Blue Skies

For whatever reason I started my fourth hour today talking about George McConnell and Samantha Johns' "Snowfuck."  Explaining this to them went about as well as you would expect - whether you know the show or not.  I remember why - I was thinking about music.  George this morning posted the song "Blue Skies" which is a painfully beautiful song that I first heard during the painfully beautiful "The Thing."  (a flavorful sample of their work can be seen here.)

I was thinking about The Killers (whose song I Can't Stay has held a similar beauty/pain in my heart for the past few weeks), and about how all these kids in front of me knew them already, and more and were carrying these little bits of beauty and sadness in the form of music we hadn't heard or known about.  But we still didn't know about the music they had.  So I asked them about music and talked with them about The Killers and Noah and the Whale and ultimately Snowfuck and The Thing.  I ended up on a bit of a rant.

Part of my internal narrative is that as I age (grow up) I would mature out of states of emotional turbulence.  I shouldn't limit that to my internal narrative - that is how we tend to talk about 'growing up' isn't it?  We tell people who are upset about this or that to grow up (unless we justify their turbulent state - death or a breakup - at least for a period of time).  My Mom once said to me that being an adult meant being able to cope with difficult circumstances while being able to carry on in other parts of life.  I was an emotional kid, and while feeling down was a serious bummer, I also frequently felt up, which was amazing.  I figured adulthood would provide me with a more stable emotional life, with the highs and lows replaced with some abstract sense of tranquility and inner-peace.

Well I'm starting to call bullshit on that one.  Certainly there is some peace out there for us to access from time to time, when my schedule relinquishes me for a moment or two.  Much more enjoyable were those periods in my 'youth' where I touched on something risky and powerful; when I was nearly incapacitated by my feelings.  This was called drama by me and others.  Drama!  Look out!

When I made my attempt at explaining the strange and beautiful performances, my students balked.  The scene from The Thing that persisted for me, that is intractable from the song Blue Skies, was two characters lightly boxing or wrestling, then locking eyes and facing off.  They looked like they were about to fight or make out, and they sort of did both.  It was an intimate moment - it looked unrehearsed.  It was intimate.  One pulled out a sandwich, took a bite, then the other took a bite and suddenly they were kissing - this tender moment mediated by a pb&j.  But my students weren't having it - 'you paid to see that??'

So I tried again - a friend in high school crushed on someone, took an opportunity in an elevator and kissed him - no words - and they went on their way.  My kids demanded to know what happened to them - did they get married, and so on.  This moment was more recognizable to them but still did not fit the narratives they knew.  It was an episode, I told them; it was a moment suspended in time, just like the first.  Two people acting on an impulse that drew them together.  Here I held up my hands like puppets with closed mouths and drew them together, like for a kiss.  Don't we all just wish that would happen to us, I said.  These moments so beautiful they almost hurt.

Maybe I'm waking up from something; I can't really justify not knowing The Killers.  But discovering them was truly an exciting moment.  Here was a range of songs that I thoroughly enjoyed, some of them beyond reason, and they seemed to just appear on my horizon.  Blue Skies was similar.  These songs articulate something beautiful and sad.  They seem to capture a suspended moment of potential.  The songs have a deadline, a finish, and when we rehearse them, play them back again and again they lose something.  They age.

The Thing, like a lot of the work from George McConnell and Samantha Johns, also generated a charged gap between me and my hopes, the beauty and excitement of a potential connection and the sadness of our longing for that connection.  Those works felt immediate, unrehearsed.  I've sometimes wondered if watching TV and movies of the moments we hope for in our lives is like rehearsing them.  How can we avoid measuring our experiences against those we see?  How refreshing to see a performance that felt like listening to great music for the first time.  Hearing that song again brought me right back there.

I'm not sure what part of me is horizonal at this time, experiencing that gap.  Maybe that's just part of being a person.  I finished my rant to my students and with some effort pulled back on course.  I was shaky and distracted.  These pop songs like candy.  Fleeting, unfulfilling, earth-shattering songs.

Thanks for reading!

Winter Biking Part Duex

Steph Hart had a great suggestion for staying warm in the wintery breeze in the comments section of the last post.  It reminded me of a few extra little tidbits concerning winter biking.

First of all, as C pointed out, how far you are biking can have a big impact on how to dress.  I bike about 5 miles, most of which is uphill on my way in.  That generally means I am chilled when I start and warm by the time I reach the 3 mile mark.  If I was only biking 2 miles, I would probably dress warmer.  Also, C used to bike 10 miles (both ways!) to work, which meant that her extremities would get way colder by the time she arrived.  Even the secret trick of putting baggies under her boots didn't keep her feet warm on those extra cold days.

Speaking of baggies, there are some indispensable bits of apparel that I neglected to mention, the most important of which is the neck gator.  I have a lovely smartwool gator ($30 at Midwest Mountaineering) that has kept me warm for 4 years of winters.  I only wear it when it gets below freezing - it is hard to adjust the gator like you can a scarf if you get warm.  Another must for those super cold days are wrist warmers or long gloves.  I have some knit wrist warmers that someone left at the River House after a party a few years ago.  They are homemade with little thumb holes and I wear them under my gloves on extra chilly rides.

Most important is to find what works for you.  I'd rather be too cold than too warm, so I err towards less clothes - you may be different.  I hope these posts encourage you to treat the colder weather as just a new type of biking - not a no bike zone.  Especially when there isn't much snow and ice on the ground, biking in the cold is pretty much the same as biking any other time.  Try it this Friday!  You won't regret it!  Thanks for reading!  

Winter Bike Minneapolis!

Hey folks!

After those last few posts, time to lighten things up a bit with some post-holiday bicycle cheer! As many of you know, I am (or lately, attempt to be) a year-round bicycle commuter. I'm so proud of myself for that I even put it on my grad school application. It isn't the easiest thing to do, but it is much easier than it appears at first, and it has so many benefits that once you get going it can be tough to stop!

I'll spare you my hyperbolic praise of winter biking for the time being, and give a short overview of how I manage to be a world-class athlete without being anything close to a world-class athlete.  I should title this "Winter Biking is for Everyone!"  I'm going to give an overview of how I dress for success when I pedal through our winterwonderland.

Alright - so it's cold now, and admittedly if you are not already riding your bike it will be tough to start now.  It's best to have a nice biking routine going in the nicer weather for that transition to winter.  But it's not too late to look like a hero just by showing up to work!  I for one am in the worst shape of my life, my body is practically falling to pieces but I biked this morning!  5 miles!  Uphill!  Through three feet of snow! ... But seriously you can always hop on your bike.

I ride a 12 speed Motobacane from the 70s - road tires, no front brakes and I never shift, ever.  You can ride one of those fancy fattie tire bikes but you can ride absolutely anything.  I'd recommend trying whatever bike you would ride during the summer months.  Whatever you are comfortable on.  There is a tiny chance you will fall if you keep it up (I fall maybe once or twice a winter - often on the same ride), so not anything too delicate.  Once you have your bike, head to your winter gear basket cause it's chilly outside!

Biking is different than walking - your body is more active and there is more wind.  Scarfs and gloves rather than heavier coats.  That kind of thing.

Everyone is different temperature-wise but there are a few rules of thumb for dressing well for winter biking.  Try to be a little chilled when you leave.  If you are warm at the start of your bike ride, you will be overheated before long.  Your fingers, face and toes might get cold, but if your core is warm you are warm.  Unless you go out bare-chested, your core will be warm.  Today, at +10 degrees, I wore my work clothes (button down plus sweater) under a windbreaker shell with no lining and I was never cold.  I don't wear much more than a sweater until it gets below freezing.  Don't over dress beneath a windbreaker - you will bake.  For me that's no more than 3 layers under a windbreaker until it gets well below 0.  I'll double up sweaters at +20 or +30 and be comfortably warm after a mile or so.

I almost always wear regular chinos or cords or whatever pants I wear to work when I bike, unless it gets below 0, then I add a layer of windpants or something.  My legs were chilly today, but didn't make me cold.  If you wear skirts or dresses, warm leggings is a must below about +20 (so I'm told).

Worry about your hands, face/head and feet.  I wear a light balaclava on my head/face all winter (under my helmet!) - nothing else, and my head is always fine.  I pull it over my face at 32 degrees.  I generally have a scarf around my neck, which is helpful for temperature regulation when I start getting warm.  When it gets below +10 or so, I'll pull the scarf over my mouth and nose.  My breath then keeps my nose and eyes warm.  If you are out for a while, or if it is windy, ski goggles are a good idea, but I have not found a good way to keep them from fogging up, so I don't wear them unless it is below -10.  I have light and heavy gloves, which do the job.  I wear the lights from +40 to +20, and the heavies below +20.

My first winter, I over-estimated how much to wear every time the temperature dropped.  This isn't a huge deal, but it does make for an uncomfortable ride and a smelly morning.  If you underdress, you will be chilled for a while but you will warm up, and you will know for next time.  It took a few weeks, but I found the right clothes for me for the temperature ranges I faced each morning.

Thursday and Friday of this week both look nice - get out the bike!  It will be in the low 30s - wear your normal clothes, a light hat and gloves and a light jacket and you should be fine!  Remember, be a bit chilled when you start and you will feel great when you arrive!  If your core is warm you are warm!  Good luck and thanks for reading!  

The Borderland Between Sick and Well

In a scene of The Great Gatsby, Nick Carraway mentions how ill George, another character, looks.  Fitzgerald then gives him one of the many profound lines of the novel: "It occurred to me that there was no difference between men, in intelligence or race, so profound as the difference between the sick and the well."

I have struggled with this distinction.  Foucault and queer theory have struggled with any distinction.  I am not what I experience, nor a tidy sum of my actions or beliefs.  Sometimes I am sick, sometimes I am well.  Much more frequently I am both.

The more clear distinctions happen rarely - though they have both happened recently.

I was in the hospital a few weeks ago with a UTI.  This simple little SOB landed me in Abbott for three days.  Some people, god knows why, talk their way into a hospital.  I generally resist going in and spend most of my time in trying to get out.  I've thought about being that guy who sneaks out, but I respect most of my doctors and nurses.  Besides, this time, I was sick.  Like, sick sick.

This has happened to me a few times; I go from feeling fine - you and me fine - to asking for a ride to the ER because I can't hold anything down and I've got a climbing fever of 103 or 104.  This typically takes six to eight hours.  I undergo a profound transformation from the time I walk in the door, clothed in my clothes, my wrists free from hospital plastic wrist bands, looking and feeling like a healthy person.  This is when I feel awful, but am still my own person - sick but not hospital sick.  Not naked in the gown.  I might lean on a wall for support but I am leaning with my shirt sleeves, with my phone in my pocket, with my shoes on.

An hour later I am in the gown, toting an IV pole.  And I am seen anew.  The hospital is the place where I am home.  Think about that.  Where are you 'home?'  When I walk through a hospital for some other reason I am a visitor - passing through this land of the sick, this quarantine of disease and infirmity.  I think of the hospital as hallways doorways and elevators.  Transience.  A place to pass through.  When I am 'sick,' the hospital is a room, a bed from which I move reluctantly and with caution.  It is the space between my bed and the bathroom.  Asking for another blanket.  Asking for a glass of water.  Asking for a drug to make me feel less nauseous.  Being asked to take four deep breaths.  Listening to the ragged breath of the guy sharing my room.  I'm pretty sure he never left.  In the hospital I am attended to.  I can ask for things.  I give up something to gain access to this treatment.  Perhaps this is what Fitzgerald was talking about when describing George Wilson, desperate with jealousy - a person loses a piece of themselves to sickness or death when the hospital is the place from where they exist.

I imagine a struggle for nurses as well, working with dozens of partial people every day, humans at a valley of dignity.  On the one hand there is so much suffering in the humanity of these people, of me in a bed, dirty, unshowered, weak and emasculated - how could a nurse remain open to such suffering while administering care within the confines of a hospital.  There are only so many kinds of nurses, and at the heart of it just two - those who see patients as humans and those who cannot.  I do not fault those who cannot - I cannot.  What an awful place to be; sick.

Being well is much more familiar to us - to you, really.  Biking to work on a crisp morning, passing cars at a stop light, dodging potholes, having cold thighs taut with blood.  Powering up a hill with some leg left at the top.  This is being well.  It is miraculous, and the gift of being so often sick is to have ready access to that miracle.  Feeling the cold wind on my face is sometimes everything.  The unmitigated world is a miracle, but the condition of this experience is wellness.

Most of the time I live between sick and well.  I'm like a spy, surveilling the country of the well, passing as not-sick.  I don't make a habit of talking about why I missed school, or how I spent my weekend trying to catch up on sleep and work.  But I do those things - miss school and sleep a lot.  I struggle to carry my share along with my guilt for not always carrying it.  I navigate the collateral damage my health inflicts on the people who love me.

I standardize my answers; I rarely know how to talk about myself, or about my weekend.  I lie outright sometimes, which comforts me as much as it does them.  I sometimes enjoy the secret, that I am secretly sick and most people would never know.  Other times I feel alienated and alone in the middle of a crowd - that people do not know my reality.

Of course these experiences are not uniquely mine, but I may experience them more profoundly than most.  We all attend to the various unfolding crises of our lives.  And many of us exist in the space between things.

Nick Carraway eventually abandoned the jaded East to return to the cultural subtitles of the Middle West.  The hard, defined living with the likes of Jordan and Tom and Daisy didn't suit his temperament and he went home.  Plurality affords him a more flexible interpretation of who he is, and that seems to suit him.  Thanks for reading!

A Crucible

Every fall I teach a unit centered around The Crucible.  The assignment I give my students is to draw connections among the witch-hunts of the 1690s, the red scare of the 1950s and then to an issue of their choosing for today.  The students are charged to find three parallels among these three time periods.  Their working thesis is that a culture of fear creates strikingly similar social situations, and that some parties exploited that culture of fear for their own gain.  That these witch hunters begin by targeting social outsiders, and rely on the common persons' tendency to want to fit in - to conform - to support their purge.  Ultimately, the common person is cowed into conformity (and consequently hypocrisy), because they fear for what they stand to lose if they challenge what over time becomes the new status quo.  These situations call for heros - for uncommonly brave individuals to stand against this tide.

One of our examples is Ed Murrow's crusade against Joe McCarthy in the film 'Good Night & Good Luck' - well worth watching and extremely applicable to this topic.  What has been driven into me over these past few weeks are the words of Arthur Miller and Ed Murrow among others, as they have spoken out against the terrorizing McCarthy.  Their words have been echoing in me.  Particularly Murrow's sentiment that 'No one can terrorize a whole nation unless we are all his accomplices.'  Many of Murrow's contemporaries, including his boss, believed that McCarthy would self-destruct, and encouraged Murrow to spare himself from being 'subjected to the attentions of the junior senator from Wisconsin.'  What prompted Murrow to make his stand against McCarthy and the red scare he hid behind?  For that matter what gave Arthur Miller strength to refuse to 'name names,' placing his promising career in jeopardy?  Perhaps most bafflingly, why do individual children, in the face of their peers and sometimes their superiors, stand against violent bullies when their likely reward is more of the same?

One of the most common examples used in my students' papers is homophobia - a social pressure they feel themselves.  This unit has come to mind for me again and again as I follow the conversations about the church's most recent pathological pursuit of sexual conformity.  I am employed in an institution that is compelled to support this pathology.  The place itself is dear to my heart, as all of you know, and the people who work there are some of my closest friends and allies.

While the mainstream is coming about to accept the differences among its people (yet again), the church and its institutions remain in the grip of fear and paranoia.  These institutions will still require some brave people to stand against them, at great risk to themselves and possibly the people around them.  I cannot claim to be one of those exceptionally brave individuals; while I attended an event at O'Gara's and am writing this, you will notice that I have carefully avoided using certain words that would betray me to someone looking for dissent with a Google search.  I have struggled, pathetically at times, with the tension between the draw of safety and job security within the folds of a hypocritical church - the church deeply and secretly divided on this topic - and the desire to maintain my integrity as a person; to stand outside, exposed to scrutiny and bright light.

The lasting effects of the delay I exercise, along with my struggling colleagues, is shame.  We have been put in the position where it is impossible to be ourselves and remain in communion with our church - we are personally divided, and nothing holds us back but ourselves and our fear.  It is the same paralyzing shame experienced throughout our history, used to suppress dissent and to control.  Coming from the church, this should be no surprise.

The results of the witch hunts and red scare seem to have been a bewildered population waking from a stupor, the careers and lives of those targeted detritus around their feet.  So far the desire to be among the walking stunned has outweighed the desire to be among the martyrs of history.  But I am paying for that safety with little parts of myself, and so are many of us who are compelled to silence.  Thanks for reading.

A tirade on the ACA

The other day I had a chat with someone close to me about the Affordable Care Act.  I have been curious (dumbfounded) about the opposition for two main reasons and while I thought she and I had a positive and congenial conversation, we seemed to be speaking different languages at times - or at least getting our information from different sources.  This is not a new issue when it comes to politics - indeed it seems to me to be fundamental in understanding our severe political polarization of late.  But I decided that I could take my considerable energy about the issue and purge it with relative impunity here.  

The ACA is particularly close to me for a number of reasons, and the current public debate is particularly confusing to me given the information I have about it.  Here are my thoughts:

One - it seems to be the position of the many opposed that the bill will raise the deficit because it will increase costs.  My understanding is that we REDUCE the more expensive emergency care visits (which we currently pay indirectly) by providing people with less expensive preventive care.  We also add people to the insurance pool (through the tax or mandate).  Besides making logical sense, the non-partisan Congressional Budget Office reported that this "would yield a net reduction in federal deficits of $132 billion over the 2010-2019 period".  That some people insist that the plan would raise the deficit seems almost willfully obtuse to me.  

Two - that the main principles of the law (mandated participation in a private and competitive health care market) was a conservative position twenty years ago.  As I understand it, their plan was in opposition to the 'Hilarycare.'  

I was not able to find the Heritage Foundation report on this but plenty of others have referenced it and I have to imagine that when Clinton was pushing the government plan in the early 90s, the opposition at the time were paying attention to the alternative plan offered by Gingrich et al (sources here and here - again, not my preferred source, but the quotes are real).  While it has been well known (and criticized) that Romney created a very similar plan in Massachusetts, it seems lost on many that the plan was a widely accepted Republican platform in the 90s.  

Finally while Roberts' ruling did not permit congress to assign an economic mandate in the realm of health care, it remains plain and logical to me that the health care market is not and cannot be a self-selective market.  We talk of the freedom for someone to buy or not buy a house, to buy or not buy a car, but health care like the highways, the traffic laws, the regulations on the food we eat and plenty of other ancillary benefits we gain by being physically in this country are ours not by choice.  I cannot 'opt out' of safe drinking water or 'opt out' of benefitting from the highway system.  I cannot 'opt out' of police and military protection.  People cannot currently 'opt out' of health care!  Hospitals MUST provide emergency care!  To everyone!  This boggles my mind!  

This is an extremely personal issue to me.  When I traveled, I paid for insurance out of pocket through CDH.  Something went wrong with the paperwork and my drugs were not covered for a while - there was a chance that my coverage might have lapsed because of a mistake - CDH did not file paperwork.  While the HIPPA law of 1996 requires that group health care cover anyone with any condition, you MUST have comprehensive coverage going in - you cannot lapse for 63 days or they may deny you.    

"HIPAA imposes limits on the extent to which some group health plans can exclude health insurance for pre-existing conditions. For instance, if you've had "creditable" health insurance for 12 months, with no lapse in coverage of 63 days or more a new group health plan cannot invoke a pre-existing condition exclusion. It must cover your medical problems as soon as you enroll in the plan."  That insurance companies did this - that they have a separate deductible for mental health does not make me sympathetic to their bottom line.  The law need not protect insurance companies - they have plenty of laws (including title 2 of HIPPA) that protect them.  I could have lost coverage and no one would be required to pick me up again.  My life would have been altered fundamentally and permanently.

With this Affordable Care Act, I and anyone who 'lapsed' for whatever reason could not be denied health coverage that we want and can pay for.  No other market denies participation like health care has.  I can think of 4 close friends of mine who have been desperate to get coverage and have been denied for pathetic reasons.  They could pay for it, they were denied coverage.  When I thought I had lapsed C and I talked about moving to Sweden or Canada.  Seriously.  That was the option afforded us as the law stood.  

It is hard to keep up with the false and misleading claims about it - one is the claim that this is a 'government takeover' of health care.  there is no new government health plan that people can buy - there is no 'government run' health care other than what is already provided to government workers!  It is all private!  How in hell is this a government takeover of health care when the government is only telling people that they need private insurance!  The death panel claim is more egregious and insidious.  The actual issue (as explained by a close friend) is a standard living will document - only a doctor in a nursing home could withhold resuscitation/antibiotics for someone EVEN IF THAT WAS THEIR DIRECTIVE.  So nurses and staff were required to call an ambulance even when the person had a directive saying not to.  Why would anyone in their right mind oppose changing that?  

I cheered out loud when I heard the news about the law being upheld.  It fundamentally changed my relationship with my health care, my job, how I think about my personal choices.  C's co-workers congratulated her ON MY BEHALF.  I cannot understand opposition to this law, other than bullheaded politics.  Can someone help me out here?  How can so many be so opposed to this?  

End of screed.  Thanks for reading!  

Biopsy Results! And a full Wedding Weekend!

I'm moving a bit gingerly today, in part due to a full weekend of brunches, lunches and fun wedding times.  The wedding was beautiful - great weather, lots of great family and friends to celebrate with, and a memorable service and reception.  Maggie and Pete were happy throughout.  I was honored to have been in the party, to stand at my sister's side as she made her pledge in front of god and everyone. There are some great photos floating around on Facebook, thanks in large part to my cousin Andy Zimney - great photos Zim!

The other news of the weekend, the biopsy results!  Turns out my creatinine was high because of an 'acute cellular rejection' with some small incident of IgA nephropathy.  Of the various types of rejection, acute cellular is the least dangerous so far as I understand it.  It is also much more hopeful than a chronic failure which would be untreatable.  The nephropathy is likely a slow burn type of issue that may or may not be an issue.  It is not terribly well understood largely because it isn't often an issue.  A cellular rejection tends to slowly raise the creatinine levels as the surrounding tissues attack the transplanted kidney.  As is standard, I got a three day dose of steroids to reduce my immune system and give the transplant a chance to cozy back into my belly without being harassed by my t-cells and what not.  The steroids are not without their side-effects which added to the general excitement of the weekend.  Synthetic prednisone mimics a bodies stress response, which is what we all experience when we are under stress.  The feeling of being on a relatively high dose of prednisone is similar to being totally revved up, where it doesn't take much to start a rambling conversation or to obsess over one thing or another.  Being somewhat prone to rambling conversations and obsessions already, the effects on me were both familiar and a bit tiring.  This is the other source of my ginger movement today.

After bopping around all weekend with visits to the Abbott infusion center, dinners, the wedding and so on, this morning I've been slugging through a fog, where my body feels a bit disconnected from my brain - my self somewhere in limbo between them.  It's a bit tricky to track my thoughts enough to put down something coherent.  There's a thickness behind my ears and eyes and my muscleys are all mooshy.  On days like this it is hard for me to determine cause and effect - to suss out how much of my body is reacting to the drugs or stressful weekend of just a night of bad sleep.  Consequently, being an introspective chap, I lay about searching out how I might respond to this situation - or more simply how I think of how I'm doing.  Am I tired?  Am I reacting to steroids?  Am I coming off an emotional week where I was fairly convinced I was about to re-enter the doldrums of dialysis and waiting?  All of the above?  Maybe this is never a simple question - 'how are you doing?' - and we are only able to fake through it when our circumstances are stable for long enough to present a convincing story.

It is now Wednesday - I gave the thing a few day's space to see if anything cleared, and it has somewhat.  I'm a few days away from the steroid run and my body has somewhat settled out.  I've had a follow-up blood draw yesterday which held the creatinine low enough to keep everyone happy.  Coming off of this will take a few weeks; I remember the feeling of just starting to relax after having the second transplant (the first going so quickly), how it took months before I started to feel like a regular person in the ways it seems to count.  Normal walks through the grocery store and not anticipating taking my morning or evening drugs.  Ellie and I have a few more days at MITY before drawing another great session to a close.

Sorry this took so damn long to post - and thanks for reading!  

Biopsy!

C and I showed up at Abbott at 10:45 and I was admitted to unit 44 - a daytime unit used for overflow and short inpatient procedures.  My blood pressure was a bit high, even after I doubled my metoprolol for good measure.  So after they got an IV in and checked and rechecked BP, we got bumped in the radiology line and didn't have the procedure until 2:30 (it was scheduled for 11:30).  

C and I passed the time with conversation, some reading and a nap.  At this point I was undressed and in my hospital 'gown.'  90% of my stay was lying in a bed - doing nothing, needing to do nothing, and feeling fine.  But just wearing the clothes of the sick and lying in a bed that automatically adjusted to my movements and hearing the soft voices from the hallway was a lot to handle.  I think what got to me was the atmosphere, what the place felt like.  My caregivers were attentive and well-intentioned, but in their absence a person is almost oppressively IN a HOSPITAL without any recourse to leave.  It is this state of suspension, removed from the movement of the world, from the weather, from the normal passage of time that wore me down yesterday, along with my anticipation first of the procedure and then of the results.  The biopsy trip reminded me of what had been so inexplicably hard that first time through ten years ago.  

My Doc put the kibosh on pictures, which is too bad because as C told it, there were some neat images from the procedure.  The biopsy was an 'ultrasound guided biopsy,' which meant that a radiologist (or assistant of some kind) held the ultrasound while my Nephrologist poked in the needle.  The ultrasound is a standard thing - the same used in all ultrasounds and seen in movies - where there's the handheld bit and the grayish projection on the computer screen along with the goop that conducts the ultra sounds.  The needle used in biopsies is a real doozy.  It has a cylindrical handle with a big button on the top and a needle end about eight inches long, about the diameter of a metal coat hanger.  While it is pretty menacing, it doesn't necessarily feel like much as they numb the hell out of the belly area where they go in.

Because the transplanted kidney is in the front of me, located where you might rest your hand if you put it just inside of your pants.  The biopsy, consequently, was about two inches below my belt line.  The helper person, a female John C Riley, located the spot with the ultrasound where my doc would go in and he numbed it up with some lidocaine, which is ironically the most painful part of the process.  A short pinch and he let it set for about 2 minutes.  He then inserted the mega needle saying 'pressure is normal, pain is not.'  I did feel a bit of pressure, but the insertion was remarkable smooth.  I could feel the needle catching my skin on the way out a bit, not to mention see C's face, but I was totally numbed up and could only feel the movement.  

I have to take a brief aside here to say that my first transplant biopsy, in the spring of 2002, was thoroughly awful experience.  I was biopsied by a resident who shook, sweated and needed to make a second excursion into the barely permeable expanse of my belly.  Each journey of the needle through the layers of my abdomen were jerky and hesitant; he struggled to get the needle through and kept telling me to relax.  I'm not sure what kind of patient I was at the time, but I am grateful beyond words for the professionalism and sure hand of my current doctor.  The procedure, from cleaning to band-aid, took about five minutes.  Easy peasy.  

We now wait for the result.  It could go a few directions - everywhere from staring over to nothing changing at all.  I continue to attempt a balance regarding the impact and scope of this episode.  It brings up a lot for me and I'm working through that stuff, here mostly.  But I'm also well aware of how much worse everything could be.  My basement has some water in it after all this rain, but it's nothing compared to Duluth.  

Thanks for reading!  

Numbers

So I got the numbers and as I had expected they were about the same - 2.2, so game on biopsy!  To be honest I'm kind of excited to be able to write and post photos of the biopsy stuff.  C will be around the the procedure and I'm hoping to get some fun pictures with my Kidney Doc.  Mad Doctor stuff.  It is a grab bag of emotions for me right now - not all bad but certainly some difficult feelings in the mix.

I got lunch with my mom on Thursday - I talked to my mom about Slavoj Zizek, the Slovenian philosopher.  He's kind of a side-show youtube sensation, famous for proclamations about what toilet design can tell you about a culture.  Well he has some slightly more serious talks on the true functions of organic fruit (to comfort the buyer) and one that struck me about how in a permissive society, as we live today, in a permissive society a person feels guilt for not actualizing all of their desires - for not being everything to everyone all the time.  Old fashion guilt, he says, came from our unspoken transgressive desires, which we had purged from us in psychotherapy, or expressed in art as Aristotle would have it.  We used to feel guilty for wanting things.  Now that we can want anything, we feel guilt when we do NOT want things!  And we suffer a crisis of impotence.  We cannot possibly enact all of our desires - physically or emotionally or pragmatically so we must not be enough.  Permissiveness does not make us happier we only feel guilty for different things.

I carried on for some time on my unsuspecting mother but there was a reason and I remembered it; when I enter a health crisis this guilt or inadequate feeling dissipates - as though it were never there.  I was waxing on about the abstract benefits of a health crisis.  And it's true - in a lot of ways kidney failure was one of the best thing that happened to me.  I have clear memories of the weeks after the hospital when the world was spread out before me, new and ready, everything but my next few days stripped away.  My life was the equivalent of a near death experience in a safe clinical environment every few weeks!  At least it was in 2002.  It never took long to lose perspective and get bogged down in the stupid shit of everyday life once again (namely my insecurities and my resistance thereof).

My first reaction to hearing the high creatinine level was a kind of calm focus.  What I had to do next was clearly laid out in front of me, prioritized and simple.  And I did not have control over the outcome, which meant I couldn't do anything wrong.  That was a welcome feeling after years of my future outweighing my present.  I never once wondered why it had happened, or why it had happened to me.  I was never angry about it.  The wounds feel quantified to me; they are mine and I know them.  I wouldn't trade them for anyone else's scars or naivete.

Yet I'd still rather not go through this - especially again; it is something that given the choice I'd rather not happen to me.  My curiosity and even tracking my experience here feels like a kind of masking, intellectualizing the hurt to damped it.  I mentioned to C that I hoped I could remain productive should I be laid up again - that in 2002 when I was going on dialysis I moped about, played Civilization III and ate impressive sums of chocolate chips.  I didn't even read much.  I was attending to myself at the time but that too was a loss I did not understand, even though I felt it.  It is a challenge to plot a course among the centers of my emotional well-being.  The lessons of clarity of purpose (not dying) remain elusive to me.  Joy and suffering create meaning and it seems like it might be my turn for some of the latter.  But really, given the choice; no thanks you know?

Thanks for reading!  

What Support Is

More than any other post I've written I thought and stressed about that last one.  I asked C if I was over-sharing (a few times), and she suggested that I might relax about the whole blog thing and to not over-share worrying about it.  That people would be supportive and would be interested in knowing and so on and of course she was right.

In the twelve years or so 'AK' (after kidney? I'm experimenting) I've been overwhelmingly supported in lovely, pragmatic, real and non-pitying ways.  I remember thinking that the initial attention and support (both welcome and uncomfortable) would wane just in time for me to lose direction or fall apart entirely.  Not the case.  I suffered my quarter life crisis like everyone else and adjusted to the new post-undergrad world in quiet, nondescript ways.  Without fail folks have been available to me in just the way I would have wanted and have tried to be available myself.  I did not become 'that guy who had the kidney transplant' except to save distant acquaintances who lacked better conversation topics - and really, health is as good a conversation topic as any, if a little premature for people my age.

But to this day I struggle to talk about this or that issue being hard or troubling.  It has been tricky to self-advocate when my emotional well-being is at stake.  On matters of health I have been a vociferous advocate for myself; I ask questions, make suggestions and have filed complaints.  I consider myself a great patient, I try to have a sense of humor, to be light hearted, to be empathetic to my caregivers - but I am not shy about pointing out when something is wrong.  But so long as everything is going 'right,' I struggle to bring myself to talk about how uncomfortable or painful a procedure was, or how lonely it can be in a hospital.  In fact part of what made me feel like a great patient was that I did not talk about (I have to force myself to not use 'complain') how I have struggled.

Good nurses ask me how I'm doing - they know how I'm doing, they are just giving me an opportunity to share it - and I say I'm doing fine with a smile.  And they smile.  And for a bit there it is fine, just two folks bumping into each other, saying hello.  There is so much reenforcement for putting on a brave face, I was commended over and over for handing everything so well.  Largely I think I did handle it well.  And I believe my positive attitude helped me through the tough spots.  The tough spots I remember are a limited bunch amid a wide range of clinic visits, procedures, and major life adjustments.  I feel like I've navigated this experience well.  Yet the flotsam remains, and no one is a rock.  Or an island or whatever.  Porcupine.  So given this history of supportive friends and family and a good attitude welcomed by my caregivers, why have been I so reluctant to delve into the story in more than cursory ways?

Geez that's a big question.  Maybe it's time for a little tangent.  I mentioned the numbers game yesterday - that the thing to do now was wait for lab results and take it from there.  I had a dream this morning that I got a call from someone named Kevin at the clinic who told me, with evident relief, that my numbers were down to 1.95 and asked jokingly what I was doing with those numbers.  You silly man! What are you doing with your numbers!  Goodbye Kevins!  Then I was in the basement of my childhood home with life-sized pictures of underwear models from department store ads ....

No, I can't do this topic justice.  Not yet at least.  If six fig newtons can't get me there nothing can.  Too many gender rules, too much family history - it would take more therapy than I can afford right now.  Perhaps its enough to say that accepting support is what I am working on right now, and it is no small task - even in relation to the thing I am receiving support for.  I have survived this ordeal so far, and with some grace.  It is complicated and difficult to be vulnerable.  Publishing that last post, and now this one, brings me closer to the heart of this experience as much or more so than waiting for lab numbers.  Which by the way remain forthcoming.  I guess I'm saying that for me the lab numbers are secondary to my sharing the story.  The numbers will be what they will be and my next few weeks or months will play out accordingly - there is little I can do to affect that.  My struggle is to remain small and vulnerable in the face of this.  Like the last fig newton.

Thanks for reading!  

Once upon a time ...

For most of the last year I have anticipated sitting down to develop my experiences abroad into something deeper and touching more upon, with the benefit of hindsight, my emotional states at the time.  India in particular unsettled me deeply and I have struggled to find the language to express how it left me when I left it in the spring of 2010.  However, the direction of the next few threads will concern another facet of my life; one somewhat related to my Indian experience.  Almost twelve years ago, in August of 2001, I was diagnosed with kidney failure.  The first two years were a wild ride, comparable in a number of ways with my experience in India - it was a paradox of the intense and the ordinary, being hungry without being sated, and interminable in that instantaneous way - an off year of life.

Then from 2003 on my life returned to its normal trajectory - I started a career teaching, I lived in a few apartments before buying the duplex where I currently live, and as you all know I traveled enviably, extensively.  Thanks to the generosity of my uncle Bruce and many many others, my life was barely compromised by my chronic illness.  Like India, the period of my early twenties feels comfortably distant, dim on my horizon.  

Yet while I can choose to avoid the subcontinent in my future, my transplanted kidney function will most likely slow, and at some point it will need to be removed, setting in motion the same machinations that interrupted my senior year of college.  No one can say when that might happen - there are few people in my situation who might serve as guides, I am otherwise healthy - there was no known cause for my illness, and I am very young relative to most people with kidney failure.  I have labs done every few months to keep an eye on my blood levels.  With a few small adjustments, I have been on the same course for nine years.  Recently, however, my numbers have started to creep, and labs done last week indicate that there might be something wrong.  

There are so many aspects to these stories that I have not told - so many of my thoughts and feelings.  It is difficult to create a linear narrative.  This was my initial hope with this blog- to suss out the untold details and meta-narratives of my world travels; how the music I listened to in different countries remains locked there - lilacs, perfume or that smell in an old brick building - I turned on Beach House to sit down now and my mind keeps playing images from Morocco.  Morocco feels as distant to me as it must to you until this music starts and slam I am on a bus, climbing a hill, lonely and scared, clinging to the English speaking travelers I met.  

I had labs done today to double check the results from last week.  Leaving the clinic I called C and opened a bit in the car.  I flashed back to a number of episodes that continue to resonate in my memory - experiences impossible to relate.  Flashes of being in a dialysis center, of outpatient procedures, of doctors and nurses, 9/11, coffee shops - all neatly associated with this pervasive facet of myself that has been dormant.  I had not yet written about India because I knew it would be right there waiting for me.  I knew that time would not dim what I had experienced there.  Even so, I underestimated how close these 'kidney' experiences were to me.  

I have not talked about almost any of this publicly for reasons that are difficult to explain or understand myself.  I often think that I do not want to complain or sound whiny, but it also feels private to me, like a secret weapon almost.  Certainly some psycho-babble could explain a lot of this.  Even what I wrote so far has felt intimate.  

The labs look at a few indicators of kidney performance, most importantly creatinine.  Creatinine is exclusively cleared by the kidneys and thus is a useful indicator of kidney function, and it was my creatinine levels that have recently caused alarm and raised this blog post.  

A 'normal' creatinine is 1.0 - mine had floated around 1.5 - 1.7 for years.  When I returned from traveling, the number drifted up to around 1.9 - or roughly 50% of healthy kidney function.  In the last few weeks it spiked at 2.1 and then last week at 2.35.  That is a pretty high number, and the clinic responded by scheduling a biopsy for next Tuesday, pending similar labs drawn today.  

So that's where we sit today - wait for the numbers.  It's possible the numbers will adjust and we will be back to normal and wiping the sweat from our brows in relief.  Yet I must confess that this most recent health incident is weighing heavily on me.  The world shifts slightly on its axis with a potential adjustment like this on the horizon and I'm not terribly hopeful about it.  

This afternoon, however, it is summer.  Tony and I posted quite well in another Urban Assault, 5th overall this time.  C and I are planning on burgers, wine and backgammon tonight.  And I'm thinking about buying a new bike!  All very exciting things going on, and now time for an afternoon nap.  

Thanks for reading!