Sunday, December 30, 2007

How to Cry

If you're me,
1. Go into a dark room, alone.
2. Shut the door.
3. Put on headphones and listen to either
Ben Harper's "I Shall not walk Alone", Sufjan Stevens' "Seven Swans"
or just about any track from Sarah McLachlan's "Solace."
4. Accept that there's still only about a 5% chance this will work.

The London Daily Mail ran an article in April about clubs where Londoners can go to get their cry on. Forget the release of alcohol, the oblivion of cocaine, or the sweaty debauchery of gyrating with scantily-clad twentysomethings until dawn (well, don't forget it...but put it off for tonight). The ultimate release, in a hypermedicated and plasticized society, is that of genuine emotion, experienced with others who are 'going through' the same thing and thus are able to sympathize (or at least witness it without looking uncomfortably away). And screwed up as paying for entry to a 'misery club' may be, I understand why someone would do it. There have been periods of my life when I have gone literally years without crying, and the incredible energy that's released when tears finally come is mind-blowing. Imagine crying for the first time in three years. Imagine all the pent-up rage and frustration and sadness and guilt and shame and EVERYTHING that would be pouring out of your eyes. Like a lake bursting through a dam. Intense.

I'm still not a cryer. Often I'll WANT to, but won't be able to--probably too much information, and profoundly uninteresting, but I'll just say that it's frequently as if I can see my emotions in a glass case, like the one Snow White was kept in in the old fairy tale. I know they're there, and I can go up to the clear, cold pane and rest my hands against it; but I can't break through, no matter how much I pound. Is this my own psychopathology (yeah, I know it probably is) or is my Effexor and Depakote and whatnot, an iatrogenic numbing? When I was last in the hospital, I cried...let's see...about a dozen times in a period of three weeks. That is, by far, the highest day-to-sobbing-episode ratio I have ever managed. One of the therapists admitted candidly, "Your problem is that you don't cry enough. I'll just say it frankly: part of my job these next few weeks is going to be to try and make you cry." Awesome. My insurance is paying how much a day for someone to monitor my eating and try to reduce me tears?

But to anyone who's ever had a really good cry, I ask: what's better? It sucks at the time, and I hate the feeling of vulnerability, like I'm melting and pieces of me are sliding down my face, and I worry someone will see me and think I'm weak and hyperemotional and that's the last thing I want anyone to think when so much of my time and effort is invested in creating this facade of invulnerability and indomitable competence, but at the same time I also just want so badly for someone to come and stroke my hair and let me cry on her shoulder. You know? Maybe not. But then you're done, and hopefully you feel better, and for a while after that your breathing stutters every now and again (I have coined a term for this: the crygasm, appropriately enough, since I've had some sob sessions that were better than sex; whether this speaks more about the quality of the emotional release or the quality of the partners I've had is up for debate).

There's also a website, Crying While Eating, where people post pictures and videos of themselves (duh) eating and crying, with notes re: what they're eating, and what they're crying about. Reasons for tears range from "She really loved him" (awww...) to "He missed the biggest pizza party of the year" (for a guy eating a single pizza crust).

Bad, bad news (A Distressing Symptom (tm) Moment)

Let's say you have a patient, and that patient is peeing. Or rather, was peeing. Yesterday, she was a veritable fount of pale gold urine, the color of a nice Riesling. Today, she's barely put out 200 ccs, and it's closer to the color of a dark ale, or God forbid a merlot. What the hell? We can't serve that with fish! With salmon maybe, but not tilapia...oh, wait. The patient. Right.

You're looking at hematuria, my friend, from the Old Greek and/or Latin "Holy crap, they're peeing blood." Now, there are several kinds of hematuria--The first type is gross, in which you have actual red blood cells in the urine (there's an injury somewhere in the urinary tract, and whole blood is leaking into the system. To the person who said, "This all sounds gross," well, we'll see how funny it is when you come face-to-face with a foley bag full of merlot, young man). The second (sub)type is hemoglobinuria, where you have hemoglobin--the pigment that makes blood red and also ferries oxygen through the cardiovascular system--present, but no red blood cells running around in the urine. This happens when there's an excess of free Hb knocking around; if you drew off a blood sample and let it settle, the plasma would be red (normally it's a clearish yellow color). Last, there's myoglobinuria. Myoglobin is a specific kind of hemoglobin that's found in skeletal muscle, and it's liberated when there's trauma to a muscle, or the muscles begin wasting like crazy for some reason. In most cases liberation is a good thing; this is one of the times when it isn't. Why, you ask? One, when muscles start breaking down, you have a lot of protein rushing into the blood at once, and the kidneys have to filter all that crap. Does the liver bitch about that kind of stuff? No, of course it doesn't, but the kidneys do, and if they're peeved enough they'll shut down altogether (why your patient isn't the open tap she was yesterday). This is why, if you know any nephrologists, they're probably uptight and stressed out people. You would be too if you had to deal with kidneys all day. [Disclaimer: I have thus far been lucky enough not to know any nephrologists, so I have no basis for that statement. I'm just guessing].
So what do you do? Hang a bag of saline! And another! And another. Saline bags for everyone! Rhabdomyolysis due to malnutrition? Have a banana bag--and another bag of saline! NB: A banana bag is a solution of vitamins, especially thiamine and folic acid, and sometimes of magnesium too. It's yellow, hence the name banana bag.

Thursday, December 27, 2007

Tigers and Benazir Bhutto

I hate to say it...believe me, I really hate to say it...but surely everyone saw Bhutto's assassination coming from a mile away. Musharraf's people did it, whether he personally ordered it or not. There.
When she went back to Pakistan this fall, she must have known that she was coming back to die. Frankly I thought it was going to happen while she was under 'house arrest' at the beginning of November, but of course I hoped it wouldn't. I won't indulge in the posthumous deification/ vilification you usually see in political figures. She wasn't a saint, she wasn't a villianess. She was a very rich and privileged woman in a very poor country (she earned her degrees from Harvard and Oxford respectively), true, but couldn't the same be said for our own nation's leaders? She and her family suffered a great deal at the hands of the opposition party, but does suffering alone justify admiration?
She was the first woman to serve as prime minister of a Muslim country, and for that she deserves a place in the record books, and our admiration. Radiya 'Llahu'anha.

Second, apparently a tiger at a San Francisco zoo attacked three people, killing one and injuring two others. No one's sure how the tiger got out of its enclosure, but there's been speculation that someone taunted it into jumping and/or let it out of its holding area. The father of the man who was killed was on Fox News (again, it was on at the gym, and I wasn't going to get off the treadmill just because there was stupid sh*t on the TV) and he said, quote, "I don't care what happens, they could be throwing rocks at the tiger or whatever, the tiger shouldn't escape." Well, yeah. about not f'ing throwing rocks at the animals? How about if you do things like that you deserve to get your ass eaten? Not that I'm justifying people-eating (I don't want to send that kind of pro-violence message to the young tigers of America) but hell! Power to the tigers. NB: at the end of the story, the reporter added that there would now be a CCTV camera installed at many of the animal enclosures. Maybe they'll catch those pickpocket lemurs into the bargain.

Tuesday, December 25, 2007

Today I learned about myself, about the natural world, about art, and about the fact that people will put anything and everything into their orifices. More specifically, I learned...

That I have the same birthday as Tina Fey and Omar Khayyam (though not, obviously, the same birth year).

That the aurora borealis is caused by the induction of electric current in the Earth's magnetosphere by rushes of charged solar wind moving perpendicular to the Earth's surface (and for the first time in my life, the Electromagnetism unit from college physics was actually useful for understanding something). Wikipedia it, it's interesting. I'd like to see it in person someday. Apparently March and October are the best times to go north (or south, to see the aurora australis) and skywatch. Coincidentally, it was reading the Golden Compass series, by Philip Pullman, that inspired me to look this up; and it was my friend Amy who suggested I look into the series (thanks, Ames!).

Apparently, peppermint oil and human mucous membranes don't mix well. I got a Christmas call from a friend of mine who works in an ER...somewhere in the United States...and she said that a young woman came in a few days ago, or fifty years ago, or some vague unspecified span of time in the past, with a portion of a candy cane lodged in her vaginal canal. Couldn't get it out. Apparently the menthol really started to irritate her tissues, and she and the boyfriend were both so freaked out that they couldn't get it to budge from her holiday hole by themselves. With the aid of a speculum and a (slightly traumatized) intern it was retrieved...lucky for the woman, considering that otherwise she'd likely have been looking at a White Christmas, by which I mean massive discharge from a killer yeast infection.

That Natalie Merchant (and earlier, 10,000 Maniacs, the band she fronted) once did a song called "What's the Matter Here" that offers a pretty poignant look at child almost made me cry, honestly. And musically/artistically, it also has great merit: "I've heard the excuses/ everybody uses/ He's your kid, do as you see fit...but what gives you the right/ to do this/ to your own flesh and blood?"

That you can blow out your liver just as easily with NSAIDS (non-steroidal anti-inflammatory drugs) like acetominophen, ibuprofen, the cox-2 inhibitors etc, as you can with alcohol. Maybe easier, since most people know that knocking back a six-pack of beer every day isn't good for you but don't know that tossing back six Advil every day isn't so hot either.

Monday, December 24, 2007

Some poetry. And a song.

Female, 78, pelvic fracture

First of all her Hummel figurines
had fallen from the table near the place
where she herself had fallen,
her splayed hands
clutching at the carpet as if it were life itself.
A neighbor stopped to check on her and called
911 when he heard her moan
from be hind the door, festooned
with a merry wreath
which wouldn't yield no matter how he slammed
his shoulders into it.
How long has she been here?-I wonder, ask;
she answers, seven hours.
We check her pulse
and roll her like a turtle to her back.
She moans again: her hip is broken, leg
turned out as if into a grand plie, but for now
no leaps or arabesques for her.
Onto the stretcher, out into the cab--
her pulse is quick from pain, breath rapid too.

Oxygen mask and morphine, and she sighs,
frail body melting into the cot
like a spring allowed now to unwind.
I take her hand--
"You're going to be fine."
Her skin is like rice paper, loosely draped
over a web of veins, a bunch of bones.
"Fine," she repeats, the morphine drips, eyes swim,
then close. "You know," she says,
"I used to be a dancer. When will I dance again?"
An honest question answered honestly:
"Not for a while, and please, keep your mask on.
You need to relax." I stroke her hair, grey gone thin in patches,
or all gone.
The lead medic snaps, "Check the supplies."
Is too much tenderness prohibited?
Still, I am glad to pull myself away
from that vortex of human suffering;
a reminder that even one as young as I
will someday age and fracture, fall and die.

Bread and Roses

I know that I need beauty
more than I need bread.
Bring home baguettes to admire,
then photograph;
food to write odes to.
But more important,
bring me roses
in the gentle curved clasp
of your fingers;
bring me your lips
arched like bows
and fire at will.

And a song...I still have to figure out the guitar part in its entirety:


It's three in the morning
I'm walking down Broadway
My friends and my neighbors have all gone to sleep
And from their apartments
the windows spill secrets
that during the daytime they struggle to keep

Insomnia does that, it sets you apart
It's the tension in eyelids, the seal on your heart
It's the kinship of coffee
and honey, believe me
Come meet me on Broadway some night and you'll see

I have a prescription
to help me drift off but
It doesn't work, I still toss, turn and moan
I don't care what the med is
'Cause anyway bed is
More lonely than sitting up writing, alone.


Some night I will meet you
at four in the morning
At that all-night diner on 39th street
You'll ask for my name
and I'll ask you the same
And we'll know we've been waiting our whole lives to meet


At last I am sleeping
I slip into dreaming
Of streets and apartments and coffee shops too
And though we haven't met
at least not quite yet
Awake or asleep I am thinking of you.
Now if only I could figure out a way to record it that didn't make the vocals sound like I was using a garbage can for a recording studio...

Friday, December 21, 2007

Hope I die 'fore I get old--some song

I just saw an ad for the new Jack Nicholson/ Morgan Freeman flick "Bucket List," where two guys have the chance to do all the things they want to do before they die. And it got me to thinking...what things do I want to do before I die?

1. See open-heart surgery
2. Make love to a beautiful woman in a beautiful place (Angelina Jolie? In St. Patrick's Cathedral?)
3. See Paris, Berlin and London (ooh, and China too)
4. Have a book published (not just in a compilation/anthology)
5. Perform one of my songs in public
6. Save a life
7. Give birth
8. Go parasailing
9. Fire a gun
10. Sleep in a treehouse

What do other people want to do? Shit, what do other people's lists look like? This isn't a top ten or anything, just 10 random things from a list a bazillion miles long. Also included: getting an MD, falling asleep in someone's arms during a thunderstorm, going to Michigan Womyn's Music Festival, finding a long-term partner, learning how to make angel food cake, knitting an entire sweater, running a marathon, finishing a triathlon, climbing a mountain...and the list goes on. Sorry this isn't interesting, but I swear this introspective mood will pass (how long does it take a twentysomething woman with an attention span X and a need, Y, to be adored for her wit and intelligence, to stop writing about her goals and dreams and start trying to amuse other people with interesting anecdotes and jokes about other less personal things? Solve for Z in terms of years of crushing loneliness).