Tuesday, June 29, 2010

Life, Death, Sex and the Nature of God

A lot to cover in one post, but I'm going to try. So just a few weeks ago, I lost a close relative to suicide (well, I shouldn't say lost--it isn't as if he's been misplaced or forgotten--but that's the best word I can think of at the moment). Now, most of my life I've assumed that the reason suicide is such a heart-rending way to lose someone is because of the stigma involved; if cousin Rick had a heart attack, you'd feel perfectly comfortable saying, "It was his heart." In this case, however, it just didn't seem right to say, "He shot himself in the head," or even the less graphic variant, "He committed suicide." It is that, in part; but another source of the pain is the fact that you question yourself--how you interacted with the person, whether you could have (by calling more often, offering some words of encouragement, somehow being more clued in to their state of mind) averted the catastrophe that occurred.

When my uncle killed himself, he left a package of his papers (including a DNR--do not resuscitate--order) for another member of our family to find. As I was running in Forest Park a few days ago, I started going over the ethical implications in my mind. If someone had found him in time to perform resuscitation, would his DNR stand? Ostensibly, if he was not of sound mind when it was drafted and signed, it shouldn't, and power should revert to his healthcare proxy. What if it was signed months ago? Some evidence (the person who told me didn't elaborate, and I honestly didn't want to know) suggested that he'd been planning this final denouement for the better part of a year. Had he been unremittingly suicidal all that time? "Merely" depressed? Can a person make a rational decision to die as an escape from psychological or existential pain?

Flash forward to the funeral/"memorial service." I'm in one of the front rows, listening skeptically as the sermon begins. I'm hoping that, despite the fact that the service was arranged by my more...evangelical family members, the overall message will be comforting and uplifting. And at first, it seemed to be. It's part of the human experience to wish for death from time to time, the pastor said, pulling up examples from Scripture: Moses, chafed by the complaints of the Israelites in the desert, asked God to put him to death. Jonah did much the same thing. Even the holiest among us at times feel so bad that death looks like a respite, he said. I breathed a sigh of relief. BUT, he said--and at this point I knew we were in for it--to act upon that wish is a mortal sin. There was some more exposition (which I could barely hear over the sound of my blood boiling in my ears), but the take home message was that my uncle, because he was not a professed Christian, and because he killed himself, was now writhing in the fires of hell. I walked out shortly after this statement was made (largely because I didn't trust myself not to stand up and attack both the pastor's parentage and exegesis in phrases thick with four-letter words) and didn't hear the rest of the sermon.

I called my other uncle a few nights ago, to ask him some questions that have been plaguing me, and just generally to build a better relationship with what remains of my family. He was the one that found the suicide note; I wanted to know what it said, and to check on how he was doing, and try to discover what exactly happened (my parents told me part of what happened several days after the fact, once I'd 1. taken my Boards and 2. had driven to KC, so I wouldn't be alone). We talked a long time. He emphasized that my uncle had been struggling with severe depression for a very long time--this is true--and that ultimately it was just too much for him to bear. That's what I wanted to yell at the pastor, to tell my relatives, to have emblazoned in skywriting above the church. My father, and every single one of his siblings, has a mood disorder (either major depression or bipolar disorder), an anxiety disorder, or both. Lucky girl that I am, I--through some combination of genetics and circumstance--have been blessed with both as well. We, of all people, should know better.
As one of my friends with depression (and an Episcopal priest) said when I told her about the service, "I hate smug sane people." Exactly. Because having been on the other side of suicidality, and more that cursorily, I can say it's not about 'presumption of God's mercy,' or 'willfulness,' or hurting those left behind. These are the furthest things from your mind. It's about the pain: the incessant, bone-crushing, soul-rending, heart-shattering pain, and the animal instinct to escape from it by any means possible. At the moment I'm doing pretty well, but I know that I am always at risk for relapse; my uncle had so many happy times, but he also ultimately killed himself. Depression, while not a sentence to a life of unhappiness, is not something to take lightly. I guess his death has made me more aware of my vulnerabilities, and more dedicated to vigilance in the face of this disease.

And then what of God? My definition of that word, even, is difficult to pin down; but as my uncle said to me on the phone (and I thought this was a very good point), what sense does it make to hold Ward Cleaver to a higher standard of compassion and forgiveness than the Creator of the Universe? Because what did Ward do when Wally or The Beav screwed up majorly? He sternly advised them to fix whatever it was they'd effed up, made sure they followed through on fixing their friend's bike/got the bandaids off the cat/ never hotwired a car again...and then tousled their hair and told them they were forgiven and loved (and also to make him a whiskey on the rocks...because, hey, it WAS 1950). Yet The Lord God, Creator of all that is, Seen and Unseen, gets so pissed off at disobedience/sin or a creature's disbelief that eternal damnation and torment is the answer? No chance for reprieve? No. Not my God.

Friday, June 18, 2010

Today was orientation. We learned an ungodly amount and practiced putting in nasogastric--ie, feeding--tubes, and Foley catheters for males and females (best quote of the day is probably from the nurse that demonstrated the male catheterization, in response to my tentative grasp--"You're going to have to grab that penis like you mean it." Oops...hope that word doesn't get me put on some unsavory list). Then there was knot-tying, which apparently is an uber-important surgical skill, and suturing, at which I sucked tremendously. Of course, it probably didn't help that last night, in my forgetfulness and due to my recent space-cadet status, I took both the Thursday and Friday doses of my usual medications. And then proceeded to have a panic attack, and go to the ER, assured that my demise was only minutes away, only to be told that I was (essentially) being a one-woman freak show (though of course the doctors don't tell you that...perhaps more disturbing, I knew the attending who saw me from another context. Thankfully I don't think he recognized me). Why. am. I. such. a. freak? Then again, I guess I answered my own question when I told the resident the reason I take the medications I take--"for depression and PTSD."
To be fair, although it wasn't a massive overdose, it was a some pretty potent stuff, and I've felt essentially *gorked* all day today (I swear, that's hospital patois, not drug slang. Don't recognize the word 'patois'? Look it up and be edified!), which made paying attention to the two-hour presentation on the hospital computer system impossible rather than merely difficult. And which resulted in the suturing instructor telling me no fewer than six times, each time holding up his forceps as an example, and each time getting a look of utter incomprehension from me, to "hold your forceps like a pencil. Not like that. Like a pencil." Finally dude just came over and placed my fingers in the correct position around the forceps. Word on the street, however, is that such a stupid or lackadaisical response to commands in the OR will cause a surgeon to backhand you across the Mayo stand. Needless to say, on a day which ideally would have found me in top form, I was (or at least felt--let's cognitive-behaviorally reconstruct that thought, huh?) sadly lacking. On the other hand, it may have been all to the good that I was semi-sedated--this was a nervy, pressured day, and I actually *objectively* performed quite well in the sharps safety training, which was simulation-based and a lot more fun than I anticipated.
So in the sharps training we learned to perform--according to OSHA requirements--venipuncture/phlebotomy (ie, "taking blood") and IV starts. We also learned to stick for an arterial blood gas (which I hope I first get to practice on a comatose patient, because it hurts like a mother, though that may be a moot point because someone sick enough to be in a coma is probably already equipped with an arterial line).

Wednesday, June 16, 2010

RIP. I'll think of you the next time I go to the Soulard Market, Uncle Jim. That's still one of my favorite St. Louis memories.

Jim Giedinghagen, age 58 of St. Charles, MO died on or about June 8, 2010. Jim was the son of Lewis A. and Anna I. Giedinghagen and was born on June 5, 1952. He will be missed by his mother; his brothers David and Dale; his sisters Marsha Bearden and Diane Stevens; his sisters-in-law June and Vicki; his brothers-in-law Rick Bearden and Bob Stevens; his nieces and nephews Beth & Willie Bray (& Will), Adam Bearden, Grant & Jennifer Bearden (& Riley), Joshua Bearden, Stephanie and Anne Giedinghagen, Melissa & Eric Trautman, Andrew and Rachel Giedinghagen; and close friends. Beloved, troubled son, brother and trusted friend. The memories of your kindness, empathy and gentle, caring spirit will always live in the hearts of those who love you, and will through the grace of a forgiving God, temper our profound grief. All the bright days, your abiding love and wonder in nature, your sharp wit and the laughter we shared will give us solace. Mercy, charity, forbearance and tolerance marked your path through this world. May they guide ours as well, as we acknowledge the darkness, yet watch for the breaking dawn. A memorial service for Jim will be held on Saturday, June 19th at 2:30 PM at the First Evangelical Free Church of Franklin County, located at 480 Hwy AT, Villa Ridge, MO 63089. In lieu of flowers, friends may honor Jim’s memory with contributions to Heifer International or the St. Charles Humane Society in care of Alternative Funeral & Cremation Services, 2115 Parkway Drive, St. Peters, MO 63376.

Tuesday, June 08, 2010

Ok, so it shouldn't surprise me that Hooters has sexist business practices, but welcome to today's installment of YHTBFKM (You have to be f*cking kidding me) news!
A number of Hooters waitresses (you know, that place where you can ogle heavily made-up, fake-tanned, barely-legal women in shorts so tiny they require a preliminary bikini waxing...and where they serve, um, wings...yeah, it's all about the wings...) have come forward to say they have been placed on 'weight probation' by the company--given a 30 day gym membership and told they have a month to either shape up or ship out. Literally. Some--ie, Hooters management--have argued that this is no different from "the policies of such organizations as the Dallas Cowboys Cheerleaders or the Rockettes" (bastions of pro-woman sentiment and positive body image, no doubt). So what about this undershot even my snakebelly-low expectations for this particular corporation?
Here. A woman who is nearly 5'8" and 132 lbs--whose BMI is 19.8, for the love of Jeebus--has been told to lose weight or lose her job. If one were specifically writing a scenario designed to give someone an eating disorder, it would be difficult to do better. I don't know how much weight they wanted this young woman to lose, but she is already at the low, LOW end of normal for her height; in fact, losing even 10 lbs. would put her squarely in the "underweight" category. It's not enough that their business practices are themselves chauvinistic and exploitative, IMPLICITLY making workers feel insecure and encouraging unhealthy relationships with food and weight; now Hooters (I know it's not funny, but I still can't say/type 'Hooters' without wanting to giggle; I'm secretly 13 years old, so sue me) has to EXPLICITLY encourage young women to damage their health in pursuit of appearance and approval. I would imagine that no one who reads this on a regular basis (if in fact such people exist) is frequenting this particular business establishment, but if you are, I would implore you to boycott. No one should have to choose between being unhealthy and being unemployed.

Monday, June 07, 2010

To shave...or not to shave?

So, as third year rotations rapidly approach, I have decided I'm going to take the leap and...gulp...shave my legs, and possibly my underarms as well (because I am much less likely to wear outfits that showcase my pits than my gams. Rowr.) I haven't shaved since I was fifteen--a full decade--and while once upon a time it was fine (both the hair and the grooming practice), it's become less so. As a teenager, and even in college, I'd occasionally have people tell me they thought it really brave, or rad, or some such adjective, that I wasn't giving in to the patriarchy, and we'd have a dialogue about my reasoning. That doesn't happen so much anymore--maybe because I have fewer hippie friends and acquaintances. Medical schools, like medical professionals, are not overly noted for their liberal leanings.

So why am I doing this? Primarily because I don't want to get marked down by an intern or disgust an attending. There. I said it. Also because a friend intimated that shaving might up my chances for getting laid. And because I pluck my eyebrows, which makes me feel a little hypocritical.

What were/are my reasons for not shaving? Well, there IS the laziness factor--I'm not going to lie. Also, it pisses me off that everyone acts like women's body hair--which grows there naturally, and will stay there unless you actively remove it--has an ick factor higher than 'Alien vs. Predator' and open heart surgery combined. Julia Roberts has a little fuzz under her arms? OMG, EWW to the max! Whereas I feel guys can, essentially, look like bears--and it's all ok. Granted, I know arguing that it's 'natural' not to shave can be struck down reductio ad absurdum--that is, by pointing out that in our natural state human beings don't wear clothes, don't shave anything and smell like a combo of donkey, Cheetos and feet. C'est vrai.

However, it seems like a slippery slope to me...perhaps because in the last 25 years the body has become the site of such anxiety, and has become such a domain to be mastered, that I wonder where this will all end (yes, I realize I sound like I'm 75 years old). It's practically de rigeur to shave underarms and legs. After that, in order of necessity, would probably come bikini waxing or shaving (do you realize it was only 10 years ago that the J Sisters Salon in NYC started performing the now-infamous Brazilian wax? O sisters, what have you wrought!?), and it's become less and less common to get just a 'little off the sides'--ie, so that it doesn't look like you bought a swimsuit with fur trim. Now EVERYTHING comes off. And then there are eyebrow waxings, upper lip waxings...when can we stop preening and pruning ourselves?