Thanks Giving in Buffalo Wallow

Of course, I’m not really in Buffalo Wallow, which must be somewhere in flatland. I’m up here on a pine mountain in the ancient land of the Chumash, who regarded it as the center of the world. Apparently, a Chumash trickster spirit, Coyote, or whatever he calls himself has been toying with us, so my gratitude this day is a little skewed.

I am grateful that Ikea’s designated delivery company finally delivered the bed. I bought it on Oct 23 by phone while I was still in Canada. I was told the first delivery date possible on this remote mountain in California was Nov. 8. This remote mountain is 40 minutes up the I-5 from the Ikea distribution center in El Tejon. While I slept on a mattress on the floor, my bed sped past me down the I-5 and came to rest in a warehouse south of Los Angeles, where it sat in a tight roll and disassembled pieces. Meanwhile my 82-year-pld body lay in a tight roll trying not to disassemble in agony. I missed the delivery date – they had been phoning my Canadian landline, but I am grateful that they delivered it on Veterans Day. I am also grateful that my daughter’s good-man-good assembled it with only minimum  damage to his body. So he says. I try to believe him.

It is 10 days later, my body is beginning to unwind.

Meanwhile, Mr Coyote’s trick involved a whole raft of medical specialists – general surgeons, radiologists, ear, nose and throat fellows, urologists, neurosurgeons, pain specialists, and a raft of CT scans, x-rays, MRIs, blood tests, cell cultures and biopsies. The diagnosis was kidney cancer, then metastatic kidney cancer, then benign tumor and early stage kidney cancer, then two benign tumors, one kidney, with a dissenting vote from the radiologist, who’s still got his money on the big C.

Update: a neurosurgeon has removed one tumor and it seems as though years of sciatic pain and months of insomnia have been cured. So thank you, Dr. Liker and all those friendly nurses at Henry Mayo.

Next stop, the urologist.

 

 

 

Advertisements

All is Well: differential diagnosis

115journals.com/2018/10/06/all-is-well-another-contradiction-to-despair/

In the middle of October, I posted “All is Well”, another contradiction to despair. Events overtook me and I posted “Interval”, promising to post “All is Well: part 2”.

I will begin by explaining the difference between renal cell carcinoma and fat poor angiomyolipomas, so far as I understand it. The latter, also referred to as AMLs – not to be confused with Acute Myeloid Leukemia (that’s someone else’s nightmare) – are made up of blood, muscle and fat. Ours was spotted incidentally during an unrelated CT scan. It was a 4.1 cm. mass in the right kidney.

Did you know renal carcinomas can be diagnosed visually? So three weeks ago we got the bad news – kidney cancer. But wait a minute, the real target had been a 3.8 mass in the hip on the same side. Could be metastatic kidney cancer.

Honestly did not know I was capable of howling loud enough to alarm my neighbors.

But, stat, there was an MRI guided biopsy of the hip lump. Hip tumor not cancer. Rather a schwannoma, a tumor of the nerve sheath, in this case on the sciatic nerve and, in this case, benign.

Can there be kidney schwannomas ,we asked the Google gods. Possibly.

Let’s do another scan, stat of course, to see what is going on in adjacent organs – I imagine this one as High Def – and get a good look at the kidney interloper. Two days later, a voice mail message. Not cancer, but a fat-poor AML.

We had got used to the worst – every day terror, bleak future, all that good stuff. Hearing the no-cancer news, I had to put my head between my knees. One of us fell to cursing. The patient cried.

For three weeks, we had followed doctor’s instructions: prepare for the worst, maybe 17% survival in 5 years, gone in her early 60s. Then, when it was just kidney cancer, not metastatic we had a 96% chance. Now, we were back to 100%, or as close as you can be, given traffic on California freeways. We should have been happy, but we went around muttering, “It’s Tuesday, it must be cancer.” “It’s Thursday, it certainly isn’t.” “It’s Friday…”

We didn’t trust any doctor and certainly not a radiologist. The current one still wanted to call it cancer, despite a visible few fat cells. What we read, and we read everything, told us carcinomas had no fat. A radiologist in 2012 had reported that a tumor of 3.8 cm appeared on the left kidney. We ordered the CD record of it. Definitely, on the right. The radiologist had reverse-read the kidneys. If he had not, we would never have fallen for this funny little trick Nature sprang on us.

Lucky us. Lots of patients have discovered only after they’ve lost a kidney that they didn’t have cancer.

This morning, the urologist assured us that the offending growth will be biopsied when it is removed. When will that be? Well, first the main player, pain-wise, has to go. Simple to cut a schwannoma off a sciatic nerve, just don’t cut too close or -bingo- a different crisis here in Kern County. Recovery will take 2 days. When the patient feels better, she can call and get the kidney surgery date.

The issue of getting something to kill the pain is another whole drama. Governments make doctors’ lives hell when they prescribe opiate-type drugs. As far as I can see their draconian rules have not made a dint in the opioid crisis as yet. The neurosurgeon breezily suggested a pain clinic. Wait times for pain clinic appointments are at least 30 days. We live near an opioid addicted town, we might get lucky on a street corner. But, no, the urologist came through for the next 5 days. Not the same effective painkillers, not nearly as effective and rife with side effects. Weeping over the phone to the pain clinic got us an appointment in 5 days. And this is a temporary need, until surgery, for someone who can’t get up off the couch most days.

I am Canadian. We have the same struggles with diagnosis and waiting for surgery. I once waited for 7 weeks to have an intestinal carcinoid removed. I could eat only fluids or runny pureed veg. Great slimming diet. I was prescribed liquid morphine. But I absolutely never had to think about cost. Not true in California, even with Medicare.

This is a wonderful country, don’t get me wrong. Driving up the I-5 from the neurosurgeon’s, I remembered that, if California were a country, it would be the 5th largest economy in the world. But *#@! it, why doesn’t it take care of its people. My great nephew in Belgium had a 15 hour surgery on his brain, lived to tell the tale and got no bill.

Next up: insomnia of 10 months duration.

“All will be well and all will be well and all manner of things will be well”

 

Drunkenness: probably NOT a contradiction to despair

It’s quarter after 3 and there’s no one in the place
‘cept you and me
So set ’em Joe
I got a little story I think you oughtta know….. (Harold Arlen/Johney Mercer)

(Frank Sinatra,melancholy, on a bar stool -the apotheosis of melancholy, too romantic to be despair. Tears in my beers).

It was quarter to 4, when I woke up. It’s inching toward 5:15 dawn now. No big deal. A friend of mine hasn’t really slept for six months. I just logged 4 hours. She sometimes gets only 2, although there are signs she’s moving out of Winston Churchill territory. Five hours seems doable to her now.

What better time than the tail-end of the night to contemplate drunkenness.

For the past few days of global chaos, I have been reading Ken Bruen’s last two Jack Taylor crime novels, The Emerald Lie and The Ghosts of Galway. When I say ‘last’, I mean adieu Jacko, at least that’s what the author has implied in interviews. From the condition of the man, it’s no wonder. He has suffered so many vicious attacks as a Guard and a private eye that he is a physical wreck -lame, deaf, with mutilated fingers, and a heart full of grief. All of his friends and even his dogs meet dreadful ends because of him. Well, not even Bruen is heartless enough to eliminate every last one. Maybe there is a short story that will clear up the oversight. Jack drinks! He likes a Guinness and a Jameson chaser. He likes the Guinness built just right. In the right mood, he can lose months of his life to these libations and then months more to the aftermath.

He can’t go into a bar without someone, usually a woman, with a wad of cash, sidling up to him and saying, “You’re Jack Taylor.” It may be a simple job, like ‘find my lost brother’ -who is entirely fictional, but more often as time has gone on, it has been ‘Look what this bastard did to my girl. Get me some payback.” Payback gets gotten, although not always by Jack. Jack’s a hurley stick man, but others in his orbit use more lethal means.

Jack is a good man, his landlady says early on and his good friend, the outside nun, later on. He is a keen man for justice, humanized by reading and music and his love of dogs and swans. He has been hardened by his “walking bitch of a mother with her tame priest”, by the corruption of the church and  the government, by the miserable poverty attendant on the collapse of the Celtic Tiger and, perhaps most of all, by the water tax.

Suffice to say Bruen knows from PTSD.

The Irish have a reputation for enjoying a drop. I do not say drunkenness. Who am I to judge? I lived with Connor for many years. He gave up martinis every Lent. I lived in hell for 40 days each spring. I have a beloved relative, Colin, who is more sensible and less church-ridden. He says of his year-round habit, “Mostly ice,” as he pours his Bombay Gin. Vermouth doesn’t even get to breathe on the glass. Both get loquacious, even argumentative. I got many a cooking lesson in front of guests from Connor. Neither fall down or pass out or miss work.

I find it hard to read the Joe Nesbo books where Harry Hole descends into drunkenness and heroin. But then some experiences have to be first hand: sex is another one. And Harry is needed sober and strong back in Norway.

College binge drinking lost its glow for me before I got out of high school. Just that one, totally horrible, unable-to-feel-appendages experience put me right off. The stag and doe parties that I see depicted on Brit telly and which apparently happen here as well are not my cup of booze. I also had a terrible experience with a brownie on my niece’s 50th. That  limited my appreciation of getting high for good and all.

I know I drink too much wine for a person of my age and constitution. A 6-oz-glass puts me in legal jeopardy, although drinking in solves that problem. Drinking alone? Get real.

(A librarian once told my daughter never to eat while reading. My daughter was outraged, “You have to eat, you know.)

So the flaming world is falling apart. The leader of the free part is tailoring his actions to please 30% of his country. They don’t seem to be terribly well-informed about historical precedent. They don’t seem to know much geography and certainly even less economic theory than the rest of us. Which is saying something! They can’t tell a good guy (Canada) from a bad guy ( Russia). They claim to be helpless to prevent child massacres on their home soil. To them, children separated from parents and locked in what sure do look like kennels if not cages, brought that on themselves, and can damn well show up in court to coo or babble their own defense – in Spanish.

Who wouldn’t drink?

The most drunken person I ever met was my Aunt Mae. She was drunk on the love of Jesus, and joyfully swept all and sundry up in her ecstasy. Also she wouldn’t say no to a nip of brandy.

Jesus and I fell out one time.

Yet I know that what woke me up this night and what is keeping me awake is fear and self-restraint and that the answer is release.

Coleman Barks organizes some of Rumi’s poems into ‘Tavern Madness’ in Rumi: the Book of Love. The tavern is a place where passion breaks loose, an excited place where one is out of one’s mind, with others.There is the shared sense of the presence flowing through. We are connected. We are one, present and absent at the same time. I love the poem that says
I didn’t come here of my own accord
And I can’t leave that way
Whoever brought me here will have to take me home.


It reminds me that something has charge over me. Whatever that is will see me safe home.When I read that, I remember I am not alone in passion or rage or goodness or hope or despair or terror. Whether what holds us together is DNA or Soul, it is universal and wise enough, drunken enough, to triumph.

In the meanwhile raise a glass – soda water with or without lemon will do. Drunkenness, O Necessarily Sober One, is fundamentally not about alcohol.

(Full disclosure: my biological grandfather, who hailed from the Emerald Isle, died syphilitic  in New Hampshire madhouse. But may have been teetotal.)

 

 

 

 

Serendipity: contradicting despair #3

Serendipity: the faculty of making happy and unexpected discoveries by accident

I’m back in the mountain village in South Cal that I write about in these blog posts and in my mystery Hour of the Hawk. joycehowe.com

When I arrive, I usually stay at the house in the pines for the first few nights, before moving to the other mother’s house. The house in the pines is the abode of our children. We are the mothers or the mother-in-laws. They are happily married and my moving after a few days enables them to stay that way.

In the house in the pines, I sleep on a mattress on the floor for the sake of my back. Last night, I was reading Masaryk Station by David Downing, rereading really, but that’s neither here nor there, when a tiny black shape scuttled under the door and flattened itself against the wall.

I processed this information, fixing it with my gimlet eye.

We knew we had a mouse and, apparently, one that could spring a trap and escape. I had mouse experience, although not recently. Mice don’t  seem to climb 14 floors. I knew mice of old as long and narrow, fast moving critters that induced shudders. This mouse was not like that. Sitting, it was more of a triangle with large rounded ears. Cute as all get out.

It was in the right house.  MIckey had been the founder of the feast. MIckey Mouse artifacts and High School Musical Awards adorned the place. Walt Disney’s cute little guy and his immense studio had been in at the rise (and fall) of family fortunes.

I don’t shriek when I see a mouse. Well obviously. Yet I knew that health and safety were at issue. Is there Hunta Virus in Kern County? I knew I had to stop staring into its -oh, what the hell – his eyes. It was not clear who was hypnotizing whom.

“Mouse, mouse,” I cried.

Then as quiet fell, the mouse and I went back to gazing at each other.

My daughter eventually appeared, put her head in and looked down. My son-in-law followed in due course. The mouse sat staring at me.

We talked it over. I didn’t move. We decided to try the spider rescue trick: cover it with a bowl, slip cardboard underneath, carry it outside.

The mouse and I were motionless still. Son-in-law returned with pan and swooped down. Mouse made for the closet, slipping underneath the door. The closet floor is stuffed with laundry baskets, shoes, yoga stuff and more. I asked son-in-law to bang on the door and assumed my tiny friend had scarpered.

Half an hour later, as I returned from tooth brushing, he sallied across the room and back to the closet. Fifteen minutes after that, he re-emerged running toward me. He stopped eight inches away and stared into my eyes.

“You cannot be here,” I told him. He sat listening. “You have to go away, back out to your field.” He didn’t move.

My daughter, who had clearly just woken up, opened the door. The mouse retreated to the portable heater, where he sat in plain view, convinced we could no longer see him.

I gathered my quilt and my pillow and carried them to the living room where I cocooned myself on the suede sofa. I slept like a log and woke up stiff as one.

I was changed of course.

And so good morrow to our waking souls
That watch not one another out of fear (John Donne)

 

 

Winter Solstice

Winter solstice occurs this year on Friday, December 21 at 11:12 UTC around 4:15 p.m. here on the west coast.

This poem was written nearly 20 years ago, when I was living in an apartment on Venice Beach. I brought a copy with me on this trip and it feels applicable now as we approach the longest night, a time when physical light has reached its lowest ebb and now will begin to grow again, a time when inner light is at the full and can be accessed.

images

Winter Solstice

Such deep dark
so long sustained
should smell of balsam,
cedar, pine,
should have a canopy of icy stars,
of Northern lights,
shifting panes of white or green.

-A child under a buffalo robe
watching a sleigh runner
cut through blue
moon-shadowed snow
sees a rabbit track running off
into deep woods.-

Waking in the depth
of this longest night,
thirsty for sleep,I hear
the pounding surf,
an angry wordless shout
one floor below
and the reverberating slam
of a dumpster lid.
The sky at least is quiet:
a star hangs
above the flight path.

In my long sleep,
I have been following
that track back
into the woods
breathing sprue pitch
and resined pine,
lashed by boughs of evergreen,
until I have arrived at this
secret place
which only wild things know,
a place to shelter
while things end,
time unwinds,
the circle turns.

When we awaken,
shouting, homeless,
single and bereft,
we will go forth
into the growing light,
a light
we creatures of the dark
must yet endure.

This is the place,
now is the time
for the birth of the Child
in the cave of the heart.

The First and Second Sleep

In Medieval literature, including Chaucer’s Canterbury Tales, there are references to the time between the first and second sleep, which was the ideal time for study, one book said. I vaguely remember knowing that already, possibly from a long ago summer course. I learned it anew from my morning paper, the National Post, which published excerpts of Dreamland: Adventures in the Strange Science of Sleep this week.

The book’s author David K. Randall recounts how a Virginia Tech history professor noted these references in his reading and how a Bethesda psychiatrist put the question of what this meant to the test. He deprived those in his study of artificial light. Initially, they took the opportunity to sleep deeper and longer than they had before, but eventually, they seemed to catch up on their sleep deficit and a new pattern emerged. They fell asleep shortly after sunset and woke up sometime after midnight, at which time they stayed awake for an hour or so and then fell back into a second sleep. Having escaped the tyranny of artificial light, they had apparently reverted to the medieval sleep pattern.

Okay, I know I’m old, but this is ridiculous. I remember my grandfather sitting up in the middle of the night in his wooden chair with the wide arms. I had been woken up by the smell of the herbal cigarette he was smoking to soothe his farmer’s lungs.

When I was born, we had no electricity in our rural community. In fact electricity did not come to those hills until well after World War II. It was not until then that the people there got out from under the Depression and were able to afford to pay for the lines from the road to their farmhouses. And while I lived in town from the time I was 5, I spent summers back there with my grandparents, so I do recall a way of life that was mostly devoid of artificial light.

I say “mostly” because toward the end of those years, my grandmother managed to buy an Alladin lamp. Not the kind that you rub for three wishes, but a tall kerosene lamp with  a brighter light, which may have had something to do with the mantle. This particular lamp could also be hung on a wall bracket where it gave us kids enough light to see our playing cards half way across the kitchen. My grandmother sat nearer it to sew or knit and my grandfather sat in his grandpa chair at the gloomier end of the kitchen. The old, little oil lamp was still carried upstairs when we children went up to bed but the puddle of light it shed went back downstairs with Nanny.

I remember sitting on the porch in the evening watching the light fade in the east, my young aunt and uncles climbing onto the porch swing beside their father. The sun was going down behind the house, sinking below steep Hereford Hill. As the sky faded into an improbable turquoise in front of us, a single silver star gradually appeared over the Mount Monadnock. My grandfather broke the silence that had fallen on us five children.

“That will be Venus,” he said.

The evening star! And we children whispered to ourselves, “Star light, star bright/ the first star I see tonight/ I wish I may I wish I might/ Have the wish I wish tonight.” And then we refused to tell our wish for fear it would not come true.

I don’t remember what I wished, but it may well have been just to go on living in such blissful peace.

As darkness fell, a soft cloud of light bloomed softly from the town across the border in Vermont where there was electricity. Then one by one, the other stars popped out until the dome above us was full of them. We stood on the gravel drive gazing up at them, turning with our arms out for balance and nearly falling over, until Nanny called us in.

Once in a while, we found it necessary to journey to the outhouse before bed, a journey which could be undertaken only in pairs. There were no flashlights. It wasn’t worth lighting a lantern. I remember stepping down off the flat stone that served as a porch step and turning into a darkness as thick as black velvet.

“Stand still for a minute,” Nanny called before she shut the door against the bugs. “You’ll get your eyes back.”

I would have been glad just to get my breath back. Our voices seemed suddenly small. The darkness immeasurably large and strangely silent.

Were there wolves?

I have experienced such darkness as an adult at Peppermint Creek camp grounds above the Kern River in the Sierras. We always avoided the “serviced” camping area, pitching our tents next to the creek itself. Under the huge trees, there was no light pollution. The stars were numberless. It was possible to believe as I have heard that there are as many stars in the sky as there are grains of sand on all the beaches on earth.

Talking about the medieval two sleeps, a number of us have decided that we can take a new attitude to the tendency of age to wake up in the middle of the night. We can do what they did in the Middle Ages and value it as time well found.

http://fullcomment.nationalpost.com/2012/09/17/book-excerpt-how-the-lightbulb-transformed-the-

http://fullcomment.nationalpost.com/2012/09/17/book-excerpt-how-litttle-we-know-about-sleep-is-sciences-dirty-little-secret/