Autumn and what comes after

Death
is the richest breeding ground
for life.
The gardener knows
this, piling loamy soil
thick with last year's harvest, over roots,
The soft scent of decay which underlies
the sweetness of the blossoms that will come;
The surgeon knows it too, at 3 am
lifting out the liver or the heart
from the body which outlasted life
for one at least, but which will surge again
with blood and gladness in some other chest,
another waiting, ribs splayed apart like hands
opening to receive the gift at once
both horrifying and magnificent,
and to close,
as hands and circles do.

-AG, Nov 2009

Wrote this, perhaps not so oddly, after talking to an acquaintance about her time on the transplant surgery rotation. The first few lines just came to me as I was walking home from school afterward, in the November dark with fallen leaves all around.

If I am diabetic, I will punch someone in the face

Well, no, I won't actually punch anyone in the face--mostly because I wouldn't know to whom to do it (though one of the people on the street who always asks me if I have an 'extra cigarette' might be in for it...just a note: I do not have any 'extra' cigarettes. I do not have any 'extra' anything, except perhaps pounds in the region of my ass and room in the trunk of my car, which is of a capacity to serve the needs of any major crime family. Each pack has 20, which I divide in the following way: 20 for me. Et fin. At least until I quit on OFFICIAL FINAL QUIT DAY TO END ALL QUIT DAYS, NOV 9th 2009. Leave me alone).

So there have been myriad tests. Glucose tolerance tests, pelvic ultrasounds (which somehow manage to be even less fun than they sound), rounds of superfluous antibiotics ("Is there anything else that's been bothering you besides the fatigue?" Dr. W asked solicitously. "Anything at all?" I coughed--again, because I smoke--and said I'd been feeling a little sinus pressure...and won a 10 day round of Augmentin that accomplished precisely nothing), got a CBC, a TSH, a hormone panel, another hormone panel, a metabolic panel, a urinalysis...And suddenly the discovery of a high fasting glucose, and ketosis. Perhaps my immune system has decided it's tired of munching on my thyroid and has decided to feast upon my pancreas as well. I cannot effing possibly have Type II diabetes. Why? Because. Because my diet is composed of fruits, vegetables, whole grains, and low-fat vegetarian protein. Because I exercise every day. Because it would be so unfair ("Life isn't fair," I can hear you saying, to which I reply: "Bite me").

So I'm kind of pissed, and wondering why this is all happening, and having the usual struggles that people have when accosted by illness. 'Why me?,' while of course the most prosaically human of questions, is also the most difficult to answer. OF COURSE I don't believe that people get sick as 'punishment' for things, or that being virtuous provides even the faintest protection from harm--though you have to admit, popular culture does feed into the assumption that if you eat enough veggies, don't smoke, exercise, limit your stress and sodium and fat intake and get lots of fiber and antioxidants...you'll never get sick, never age, never die. Having in some ways lost the moral imperative in the realm of the soul, it's been transferred to the realm of the body. Which still leaves me thinking that I shouldn't be having all these problems, because while I'm certainly not perfect there are also many people 'worse' than I. People who eat puppy sandwiches with kitten au jus. Go after one of them.

What's the Big Secret?

Ok, they're not that big. They're actually little secrets. The ones you don't want people to know, not because you would be dragged before the tribunal at Nuremberg but rather because you know people would think of you a little differently--perhaps more negatively. Not the big, horrible, need-therapy-to-deal-with-it shames, but those things you wouldn't even tell your therapist. Because they're too small, but also because she'd think of you differently, too. The things that aren't crimes but rather matters of style, that would mark you as crass or a nympho or deeply un-PC. We all have them. Put up one or two of yours! Seriously. I know people read this but no one ever comments.

1. I love poetry. Love it to pieces. But...I really can't stand Maya Angelou's poems. I am aware that this makes me a bad person.
2. I have a thing for older women. Not 'elderly,' but older, and definitely powerful (Kissinger was right about power being an aphrodisiac. Was that Kissinger?). At various times in my life I've crushed out on Hillary Clinton, Nancy Pelosi, Meryl Streep and Madonna. And on numerous female members of the Cornell and WUSM faculty.
3. In most areas of my life I am utterly nonjudgmental. You can be gay, bi, trans, straight; into SM or roleplaying or leather; you can smoke, drink and gamble. However, I cannot abide errors in punctuation or spelling. I have actually not entered restaurants just because of mispunctuated signs.
4. I haven't read Moby Dick, or The Grapes of Wrath, or Great Expectations. Nor do I particularly wish to. I can couch this in feminist ire by saying that literature by dead white men is overrated, but the truth is I'm too lazy. At the same time...
5. If I see you reading Nora Roberts or Danielle Steele on the Metro, I will judge you. Again, I realize this makes me a bad person.
6. I HAVE to exercise every day. If I don't, I am secretly convinced that I will gain 20 pounds and lose all my cardiovascular fitness. The only day this doesn't apply is the first day of my period, when I'm not in a condition to be exercising anyway.
7. I've been drinking it since college, but I still can't stand the taste of coffee. Vicious bitterness, that's what it is. Finishing the dregs in the bottom of the cup often makes me feel that I am literally about to vomit... which is why I often throw the last 1/4 to 1/6 of the cup away.
8. Speaking of beverages...before I got nice stemware (read: 1.49 a piece at World Market) I occasionally drank red wine out of a coffee mug. Classy.

Anniversary--Six Years Is a Long Time.

A lot has changed since September 2003: I've graduated from Cornell, started medical school, had a job in the interim, had several relationships.
Since then I've become fluent in German, lost 60 pounds, competed in road races, had essays published in several anthologies.
Since then I've become an Anglican, become an activist, marched in a gay pride parade, have grown more comfortable being 'out' about both my spirituality and my sexual orientation. Yes, a lot has changed.

Six years ago today I was raped by a stranger. It was violent. It was terrifying. It was painful. I was injured both physically and emotionally. "Why talk about it?" I can hear people asking. "Keep that stuff to yourself. It's too dark, too personal. No one wants to know. It makes us uncomfortable." Even the word itself--rape--makes people wince; its single syllable falls like a blow. 'Sexual assault' is gentler; it spreads the impact over multiple words. It is less explosive, less primal. This is precisely why I make the effort (though it is still difficult for me) to call what happened to me rape.

It makes me uncomfortable too, but I don't have the luxury of expunging it from my memory and living free of any consequences. I cannot forget. And as long as women are being victimized--as long as I know my sisters are being hurt and humiliated and then, on top of that, shamed into silence--it is my intent to prevent anyone from forgetting it. I don't think people ignore issues like rape out of callousness (though perhaps some do); it is rather a need to protect their delicate human hearts. It is frightening to witness another person's pain, especially a pain of this intensity. It is uncomfortable to face injustice and violence--to know, not at a superficial level but to acknowledge in a way that can only produce horror, that there are human beings who intentionally hurt other human beings to gratify their own drives.

Tonight I went for a run in the park. I misjudged the sunset and ended up halfway through my run with almost no daylight left. The rape happened under similar circumstances. I was freaking slightly. It felt like a fairy tale, where someone is always warned at the beginning, "Don't touch the pumpkin," or "Stay away from this room at midnight," and at the end of the story finds themselves doing precisely what they were told not to, and thus bringing disaster upon themselves. I peered through the darkness, checking every tree for figures, running along the road (where the lights are). By the time I crossed Kingshighway, though, a peculiar joy was running through my veins. The moon was a waxing gibbous; waxing moons are auspicious, and I could practically feel her beaming down at me as I ran the last few blocks home, my footfalls and heartbeat synchronized with my breathing and the drone of cicadas, like a symphony of flesh. I have made it through six years. Not without pain or injury; not without bouts of choking sadness or ragged anxiety, but also not without hope.
Tonight is also the feast of St. Michael and All Angels. As autumn descends, as the days shorten, everyone gets caught up in the universal drama of dark vs. light. It's a constant struggle. That's the point. Who will win is not a foregone conclusion. But then that's what hope is about.

I took a glucose tolerance test today, and as a result spent the day riding the blood-sugar rollercoaster from hell. A glucose tolerance test (GTT, for those in the know) involves drinking 75 grams of sugar in one go in the form of a delectable 10 0z of "orange flavor glucose tolerance beverage." Hummingbirds love the stuff, I'm sure; me not so much. It didn't help that the promised orange flavor was in fact a bizarre hybrid of grapefruit and ass. And that they took 6 tubes of blood at the beginning. And another one two hours later.
Nothing terribly exciting to report--no convulsions, no fainting--just a profound feeling of fatigue, some nausea, and a headache.
All this in an attempt to figure out what's going on. More poking and prodding Friday. And then: answers. I hope.

"Cosmetic intervention" are-you-f*cking-kidding-me corner

So I'm flipping through O magazine in a doctor's waiting room, and I happen upon a full-page ad featuring Brooke Shields. Oh, yeah, I remember her from the 80s and 90s. Cute kid, heavy on the eyebrows. Cool. Then I notice that the ad is for--I kid you not--an ACTUAL DRUG (did you get that? A pharmaceutical formulation. A drug) called Latisse, intended to cure the life-shattering ill that is hypotrichosis. Waitaminit, I say to myself. Trichosis--that's 'hair.' As in trichotillomania, when people compulsively pull their hair out (knew a girl in high school who did this--she had a cute side-part all the time, and it was only when I spent the night at her house that I discovered it was covering a silver-dollar sized bald spot), or hypertrichosis, the overgrowth of fine downy body hair that I experienced when I was way underweight in college. So hypertrichosis is...not enough hair?

Right enough, but in this case it refers to--as the makers of Latisse say on their web site--'inadequate eyelashes.' Wow. Now the ballsiness of this alone was almost sufficient to send me into conniptions. Now not having the lush, luxuriant lashes of a mascara model is a clinical disorder. "Once you begin treatment," the site promises--TREATMENT, for the love of Christ--you will begin to see increases in eyelash darkness, thickness and length within four months (I will say that it appears to work--Brooke's eyelashes look downright shaggy). In the 'safety' section, it is mentioned that some people experience eye irritation and redness. Or darkening of the eyelids. Or eye infections, if it isn't applied correctly. Also it may darken your irises permanently, and you have to keep using it for as long as you would like to remain in possession of your newly bat-worthy eyelashes. Mostly the folks at Allergan just wanted to remind you that deviations from the standard of Western female beauty, no matter how small, can be considered illnesses, and that you're never good enough as you are.

Oh my goddess, this is so lame I almost had a seizure.

Exams of any kind make me nervous, yet they're also sort of like sporting events. Me vs. the test, me vs. me, me making a last-minute three-pointer at the buzzer (is it a hyperplastic polyp or a serrated adenoma? She shoots...she scores!). In college I even had a set of little rituals that went along with test-taking--put on the lucky shirt, drink the optimum blend of caffeine (for energy and clear-headedness) and gingko biloba tea (for, you know, more clear-headedness).

This week is an exam week--ENT, general pathology and pharmacology. I feel prepared for the first two, not completely ready for the last.

Hopefully by Friday I'll have all the adrenergic and cholinergic and everything else -ergic drugs committed to memory (I'm 90% there, I think--just a little more work around the edges). This is all absolutely cool stuff to get to be learning. Hey, here's how aspirin works; hey, this is the reason selective COX-2 inhibitors like Vioxx--and Celebrex, may it rest in peace--don't eat holes in your stomach lining as readily as ibuprofen! As for learning antidotes, that was just a piece of practically shamanic coolness. Give Narcan for heroin OD. N-acetylcysteine, if given early enough, can protect the liver from acetominophen overdose. A kid ate some Jimson weed--try physostigmine. It's like a throwback to The Olden Days, when you'd give feverfew to someone with (duh) a fever, or black cohosh tea to someone with dysmenorrhea--except, y'know, now we know why things work. And we use fewer plants (although vinca alkaloids and Taxol are both plant-derived, and are used in cancer treatment). Just rambling.