Aramink

Engaged with the World

Category: Health (page 1 of 3)

Dr. Kermit Gosnell, Killer

Dr. Kermit Gosnell is currently on trial in Pennsylvania on murder charges (among others)  because of  practices at his abortion clinic. In January 2011, Gosnell charged with eight counts of murder resulting from gross medical malpractice in treatment of patients at his clinics. The eight victims of his alleged murders were seven infants said to have been killed after being born alive during attempted abortions, and one adult patient who was administered an overdose of painkillers during an abortion.

Medical malpractice is the action of medical providers that intentionally or negligently injure or kill a person in that medical professional’s care. From all accounts I have found and read, Dr. Gosnell is at the very least guilty of egregious and frequent medical malpractice.

Dr. Kermit Gosnell is a real-life horror story.

The mistreatment and maltreatment reported by patients and even his own staff is hair-raising. Patients who change their minds about having an abortion, even if their feet are already in the stirrups, must be respected and treated with dignity. Unless the procedure has already progressed beyond a point of no return, it should stop immediately. This is true of any elective procedure, whether it is wart removal, plastic surgery, abortion, or hip replacement.

When I hear of patients infected with STDs because a doctor used unsterilized instruments on them, I am appalled.

When I hear that of bags containing at least 47 aborted fetuses were stuffed into a refrigerator, my stomach lurches. What the hell was the point of that?

My anger rages when I hear a 15 year old girl who changed her mind on the table was physically restrained and the abortion performed anyway. That is abuse. Assault. Battery.

When I think of a live baby’s spine snipped with a pair of scissors, my fury explodes.

Dr. Gosnell has been accused of all of these things. If they are true, he should never be allowed to practice medicine again. Ever. And he should go to jail.

I am not appalled that he was performing abortions. Women need a safe place to have abortions. But Gosnell’s clinic was not safe. Not for them, and not for the babies apparently born there after botched abortions. According to Philadelphia District Attorney Seth Williams, “The grand jury went to the scene wearing Hazmat suits.” The scene was littered with animal feces and stray cats had apparently had their run of the clinic.

Why Kermit Gosnell had Patients

Over the past 24 hours hours, the anti-choice media has been bewailing the fact that the case has not gotten much media coverage. I have seen it in my news feed daily over the last month, so until I investigated further, I didn’t understand why they claimed there was no coverage. Seems that the pro-choice media has covered it thoroughly – because Gosnell’s clinic is a harbinger of what will come if abortion is made illegal everywhere. The anti-abortion crowd has not covered it, because of the focus the case trains on illegal and unsafe abortions, which they know will happen with hyper-regulation and limited abortion access through safe, mainstream healthcare channels. Unfortunately, in today’s anti-choice climate, places like Gosnell’s clinic will become more common, not less. When abortions become illegal, vultures like him will be able to prey on more women.

The anti-choice advocates do not want this story covered, because this story will become more commonplace the harder abortions are to come by.

Women determined to abort the fetuses they are carrying will do so, one way or another. They should be able to do it in a safe, sterile environment that will prevent their own death or incapacity. This was where Dr. Gosnell failed. The women who sought treatment from him got rid of their unwanted pregnancies, but apparently often did so at the cost of their own health and safety.

Why should only the rich be entitled to safe health services? Why should abortion be readily available to wealthy patients, but not to poor ones? In one respect, Dr. Gosnell did indeed provide a necessary and desirable service. His method of purveying it, though, was devastating to his patients.

Gosnell is a symptom of a broken health care system. He is the poster child for why abortion services need to be safe, sterile, and sensibly regulated – not over-regulated so that only wealthy women can afford them.

Late Term Abortions for the Poor

When abortion is too expensive for a woman to be able to afford early in her pregnancy – when it takes her too much time to come up with the expense of resolving the problem of an unwanted pregnancy, she is forced to wait to abort the pregnancy. The longer she has to wait, the closer to viability or even to term she must have that abortion. By making abortion difficult to come by and expensive, we ensure that poor women must wait longer than wealthy ones to have abortions. We create the problem that a viper like Gosnell can take advantage of.

Elective late term abortions are not unheard of, even if they are rare. Late term abortions happen because women are either denied earlier access or because of medical reasons affecting wither the mother or the fetus. If a woman has to wait beyond the point of viability, but is still determined to end her pregnancy, she will still do so. And as long as it remains difficult and illegal for her to do so, she will accomplish her goal illegally. Outlawing late term abortions will not stop them. They are rare even without the legal restrictions. Women who are able to end unwanted pregnancies as soon as they can. They don’t wait for the opportunity to kill a baby.

If his patients had had the chance to go to a clean and safe clinic, Kermit Gosnell would not have had a practice. As someone I spoke with said recently, Gosnell’s clinic was “the template for underground and illegal abortion [mills]. As abortion rights get more restrictive, as people seek to find ways to make them even harder to come by, people looking to make money off this human suffering will find a fertile grounds on which to thrive.”

When a “Baby” is not a Baby

A pregnant woman talks about her baby in the present tense, but she has no offspring yet. We refer to saving the lives of babies when we talk about prenatal health care. The anti-choice crowd talks about saving babies’ lives when they talk about not aborting pregnancies. So when is a baby a baby, and when is it not?

A fetus is the unborn or unhatched offspring of  non-marsupial mammals – any non-marsupial mammal, including a human, a goat, a bear, or a platypus. (Marsupials do not have a fetal stage. They go from embryo to joey instead of from embryo to fetus.) A fetus is dependent on its mother for oxygenation, which is essential to life.

Viability, or the ability of the fetus to live outside the womb, is the measure the Supreme Court uses to determine the point at which the states may restrict abortions. Prior to viability the fetus cannot survive without its natural life support system: a woman. The point of viability is not a clear, bright line for every developing fetus. Some fetuses delivered earlier may live, while some delivered later may not. Medical advances have made it more likely that younger, smaller fetuses can live if their families choose to exercise those so-called heroic measures.

Until living tissue can oxygenate itself, it is dependent upon its mother and is not a baby. It is living tissue, but it lives a parasitic existence. As long as it lives a parasitic existence, its host may either accept it or reject it. We take steps to reject other parasitic lives dependent upon us, whether the parasite is a hookworm or a paramecium. The difference between these parasites and a fetus is that the fetus is a developmental stage of our own species, made with its host’s own DNA. We are more reluctant to reject our own species than we are to reject another. Once a fetus is born it becomes a baby that any other human can care for. After the umbilical cord is cut and the baby draws its first independent breath, it can be given to a wet nurse, it can be held by any other person or set aside in a crib away from other people completely. It is still dependent, but not for each moment of life. Its sustenance can come from anyone, not only from its mother.

Furthermore, after a fetus is born alive – that is, after it becomes a baby at the magic moment of birth – certain rules go into effect. Those rules allow us to remove terminally ill, dying, doomed, and comatose from the medical interventions keeping them alive. There is no legal requirement that heroic measures be taken for anyone, regardless of how long they have been breathing.

Why should there be a legal requirement that life support systems must stay in place simply because of the short length of time since conception? And why should anyone be legally compelled to provide life support for another person at the expense of her own body?

Someone pointed out McFall v. Shimp in a discussion today. In that case, McFall needed a bone marrow transplant and Shimp was the only suitable donor found. When Shimp refused to donate bone marrow, McFall sued. The court famously found that while Shimp’s refusal was morally indefensible, the court had no authority to order him to submit to personal, physical harm and bodily intrusion in order to save McFall’s life, and would not do so. Personal ethics are one thing. Demanding that another person put himself in harm’s way is yet another.

A pregnant woman unwilling to sustain the developing life within her own body is analogous. Every pregnancy has adverse health effects on every woman, Increased heart rate, edema, sepsis, increased blood pressure, hormonal surges…the list of physical systems challenged and even compromised by pregnancy is long and frightening. Then there’s death. Every woman fears death as a result of pregnancy. A woman may be under a moral obligation to provide healthy conditions for the tissue in her womb that has the potential to develop into a human being; however, she is under no legal compulsion to do so.

That is why women who use drugs and alcohol during their pregnancies are not incarcerated.

A fetus becomes a baby when it is born – when the umbilical cord is cut and it takes its first breath of air. At that moment, it is no longer dependent upon another creature’s continued life in order for it to exist. If a pregnant woman dies, the nonviable fetus inside her also dies, as does a viable fetus not immediately removed surgically.

Too often the terms “fetus” and “baby” are used interchangeably. I’m guilty of this, too. It’s the colloquial vernacular. These are not interchangeable terms, though. One means a creature that has not yet been born; the other means a creature that has been born.

A fetus does not become a baby until it is separated from its mother and living on its own, even if “living on its own” means that some degree of medical intervention is necessary. No one condones severing the spinal cord of an already-born baby who otherwise is healthy and able to survive. If the news reports of the testimony at Kermit Gosnell’s trial is accurate, he may have killed at least seven healthy babies – not fetuses.

There is a difference.

Valuing Human Life and Dignity

Valuing human life and dignity takes many forms. Personally, I value the life in existence more than the potential life. I certainly value the dignity of an existing person capable of feeling indignity more than that of a theoretical one.

The inherent point about abortion is that a woman who is determined to end her pregnancy will do so, no matter how much it costs, no matter what lengths she has to go to, and no matter if it may kill her.

I have witnessed abortion. The life, health, and future of my friend having that abortion while I held her hand was more important than the potential life that was then unable to live outside her womb. To this day, nearly 32 years later, she does not regret her choice, and I do not regret making sure she was able to have that abortion safely. I called home from college and asked my dad for the money. My friend could not ask her parents, but I knew my father would help me without hesitation and he did. I don’t know if he believed me when I said it was for a friend, but it did not make any difference to him. A young woman’s future was on the line.

I have also seen ultrasounds. I’ve seen different stages of healthy fetal development, and I have seen severely malformed fetuses in ultrasound after 20 weeks. One such fetus was also aborted. Less than a year later, performing that abortion would have made a felon out of the very humane and humanitarian doctor who performed it.

The fetal human being suffers no more and considerably less than the animals we humans routinely slaughter to eat, and does so with significantly less fear and trauma. It suffers less than a living human being whose artificial life support must be withdrawn because of health care directives. It suffers for a shorter period of time, too, and its death in safe, sterile surroundings does not compromise anyone else’s life or quality of life.

Abortion opponents want us to believe that abortions will stop if they are made illegal. They won’t. More people will suffer at the hands of butchers like Kermit Gosnel is reputed to be.

Butchers like Kermit Gosnell are the reason Roe v. Wade became necessary.

Butchers like Kermit Gosnell are the reason pro-choice proponents despair of ever-restrictive abortion laws.

Spring Allergies Blow

Trees are trying to screw me. During a weekend spent dipping oak squigglies out of my pool, airborne jizz of various tree varieties has invaded every one of my exposed orifices, spewed onto my delicate skin, and now has me scratching and sneezing and using up yet another tree’s worth of Kleenex.

Benedryl is now my friend with benefits.

I sleep with it.

Twinkies

Because someone mentioned it in comments on my Facebook link to a recent blog post, I am now compelled to discuss the pros and cons of Twinkies, that sweet treat adored by stoners and other kids everywhere.

The Twinkies Legend ramped up a few years ago when the fried Twinkie was introduced to thronging sophisticates of fair fare.  People drove for hours just to taste it, and the initial purveyors of this particular fine food sold 26,000 fried Twinkies in just 18 days. The magic was not obvious to those watching from the sidelines, but no one can deny the faithful. We, personally, have never tried this delicacy. According to reports, the the famous creamy filling melts and soaks into the cake, giving it a souffle or pudding-like texture. It was an instant hit.

Deep-frying isn’t the only way to get Twinkies into your family’s diet. There’s an entire cookbook, 112 pages long, containing more than 50 recipes with Twinkies as an ingredient.

Never get between Americans and their Twinkies. In 1987, teamsters who delivered Twinkies to New York City and its New Jersey suburbs went on strike. Area Twinkies lovers panicked. The reaction was “not unlike smokers who start to tense up when they run out of cigarettes and all the stores are closed.”  Twinkies addicts called distant friends and relatives to send in emergency supplies. We imagine the airlifts resembled Berlin in 1949.

Disaster struck again in March of 2000, when the teamsters’ strike closed bakeries all over the Northeast. The Internet came to the rescue during this “Great Twinkie Famine of 2000.” Ebay made out like a bandit, selling 20 batches of Twinkies for over $5,000.

Twinkies are popular, no doubt about it. According to Hostess Foods, 500,000,000 Twinkies are produced annually. In case you got cross-eyed counting zeroes, that’s half a billion, with a B. America’s population today is a little over 3.14 hundred million; America is pi, and Twinkie is the ubiquitous cake that radiates among us.

You might think that with popularity like this, the company that concocts Twinkies would be sitting on a big pile of money. Not so. Just this January, Hostess Brands filed for bankruptcy protection – the second time it has done so in the last ten years.  Yesterday we learned that negotiations with its unionized employees might result in the employees owning a piece of the action. Twinkies lovers everywhere hope that out of these bankruptcy negotiations will come the ingredients for Twinkies’ success.

Like so many of our favorite mass-produced foods, the ingredients of Twinkies cannot be identified by the common consumer. In fact, they are so mysterious that a guy named Steve Ettlinger wrote an entire book about these ingredients. It turns out that Twinkies come from mines. That’s right. Twinkies ingredients are mined (limestone, gypsum), drilled (petroleum), refined, and synthesized into those tongue-twisting polysyllabic compounds that are printed on the package.

Upon learning about these ingredients, we were bemused to realize that it is necessary to chill Twinkies before frying because plastic melts at high temperatures. And that creamy filling? There’s no cream in it. It’s sugar and shortening. Maybe even made from beef – so vegan Twinkies lovers, beware. When confronted with the truth about the sources of ingredients, David Leavitt, Vice President Snack Marketing at Hostess said, “Deconstructing the Twinkie is like trying to deconstruct the universe. We think the millions of people … would agree that Twinkies just taste great.”

That’s right. He said it. Food doesn’t actually have to be made of food to taste good.

Science has weighed in on the Twinkies question. The T.W.I.N.K.I.E.S. Project at Rice University subjected Twinkies to a series of strenuous tests to determine their properties. T.W.I.N.K.I.E.S. is an acronym for Tests With Inorganic Noxious Kakes In Extreme Situations. Dedicated researchers jolted Twinkies with electricity, dropped Twinkies from staggering heights to replicate Galileo’s experiment, exposed Twinkies to radiation, plumbed the depths of Twinkies intelligence, subjected Twinkies to rapid oxidation, tested the density of Twinkies, and more.

The Twinkies Project

We were not able to find peer reviews of these experiments, so we cannot herein vouch for them.

At this point, we are hard-pressed to find anything positive about Twinkies except their taste. We thought that perhaps the nutritional value would be positive, since we heard rumors a couple of years ago that someone once went on a Twinkie Diet and actually lost weight. It turns out that what the guy essentially did was starve, so don’t replace your amphetamines with Hostess products just yet. If you want a hypoglycemic rush, Twinkies are your tool.

So what about the rumors of the eternal shelf-life of Twinkies? Turns out this is in error, too. We can attest to the lie. When we helped our teenage son empty the trunk of his car once, we found a box of Twinkies that had been bouncing around back there for quite some time. “In case I need a snack,” he explained. Sure. Boys get hungry. We understand. So we removed one of those delicious golden snack cakes from the box. It felt funny. It was hard. Like, brick-hard.

“How long have these been back here?” we asked.

Our progeny shrugged. “A few months, maybe.”

We were glad he hadn’t been on a crime spree. Had he needed to use the Twinkie Defense, he’d’ve broken a tooth.

Another Day Gone

This is My Brain on Migraine
(source)

I wake up; the pounding in my head forces me to. I drag my sandy eyelids up and try to focus on the clock. 4:45 a.m. My mouth tastes like dirty socks and my stomach wants to heave. I make myself sit up and the room reels. The telltale rush of saliva into my dry mouth warns me that I don’t have much time. When the room stops moving I put my legs over the side of the bed. Somehow I’m vertical and staggering toward the bathroom.

I keep the shots of Imitrex ready to go. Finding the injector in the dark is not a problem. The container is on the bottom shelf of the bathroom cabinet, right where it’s supposed to be. My fingers fumble and pry up the lid on one of the twin ampules. The only reason I can do this now is years of practice. When my doctor first gave me the shots I was slower. The novelty meant I sometimes couldn’t prime the injection device properly and a spray of precious triptan would shoot across the room instead of into my flesh. When the headaches are really bad, sometimes that still happens. Migraines steal fine motor coordination. Gross motor skills are pretty much out the window, too, but it’s the fine motor I need now. And the dismay of seeing an injection that costs over a hundred dollars wasted into thin air has no equal. This morning I manage to load the syringe and press it to my flesh. My thumb hits the button on the end of the device and I can’t help but hiss as the sting of the medication hits my intramuscular tissue. It takes a couple of tries, but I manage to cram the injector into its holder and prime it for the next shot. Then I stagger a couple of steps to the sink.

Surely I will feel better if I get those nasty gym socks off my teeth. My hands tremble as I load my toothbrush. Applying toothpaste to my toothbrush takes extra time and effort. It’s hard. I turn the water on and wet the brush, then bring it to my objecting mouth. No sensation is good, because every sensation is amplified with a migraine. The sharp taste of minty-fresh explodes in my mouth and I rinse the brush again. I just want to peel off the cotton that coats my mouth, not breathe on anyone. I don’t want to sanitize myself yet. I just need to get rid of the grimness of first waking up.

Afterward, I grip the sink with both hands. The Imitrex still isn’t working, and even the slightest head movement is agony. Maybe if I lean here for a moment the drug will kick in. But not yet. The jack hammer in my skull subsides with stillness. When I think I can bear it, I move tentatively toward the toilet. Whether or not I really need to go, I need to sit down, and, at a distance of twenty feet, my bed is too far away. I miss the three-foot-tall stacked cube shelf that I used to have in my bathroom. I could sit on the toilet, pull it close, and rest on it, my head lying on my folded arms. Sometimes I would drift into unconsciousness that way and my husband would call to me, asking me if I was all right. If I had assumed that position, I was never all right. Now, though, the shelf lives at his house and the twelve-inch distance to the tiled wall is to far to lean, no matter how good the cold tiles might feel on my skin. I sway as I sit there.

My eyes are closed. I lose track of the minutes. I beg the drug to start working. I wait for the sensation at the back of my neck that signals its effectiveness. Nothing happens.

Eventually, I think I can make it back to bed. The nausea is a reminder that the meds aren’t working, and I know that on my way I need to get the Phenergan. Dr. Archer has prescribed it in a cream. Philip at the Drug Store compounds it and puts one dose into a syringe without a needle. A plastic cap at the tip of the syringe keeps the cream from drying out. It’s hard to get those caps off. I dread the effort, but I know it is necessary. If I start throwing up, I won’t stop. Vomiting with a migraine doesn’t make anything better.

I stand before the door of the medicine cabinet again, reach into the Ziplock bag that contains the Phenergan cream syringes, pull out a syringe, and start wrestling with the cap. Not only do I lose coordination with migraines, I lose strength. It takes me more than a minute to pry the cap off. With a grateful sigh I push the plunger and spread the cool cream on my wrists. I aim the syringe at the trash can and let it go. Of course I miss. I’ll pick it up later. Now it’s time to stagger back to bed and hope that the combination of drugs will stave off the nausea.

Too late, I forget that I have a bead of blood on my skin from the Imitrex injection. I know I smear the sheets with red as I lie down. I hope it has dried and I can brush off the crumbs of blood easily. I washed and changed the sheets just yesterday, using strong spot remover on the blood stains from last week’s migraines. They never seem to come out completely unless I use bleach. I care, but not enough to do anything but pull myself into a fetal position. My pillow is too hard. There’s nothing I can do about it except keep very, very still. My body is covered in a sheen of sweat from the nausea. I don’t want under covers yet. Warmth amplifies the pain. When the Phenergan kicks in, the sweat turns clammy, then evaporates, leaving a salty residue. Once my skin is dry, I find the coolest spot on the smooth sheets. I tug the top sheet over me, and a few minutes later pull up the quilt, too. The Imitrex still isn’t working. I am grateful for Phenergan’s fortunate side effect of drowsiness. I lie there, waiting for the Imitrex, and waiting for sleep.

Sleep evidently came. I am wake again. It’s 7:40 now, and the Imitrex has only dented the migraine pain. The nausea is mercifully gone, but even though every shift of my head doesn’t bring waves of agony, a full-blown migraine still actively assaults my head. I try to sleep again, lying still and letting my mind drift hypnotically. It’s no use. I’m awake and alert, pain and all.

I can dose myself with Imitrex again. After two hours, if I don’t have relief I can take one of the tablets. I carefully leave my bed and make for the bathroom. The blackout curtains in my bedroom don’t close completely, and the shaft of daylight stabs my eyes as I pass through it. I need a ladder to reattach the last drapery hook to the rod.  Not now, though. I can barely walk steadily. Climbing a ladder is out of the question.

Imitrex’s packaging is intended to be impossible to open. Insurance only pays for nine pills a month, and they come in paper and foil-backed blister packs. Normally I take all the pills out of the blister packs and transfer them to a pill case as soon as I get home from the pharmacy. Stupidly, I neglected to do so this time. It’s a new box of pills, and I fumble even to tear away the box top to get at the blister pack. I still have no fine motor coordination, and tearing away the paper and foil backing is beyond me. Finally I stab the back of the pack with tweezers to get it open. The pill breaks as I extract it. It will leave a horrible taste in my mouth because of that. I swallow it anyway, and take a long drink of water to wash away as much of the residue as I can. Now for the other weapon in my migraine arsenal.

Hydrocodone. I hate it. I love it. I hoard it. Dr. Archer allows me twenty pills a month, but I rarely use them all. It scares me. The last thing I need is an opiate addiction. My tolerance to it is high. For all I know, I’m already addicted. I don’t know. What I do know is that hydrocodone is an extra lifeline for when the triptans don’t work. Today, I need it. Maybe I can go back to sleep. It will be an hour before either it or the Imitrex tablet will take effect. I shake the fat tablet into my palm and wash it down with water. I go back to bed.

I doze, but I don’t go back to sleep completely. After an hour, there is no change. I am tired of my bed. The cats have been anxiously head-butting the door and crying. They’re hungry. Their water dish is probably empty, too. I debate taking another hydrocodone tablet, but decide to wait. I want to see how the effort of climbing the stairs affects me, and if I take one now it will make me itch. Of course, I can always take Benedryl with it. The antihistamine will help with the itching and make me drowsy again. No, I’ll wait.

I should have taken the second pill. In my kitchen, I sink onto a stool at the breakfast bar and lay by head on my arms. The cool granite of the counter feels wonderful. The pounding in my skull does not. When it subsides, I reach for the bottle of hydrocodone I keep on my lazy Susan. The cats are sitting next to their empty food bowls, expectant. “Just a minute, guys,” I whisper. I run water into a dirty glass sitting in the sink and swallow the pill. I stand at the sink for a moment, waiting for the pounding to start again because of the movement. Thankfully, it does not.

The cats’ food dishes are on the floor. I squat slowly, not wanting to bend or even tilt my head for fear that blood will rush into it and the throbbing will begin again in earnest. I nearly lose my balance, but I’ve thought to hold the edge of the counter to ease myself down, so I have a lifeline. I’m shaky as I rise. The three steps to the bin of cat food in the pantry go well. I scoop food into one of the bowls. No wet food this morning, kitties. Sorry. I can’t bend over to get the can, and the smell of it would destroy me. I can smell the litter box across the room, and I know it needs attention, too. There’s no way. Not now. Not yet. Please understand and don’t do your business in the house plants, I beg them silently.

I sit on the stool again to recover from this round of activity. I need to eat something. Lack of food will only make things worse in the long run. I keep coffee in the fridge. Caffeine sometimes helps, sometimes hurts. As bad as this headache is, I decide to give it a try. Iced coffee with a bit of hazelnut-flavored sweetener and a dollop of milk. It isn’t as sweet as Starbucks, but then nothing really needs to be. My sister says those sweet coffee drinks from Starbucks are “a candy bar in a cup.” She’s not far wrong. I sit and drink. It tastes good. I feel stronger after sustenance. I mix myself another iced coffee, and munch on a few strawberries. The carbs will give me strength and energy.

It’s 8:25 now. I move to my computer, which sits in an alcove off the kitchen. I bring my coffee with me. I can sit relatively still, reading blogs and news, and wait for the hydrocodone to do its magic. Eventually, the itching starts. I keep a back scratcher next to the computer because my perpetually dry skin always itches. Itching from too much opioid  is not satisfied as easily. I read. I sit. When I get up to forage for more food, my head reminds me that I need to stay still. I return to my computer chair with a small chunk of Havarti cheese and rice crackers.

A little after eleven, my phone rings. It’s Jan, wanting to go to The Full Monty at the Weekend Theater. She’s not sure we can get tickets. Tonight is the last night. Even though I tell her I am not up for it, she is determined to go. She will have to drive in from Hot Springs, so if the show is sold out then she’ll have a wasted trip and an hour’s drive home. I turn down the volume on the phone, because the conversation is unnaturally loud. I tell her I’m not feeling well, but that she is welcome to come by if she can’t get a ticket. I hope the show is not sold out. I hope she can go. I realize I need to go back to my bed. We hang up, and I take a deep, slow breath to steady myself. The phone call has brought back the raging throb.

I get a glass of ice water before descending the stairs to my bedroom again. I climb into bed. The sheets are smooth and cool, and I think again that I need to rehang that drapery hook so the curtains close completely. The shaft of midday sun coming through the opening stabs my eyes. My head hurts too much for me to turn my back to the windows. Besides, the light bounces off the wall; it doesn’t really go away if my back is to it. I close my eyes and hope for sleep.

I haven’t yet started to doze when I hear the garage door open. Jack is home. Lora is with him. They’re going to hang out in the basement. He brings me an icepack. I’m glad he’s come home, because I can really use that icepack. I drape it over my forehead, pressing its ends to my temples. The kids go to the basement. They know to be quiet when I have a migraine. Poor Jack. His whole life, his mother has been sick. Sometimes, she’s sicker. Like today. He has told me that by the time he was eight, he could read the labels on my meds and even spell hydrocodone. I don’t doubt it. I sent him to get them from the cabinet often enough.

I doze, and finally I sleep. It’s almost 5:00. The migraine has receded to the back of my brain. It’s still there, but right now it’s not attacking me. It doesn’t hurt. I go upstairs again. If I don’t eat a meal, I’ll suffer for it. I need protein, vegetables. I make a sandwich and chew it slowly. I don’t really want it. I’m not hungry. The consequences of not eating will be worse than forcing myself to eat now. I sit at the kitchen counter and read a  magazine while I take unenthusiastic bites. I hear the kids come upstairs. They’re leaving. They chat cheerfully. Their good moods and the sandwich have combined to lift me up. Lora tells me she’s reading The Princess Bride, and I am delighted. It has been my favorite book since I was sixteen. I refused for years to see the movie, because I was so afraid that Hollywood would ruin it. I shouldn’t have worried. William Goldman wrote the screenplay for his own great book, so everything was as it should have been. Miracle Max and Valerie. Fezzik and Inigo Montoya. The Man in Black. Buttercup. Prince Humperdink. The Six-Fingered Count. Talking about it with Lora, I feel animated for the first time today.

The kids leave and I return to the computer. I need to sit still. If Jan comes tonight, I need to be functional. I’m functional now, but I don’t know how long it will last. I start writing this blog post. I feel myself tiring, but Jan calls at 7:30 to say she could not get a ticket to the play. For the last hour I have been checking the clock, wondering if she will call. About fifteen minutes ago I had decided that she must have gotten in, or I would have heard from her. “No, no, it’s fine,” I tell her. “Come on by.” I go downstairs to get the skirts I need to alter for my niece’s school uniform. They are hand-me-downs from her sister, who is shaped differently. As Jan and I visit, I rip out the hems. By 9:30, she says she’s tired and is going to get back on the road. I’m glad, because I’m fading, too. The headache isn’t back, but it’s skulking in the recesses of my skull, waiting to strike. And all those meds exhaust me. I’m happy to have seen Jan, though.

After Jan leaves, I rip the hem out of the last skirt, and I head downstairs with a fresh glass of ice water.

I read a little in Sacré Bleu, the newest book by Christopher Moore. I’ve had it since its greatly anticipated release, and I keep getting distracted from it. I love Chris Moore’s books. I wish I had his wild imagination. I want to keep reading, but my brain won’t let me. I’m too tired.

Another day sacrificed to migraine. Another day, gone.

 

 

 

Medical Malpractice and Tort “Reform”

I’m riding my white horse today.

As a lawyer, I know that people get harmed through no fault of their own by other’s people’s negligence and failure to pay attention to what is important. Whether it’s a car accident, a doctor who ignores symptoms, or a vicious dog who attacks a child, the person who is hurt should not have to pay the price for the injury. The court system cannot give back the things these people have lost: time away from work which leads to the loss of their careers, the pretty face that existed before the dog mauled the four year old girl, the mother who was killed by a drunk driver, living without constant pain caused by the injuries in the accident, the cheerful contributions to her family that the coma patient used to make before the doctor ignored the pulmonary thrombosis that led to her vegetative state.

When lawyers screw up a case, clients want to sue them and recover their losses. And they should. They should also be able to sue doctors, negligent drivers, and other people whose failure to pay attention has hurt them.

Unfortunately, “tort reform” usually means “medical malpractice lawsuit reform.” People think that lawyers are mean to doctors, who are just doing their best to heal people who probably can’t be healed in the first place.

That is not the case.

Look at the statistics in a recent Huffington Post article. Only 2-3% of ALL medical malpractice results in a lawsuit. That’s not 2-3% of medical care cases; that’s 2-3% of actual malpractice situations. Is such a number of lawsuits really excessive?

Caps on punitive damages is the issue Obama is expected to embrace, though. Punitive damages don’t reimburse someone for money they are out. Compensatory damages cover that. Punitive damages are intended as punishment – hence, the name “punitive.”

Why would someone require punishment for a screw-up? Think about how we decide how and whether to punish our children for negligence. Let’s say that Susie and Jenny are at a birthday party for one of their classmates and it’s cake and ice cream time. Susie gets excited explaining something and throws her arms wide, knocking over Jenny’s glass of punch, spilling it on her and ruining her party dress. Of course, Susie has to apologize to Jenny, and she has to get Jenny another glass of punch. She has to help clean up the mess, and if Jenny’s party dress is expensive Susie’s mom might offer to pay for it to be cleaned. These actions are compensatory in nature. They compensate Jenny for the loss of her glass of punch, her clean and dry dress, and her hurt feelings.

If Susie knocks the punch over because she was dancing on the table, though, Susie will be punished. Punitive action will be taken to ensure she doesn’t dance on the table and spill someone’s punch again.

Maybe we put Susie in time-out. Maybe Susie gets a spanking. Maybe Susie is grounded from her Barbies, or she is not allowed to go to any parties for the next month.

The point is not that Susie is being punished for doing something intentionally. She did not. She did spill the punch while being grossly negligent, though. She should have known that if she danced on the table where Jenny’s punch sat, the punch would spill.

Punitive damages in these cases are intended to stop gross negligence. They are not appropriate where there is no gross negligence – where the punch spills accidentally due to something unforeseen or where the negligence was minor. Punitive damages are for those egregious cases where the doctor ignored clear warning signs of his patient’s impending doom and did nothing.

Punitive damages are not awarded lightly by any jury. If a jury awards an amount in the millions, it is because the defendant in those medical malpractice actions has the resources to pay such an amount, even if it hurts. Punishment is not intended to kill, and punitive damages that bankrupt a company or a doctor aren’t appropriate. Punitive damages are supposed to hurt, though – just like being grounded from birthday parties hurts. And just like Susie, the idea is that punitive damages will hurt for a little while, but the defendant will get over it – hopefully to go forth more carefully in the future.

Après la Chirurgie

Did you hear? I had a softball-sized tumor removed from my neck three weeks ago.

I noticed it about a year ago and shrugged it off, thinking it was a little lipoma that wasn’t any big deal. Then I began having trouble turning my head. The lump was getting bigger – about the size of a golf ball – and I couldn’t comfortably wear turtlenecks or even mock neck shirts. I named my lump Esmeralda and patiently waited for her to gain sentience.

When Esmeralda started aching, I decided to go to the doctor. I hate going to the doctor, especially if I think I’m going to get bad news. I’ve had cancer twice, so having a tumor made me think that number three was here. If I pretended it didn’t exist, it would go away.  I’m a very bright girl in these matters. I knew exactly what I was doing when I ignored the wretched thing for so long. Really.

My doctor looked at it and said that there was no question that it needed to come out. Clearly, it was causing me trouble. Even if it was probably just a lipoma and not something devastating, it was in a bad place. And, he said, even for a lipoma it was, well, kind of big. There was definitely an asymmetry to my non-gazelle-like neck. A bump about the size of half a golf ball hung off the side it.

I knew all this before he told me. I knew he’d have to refer me to a surgeon. That’s why I was there, right? So, deep breath, I got the referral and made the appointment and went the next week to see when I could divorce myself from dear Esmeralda, who I was beginning to think of as my dicephalic parapagus conjoined twin.

He sent me to an otolaryngology clinic. Otolaryngologists  cut on people’s necks when the spine isn’t involved. I was glad my spine wasn’t involved, although I did wonder if that was because I simply didn’t have one. What kind of person, being possessed of a spine, was afraid of what was probably just a harmless little lipoma?

At the otolaryngology clinic, I got a CT scan of my neck. Back in the examination room, the surgeon pulled up the scan on the computer screen. “Wow, it’s really big!” he exclaimed. He showed me what to look at. The difference in the two sides of my neck was obvious. One side of the screen looked like what you’d think a neck should look like on a CT scan. By that I mean it had not much flesh and a big amount of bone. At least, that one side did. The other side? Well, it was different. Waaaay different.

lipoma-scan
There was a vast blackness that took up a lot of space on the right half of my neck. It looked as though Darth Vader himself had taken up residence there and his helmet was pushing things around.

The doctor pointed out how my muscle was stretched over this dark growth, how my nerves and blood vessels were pushed out of place, and how much space the thing took up.

“It’s sooo biiiig,” he said again. And again. And yet another time, just in case I hadn’t heard him before. That’s right.  Only I could have a freakishly large tumor in a place with as little flesh as my neck and not notice it for years on end. Evidently, I can’t see a damn thing with my eyes full of sand.

Lipomas usually grow just right under the skin and are fairly simple to remove. Unless they become bothersome, it’s not necessary to remove them at all. Mine was different. It was under the muscle, which, the doctor graciously postulated, was probably the reason I had never realized it had been growing there for so long. It was also pressing on important nerves and blood vessels. There just isn’t a lot of room in a neck, and there’s a lot of important stuff there. Like, say, the carotid artery, which feeds blood to the brain. Which my lipoma had shoved out of place. In fact, it had shoved things so far out of place that I was in danger of soon looking like the Elephant Man.

Surgery wasn’t just an option; it was necessary due to both the size and the location. If Esmeralda really did get large enough to become sentient, state law would forbid me from removing her. I mean, I could already forget about using federal funds. Her presence could no longer be disguised with loose clothing or makeup. I had to act, and act quickly.

The problem was, the size and location of the tumor meant that a different doctor needed to do the surgery. Someone who specialized in cancers of the head and neck.  Swell. The”C” word again. Fortunately, I liked the new surgeon. I liked the old one, too, but the new one was quick-witted, funny, and personable. And probably married. (sigh)

My family rallied around me. My sister went with me to the pre-surgery appointment. My mom took me to her house after the surgery so I could be pampered. Jack came to see me that night.  I felt pretty raw, and my throat, complete with a drainage tube, wasn’t pretty either.

scar

Wanna see?

Three weeks later, I’m still a little tired, but I’m fine. Some mornings it’s harder to shake off the latent effects of the anesthesia than others. Of course, staying up until 1 a.m. to finish a novel I can’t put down sort of contributes to the problem, but I’m gonna do what I’m gonna do. (The books are really good. Brent Weeks is a new, young author and he has time to grow. I can’t wait for his next offering.)

night-angel-trilogy

My son, Jack, has demanded credit for cajoling me into reading this series.  Here you go, son.

I have an awe-inspiring scar on my throat. I can come up with plenty of tales to explain its presence.

I’ve told the story of Jack the Ripper to my wide-eyed nieces and youngest nephew (they’re 11, 8, and 6). I have the scar to prove that I narrowly escaped him.

Next, I plan to work up a tale of the Bride of Frankenstein for their entertainment. I’ve already got the white hair at the temples going on, so between that and the scar, I’m not going to have to spend a lot on costuming.

bride-of-frankenstein

The surgeon said that the tumor had to have been there for a very, very long time to be as large as it was. How the hell does a softball manage to hide in a neck for years and only show up as a golf-ball sized bulge?

The size of the thing was apparently really impressive. Every time I call his office his nurse exclaims, “Oh, you’re the one with that really huge lipoma!” Every time. Every stinkin’ time. I’m beginning to wonder if I ought not to have saved the damn thing and taken it on the road. I could have made a living in the sideshow as the girl with the softball in her neck.

Maybe I should have had the thing cut in two and used it for a boob job. Next time, if there is a next time, I’m going to think that through carefully.

I Just Solved All Our Problems

In response to the blog post of a friend who is understandably bemoaning the state of the nation, I got a wee bit windy.

I know, I know – it’s hard for anyone to believe that I – moi – would spew opinions unrestrained against the drums of ears attached to mouths that were asking rhetoricals, not practicals. Nevertheless, I have the answer, and if the president would only sit down and pay attention to me, all the country’s problems – yea, even all the world’s! – would be solved.

The economy is not going to be fixed overnight, and right now Obama is listening to the experts who advise throwing more money at the economy in all the wrong places – at least IMHO. But, in response to those who are nodding sagely, saying “We told you that Obama would bring socialism and liberalism to the country, but did you listen?  Nooooo,” I say that (ahem) this started on the Republican watch. Obama inherited this disaster; he did not create it. And since no one has ever dealt with such a staggering world-wide economic crisis before, that means he is inventing this wheel as he goes along.  Will he get it all right?  Of course not.  But he won’t be likely to get it all wrong, either.

From what I hear and read, the economy isn’t going to start upward on any consistent basis until at least next year, and maybe not until 2011. Whenever in history the economy has tanked as suddenly and as severely as it did last summer and fall, the recovery has always been slow. That’s why they call them “depressions.”

Consumer confidence is badly shaken, and as more and more jobs are lost and more and more foreclosure notices are mailed, it’s not as if Dick and Jane are suddenly going to decide to splurge on that vacation home, lavish gifts for their status-conscious kids, or a pricey new automobile. Their businesses aren’t going to be hell-bent to hire new employees, either, because if sales are down, and no one is getting the services they offer, the employers simply can’t justify it.

The economy is, believe it or not, depressed.  And Economic Abilify has not yet been invented.

My opinion (and one or two of you might possibly be aware that I have one or two opinions, even though I rarely mention them in polite company) is that Obama would be better off to give stimulus money to the people and entities that are best in a position to turn this thing around, i.e., all of us, but in different ways.

Money should go to the homeowners trying to stave off foreclosure as a condition of and part of the debt renegotiation with the lenders – that way the lenders get paid directly by the government on behalf of the homeowners, the homeowners and their children aren’t sleeping on the streets, and the banks don’t own homes they can’t sell.

If a home is undervalued for the debt the homeowner has against it, the government should pay the difference as soon as new terms for the remainder are worked out between the borrower and the lender. If the borrower can’t afford to continue making the original payments – not the juiced-up interest payments – then there can be a second tier of incentives for the lenders to extend the debts to a 40 year amortization as opposed to the customary 30 year schedule.

And NO MORE INTEREST-ONLY long term debt!  Whose idiotic notion was that, anyway?  “Here, Joe Bob and Sally Sue, take this money that you never have to pay back. Just pay us interest and we’ll all be happy.”  The hell, they say! Morons.

Next, apply stimulus funds to the remaking of the American infrastructure, especially rural and smaller urban areas without reasonable public transit. Make light rail, high speed rail, and buses reach more places and serve more people on better schedules. One of the worst things we ever did was allow our railroads to be dismantled in favor of three cars in every driveway and five lanes on every freeway. Refurbishing and improving our infrastructure will employ hundreds of thousands of people in various positions throughout the country. From engineers to draftsmen to laborers to porters, we can get this country moving at a much more economical rate, and faster, if we’ll commit the funds to do it. And those jobs won’t go away when the projects are complete – they will need to be maintained, too.

Simultaneously, pour money into scientific research and development of alternative energy as well as into to cleaning up and maintain the environment. I’m not talking about just reducing greenhouse gases, although that is certainly a big concern, but (for example) about making reasonable accommodations for heavy metals that are the by-product of mining and drilling. A rocket laden with nuclear waste, arsenic, mercury and lead headed for the dark side of the moon might not be a bad use of NASA’s funding.

Put people to work cleaning up the environmental damage we’ve done to the planet, and making sure we’ve still got a planet to leave to our great-grandchildren. Clean water, clean air, and fewer chemicals artificially enhancing the soil and crops will go a long way toward making us all healthier – not to mention the possibility that our grandchildren might be able to play with frogs in their back yards some day.

And while we’re at it, quit giving chickens and cows all those damn hormones!  I have yet to meet a teenage girl whose double-D’s don’t put my paltry gifts to shame.  Why are their adolescent mammaries the size of a Holstein’s udders? Hormones!

Reduce the employer’s share of employment taxes. With the matching amounts that employers pay for health insurance, medicaid, unemployment, and social security, the cost of hiring an employee is a lot more than just what the employee sees in his check. This would be a real, dollar amount of savings for employers and would probably allow businesses to hire more workers across the board and at all levels.

Nationalized health care? Bring it on. Insurance companies will always provide coverage to people who choose to pay more for less care.  Those of us who have survived cancer (twice, thankyouverymuch) or who are on certain costly medications can’t get health insurance without staggering pre-existing conditions clauses that make our health insurance worthless and excruciatingly expensive – if we can get it at all.

When health insurance benefits dictate whether a parent can open a business of his or her own or must stay with an employer who provides health coverage the family can’t get elsewhere, entrepreneurialism is stifled. This country is dependent on small business and entrepreneurs. We absolutely must break down the barriers that prevent people from making an attempt to achieve their dreams. I don’t know about you, but I work a lot harder for myself than I do for someone else. I don’t think failed businesses should be propped up by the government (Detroit, are you listening?), but when something like paying for childbirth determines whether a family can start a small business, there’s something desperately wrong.

Where, O Where will the money come from to do all this?

(clearing my throat)

The same place the last two trillion dollars came from.  And the next trillion will actually make a difference. It will put people to work, shore up the foundation of the country, and stabilize the economy. It will also have the added benefit of making the world a better place.  And if any of you out there are thinking there won’t be more stimulus money forthcoming, you just hide and watch. It’ll come, I promise, whether the president takes my incontrovertible advice or not.

Now that I have solved the problems of the environment, the economy, health care, and reliance on fossil fuels, are there any other problems you’d like me to take a look at?  My rates are reasonable, and I’m in a spewing mood.

Tree Splooge

Spring is a miserable time of year.

First, there’s the weather. The damnable, changeable, hot-then-cold-again weather. The tornado, thunderstorm, wildly fluctuating barometric pressure, what the hell do I wear today, blustery, windy, knock me on my ass, fifty degree temperature spread in a day weather.

Then there’s the plants. You think it’s warm. There has been a recent series of beautiful warm spring days so you go to the local nursery and buy plants. You know, those tender annuals or baby herbs or vegetables just sprouted that make your mouth water with the promise of zucchini to come and tomatoes heavy on the vine. You put them in your car. You ferry them home. You place them where you want them and tamp the cool soil around their delicate stems, and after spending a day soaking up natural Vitamin D you go to bed, tired but fulfilled from a day playing the farmer, only to wake up shivering because you turned off the heat and the indoor temperature now matches the outdoor temperature of about 27 degrees and all the work you did yesterday is for naught. You vow next year to give it a week even after the frost-free date before you buy so much as a single packet of parsley seeds, knowing full well that spring’s siren song of false seduction will lure you to the nursery for that fateful waste of valuable money on plants doomed to die by the next sunrise.

The very worst part of spring, though, has to be the trees. Tall, bare-limbed, they stretch themselves and shake off the winter by emitting tentative tendrils of leaves, and before even the first leaf is full formed, the oaks go into full rut.

Oaks are horny bastards.

Because of the oaks, heinous fuckery most foul is visited upon me. Each fall the acorns hit my deck sounding like scatter shot, someone’s Daisy BB gun with an automatic clip, a terrorist squirrel at the helm of a acorn-grenade launching Gatling gun, firing hell bent for leather at my precious darling deck which never hurt anyone. Acorns are the demon-spawn of oaks. To create those diabolical children, the oaks engage in a springtime orgy that makes Bacchus himself blush at the pure wanton sex those oaks put out there for all the world to see.

The mighty oaks are masculinity personified. Baring their knotted chests, in Spring they take a deep breath and grimace, and from every pore pop squiggly spermatozoa, wiggling and waggling at other oaks, daring the other oaks to take a breath themselves and shoot back tentacles of spermatozoa in a war of silly string battle-inspired posturing and thrusting. It is indeed heinous fuckery most foul, as the foul squigglies waft their pollen and fill my unsuspecting gutters with their decaying carcasses.

Victims of these oaken battles of male dominance are cars, covered in a greenish yellow dust that hides the metallic grays and greens and reds. Victims also are the furniture, helplessly stationary in their designated positions, the flat planes of which act as a breeding ground not for acorns but for that same greenish yellow film that coats unprotected patio furniture and wafts into the cracks of car windows someone forgot to roll up.

Victim also are my sinuses, and Jack’s, and the sinuses of my receptionist (who I think has had a sinus condition since November). The virile oaks seek to splash their splooge on every available surface, in hopes that all the world will turn into acorns proving their masculine Darwinian fitness. In Spring, we walk through breezes of tree splooge morning, noon and night. Those damnable trees believe, like so many Arab IMers, that the world is a woman, open and panting for their splooge to fall fertile on something and make an acorn of it.

There is a scene in Christopher Moore’s classic Fluke: Or, I Know Why the Winged Whale Sings in which a pair of female oceanographers are studying sperm whales, and upon seeing a mating pair are delighted at their rare good fortune – until, that is, the female whale moves one way and the male moves the other just at the moment of his ecstasy. The two women are drowned in a sea of sperm whale splooge and instantly turn lesbian, seeking never again to encounter such a substance again.

That is also the novel in which I first encountered the term “heinous fuckery most foul,” uttered by a caucasian Rastafarian surfer called Kona.

My nose is stuffed so much I can’t sniffle. My cough barks deep within my chest. Today, I identify totally with those two female oceanographers. If I never experience tree splooge again, it will be too soon.

The oaks are virile indeed.

The fuckers.

Breast Cancer Awareness

Breast cancer has taken the lives of women we knew and loved, and has made the lived of other women we know and love very difficult. Has anyone’s life been unaffected by it?  Don’t we all know someone who has had breast cancer?

The Susan G. Komen Foundation is the beneficiary of a Three-Day Walk for a cure for breast cancer. The walk is a National Philanthropic Trust project, aimed at nationwide and even worldwide participation.

With money for cancer research, more women diagnosed with breast cancer can be like my friend Ellen, who miraculously survived with a spontaneous remission despite being given a death sentence by her doctor, and my aunt Jackie, who survived with successful treatment.  I can name others who have recovered and others who, sadly, have not.  My cousin Margaret, my neighbor Sassy, my old friend Faye…. all have been the unlucky victims of this insidious disease.

As many of you reading this blog know, I’ve had cancer twice. I’ve not had breast cancer, but my nightmares tell me to I expect to. None of us are safe.

Please donate to this worthy cause.

My friend Kathi, who happens to be my former husband’s girlfriend, is participating in the three day walk in October. If you don’t participate yourself, please donate to her effort to raise money for a cure.

Is it weird that I ask you to support Kathi?  She’s dating my ex-husband, after all.  If you don’t already know, Skip and I have a wonderful relationship – much better than when we were married – and it all revolves around a certain boy who is closing in on adulthood.  Our son Jack is sixteen, personable, creative, and reasonably well-adjusted despite  his parents’ divorce.  Skip and I have worked hard to make sure we work together for Jack’s sake.  He is the single most important thing in our lives.  Skip and I encourage each other constantly, talk almost daily, and support each other’s goals, hopes and dreams.  We call each other for support and to vent. We still like each other.  Thank the gods we divorced before we could develop hatred for one another!

I support Kathi not only because she is my friend and Jack’s possible future stepmom, but because she is actually doing something for a cause I believe in strongly.  If you don’t participate in the walk yourself, support someone who is.  Support Kathi!

The link will get you to the page where you can donate money to the cause.  Five dollars, ten, any amount you can contribute will help.  Please help!

Here is the message Kathi is sending out to her friends:

I just wanted to send an update on the Breast Cancer 3Day Walk that I am doing in October.

We are asked to raise $2200 per participant and I have already raised $400 toward my goal!How exciting!Some of those donations are from people forwarding my email to their friends and I want you to know how much I truly appreciate your support.I joined a team called the “Buttercups” and our team has already raised $5,672! We are all training and getting ready for the 60 mile journey.

If you have already donated I can’t thank you enough!If you are still interested in donating here is the link to my site.You can donate online or print a donation form and mail it in.Nothing is too small and it is all tax deductible.

http://08.the3day.org/goto/kathianne

Thank you again!

Kathi

Eye Cancer

One morning in 1999 I went to my optometrist for a routine eye exam. It was time to check the strength of my glasses and contacts. With my pupils uncomfortably dilated, Dr. Randall Teague peered into the depths of my right eye. He looked into my left eye for a quick moment, then looked into the right again. He looked for what seemed like a very long time, since he was shining a light directly through the pupil onto the retina.

“Has anyone ever told you that you have a freckle in your eye?” he asked.

I was a little startled. In fact, my neurologist had asked the same question when I was last in his office for a visit for my migraines. I told Dr. Teague this.

“You need to see a good ophthalmologist,” Dr. Teague said. He turned and reached for a phone book. “I’m going to call to make you an appointment.”

This was certainly an unusual thing to happen during an eye exam, I thought. As I sat in the darkened room, in the exam chair, I watched as Dr. Teague called the office of Bill Mabrey, a very respected Little Rock ophthalmologist, and asked to set an appointment. “She needs to be seen this afternoon,” he told the person on the other end of the conversation. I began to worry.

“Why this afternoon?” I asked. I had other plans for the day, but Dr. Teague exuded a sense of urgency.

That afternoon I went to see Dr. Mabrey, who, coincidentally, was the son of my in-laws’ neighbor and close friend. Over the past ten years I had heard of Bill Mabrey’s professional progress from his mother, who loved to talk about how well he was doing and the awards and recognition he received as an extraordinarily accomplished ophthalmologist. I knew that he was the best in Little Rock.

“You have a choroidal melanoma,” he told me that afternoon. He explained that the “freckle” in my eye was similar to a mole on the skin. It was essentially a growth of pigmented cells in the part of my eye just behind the retina. Some people have small “freckles” in their eyes, just like they have freckles on their skin, and there is no problem. When the freckle grows, though, it is considered to be a malignant tumor that has to be removed surgically.

Only 5 in a million people have choroidal melanoma. That means about 1200 people in the United States have this condition. It is rare. And it is scary as hell.

The choroidal melanoma can metastasize, or spread to other parts of the body, usually to the liver or the lungs. Aggressive action to eradicate the tumor is necessary to prevent the spread of the melanoma. Usually this means the patient loses the affected eye. It is removed to prevent the melanoma from spreading. “You will most likely have to have your eye removed,” Bill Mabrey told me. My world rocked.

I have always had a fear of blindness. When I was first given glasses at the age of 9 I was told that my eyesight would continue to decline. “How bad will it get?” I had asked the eye doctor. He replied, “Oh, eventually you’ll go blind.” He thought I understood he was kidding. I didn’t, and it wasn’t until several years later that I came to understand his remark to be flippant. But in the meantime, I was sure my eyes would soon fail me completely and I would be in a world without books, without sewing, without the fine details that I loved to give to things.

More than anything else, I use my eyes. I read. I write. I sew. I make miniatures. I cannot possibly imagine life without eyes. I can lose my hearing and be okay. Yes, I love music and movies, but losing hearing would only handicap me. Losing my sight would make life much less worth living.

The fear of blindness that had permeated my childhood and adolescence came roaring back into my life. It arrived with a powerful blow and knocked me senseless. I didn’t hear the rest of what Dr. Mabrey said, but as I left I was told to make an appointment to have an MRI done on my eye.

The only place in the state that had the equipment to do an MRI on my eye to determine the size of the tumor was the University of Arkansas for Medical Sciences (UAMS), which is located in Little Rock. Pursuant to instructions from Dr. Mabrey’s office, I called for an appointment. It would be six weeks before they could fit me in. I made the appointment.

The next few weeks were hell. This was the second time I had been diagnosed with a cancerous condition. Jack was three years old the first time. Now he was eight. The notion of this cancer metastasizing terrified me, not so much for me but for my son. My dad had lost his mother to leukemia when he was a teenager and never recovered from the blow. I didn’t want this to happen to Jack. I was 36 years old. My grandmother died at the age of 39.

I walked around in a daze. Depression hit me hard. I spent a lot of time just going through the motions of life. Going to my law office, going home, making dinner, sitting in a daze waiting for the next blow to fall. I couldn’t concentrate on anything. I spent a lot of time just staring into space. Blindness, a cancer metastasizing, the possibility of my child growing up without his mother. I couldn’t even cry. I was numb.

It’s hard for me to write about those months of my life. Even now, nearly a decade later, I can’t think of them without tears. That time was easily the lowest I have ever been, and I’ve had plenty of lows.

My sister, Susan, recognized the fact that I couldn’t function. My husband didn’t – I think maybe he was too close to the situation himself to take action. My sister, though, didn’t hesitate.

Susan researched the diagnosis. She started making phone calls. She found that there were five clinics in the US that treated choroidal melanoma. One of them was at the University of Tennessee in Memphis, just a two hour drive away. When she told me she had found the clinic, she joked that she had hoped we’d have to go to New York, where the shopping was better. I managed a smile. I was so numb I really didn’t care.

Susan got me an appointment at the clinic in Memphis for two weeks later. She cancelled the appointment at UAMS and got the records from Dr. Mabrey’s office. She was ready to drive me to Memphis when a few days before the appointment my husband said he would take me.

Ophthalmic oncology is a tiny subspecialty within ophthalmology. There are approximately 147 ophthalmic oncologists in the world. Getting a second opinion would be virtually impossible, and would most likely be done at my own expense. It wasn’t practical. If the ophthalmic oncologists at the University of Tennessee, which was also associated with St. Jude Children’s Research Hospital in Memphis couldn’t save my eye, it wouldn’t be saved. (Remember the plugs actor Danny Thomas used to make for St. Jude’s on television? He founded the hospital.)

That day I waited in the crowded reception room with about 40 other patients. Not everyone had the same problem I did. There were some who were blind, some who were obviously frail and feeble, and others who appeared just as healthy as I did. After what felt like a lifetime my name was called and I began a series of tests.

After an ultrasound of my eye, photographs of my retina, and two doctors peering through the enlarged pupil of my right eye, Dr. Barrett Haik told me that the spot was most likely malignant and that there were just a couple of options for treatment. One was that my eye would be removed and I would get a glass replacement. If the second option didn’t work, that’s what would ultimately happen anyway.

The second option was a radical new procedure. A tiny laser beam would be aimed through the clear pupil of my paralyzed eye and the melanoma would be burned to a pile of ash. The blood vessels feeding it and helping it to grow would be cauterized by the laser, too. The procedure had rarely been done before, and never by Dr. Haik. However, Dr. Matthew Wilson, his associate, had seen it done. It was experimental. If I did it, I might still need to have radiation treatments on the eye. Despite the laser and radiation, I might still lose my eye. Was I willing to try it? I shrugged. Sure.

It could not be done that day. The doctors would have to get the necessary equipment from St. Jude’s. I should come back in a month. New measurements could be taken by ultrasound and by photograph at that time to confirm that the spot was malignantly growing inside my eye.

I was still numb. When Skip and I explained the options to our families, the consensus was to go for the laser surgery. I was still in such a state of shock and denial that I couldn’t pick up the phone to call for the appointment. My sister came to my rescue again. She called the office in Memphis. I had an appointment to have the surgery.

This time the reception area at Dr. Haik’s office wasn’t as crowded and I was ushered in almost immediately. The pupil of my right eye was dilated with drops. Measurements were again taken with the ultrasound and the photographs. I was seated in an examination chair and given a painkiller.

The team knew what they were about to do to me would hurt and they warned me it would be uncomfortable. Still, I was unprepared for the excruciating agony of a paralytic agent being administered to the muscles around my eye by a hypodermic needle. The shot and the searing agony seemed to go on forever. When it was finally over I asked if it was a boy or a girl. I hoped, for that much pain, I had a baby girl to show for it. Jack was, alas, still sibling-less.

While they waited for the paralytic drug to take effect, Doctors Wilson and Haik talked and joked with me. I have never met a doctor whose bedside manner was better than Dr. Haik’s. He was constantly patting my hand and arm in a fatherly manner, soothing me with his soft voice, and putting me at ease with every word. He explained each step thoroughly.

He was also honest about the fact that he had never attempted the procedure he was about to perform on me. Dr. Wilson had done it, and would be supervising him. The two medical men readied the laser and talked with me and each other about what was happening. Dr. Haik bent over me and aimed the light through my pupil onto the part of the retina where the melanoma was bulging through the choroidal layer of my eye. As soon as he was confident of his aim, he activated the laser. I felt nothing.

For several minutes he directed the laser into my eye. He explained that he was burning not only the melanoma itself, but the blood vessels that were feeding it. Cauterizing those vessels was paramount: if they could still deliver nourishment to that tumor, the spot would continue to grow. All the cancerous cells had to be eradicated.

At last he was finished. He moved aside and Dr. Wilson took a look. He readied the laser and burned a little more of the area. Still, I felt nothing. Dr. Wilson backed away and removed his mask. “I think we got it all,” he grinned. I smiled with relief. It was probably the first time I had smiled in over two months.

Four weeks later I returned to the clinic for a checkup. The tumor wasn’t growing. There was just a mountain of ash where it used to be. I had a blind spot in my vision where the laser had seared the retina and damaged it permanently. A small black spot in one corner of my vision is such a small price to pay to keep my eye. Nine years later, I don’t even see it. In fact, even when I look for the blind spot I can’t find it. (I guess I’m blind to it – right?) My brain has compensated for the small gap in my vision.

I now go to Memphis once a year for a follow up exam. Last year Dr. Haik was on sabbatical and I really missed seeing him. Dr. Wilson was there, though. I adore these two men who saved my eye.

When I came across a story of a small boy who had eye cancer, and who has a gift for something else special, I decided to share this story with you. I hope you find inspiration in it. I did. I found the courage to tell you about one of the darkest periods of my life.


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