Being a Child

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More has been written about Atul Gawande’s book Being Mortal than on most other books on medicine and health, combined. It was reviewed in the New York Times, The Guardian, The Wall Street Journal, and dozens of other newspapers, magazines, and other publications large and small.  Its study of how the medical profession handles the process of dying — whether that process comes at the end of a full life or far too soon — has changed the national narrative. Doctors are coming around to the idea of supporting patients on their own terms as the end draws near, a concept which, to many, seems antithetical to their oaths. After all, are they not charged to “do no harm?” Gawande’s Being Mortal forces the discussion and redefinition of “harm.”

In an early chapter of the book, he writes that there are two kinds of courage. “The first,” he says,  “is the courage to confront the reality of mortality—the courage to seek out the truth of what is to be feared and what is to be hoped when one is seriously ill. Such courage is difficult enough, but even more daunting is the second kind of courage—the courage to act on the truth we find.” As he shares the stories of his own patients — choosing between risky surgery and an uncomplicated but speedier end; finding ways to maintain autonomy as they age; managing varying levels of discomfort while remaining lucid and cogent — it is clear that all the scenarios where his courage to “act on the truth we find” are predicated on the first courage to “seek out the truth of what is to be feared.”

In other words, there can be no action toward healing without first determining how his patients define healing. Continue Reading…

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Contrast This

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About six weeks ago, I tripped over a bolt jutting out of the floor of my garage and landed, head-first, on a spare car battery. It became clear within a few hours that I had a whopping concussion. In the impossibly bright lights of the emergency room, a friendly young resident told me she was considering whether or not to give me a CT scan.

“It’s just how tender your skull seems to be,” she said, puzzling it over. “I’m a little worried about whether you’ve fractured it, or whether there’s any bleeding in your brain.”

“What are the reasons for and against it?” my husband, ever the pragmatist, asked her.

“Well, if we did it and found out she has bleeding, we’d definitely keep her overnight, just to be able to check her regularly and get another scan in the morning.”

“So, why not do it?” I asked.

“Well, it’s a lot of radiation, is all…hang on a minute,” she mused, paging through my chart. “How old are you, again?”

“Forty-four, last week,” I told her.

She did what looked like some mental calculations in the air above her, then recommended that we do the CT scan. When pressed, she explained that the cancer risk comes about forty years after the exposure to radiation. By then, she calculated, I’d already be pretty old. It was a worthwhile risk, given the math. Continue Reading…

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10 Foods That Saved My Soul

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In 2010, my youngest daughter, Sammi, was diagnosed with a disease called eosinophilic esophagitis. Though it turned out that this diagnosis was incorrect, we didn’t learn that for three more years. During the first year of her diagnosis, we had to eliminate dairy, soy, eggs, nuts, and wheat from her already-vegetarian diet. During that time, these ten foods became the most important staples in my kitchen, making me grateful beyond anything I had ever known before. If you or someone you love is following the “six food elimination diet,”  these foods might be just the things you need, too. Continue Reading…

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Humility in a Dark Room

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Three and a half weeks ago, I was walking through my garage with my husband David, on our way to Parent-Teacher Conferences for our younger daughter. As always, I was chatting and walking and probably planning something in my head to do or say next. We need to pick up our box of farm vegetables after the conference, I might have said, and then also the pizza place is donating a portion of the proceeds tonight to that charity that buys school supplies for kids in need, so we should grab takeout from them, and then…

I felt it. The bolt on the garage floor, the one that’s been sticking out of the cement for at least 12 years since we bought this house, the one I’d tripped over a dozen times but always caught myself. This time, I didn’t. I flew forward, maybe aiming my body around the hood of the car or maybe just flailing, helplessly, in the space between the bolt and the spare marine battery — 50 pounds and unyielding — that suddenly caught the left side of my head before the rest of me landed.

The shock of pain was sharp, or the sharp pain was shocking, or both. I cried, immediately, with the injustice of the thing I’d hit, the heft of it, the weight, the way my head and also maybe my ear hurt, the way I was left lying on the garage floor on my stomach. I lay there crying as David tried to assess what had happened. The garage was dark. The floor was gritty. My head was exploding.

After a few minutes, I sat and then stood up. David  asked if I could see him, and I could. I knew his name and mine, the president (ugh), the date. David wanted to take me to the hospital. I insisted we needed to go to our daughter’s conferences. It hurts, I said, but I think I’m ok.

So, we went to conferences. I had a few quiet, secret moments of dizziness, but I made it up and down the stairs and through a series of conversations. When we stepped outside the school, though, the first wave of nausea hit. I pretended it was hunger and pressed on — to get the vegetables, to get the pizzas. When we stepped outside the pizza place, the nausea and dizziness were so intense I nearly dropped to my knees.

David took me to the hospital. Continue Reading…

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Listen to Us

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This poem, by Shel Silverstein, always made me sad. When I was a little girl, I had an audiocassette of him reciting it, and his warm, avuncular voice is the one I hear in my head when I read it.

The Little Boy and the Old Man

by Shel Silverstein (1930-1999)

Said the little boy, “Sometimes I drop my spoon.”
Said the little old man, “I do that too.”
The little boy whispered, “I wet my pants.”
“I do that too,” laughed the little old man.
Said the little boy, “I often cry.”
The old man nodded, “So do I.”
“But worst of all,” said the boy, “it seems
Grown-ups don’t pay attention to me.”
And he felt the warmth of a wrinkled old hand.
“I know what you mean,” said the little old man.

It’s hard not to feel heard. Little children sense that they’re being ignored even if they can’t express it well. They may do other things to get the attention of grown-ups: break something, have a tantrum, or find other ways to force that grown-up to take notice. Old men may quietly do what they want, or give up entirely, but they have an understanding of who they were when they were young men — that they ignored their elders, that they paid less attention than they wished they had, and the empathy they have might lessen that feeling of sadness. These are expected responses.

But what about women? Continue Reading…

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