. People don’t just DO this kind of stuff without a reason. I always struggle with patient privacy, how far do I delve into their personal life before it is considered intrusive? How much do I need to know, anyway? And once I know, what can I even do about it?

“There is something else going on, isn’t there? You look different…. sad.”

Tears welled up and over flowed. 

I passed her the box of tissues and sat back down.