So What IS IT With Doctors?

Got my cowgirl boots on today cuz I wanna KICK some ass! Had my brain scan, everything's good, no hidden tumors, like the doctor expected - - but, hey, doc, I still got this chronic pain thing goin' on....it's been four or five years so far and nothin's gettin' any better......and YOU'RE a neurologist, ain't that right?

N: "Yes, that's right."
ME: "So you happen to know a great deal about NERVES, right?"
N: "I do."
ME: "So I've told you the history of my severe pain, I've told you the history of the Big-Dog medication they've tried me on and how it doesn't work........"
N: "Yes, but those were PAIN pills, and you don't NEED pain pills. They won't work, not really."
ME: "So what WILL work?"
N: "It's very likely that an anti-inflammatory will work."
ME: "Yeah? So will you prescribe one for me?"
N: "No, your regular doctor should be prescribing those."
ME: "Why? You're a neurologist! You KNOW more than he does about these things!"
N: "Yes, but I don't PRESCRIBE anti-inflammatorys."
ME: "Look, I've been to my regular doctor several times, I've been to Dr. Green, I've been to Virginia Mason, I've been to the University of Washington......and nobody but you has mentioned anti-inflammatorys. So I'm pretty interested. So why can't you make an exception? I am sitting here right now, in great PAIN."
N: (Looking straight at me) "I know that, but I just don't prescribe that kind of medicine. Go confer with your regular doc."

So there you have it. In this country, men are more likely to be prescribed whatever they want, while women, 82% of whom are more likely than men to be given an antidepressant for pain instead of pain medication or other meds specific to their condition) - are less aggressive about getting what they want - or are dismissed as merely being hysterical.

Chronic pain is a toughie. Part of the curse ofchronic pain is that it sounds untrue to people who don't have pain. Patients grope at metaphors that seem melodramatic, both far-fetched and cliched. Author Elaine Scarry characterizes chronic pain as not only NOT a linguistic experience, but as a language-destroying-experience. Whatever pain achieves, it achieves in party through its unsharability, and it ensures this unsharability through its resistance to language," she writes."

Anyway. Brain good, pain bad. Boots pretty, but actually made for walking, not kicking. "Some days," says Anne Lamott, "the most we can hope for is to end up just a little less crazy than before. A little less lonely. A little less impatient."

When I left the neurologist's office, we were both rubbing our own foreheads, wearily, almost furtively, as if we had both been in the ring together and no winner had been announced.

Greetings from The Birthday Girl

For breakfast, I've just eaten a piece of frozen Pink Champagne Cake, the cake that you can only get at the old McGavin's Bakery bakery on Bremerton's Callow Avenue.
I love frozen cake; especially wedding cake, it's sublime. It's gotta be white with layers of white frosting. I forgive the pink frosting on the top of the McGavin's cake because it is, after all, named "PINK champagne cake". It fortifies me. It strengthens me for the day to come. I washed my hair and put it up in rollers. I am the only woman "On Island", I swear, who actually puts rollers in her hair. To top off the visual experience, I wrap a bright scarf around my head of rollers making me look as if A giant bee stung me in the head and my top blew up. The other day a friend took me to The Harbour Pub and I gladly went along, with rollers and a scarf on my head. A woman in a booth stared at me, or more specifically, she stared at my scarf so obviously and with so much interest that I smiled at her and said, "Yeah, I guess you don't see THIS much anymore, do ya?" When she asked, "See what?" I responded with, "Rollers on the top of a head", which sounded faintly like "Diamonds on the soles of her shoes." "Oh no!" the woman said, "I was thinking abut how exotic you look!" She smiled. I smiled broader than before. My friend smiled at me in a "See?" kind of smile. Everybody smiled. We sat down and ordered a bottle of wine.

That happened the other day, when I was younger. Today I am older, but even at this age I am not shy about the rollers in my hair. My hair is thick, thick, thick and needs to be overruled. It needs to be put in its place. It is a naughty schoolgirl who must be tamed. So. I tame it.

And this morning I made a pot of coffee from "Grounds for a Change", which is a catchy title, but a terrible coffee. The blend is "Agate Pass Blend", and DO NOT buy it, or else put only a few tablespoons of grounds in it, for "Grounds for a Change" has NO taste. it is vapid, ethereal, suffering coffee. I think it must have been either very cheap or very expensive, I don't remember now. These are the two extremes I go to - cheap or expensive. Sometimes I say, "Life is too short to not buy the best" and sometimes I say, "Life is too long to buy the more expensive!" It all balances itself out.

I know a man who doesn't own a dryer. He's certain that the reason all his clothes remain looking so swell (even his deceased father's clothes remain looking swell) is because he does not torture their cloth or threads in a dryer. He either hangs clothes outside or puts them up inside on racks. I am sure he is right and, indeed, I have more and more often been drying my own clothing by draping and shaping it over my furniture. So a blouse might come out looking like the back of a sofa. A pair of pants might end up looking like my kitchen stool. In this way, I am creating a new fashion style, wearing already interesting clothing in even more interesting ways, say, in the shape of various living room or kitchen furniture.

I am one yeara older today and I have a gorgeous bouquet of flowers at my side, sent by the Dietz's, our oldest "couple" friends. I do not mean "oldest" in the way of "their ages are higher than anybody else's", I mean it in the way of "we (meaning Jim and myself) have known them the longest. I am a year older and I love the Dietzs even more today than I did yesterday, I'm sure of it. My son sent me a beautiful and touching Japanese block print, meticulously glued to a piece of cardboard, with tiny precise holes pressed through the cardboard to hold precisely secured thread so that the print may be hung on the wall. He's been in jail for a few months and in the hospital for a goodly amount of time, so the fact that he would be able to find cardboard, some kind of device to cut the cardboard, thread (did he unravel it from a hospital sheet?) and the little print, is in itself a feat. A task of love. When you are a jailbird and you go to Harborview, you are watched closely by the policeman who stands watch outside the door. You can't just run blithely down the hall lopping cardboard, gluesticks, thread, scissors and art magazines into your bag. You don't have a bag. You can't run nowhere. You Stay In Your Bed and wonder how in the hell you are going to make a present for your mother. Kevin did it and I am touched. Over the years I have been the recipient of many, many such presents from various jails and penetentiaries around the country.

Last night my friend Robin gave me a bronze antique angel to hang on my bedroom wall, a Kewpie doll to stand amongst my upstairs bathroom-collection of other Kewpie dolls, a gorgoue turquoise and obsidian necklace and an antique cow. It is the antique cow I love the best.

Years ago, before my son became a bankrobber and went into the pen, he used to steal all my birthday and Christman presents from various antique stores. The things that especially caught his eye were small, antique animals, made of metal. Painted metal. I have, for years, always kept two shelves nailed into the walls of my kitchen filled with such articles. I don't believe I have ever received any gift from my son that came through more conventional means. I am neither bragging nor sniveling. This is a fact and it is somewhat an unusual fact. Robin has, though, added two antique animal-figures which have actually been paid for. With money. An entirely new trend.

And now it's time for me to go buy some champagne. For myself. Because I deserve it. I have managed to get to this new age by walking, running, falling, crawling, dancing and, sometimes, prancing. I intend to attain more age-mileage in the very same way. Happy Birthday, Kay. Let's buy some tulips, as well.

The Last Day of My Latest Age, Or............

...........Guess what, tomorrow's my birthday! I used to think I'd rather swallow crushed glass than make it to the age I will be tomorrow, but here I am, still auditioning for shows, buying fun clothes, wearing silver and pearls, still dancing to the Stones and the Eurythmics, still singing along with poor dead Mama Cass, going swoony over Leonard Cohen and Lyle Lovett, not to mention Carole King and James Taylor. Well, James Taylor. Do I have aches? In places. But some of them are GOOD aches. In places. Do I still have a memory? Please!I'm not THAT old!

So what have I learned in this past year? Well........I've learned I can still cook. The other night I made a fantastic curry soup filled with fresh sauteed shrimp. This morning I boiled an egg. I've read tons of books, including Jonathan Franzen's new book, "Freedom", which I can hardly put down. I've learned I can rebuild a private practice without the aid of telephone books or ads. I've learned that, even on "island", I can still run a viable business without a copy machine or fax machine or cell phone. Well, I DO have a cell phone, I just don't use it. It's too little. I've learned that Valentines do still exist, especially homemade ones. I've learned I'm still flexible. I've learned quite a lot about what Stephen Hawkings calls "Model-dependent realism", built from our own amazing brains. I've learned that objective reality may not actually exist. I've learned that a homely fourteen year old girl from Chicago began a blog about style and now hobnobs with the great fashionistas of the world. I've learned that romance still exists. I've learned that I am still not a great candidate for hypnosis and that the Episcopalian church may still be too Episcopalian for me. I've relearned that, next to Ibuprofen and a little bit of Alprazalam, laughter is still the best medicine.

My mother died at 47. My grandmother died at 63. I've outlived both of them. I've learned that movie characters keep gtting younger, as with Richard Burton and Elizabeth Taylor in "Who's Afraid of Virginia Woolf", which I just watched again after twenty-some years. When first I saw this film, I thought it was about a couple of fat old people who were funny. The other night I watch two leanish youngish people who were tragic. Two months ago, I reread Margaret Drabbles fine book, "Realms of Gold" and realized that now the book's characters are way way younger than me. They used to be much older.

I've learned that when someone says, "Now, this isn't about YOU..." it IS about you. I've learned that I can absorb people being mad at me without getting all defensive or scared. As long as they don't try to kill me, it's not that bad. And even if they DID try to kill me, and even they SUCEEDED, well, I've had a damn good year and we DO have to go, either gentle or not, into that good night, sometime.

The Drum-beat In My Brain

I've had what is known as an "essential head tremor" for decades. It's inherited. Kathryn Hepburn, she's got the same one I do, or rather, I have the same one she does, except she had her's first. Remember? She tremored all the way through ON GOLDEN POND. "Someday," my first neurologist warned me, "your voice could go, just like Kathryn Hepburn's."

This tremor nearly caused me NOT to become a psychotherapist, meaning this: I was embarrassed. What if my clients thought I was marred or deficient in some sadly awful way? Or worse - - what if they thought I was AFRAID of them? And how about this - - what if they thought I was constantly nodding "No, no, no, no!"??

But, as a friend told me tonight, "The tremor is simply a tiny part of your entire gestalt, and I look at the whole picture. When I first met you, I didn't think positively or negatively about the tremor. It is, quite simply, a very small part of you."

Indeed, very few of my patients have ever mentioned the whole-lotta-shakin-goin'-on at the top of my neck. Doctors don't mention it because it obviously is not a Parkinsonian in nature; mine goes side to side, Parkinsonian tremors go up and down. Once in a while a nurse patient will mention it, but other than that, my patients' just don't seem to give a fig. And if they don't, I don't.

Recently, though, I've wanted to re-enter the world of theatre, and nobody wants to see a woman up there on stage looking like a Bobbing Head Football star. I take medication, of course, but the medication does not work. Really, it's never worked. But it's the kind of medication one simply can not go off cold turkey and I am not a woman of patience.....I don't have the patience to get weaned. My mother breast fed me. Once was enough.

My first neurologist was brilliant. He was also arrested and imprisoned for sexually harrassing legions of his female patients. He never harrassed me, though. When it came to me, he'd say things like, "God! I love it when I see your name in my schedule book! You are like a pool of water in the desert!" Or better yet - - "You! you are like a tree! You are like a fine, beautiful, proud tree, standing alone amongst small, little, dank plants."

Well, yes. I could certainly see his point. And I was sad to have to learn how many innocent women (although one would be enough) he hurt. Goodbye, brilliant neurologist.

Hello, Idiot.

My second neurologist was an idiot, or so it seemed (and still seems ) to me. No social skills. And, worst of all....shall I say it? No metaphors! One day I brought a book by Dr. Oliver Sacks into his office (I happen to adore Oliver Sacks) and this neurologist looked at me and said, brightly, "I see you are reading Oliver Sacks."

To which I replied, "Yes. I have read all his books."

To which HE said, "And what do you think?"

To which I remarked, "I think he is brilliant. In fact, I would love to BE Oliver Sacks."

The second neurologist looked at me for a moment and then murmered, "But he is a MAN."

To which I whispered, "Yes. I know."


I met my third neurologist two weeks ago. She ran me through an hour's worth of tests and, at the end of the hour, announced, "I believe what we have here is MORE than an essential tremor. Your entire left side seems to be.....compromised. I am scheduling you for an MRI in order to take pictures of your brain. I especially want pictures taken of the thick, meaty part at the base of your skull."

The thick meaty part. At the base of my skull. She said it as if she were describing a meal. All that was needed was some juice or gravy in there and we would have had ourselves a feast.

So today I went in for the brain scan. Now, one of the little-known facts about me, by no means not the MOST eccentric fact about me, but unusual enough, I suppose.....is that I LOVE MRI's. I love the noise, which is incredibly loud and invasive. I love the encapulation. I love not being able to move. I love to create formulas by which to inspire myself with the unexpected rhythms involved in the various thumpings and bumpgins and screechings and screamings and wheezings that an hour-or-so long MRI can produce. I make up rhythms inside the silent, blank spaces. I create mathematical formulas. I try to find music to match up with the rhythms; inside my head I create choreography that one or two persons might dance to, inside the array of noises.

For today's MRI, the new neurologist prescribed a intravenious sedative so that my head would not tremor inside the magnet.One is not, after all, allowed to move. The nurse found a vein into which she stuck a port or a tube or some such thing, all the while exclaiming, "What wonderful veins you have!" I was Little Red Riding Hood. She was the wolf.

I was scanned by two other persons to make certain that I wore no metal: no earrings, no watch, no necklaces, no rings. "What about your bra?" the short blond nurse inquired, "any metal in that?" To which I responded, "I came here bra-less." In a tone full of pride and substance, as if I were saying, "I have come to conquer Rome."

They assisted me in laying down on the long white bed with the nesty-place for my head. Fat padded earplugs closed in around my ears (a new thing, since my last MRI). They gave me my instructions. I felt oddly joyous, like a kid at an out-of-town carnival.

At "half-time", the technician said, "We are getting lots of wonderful pictures."

"Go for it!" I responded. Lots of wonderful pictures was merely a bonus to the beat, beat, beat of the jungle.

And then, all to soon, it was over. The bed of the machine moved itself out and away from the magnet. I was once again in a normal room with normal noises and too few challenges. I was a grown-up woman in a Radiology Clinic who was slightly goofy from the sedation and whose mind was landing on every song about "dogs" she'd ever known. "I had a dog and he had me and Bingo was his name-o." "Had a dog, and his name was Blue and I betcha five dollars, he's a goodun' too. Here, Blue, you good dog, you." And, "How MUCH is that doggie in the window? The one with the waggeldy tail? How MUCH is that doggie in the window? I DO hope that doggie's for sale."

Don't ask, don't tell.

I sang my Dog-Songs to the friend who drove me home. "Mmmmm-hmmmmm," he kept saying, the way you'd say to an idiot who was singing you songs about pencils or beans, "mmmmmmmm-hmmmmmmm."