Monday, June 30, 2008

What the hell's wrong with you NOW?

It's always something. No, not really, but every few months it's something. This time it's the fact that my uvula (you know, the little thing that hangs in the back of your throat) is seven different kinds of swollen. Ew. Problems swallowing, gagging...severe grossitude and discomfort, in other words. I'll hit the urgent care tonight just in case (because while it could just be allergies, my throat also hurts like hell and the last thing I need is a midnight trip to the ER with epiglottitis--that shit don't play--or to carry around undiagnosed strep and have it migrate to my pericardium or some retarded thing. Hypochondriacally speaking I'm not anxious; I'm pragmatic. I have things to do, and so let's catch whatever's going on now when I can get azithromycin or a recipe for Magic Mouthwash, rather than waiting until nothing will clear it up but speed-infused IV gorillacillin). Uvulitis, it's called, proving once again that medicine will dress anything up in Latin and try to take it to the prom: inflammation of the uvula. Who'd've thought? But--and this actually is kinda cool--uvula means "little grape" in Latin; it's the diminutive form of uva, "grape or berry." Ooh, now things are coming together--uva ursi, bearberry, that diuretic herb...ursa major, big bear, the constellation...and to think people say Latin is dead.
So in the meantime I'm taking it easy [read:I only spent a half-hour at the gym] having Ramen (I tried to eat a Smart Dog for lunch first. It's like a hot dog, but made of soy protein instead; totally cholesterol and fat free, for those of you who are into that sort of thing. In any case, sore gaggy throat + food that's a choking hazard even when you can swallow well = one of the worst plans since Napoleon said, hey, why NOT try to invade Russia during the winter?) and, quite possibly, taking a little snooze when I'm done here. A naparino. Did you know naparinos exist? They're just like neutrinos, the subatomic particles that have been garnering such attention and obscene research funding lately (not that I'm angry that the NES and NIH have been taking huge hits, or that the Gubmint has been taking money from mental health and sexual health research and funneling it into other more important things, like underpaying soldiers and denying them their benefits, not to mention the people on the "other side" of the war whose lives are in many cases significantly more screwed up now than they were ten years ago). But yes, naparinos--like neutrinos--pass right through you and your computer and EVERYTHING. But unlike neutrinos, which pass unnoticed thousands of times per minute, naparinos are a once-every-few-days kind of thing, and when they hit you...zzzzzz...

Sunday, June 29, 2008

So, about that sweet potato pie. B and I went down to the KC River Market last weekend to pick out some produce, and wound up with a half-peck of sweet potatoes. I swear, some of them were GINORMOUS. Literally the size of a football. The family selling them was Amish, so maybe they were praying over them, I don't know--but if it hadn't been for the little bonnets and Laura-Ashley print dresses, I definitely would have suspected growth hormone or genetic engineering involvement. Sweet potato pie is just one of those things a Southern girl should know how to make, like grits (for purposes of this post, I'm southern; my mother has family liberally sprinkled through Arkansas and Mississippi).

Which brings us to an interesting question: depending on the day of the week, or whom you ask, Missouri can be either a southern state or a Midwestern one. In favor of the "Midwestern" designation we have 'heartland values', proximity to Kansas and Nebraska, a very high casserole-per-capita rating, Methodists and Lutherans, and amber waves of grain. However, in the Southern category we have little kids out in the sticks who call everyone over the age of twelve "ma'am" and "sir," (which I have to admit cracks me up), the fact that Missouri was a slave state (remember? That was the Missouri Compromise, not the fact that half the state says "miss-oo-REE" and half says "miss-ou-RAH." I am staunchly in favor of the first pronunciation, not least because there is not an "a" anywhere in the damn word.), and the fact that there are portions of the state where it would not behoove you to be obviously black, or Jewish, or queer, or of foreign extraction. Really, confederate flags are SOO sixties. EIGHTEENsixties. And I don't want to hear about "Southern pride" or "It's about historical and regional pride, not oppression." Kids, you can celebrate aspects of your country/region that you love without resorting to emblems of past injustices. For instance (and I know some people are going to be pissed that I even brought this up, but somehow I think I'll live with that) the Germans, as a people, don't use the swastika much anymore. Yes, it was an ancient Sanskrit good-luck charm; yes, it symbolizes a time when Germany was at the height of its international military and domestic power. But it also symbolizes a lot of things whose horribleness and evil even my admittedly bloated vocabulary lacks the capacity to describe, and which I will therefore only say was very, very bad shit indeed (kind of like, say, OWNING people, and treating them as property in the basest and most inhuman of ways...I'll only say that while people bought male slaves to do hard manual labor, female slaves were usually conscripted for labor of another sort...because, hey, if you own a woman and you get her pregnant, you own the kid too! It's like a two-fer. Hell, wait another nine months and force her to have another! If this is in any way new or shocking information for you, look up Hortense J. Spillers or bell hooks.) If they were even clever about it...I mean, a bumper sticker that said "Jefferson Davis is my President" would be kind of funny. But no, it's rarely that subtle. Maybe that's good; maybe that sort of "bigot here: take it or leave it" behavior is better than the slinky, no-I'm-not-really-prejudiced prejudice you get in more liberal climes (I'm looking at you, white friend who only says "N*gger" when she gets drunk). I think the problem may be that while there's a wealth of passionate feeling, a lot of these folks who go on about *Southern glory* are much more intimately acquainted with Jack Daniels than Jefferson Davis, and in fact would not know the latter if he threatened them with acts of secession (which is what he would do, those of you who didn't pay attention in history class, because he was the de facto president of the Confederate States of America).

But yes. Sweet potato pie. The recipe in the New Joy of Cooking, with a little less evaporated milk than indicated because milk products in general freak me out (did you know that, evolutionarily and biologically, milk glands are modified sweat glands? Yum!). It turned out well; everyone said it was to die for *blush*, and I did manage to hold off my roommates (with threats and brandished spatulas) long enough to actually get it to the dinner party. I took along some of the pralines, too, and they were a BIG hit. *Yay Scalpel's recipe!*

Saturday, June 28, 2008

Bloody hell. I put in this entire entry once before (and blogger disconnected and kicked me off and didn't publish it, but I wasn't mad, oh no, even though the entry was the length of the Foucault's entire "History of Sexuality" trilogy, and even though there's no chance I'll ever manage to be as witty and engaging a second time as I was the first). SO.

Since I've had a lot of time on my hands lately, I've taken up baking. Biscotti on Tuesday, pralines (using Scalpel's recipe--delicious!) on Wednesday, cupcakes yesterday...and today, the coup de grace, for a dinner party at the home of one of the nicest little Southern women you could imagine (seriously, the first time I ever heard Paula Deen on TV I dropped what I was doing and went in to watch, because Paula's accent and inflection is just. like. hers. Or vice-versa; I don't know who was born first. Also, she was my AP Government teacher and worked for the FBI for a bazillion years before that. She's five foot nothing IN heels, genteel and ladylike, a Rose of Texas, blah blah blah, but word on the street is she's pretty damn handy with a Beretta; she's quite a smoker; and when she's mad she plays fast and loose with profanity. Like Scarlett O'Hara transplanted into a Patricia Cornwell novel. Kind of bizarre). It's...sweet potato pie!

More in a bit; I would just save and come back, but my trust in Blogger is temporarily down.

Saturday, June 21, 2008

I know it's been a while--I've been busy (busier since finishing up my job? Mais oui, jolie!).
What have I been doing? Going to numerous therapy appointments (why be shy about it?), riding my bike to said appointments, to the library, to meet people for lunch (it's a Schwinn Cimarron that looks just like the one above--purty, huh?) which means I'm getting a little bit of 'biker thigh.' Now, because I run so much I don't think I'm ever going to build up the kind of biker thighs that really scare me--you know, the ones the size of small Latin American countries?--but there's a bit more definition than there used to be. Long distance running will give you awesome calves and a butt you could bounce a quarter on, but unless you're doing a lot of hills or sprint training you're just not going to get a lot going on in the thigh department. I've been sort of training for a triathlon, or at least that's what I'm telling myself, so I'm biking 3 to 12 miles a day, depending on what I have to do that day (OK, OK, I know that's not really training--shut up already) and running 3 to 6 miles. Speaking of therapy appointments, d'you think there may be some body image work left to do? God I hate my thighs.
I've also been writing a paper--I want to submit it to "Feminist Psychology"--about how I think Borderline Personality Disorder is a bullshit diagnosis that 95% of the time gets pinned on "difficult" women with trauma histories when a PTSD or "Complex PTSD" diagnosis might be more appropriate (thanks for the new diagnostic category, Judith Herman! Props to you too, Mary C. Zanarini and Bessel Van Der Kolk! Seriously, I know I'm a dork, but I would SPAZ OUT with DELIGHT if I ever had a chance to meet BA van der Kolk or MC Zanarini. If I met Marsha Linehan, on the other hand, I might spaz out...just not, necessarily, with delight. I can say this now; if all goes according to plan and I end up practicing psychiatry and publishing extensively, slamming a colleague will suddenly be in poor taste. I may be a head case in some respects, but I'm not about to pick a fight with the woman who invented DBT--not least because I suspect she could have me killed). Or, hell, in a lot of cases, a diagnosis of "This woman was severely and chronically abused--sexually, physically, and emotionally." I'm really not being flip--I think it's fair to say that having your parents beat and/or fuck you the entire time you're growing up gives you carte blanche in the psychopathology department. Speaking of which, everyone who works with 'Borderline' patients (don't you love scare quotes for being the very bitchiest punctuation marks?) should read Judith Herman, MD's "Trauma and Recovery: The aftermath of violence, from domestic abuse to political terror." I picked up a copy at Half Price Books a few weeks ago and the cashier looked at the title and said, "So, something fun to read by the pool?" All right, light summer reading it ain't, but it's still very, very good.
Holy crap, a Google search for Ms. Zanarini just revealed she gave $1300 to the Hillary Clinton campaign! I must admit that makes me like her even more.
And I've been painting and knitting and watching The Daily Show and the Colbert Report on Hulu. Who needs a TV when you have broadband access? Oh, yeah, and studying biochemistry to get ready for MEDICAL SCHOOL. You know, in August. That whole thing. Yeah.
I need to find an apartment in St. Louis, but every time I start thinking about all the preparations I still have to do I start hyperventilating. I'm going to have to do it soon, though, lest I end up living in a box in Forest Park--or in the library.

Thursday, June 12, 2008

Turns out your grandma was right about cod liver oil.

So--it's not just a fish story. Ha ha (no, seriously, I'm sorry. I just couldn't help myself). The omega-3 fatty acids found in fish oil have significant antidepressant properties--in some cases, they're superior to actual prescription antidepressant medications. There's increasing evidence they may have a role in the treatment of bipolar disorder and other affective disorders too (cyclothymia--which is like "bipolar lite;" all the flavor, half the psychosis! and dysthymia, chronic low-grade depression: imagine being 15 years old again, but all the time, forever). Is it just me, or has this been insufficiently publicized? Gee, could it have anything to do with blockbuster sales of SSRIs? I can't help thinking that if Pfizer or AstraZeneca had managed to patent fish (don't look at me like that--there are breeds of transgenic mice that are patented), every other Newsweek article would be singing the praises of the glorious golden liquid that is fish oil. Of course, Mrs. Paul's fishsticks would also be 20 bucks a box--assuming you had insurance.

Monday, June 09, 2008

I called the police yesterday.
The family living next door to us gets into fights occasionally--not "you put the dishes in the dishwasher without rinsing first" fights, but knock-down, drag-out, domestic violence someone's-gonna-get-cut fights. So yesterday morning, around 8:30 (as I was fortuitously up and getting ready to go down the street for Quaker Meeting--no, I'm not kidding) I heard the wife screaming, then heard her running down the driveway and around the neighborhood, screaming and shouting for help. I didn't see what was going on, but I called 911 anyway--and when I got outside to see what was going on, the husband had already driven away in his truck. It turns out (I didn't find this out for about half an hour, when I asked one of the neighbors who actually let the woman onto her front porch and called the ambulance for her) that they'd both been stinking drunk and had ended up stabbing the hell out of each other. There was a trail of blood all down the driveway, onto the sidewalk and into the street. No life-threatening injuries, thank God, but damn.
What bothered me was the way everyone was automatically passing judgement on both of them--actually, it seemed like they were placing more blame on the wife than the husband. "She's being manipulative," someone said. "Crazy. Alcoholic," someone else replied. I just find it interesting that the last time the police came out, she was the one who was injured. It seems like if she's the one who gets hurt most often and most severely, perhaps she has some tenuous claim to the 'victim' status. Although, in a situation like that, it's difficult to tell who's the victim and who's the aggressor--it changes from moment to moment, and there are all sorts of power dynamics (not to mention the inherent power differential that comes from being female--strictly in a physical sense). Why are we so ready to believe that if a woman gets brutalized, it's her own fault? Even Dr. Phil (and you know how I feel about him) pulls this shit-- Why stay in an abusive relationship? If a woman is getting the crap kicked out of her, it must be because she has some deep psychological need for it, some inherent masochism. She's getting something out of it. It's somehow her fault. WTF? How about the fact that she's probably financially (and to some extent emotionally) dependent on him? What about the fact that it's hard to get a bunch of kids, all your stuff, and enough money to live on for a while rounded up in short order? What about the fact that even if you do get out, assholes like DR. Phil are still going to assume that the time you spent in a hell of domestic violence was somehow your fault, something you subconsciously wanted or invited? Sorry, but for a lot of reasons (including some personal experience that I'm not going to get into) my tolerance for domestic violence--and especially excuses for that kind of asshole behavior--is less than zero. Eat it, Phil McGraw.
There have been studies on this--a psychologist presented a bunch of research subjects with different scenarios in which both men and women had negative experiences (ranging from the mundane--getting a flat tire--to the extreme, like rape). The subjects were more likely to attribute a man's "bad luck" to just that: either bad luck or environmental circumstances. His tire went flat because there was a nail in the road; he was assaulted in prison because the perpetrator was a sociopath, etc. On the other hand, they attributed the woman's poor outcomes in the scenarios to failings on her part, either moral or intellectual. She must not have taken care of her tires. She must have put herself in a situation where assault was likely to happen. This is 2008 (although admittedly the study was done several years ago). What the hell kind of bullshit is this?

Wednesday, June 04, 2008

So, back to my original question...how much DO you know about eating disorders? A quick lil' quiz born of my absolute dismay when I walked past a group of RESIDENTS in the hall yesterday (after their ONE HOUR per MEDICAL SCHOOL CAREER 'lecture' on eating disorders) and was astonished--literally knocked to the ground and mauled--by the ignorance.

1. A 13 year old girl presents to the ER; she is roughly 15% below her ideal body weight. When asked about her diet, she says she vomits up nearly everything she eats--ie, she vomits twice a day, on average. She eats normal-sized meals; she just doesn't keep them. The most appropriate diagnosis would be:
anorexia nervosa (AN)
bulimia nervosa (BN)
eating disorder not otherwise specified (EDNOS)

The answer is AN; she has the purging type. Her weight and the fact that she doesn't binge are the clues (though in an f-ed up quirk of the DSM-IV, she wouldn't actually qualify for AN if she were still having periods. Seriously. You could be at 75% of ideal body weight, eat 500 calories a day, and still not be "officially" anorexic. If you think this is irrelevant, tell that to the insurance companies who won't pay for treatment for someone without an official DSM-IV diagnosis). Important lesson, diagnostically speaking--puking doesn't necessarily equal bulimia.

2. EDNOS, because it itsn't a "full blown" eating disorder, isn't as dangerous as AN or BN. True or False?

False, with a flashing red light and honking airhorn. It's right there in the name: EATING DISORDER not otherwise specified. People may be EDNOS when they're "almost" anorexic or bulimic (say, binging and purging once a week instead of the twice required for BN; engaging in all the behaviors necessary for an AN diagnosis but still menstruating, or still being above 85% of ideal body weight; showing typically anorexic behavior but occasionally binging and purging; Chewing food up and spitting it out instead of vomiting; using exercise to compensate for meals, etc. ) You can still end up with your potassium or sodium (or any electrolyte) in the toilet with EDNOS. You still suffer near-constant mental anguish. You can totally still die.

3. Eating disorders are always all about control. True or False?

False. That's like saying--I don't know, I can't think of a very good analogy right now--something stupid. Yes, control is often an issue, but EDs can also be responses to trauma (abuse, sexual assault, etc.), ways of displaying feelings in a family/society that discourages emotionality, a way of remaining a child and not having to deal with developmental issues, or a method of self-punishment for someone who feels (usually unjustified) shame or guilt.

4. Which of these factors make someone a more likely candidate for developing an ED?
Being female
Being 18 or younger
Experiencing physical, emotional or sexual abuse
Perfectionism
Hobbies or jobs focused on appearance and weight (gymnastics, modeling, jockeying)

That's right, all of them--though by no means are all ED sufferers like Steven Levenkron's character in "The Prettiest Little Girl in the World." Men get them; rugby players get them; 50 year olds from perfectly functional families get them. This is everyone's issue.
How much do you know about eating disorders?

I found out yesterday that one of my friends from treatment is going to be going back to ED treatment (if you're reading this, darlin', good luck and Godspeed). My friend J is still in residential. I got out of the hospital--for the 6th time--almost exactly a month ago. I'm so tired...

I have seen too many good women lost to this disease--if not their lives, their quality of life. The only thing worse than having an eating disorder be your death sentence is haveing it be your life sentence. And it seems like nothing does any of us a damned bit of good. All these big spirits, reduced to the agonizing smallness of calories, miles and mouthfuls, penance and purging. What an incredible fucking waste.

Tuesday, June 03, 2008

Got a letter from Wash-U today asking for my medical history, and letting me know that I'll be drug tested during orientation. Just for PCP and THC, though, if I read the letter correctly (which I might not have, considering how high I was at the time--that's a joke, son! So high the walls were breathing). So basically they send out a note at the beginning of the summer saying, hey, kids, we know most of you are enjoying the end of senior year, and that last free-fall quasi-adolescent summer before all your friends split up and head out into the job market (where your insufferable frenemy will discover that a French Literature degree, even from an Ivy League school, will only get you a job at CopyMax when there's a recession on). But anyway, kids--still listening?--make sure you quit hitting the bong in enough time to pass your drug test. We don't want to see stems and seeds in anyone's urine sample. As for PCP, saints preserve us! Does anyone but bikers use PCP these days?