Friday, May 31, 2013


I am in limbo, once again.

Oh, the lies, the weight of the unknown, the waiting, the burdens of others.

What to say?

I am proud of myself for remaining upright and not giving in to the forces that pull me down; that I am ignoring the voices that nearly took my life three years ago. I have no idea why I am on this journey, and why I am being tried this way, but borrowing again from Kurt Vonnegut, so it goes.

I am surrounded, as usual, by forces of the absurd. I went out with Nalini yesterday to get a pedicure. A woman ran screaming down the street as we approached the salon, saying something into a phone that approximated "Code Key" and "Poison," so we had her sit down. Nalini triaged her, we figured out that she'd ingested something that was making her feel ill, or off. Nalini figured out that there were also psych issues (of course, why not?) while I did vitals, and she was alert and oriented, just screaming and breathing fast. Apparently, she'd eaten a cookie laced with some controlled substance that she didn't know was laced with drugs. And there you go. She'd never been high, and she thought she was losing her mind. So we being good nurses, we stayed with her until the Oakland Fire Department arrived and took over. Always some excitement; then the cops arrived, and she was 5150'd for combative behavior. Better her than me, but I may join her soon. This world is insane. I don't really believe I'm the insane one anymore, just as my friend Thomenon said. It's them, not us.

At least Nalini and I were able to get our pedis, and our toenails look gorgeous (my janky one has finally grown back enough to merit painting).

I am trying not to ask "Why?", which is a tall order. Why are people so stubborn? Why do they stick their heads in the sand? Why are they so stuck in their ways, and selfish? Why can they not listen? WTF? If I were Buddhist, I'd say this is my lesson for this life, and I clearly, CLEARLY haven't figured it out yet.

I am not a hobgoblin (at least not in this life, yet). I am not disgusting to look at (in general). I am well spoken, and I try to be polite. I truly do. I respect boundaries (mostly) and am loyal. I may get upset and yell at my friends, but I do calm down and ask for forgiveness. Nalini and I had that thing in New York but she forgave me, and we have moved on, stronger than ever. We were talking about running away to Scotland, especially after she saw Black Watch, which I've been jonesing to see for seven years. (Maybe next week.) It's a play about the famous Scottish regiment's participation in the Iraq War. I am so interested to see it; the press has been amazing. It sounds profound.

I cannot stop looking at my father's face, so I will post him here. As that great line goes from Shekhar Kapoor's film, Elizabeth, starring Cate Blanchett: "I am my father's daughter."

Wednesday, May 22, 2013


I love how ideas come. Sometimes scattered, sometimes tipping off one another. Setting off memories. Reminding you of a person, or another time, or another thought you've had. Shimmering like insects (butterflies? more menacing, like iridescent beetles?) beating against you.

Reading the newspaper, watching a film, having a conversation.

Today I was catching up on the NYT, and already I set aside an obituary for a friend I may not send; a friend who loves reading obituaries. This one about Alice E. Kober, who apparently nearly deciphered Linear B, just before Michael Ventris did. A brilliant woman, a classicist, who died at the age of 43. But she is forgotten and Ventris takes the honors, although he built on all she did.

Or reading a Modern Love column: "'Maybe you can tell her that you're a man, you're my husband, and your wife wants to cook for you?' I sighed. Everything Dawn said was true, but did I really have to say it to my mother?" Damn. Another woman sacrificed on the altar of the Sacred Mother In Law. Been there. How do people balance their desires, make choices seem so weak? Why is filial love so poisonous some times?

Or the OpEd piece about hurting children by helping them: "The study, led by the sociologist Laura T Hamilton of the University of California, Merced, finds that the more money parents spend on a their child's college education, the worse grades the child earns." Hold on! My parents spent a fortune and I did quite well. But I had inner drive. They didn't do my work for me; it was all on my own recognizance, all based on my own wanting to succeed. I agree that if you do the work for children, if you don't let them rise and fall on their own, they're screwed. Helicopter parenting protects in the short term while inflicting long-term damage.

Which makes me think of how they don't enforce proper spelling in our school, and papers come home with free-form composition that gives me hives. I don't sit back and say, "Oh, that's lovely!" I can appreciate the sentiments and ideas therein, while also becoming a Tiger Mother and make my sons spell things five times correctly. I explain patiently about how writing is about presenting yourself to the world. It truly is. And no child of mine is going to self-present as a poor speller, at least not now. They need to learn to spell and then become e.e. cummings. When they're in their 20's, they can invent their own styles. Not. Yet. Precision in language matters; it matters enormously.

Anyway, back to ideas. I was revisiting the filmed version of The English Patient, and was struck by some of Almasy's lines related to communication-by-cypher: "Maddox knows, I think. He keeps talking about Anna Karenina. I think it's his idea of a man-to-man chat. [sighs] Well, it's my idea of a man-to-man chat." Okay, a little cliché, I grant you that.

I am nonetheless fascinated by what is touched upon and understood but left unsaid; the subtlety of exchanges, especially in British contexts. The codes of shared meaning and experiences. Rebukes; numbness; disappointment; love?

How does one access the ineffable? Can one cast off the leaden shoes of the literal and make the leap? Understand the heart of the person who says, "I love you" but is culturally bound otherwise not to open up?

Tuesday, May 21, 2013


I believe that my muse has taken herself on holiday. Perhaps to the Bahamas. Perhaps to Delphi. Who knows? She isn't here, though.

I've been reading about the DSM V and the debates about what was to be left in and left out. I've been rereading Moses Finley's polished words about the bronze age, brought to tears by this: "The profundity of the Greeks' kinship attachment, throughout their history, is immediately apparent for their passion for genealogies." Which led me to the Odyssey, Telemachus, and fathers, and the idea of home and strangers and return, and wishing that people might be a little more forgiving, a little less blind.

This weekend I went again to the Legion with Callum to see the second part of the Artful Animals exhibition. There was an engraving of Penelope, sitting before her loom, contemplating something: her problems; her handiwork; life? A chapter of my dissertation was titled "Penelope's Web" and dealt with the writing of the history of women's contributions to the decorative arts, in particular work in textiles (a feminist re-telling of women's needlework as profession, rather than enforced pastime). Perhaps I should resuscitate it and try to publish it. I loved that chapter as it allowed me to use my interests in ancient history and literature while honoring the women who were pioneers in British academia (for example, the archaeologist, Jane Harrison), who became designers through the Royal School of Art Needlwork, and were expert seamstresses before losing their eyesight and becoming garden designers (Gertrude Jeckyll).

Detail of Max Klinger's color etching and aquatint, Penelope, 1896.

Oh, she is a fin-de-siècle lass, isn't she? She must go to parties with the young women envisioned by Leighton and Alma-Tadema. And I love her for it.

Friday, May 17, 2013


I am cynical. Resolutely. I embrace it.

Yes, Merriam-Webster. I am captious. I am peevish.

I am contemptuously distrustful of human nature and motives.

One of the examples: Cynical people say that there is no such thing as true love.

I used to believe there were such a thing as true love. I searched for it tirelessly, I gave myself up and over to what I thought it was. But c'est la vie, l'amour m'échappe. Humans are imperfect, hence there is no true love. Just love of the imperfect, as best we can.

At work last night, someone said, "I had no idea you were such a misanthrope." I said, "I know. I smile so sweetly; it's easy to be confused." One of my cynical coworkers said with a wink, "Oh, but she could never hide the truth from me."

I remember the way I used to be. I used to have faith in human nature. I used to believe that people would do the best they could; that they'd work to help others and had good intentions. Some people do. I don't distrust all humans, but we are a very self-interested lot. Myself included.

And even by ancient definitions, I am pretty cynical. The Cynics, whose philosophy developed as an offshoot of Socratic thought, worked to achieve arete, very roughly translated as personal virtue/perfection (there is no direct English equivalent) by overcoming distracting thoughts, emotions, and life circumstances. Cynics didn't give a shit about social conventions or prettiness. They were the original anarchists. Living on the margins and calling things as they were didn't make the Cynics too popular, either. They were too outspoken and frank for middle-of-the-road folk. Sound familiar?

I am trying to find the place, that place, my place in the garden where I am safe; where no one can fail me. I made the mistake of letting people in, and...uh oh. There is always the possibility of transcendence when you go out on a limb, but experience has shown that's highly unlikely. Very unlikely, indeed. And where do I end up when I try to see if people have changed? With an angry dragon. People are far too predictable, and I am far too easy to abandon. I even say, "Thank you!" for the experience. Damn that people-pleasing conditioning.

I was talking to Nalini this morning about being fucked up. Am I kryptonite? Does it come back to my existence being some horrid disturbance in the force? Why did the metaphorical condom break? What is it that makes me *too much*? Nalini, sagely, says again and again, and as always: although it's always good to consider the common denominator in all of this (me), there are also a lot of fucked up people who have issues of their own, compounded with an inability to deal with conflict, and terrible manners.

Which leads me to last night on the unit. I had a patient who was making great progress when I took report; six centimeters dilated, hoping for a natural birth. There were students around, and the clinical instructor asked me if I would accept one. I agreed, of course, as I expected to have a delivery, and students always want a delivery. I don't mind students, and usually students are eager and useful. They usually volunteer to take vitals and ask questions and comb through the chart and try to make the most of six hours on the floor. Not so this time. First words: "I am only here to watch." WTF? This is a clinical assignment. No, she wasn't going to chart because of EPIC, but what about thinking and doing some work, some assessment, taking initiative? She didn't volunteer to do anything, and strayed from the room and my side as often as she could, even when I'd try to get her involved. She was disinterested, and I didn't care. Normally I would say something and change up my teaching style, but I was over it. The student missed seeing the MD come to the room and perform an artificial rupture of membranes because she wasn't with me. The clinical instructor, whom I admire, told me that this student in particular was "upset" that in her three days on the unit she hadn't seen a delivery. I understand. In my three days on the unit for my Maternal-Child Health rotation, I also didn't see a delivery, but I persevered and made it happen, didn't only complain. And at the same time the student was complaining, she was asking to leave *early* to go study for an exam. I have no time for that shit. And when I was at the desk monitoring and charting, she told me she wanted to sit with her friends in the break room and study with her friends. I was horribly unimpressed. I wish I had said, straight up, "You scare me. I don't want you taking care of me, my family, or any of my friends should you ever get a license, which you shouldn't. Nursing isn't about exams, it's about paying attention to patients."

The student kept asking me when my patient would deliver. I couldn't answer that. One never knows, especially with a first-time mom; could have been one hour or four. The student ended staying over, however, and my patient did deliver. The student was useless, although she thanked me profusely for "giving her a delivery." I didn't do anything except my job. Again, gross for that false gushiness. I told her that I have shifts in which I will have two deliveries, and shifts in which I have none. Her concept of L&D nursing is strange and very self-focused: it was about *her* experience and not the patients'. Well, I thought: Maybe communicate and be polite and help, and things will happen. Ever hear of being a good politician? No. Of course not.

I am so disgusted today and want to forget yesterday, but experiences like that are haunting. I have such difficulty forgetting the bad things.

I am now set to be a clinical instructor in the fall, but I am anxious after last night's experience. I fear it's going to be just like teaching at UC Berkeley at San Jose State. Entitled students whining, just like my terrible cohort at Samuel Merritt who made our professors' lives hell without knowing what they were talking about. "We're in grad school, and grad students don't use Power Point." What?!?

I can write the best syllabus ever, set out my expectations, and there will still be those people, the ones who bother me like thorns. Only in nursing my concern is more pressing than in art history because these students can eventually kill people. Why go into nursing if you're not passionate about seriously taking care of people? Yeah, I know, the money. But nursing is back-breaking and humiliating at times, and our patients entrust us with their lives. I forget that nursing doesn't always attract the brightest, most thoughtful people, and that I ended up in the field by felicitous accident.

I despise entitled ostriches. I abhor humans who cannot put themselves in other people's shoes.

I also have to say that it's frightening now to know what goes on behind the curtain of health care. I know what to ask, and when to fire nurses and physicians. Average people don't. I feel bad for them. Ignorance can be bliss, but it can also kill you. Ask providers questions, lots of questions, and if they cannot answer them intelligently, or make you feel bad for asking them, get rid of them.

Now that's off my chest: I am glad to be on strike for a week. Sutter is claiming they don't know why we're striking. Umm, try reading our contract and looking at your "last, best, and final offer," and seeing how you're being incredibly disrespectful to us. And then give us our contract.

Putting on my red and going to the strike line! Go RNs!!!

Tuesday, May 14, 2013


I have not been able to get Before Sunset out of my head.

I was thinking about another line of Celine's: "I guess when you're young, you just believe there will be many people whom you'll connect with. Later in life, you realize it only happens a few times."

It's a gift, that connection with someone. When a person is able to see right through to your innermost self, or takes the time to, or cares to. Or all of the above. But then, having that power, they can also hurt you--they know your most vulnerable spots, and they can be scared away by what they see, or be disinterested in you, or any of a thousand other things.

I have had many relationships fail. I am not the easiest person to get along with, to be sure. Long ago, my mom was having a conversation with the mother of one of my exes. My ex's mom said, "He'll never marry her, you know." My mom's response? "Oh, I'm not worried about that. Kara always breaks up with them in the end, anyway." Ouch. I didn't think that was fair at the time since I always *felt* like the the one spurned, but now I see that Mom spoke the truth. So many non-connections, so very many.

Humans are searingly imperfect, aren't we?

Having recently come into possession of some powerful information about myself, a lost puzzle piece, another step towards understanding who I was (or who I had the potential to be), I've wanted to share that information with some of the people who have loved me the most, who have had that small but important key to the part of myself that's now so assiduously locked off in my fortress. The part guarded by the dragon. They know how to get past the monster and don't fear it.

When they've affirmed my news (and me), I feel a glow that's remarkable, incredible. I feel a little more alive, a lot less frozen. It's been like shaking out a limb that's been asleep for too long, hating the pins and needles but welcoming the return of the blood to weak, blanched tissue. I don't have to expend energy explaining or acting or drawing elaborate pictures. They are intuitive. When I am anxious or excited, my brain tends to move at 150 mph. If a person cannot keep up, I have a tendency to become very upset or angry. At times like that, I need people around me with emotional intelligence, or I must have space.

I wonder what it is (serendipity?) that leads us humans to one another sometimes. What makes us connect so well to some people but not to others? What is this elusive chemistry that we feel warming our veins; that we are fortunate to experience a few times in our lives; that impels our lives to intersect; that leads us to make one another stronger, better?

It's another one of those things I wish I could control, but I cannot.

At least I can say I have been well loved, although it might not have been how, or when, or exactly in the way I wish.

Back to my puzzle.

Sunday, May 12, 2013


I am another of those who hates Mother's Day. I forget that I am a mother. It's great that the kids make things for me and wish to be kind, but I focus too much on the generation ahead.

This is the second year that I've been able to greet both of my mothers, and it's still overwhelming. For a multitude of reasons. I still feel connected/unconnected, mostly. There will forever be that cognitive dissonance, reminding me that I inhabit that space between two worlds and belong to neither.

That aside, I do have to work today. I will get to see babies born, and women become mothers for the first time, or again.

This morning my family took me to my favorite restaurant for brunch in Berkeley, La Note, where we sat in the garden and ate heartily. I could relax for an hour, drink my cafe au lait, eat my tartine, and pretend I was in Provence again. If only.

Then I was granted leave by the family to spend another hour in one of my favorite bookstores, and I only came away with only a few titles. Mark raised an eyebrow but made no comment; he hates it when I spend money on books, but today I have a reprieve.

I am going to take Callum's class on a sketching trip tomorrow, to the bay. I will talk about the process of drawing, and drawing for pleasure, and real versus imagined landscapes. Maybe about romanticism and landscape? I don't know. I am leaning towards Caspar David Friedrich in my present mood.

I just want the children to think, to be inspired. To see their home in a new way, and to express it in a way that is personally meaningful. So much of the "art" program becomes "craft" as in let's paste this here, which isn't quite the critical training that I'd like them to take away from a lesson. It's not too early for them to learn about how and why artists did things. Art shouldn't be rote doing.

Also while in the bookstore, I was struck by a line in a book about art theory for the uninitiated, by Cynthia Freeland, one of those down and dirty, give it to me in thirty minutes but yet thoughtful primers. It's a deceptively simple question: "Why has blood been used so much in art?"

And I knew that I was in the right place: here was the blood I was looking for. Here is something to dissect, something that might help me trace out my body, my mind, my place. How does one even begin to define "blood"?

And now I go to draw it, clean it up, watch its bonds, prevent its loss.

How tightly I am wrapped up in blood, how very tightly. From my blood disorders to my blood doctors to my job to my fascinations to my blood relatives to the insistence of some that blood doesn't matter, and shouldn't matter to me at all.

Saturday, May 11, 2013

Little Things

I was going over the events of the past week with Nalini again this morning, discussing the films encore, and she pointed me to another exchange between Jesse and Celine from Before Sunset. It speaks directly to a fundamental problem in my own life: namely, not being able to move on or forget people. I don't know how some people create such impenetrable fortresses of silence around themselves. And neither does Celine. Clearly the screenwriters understand that people like me exist, and the pain we feel exists, too, quite plainly and deeply, as a result of how we experience the world.

Jesse: I think my book was like building something so that I wouldn't forget the details of the time we spent together. Like a reminder that once we really did meet, this was real...this happened. 

Celine: You know, I am happy you are saying that. I mean, I always feel like a freak because I'm never able to move on like this...(snaps her fingers)

People just have an affair or even a relationship, they break up and they forget, they move on like they would have changed brands of cereals. I was never able to really forget anyone I've been with, because each person has their own specific qualities, and you can never replace anyone. What is lost is lost. Each relationship, when it ends, really damages me. I never really recover. 

That is why I'm very careful with getting involved, because it hurts me too much...or even getting laid--actually, I don't do that. I will miss of the person the most mundane things. Like I am obsessed with little things. Maybe I am crazy. When I was a little girl my mom told me I was always late to school, so one day she followed me to see why I was late. I was looking at...chestnuts falling from the trees and rolling down the sidewalk or ants crossing the road, the way a leaf cast a shadow on a tree trunk--little things. It is the same with people. I see in them little details so specific to each of them that move me, that I miss them and will always miss. You can never replace anyone because everyone is made of such beautiful specific details. 

You know, like I remember the way your beard had a bit of red in it and the way the sun was making it glow in the morning right before you left. I missed that. Shit, I'm really crazy.

Jesse: Now I know for sure why I wrote that stupid book--so you might actually show up at a reading in Paris and I'd walk up to you and ask, "Where the fuck were you?" 

The great thing is that in the films, neither Jesse nor Celine is one of those who can blithely forget. Lucky them, lucky dreams, wishes fulfilled (but not without prices and regrets, to be sure).

Wondering what is happening in that silence, in that space between, is awful for those of us who care. The truth is that probably most people don't spend a moment thinking about that maw of emptiness, what's unsaid and undone, and move on. As I've mentioned before, another friend has said, it take courage to confront the uncomfortable. The majority aren't going into that basement of their feelings; they don't want to remember, to take the risk of bumping into something, anything. "Eyes firmly forward, thanks all the same," I imagine they say to themselves, when someone reaches out to them. And they do nothing. Ignoring what is difficult is the path of least resistance for them, I guess. For me, it's torture.

I've never been one to settle for the easy route.

Even when I am angry about the pain of remembering, would I give up seeing and celebrating the little things, to avoid mourning the loss of said little things? No. The richness of what I see is too fulfilling.

All my love to Nalini, to whom I also owe great thanks for helping me get through lots of basement exploration.

Friday, May 10, 2013


The processes of writing and self-examination seem to have been my themes for the week.

I worked Monday and Tuesday, and had two great deliveries, one each shift. I am slowly getting the hang of my delivery tasks on EPIC, although I don't know how I will admit the baby, get the orders up and signed, get stickers, get the cord blood drawn (and gases, if necessary), hang pitocin after releasing orders and scanning armband (and after closing the chart, because one cannot scan for meds while the chart is open, no, that would make sense) and med--that is, if the pharmacy has released it: all that, alone, in five minutes? Mmmm. Probably no time soon. I was still fortunate enough to have help at each delivery. And while I screwed up one of the cord blood orders (hold, not workup, for non O-type Rh+ mothers, geeze), I did okay. And my recovery on Monday only took, umm, four hours instead of the regular two and half, plus the extra hour of strip charting afterwards. Shit. So. Much. Charting. I was fortunate that my patients were not on pitocin or diabetic, or I'd have been even farther behind. I know that sometimes I am not the most efficient charter; I focus on tasks and my patient, and there's always something urgent to be done, not written about (although the rule is, that if it's not charted, there's no proof that you ever did it), so I end up charting later, when I catch my breath. But there's never time with EPIC. NEVER. I know this will change, when it becomes second nature, but it will take a while. All of us are struggling.

I haven't even been to the OR yet. That will be a nightmare of snail, and I will be in a pot of boiling water.

One delivery was a gorgeous midwife-attended, natural birth: beautiful, lovely, uncomplicated. I had graduated from high school long before this patient was born. I feel so old these days. The mother of the patient said to me, "Oh, I was a school teacher. It only gets worse." LOL But I loved working with the midwife, who is so kind and easy and nonplussed, and I am energized by seeing mothers do their thing without interventions (when possible). Birth is a natural act, not a pathological one. My patient was strong, and rocked it. Plus, she got a beautiful little girl, and seeing the joy in her and her husband's eyes healed my soul. Those are the days that make me happiest at work: births without complications, without maternal disease, without everyone rushing to the room to have to fix fetal heart rates or other things gone awry. My mentors say that 15 years ago, most births were like this, but now, maternal disease (primarily the trifecta of obesity, diabetes, and hypertension, sometimes maternal age) has made things far more stressful. I have seen a change in the acuity in the majority of our patients even in my five years. Sad.

Wednesday and Thursday I went with Nalini, my film friend and soul twin, to the San Francisco International Film Festival. On Wednesday, we attended a Q&A with Richard Linklater and Julie Delpy, who were in town to discuss their film, Before Midnight (and the previous two films in the trilogy, charting the relationship of Jesse, an American man, and Celine, a French woman, over 18 years). The moderator was awful, sadly, and as a screenwriter himself focused only on the workshop aspect of three people writing a screenplay. I was amazed at how many times he could ask the same question in different form, while the director and actor maintained their cool. Yes, it was workshopped. Yes, each of the three writers wrote for each character, and each had veto power over lines. But then, let it go! Talk about other things. Oy vey. I have been in university environments much of my life and am used to having better quality questions. One person asked, after all this, if there were ideas for the ending or other scenes that were discarded. Linklater and Delpy both smiled, raised eyebrows, and said, "Yes." I wanted to say, "Where are your critical listening skills, person? Have you not heard a word of what they said for the past hour? Is your degree from UC Berkeley?" Ugh.

Linklater discussed having an idea for an interaction, but not necessarily the lines, and having placeholders in the writing process; for example, the characters would hash out some topic, but they had to decide when and where and how that would happen. I liked the idea of placeholders. It's simple, and I do it myself when roughly outlining. "Oh, this should go here, perhaps," and I insert brackets with a few words to remind myself of what I might wish to say. It's also hard to know where to start, and who characters are, and what parts should be foregrounded. Fascinating stuff.

I fell in love with Before Sunrise back when it came out in 1995; yes, it's one of those Gen X cultural markers, and fuck, Linklater gets us. I saw it when I was 25, not quite yet 26, and remembered that feeling of traveling and being open to new experiences and people and getting to know them rather quickly (or not), and moving on. I didn't exactly have that kind of experience, of meeting for only one day, but I fell in love quickly and hard and still treasure the memories and words of one particular man I've mentioned before, whom I met when I was living in England when I was 22. He wrote me the most beautiful, articulate, self-lacerating, willing-to-be-vulnerable love letters I've ever received. On my worst days, I can read them and remember what it felt like to be loved right down to my bones, if only briefly. I watched Before Sunrise again when I got home last night, and that scene as he leaves her on the train at the end was something I lived. Oh, it was bittersweet and amazing. Even when I saw the film in 1995, it transported me to that place. Magic.

I saw Before Sunset in 2004, eager for the next installment, and it was jarring and fabulous. The exchanges, the anger, the guilt, the missed meetings, the desire to find something in that space between people: what a tight, nearly perfect screenplay! There's that great line of Celine's, where Jesse wants to know if she thought about him in the nine years after they parted in Vienna, and she says, "No, I didn't [forget about you], and it pisses me off."

I had been wondering how things might play out in the new film, Before Midnight. It was thrilling to see it in SF, in the majestic 91-year-old Castro Theater, filled to the rafters with cinephiles and people wanting to know about how love changes, grows, is challenged. I watched the dance of the middle-aged characters, bickering in ways so familiar to me from my own life. Knowing where to put the knife in your partner; knowing how they're manipulating you; hating that they know you so well that they have access to your buttons and know where you're going before you get there. It was raw and real. Some of Jesse's comments about Celine could have been made about me, such as "You're the Mayor of Crazytown." Precise, hurtful, pointed. I was impressed by the analysis of how love and expectations change over time, and how as we age, we come to accept imperfections because life is a mess. There is no perfect match, there is no perfect anything. We have those who love us, or who don't, and we love those we do for who they are, warts and all. Sometimes it's difficult to love, but the offer of unconditional love is rare. And how often do we set people up to fail? All the time.

Then speaking of unconditional love and commitment, Nalini and I saw a powerful, well made documentary, After Tiller, about four providers in the United States who do third-trimester abortions. What does it mean to work with women who choose this? How do you help them? How do they arrive at that place? One of the physicians in the film said that it was an enormous burden to have women tell their stories, and then to have to say yes or no to them.

One potential client called, wanting an abortion at 35 weeks. Not for fetal anomaly, or for maternal illness or hardship, but because of bad timing, it seemed. The physician ended up declining to perform the procedure. As an RN who regularly attends deliveries of 35-weekers who do just fine, it seemed hard to imagine choosing to terminate at 35 weeks. But then, it's not my body or my life. As Mark and I discussed afterwards, why do I think it's okay to abort up to 20 weeks, or even the edge of viability, and then get squeamish? What is my invisible moral line? As another physician in the film said, when you're delivering a patient at 28 weeks, what comes out is clearly not tissue; it's a baby. But what comes first in thinking about it has to be the mother's concerns. I get that. I also didn't know that they euthanized the fetus with digoxin, stopping the heart, before performing what's basically an induction and delivery. I wonder why they use digoxin and don't also use some fentanyl, or painkiller. I know that there's this idea that fetuses don't feel pain, but believe me, when 28-weekers are born and are in the NICU, we do pain assessments on them, IMMEDIATELY. There is no imaginary line inside and out of the uterus. The idea that newborns don't feel pain is outdated and disproved to all but the black box people. I need to research this.

During the film, I sat crunched up, regularly squeezing Nalini's hand. I know I wasn't wanted. I was told more than once by my mother that wished she had aborted me. I could have been terminated. I accept that. It's her body, her life that were messed up by a pregnancy she didn't want. But now that I am in a better place in my own life, I do see that my potential would have been gone, and that can hurt sometimes. Nalini said to me, "You were meant to be here. You have to know that." But I also know the truth, and that's the hardest thing to live with sometimes. As Jesse said in Beyond Sunrise, I am crashing a party, the party of life. I was talking about being an unwanted, mistake baby one day, and Tobey, my younger son, got very, very angry. "MOMMY! You were NOT a mistake. You were meant to be here." I told him that the truth is hard, but you have to face it. I am here, and he cannot be erased now, either. But that the circumstances of my arrival were not the sunny ones of his, and that's the way of the world. I understand how his whole existence is shaken by the contingency of so many cards, balanced tenuously on one another, and yet they held, and he is here, and loved. I am touched that he is unerringly loyal and hates to think of me as being unwanted and inconvenient in 1969. Another Coeur de Leon, chivalrous and eager for battle.

I was also thrumming with anxiety to see how adoption might play out in the film, or in the discussion afterwards, as adoption is often put forward as the opposite side of the coin to abortion. I believe strongly that they're not related: adoption is the decision to parent or not; abortion is the decision to carry a pregnancy to term or not. And the film actually didn't push adoption as a good alternative to these late-term abortions. Certainly, in counseling, the women were asked what brought them, and what other options they had considered: keeping the child; having the child raised by family; placing the child for adoption. But really, none of the women there considered adoption. They all said that if they carried to term, they would keep the child. It was refreshing. One young woman, very religious and plagued by regret, said that she didn't want to keep the child or have the child raised by her or her boyfriend's family, so this was the best option for her, out of three shitty options. And yes, I support her in doing what was right for her, and by corollary, for her child. At the same time, it sucks to be the child whose mother faces three shitty options, none of which include being happy about the pregnancy. 44 years into that life, yeah, it's not awesome to know this, but we all have our crosses to bear and must find our way.

As one of the characters said in Beyond Midnight, to paraphrase, "You stop looking for someone to complete you, and learn to enjoy life, to live."

Sunday, May 05, 2013


I have been a mad insomniac lately. Well, for the past two years. I love the deep quiet of the night. Everyone is asleep except for me. I hear the slow, steady breathing of people and animals after I've watched my fill of television. I should read, but sometimes I cannot. I exercise, I don't drink caffeine after 3 p.m., I take hot baths, I drink hot milk, I take melatonin, I smear myself with lavender-scented things. When all else fails, and 3 a.m. rolls around and I'm still wide awake, I'll take an Ambien, which only buys me four hours. But at least it's four hours.

Oh, that lovely anxiety. Or pain, or whatever it is.

Today my family went on a tour of the Tesla factory, in Fremont. It was a fascinating and vibrant place, very different from what I had expected. A friend writes software for the cars and took us behind the scenes, to see how everything is put together. The factory is in the old GM/Toyota plant, and only takes up about half (or maybe less) of the space available; some parts of it, in the dark of a unlighted Saturday, made me think of scenes from Terminator. The designers have done a beautiful job, however; the interiors are bright and open and white, Bauhaus-y almost. For a factory, it's quite aesthetically pleasant. The kids enjoyed seeing the robots used to make the stators and rotors; to stamp the huge plates of aluminum to make the car parts; to paint the cars; to move the cars along a track towards completion. I'd seen one of the documentaries about Tesla, so it was especially interesting to be on site and see things in person, observing how Elon Musk wants things done in house, and how his vision extends to small details. I wondered what William Morris would make of the factory, and I couldn't help but think of all the money spent, and the labor involved (or not involved) to make these luxury items, and about the inequality of our economy...but that's another story.

I was also thinking about how to structure the article I plan to write, and on Friday, I'd run across a book that immediately piqued my interest: Oscar's Books: A Journey around the Library of Oscar Wilde, by Thomas Wright. How intriguing to get to know Wilde a little better through his book collection (and annotations!), although one cannot judge a person completely by his library. What did he think of Rossetti and Homer and Flaubert? I look forward to finding out.

Many years ago I briefly dated a very intelligent but socially inept physicist. He was not good at being supportive or reading people, and he annoyed the hell out of me when he said that he could tell who I was by reading the titles of the books in my room. At that time, I was a penurious graduate student, who had about a tenth of the books I have now, but who had of course read thousands more titles than he could see. I found his comment exceedingly hubristic and rude. I told him off summarily. It was probably the first time ever that I had told a man to go to hell and that he had overstepped boundaries, so good for me. It was not okay for another person to sum me up that way, because it seemed like he was calling me ridiculously poorly read, and like he was trying to put me in my place, in a quantifiable box with a label. He did have a point, however: I can tell a story about myself that way, perhaps a very well structured story. I can at least use my book collection as a jumping-off point. As I was thinking some months ago, to someone uninitiated, my books are a jumble of titles crossing many subjects and ideas; to me, they represent a cohesive whole. They do stand in for different aspects of my interests and my personality.

So whence?

A good tale depends on the skill of the storyteller, and the materials available. What story is it that they're trying to tell?

It's about what's put in, what's left out, what's shaped, what's edited. What are the justifications? How much heart is there in the telling? How persuasive is the storyteller? As in Yann Martel's Life of Pi, which version of the story does the storyteller, or the audience prefer? Sometimes we convince ourselves that the more fantastical will be better believed, when it won't, although it is more palliative, both to us and to our audience. There are always subtle clues that help us see the truth, however. Do people symbolize feelings in ourselves that we shy away from? Do we punish ourselves, others, or both for thoughts we cannot express, or express falsely?

Although we know that truth can be terrifying, it usually ends up emerging, anyway. As I tell my sons, "It's best to own it, early and often."

I have begun my outline. The theme is blood.

Thursday, May 02, 2013


I had a wonderful conversation yesterday with my primary care physician. I adore her. I have followed her from one office to another, and then another. I would follow her wherever she goes, she is that remarkable: beyond compare (and I know many physicians). She is now ensconced at UCSF with the resources of a great university hospital behind her, and she's training up more physicians, giving me increased hope for the future. She recently made two great hires in her office for when she's not available, and that assuages my anxiety more than a little.

She had thought I'd come in only to adjust meds and do my three-month check-in, but no, I had my sternum issue (yes, fractured indeed, no x-ray needed, must be taped), and some new information.  She added to my Problem List: "Family history of early coronary artery disease." Sigh. We were talking about all I've been through in the past 13 years that we've known each other, and my near misses. She said she cannot believe that I made it through two pregnancies and didn't miscarry or die. I said that I don't believe in guardian angels, but I must have had one. She said, "Well I do believe in them, and you have an army. What about the portal vein clot? And a platelet count of 1.3 million? And the PEs? And your wrist? And now your sternum? Do you need some anti-anxiety meds?" I told her I was fine, I had only taken one Xanax so far and I'm set with my supply, although given current events, I am shocked that I am functioning so well.

She also encouraged me to sit down and write. She said, "I've told you for years. You write beautifully. Where is the story you promised me? We physicians need to push more, people need to push more, people need to know how important family medical history is for adoptees. What you have been through was unconscionable. You could write to help others; it might help you to get it out of yourself in more polished form. Plus, it's one hell of a story." I told her my ex had called me a "hilarious raconteuse" the other week. She laughed. "See," she said. "You have some momentum."

Then we had a great kvetch about EPIC, as she'd been through it two years ago and knew my pain. Many gratifyingly exchanged expletives ensued, apropos of choices and flowsheets and order sets and lack of support from management.

I have taken a long break from writing about my adoption-related pains for many reasons. But perhaps if I approach them more journalistically, and write privately, it will be cathartic. It would feel good to write. I've always felt that writing was my calling, but I've fought it. I am not sure why. The more people tell me to write, the more I shrink into my cave of "NO!"

I dreamed last night that I was back in graduate school, being dressed down for some slight by my adviser, the chilly one who was so cruel and valued nothing of me or my work. I have various theories about why she appeared to me out of the blue. Perhaps the most compelling is that she symbolizes the part of me that doesn't think I can or should succeed in writing my story. Since I was never very good at kowtowing to her at the best of times in real life, why would I capitulate to her now, in my head? Makes sense when I put it like that.

Perhaps, then, back to Anne Lamott's father's advice, I suppose, and the birds. Bird by bird. I love that book. And fighting my horrifyingly exacting standards, against which I do measure myself, despite what people may think. It only took me how many years to write my dissertation? Can we say perfectionist?

Wednesday, May 01, 2013


I took a baseball to the chest last week, heard a crunch and saw a large bump growing. I didn't think much of it at the time. It was too big to be a simple bruise, though. I should have thought more of it. In retrospect it reminds me of when I broke my wrist. Now I am pretty sure that I fractured my sternum on the left. It never went purple. Just drained, went south and turned that sickening overripe banana yellow, leaving a huge knot on my second rib on the left. Yep, I'm guessing a fracture. I see my primary care MD today, and I will have her check it out. I am so fragile these days, thanks to the Lovenox and my BMI and whatever else. The injury never interfered with breathing or movement, so I blew it off. What's another fracture? Can't do anything for it, anyway, except pain meds and rest. Story of my life.

I saw a beautiful film yesterday, Blancanieves, set in 1920's Spain (primarily in Seville), and directed by Pablo Berger. Filmed in black and white, and silent, it tells the story of Snow White through a different lens: imagine her the daughter of a toreador, with an Evil Stepmother as dominatrix. She is rescued by seven traveling, bullfighter dwarves, who help her find her true identity in the ring. There is a very sad, Spanish ending that the Brothers Grimm would approve. Not Disney at all. I adored how the Evil Stepmother was dispatched, in an Picasso-inspired scene. The film tells a dark tale of loss and longing and redemption: there are no rainbows, but some brief moments of happiness to buoy your heart. I was cheering for Blancanieves to fight her way through the pain of parental neglect; her ability to forgive was inspiring. As one line in the movie said, to paraphrase, mourning the past is like chasing the wind. It's what you have now, it's your present actions that are your legacy. What are you made of? How do you prove that your soul is not oily and weak? How do you face down your bull? Will you run and hide? Can you?

This morning I attended a union meeting with fellow L&D RNs to strategize. It always feels good to vent and to plan. We have a strike on the horizon, as well as ideas for petitions and letters and a media event. It was reassuring to hear that most of us are struggling with EPIC, and to laugh that maybe all of the budget for STORK, which would have made sense, went to the ridiculous We Plus You campaign. Apparently it was decided that STORK wasn't needed for most of the hospitals, so it was voted down for us, when our huge unit needs it, requires it. But at recent bargaining, STORK was put on the table for perhaps a year from now. So we work on, together, stronger. We have each other, and we will fight. Word is, they don't like to mess with our unit because they know we will mutiny.

Vive la resistance!