The sharp end of the knife

As a surgeon, it is a difficult position to be a patient. Perhaps this is why there are so many comments about doctors and nurses being 'bad' patients. We know too much.  Enough to be scared. We know about risks.  After all, we talk about them everytime we consent a patient for surgery. We review complications and deaths with our colleagues in the attempt to improve care for future patients. And perhaps some of us went into medicine in the hopes of cheating death. But, everyone of us is human and subject to illness and death just like every other living being on the planet.

Years ago, I had my first surgery and recently a second, though I am soon to have another more major surgery than either of the previous two. Each time, I have known that there was really no other reasonable choice. The day before my first surgery, I was talking to two colleagues. I commented that, up to that point, I had maintained a 'double standard' about surgery. One of my colleagues, looked stunned. He was Black and thought I was referring to race. I explained that it had nothing to do with race. I tried to treat all patients the best I could, but rather it had to do with the fact that I had done surgery on thousands of patients but no one had ever done surgery on me. I felt scared. I really didn't like the thought of being on "the sharp end of the knife." Or at least, I didn't feel comfortable as a patient, I didn't know how to feel, while I had become quite used to being a surgeon. His expression changed and he said that he certainly could understand that. That surgery went very well. I was home the same day and back to exercising within the week.

My second surgery didn't go as smoothly as anticipated. Hospital stay and pain were both far more than I had anticipated. But it was still necessary and has helped to heal me.

Since my recent hospitalizations, I have seen several of the people who took care of me. All have commented that I seem to be doing well. Again, during the hospitalizations, I had some times that I was scared. While in the emergency room, I was placed in a private room. I'm sure it was done to give me some privacy since I was a staff member. But it was scary for me to be alone. I was in pain and my blood pressure was quite low. I had yet to have any significant treatment. I thought they would just leave me there alone as things got worse. I thought that I might die. I worried about my children, still far too young to be on their own. I called for help, more than I truly needed it, but I didn't want to be alone. I was happy when friends and colleagues came by to visit.

Being a patient, or the family member of a patient, is certainly important for medical professionals. It can teach us a huge amount about how the patient feels and how the family feels. It can teach us how to be more compassionate as caregivers. It can help make our care better for future patients. But, the process is far from enjoyable.

AANS Neurosurgeon – Interview with Dr. Sarah Woodrow

Here is a recent interview I did with Dr. Sarah Woodrow who worked in Ethiopia, helping to train neurosurgeons there.

AANS Neurosurgeon – Interview with Dr. Sarah Woodrow

A brush with mortality

Seventy one years ago, my grandmother had appendicitis. She was one year older than I now am. Her presentation was not typical, leading to initial misdiagnosis and thus delay in treatment. Her appendix ruptured. She developed peritonitis and died. 

While I never met her, I feel close to her from the stories I heard about her and the photos I have of her. I recall meeting her youngest sister when I was nineteen. She had not seen my grandmother since she left Poland for America in her late teens. My great aunt insisted on calling me by my grandmother's name, which is my middle name, because I looked so much like her, though she said it looked like I had been dunked in bleach since I am a bit fairer than she was. She also commented on similar mannerisms and speech patterns, though I knew little Polish at the time and my grandmother knew no English when she left Poland. Others, too, have commented on the similarity, mistaking a photo of my grandmother and mother for my mother and me. 

Perhaps this connection has led me to trying to learn more about my family's past. So, in a sense, my grandmother has led me to researching and writing histories of relatives who were not able to tell their own stories. And that has lead to this blog.

A few weeks ago, I almost followed my grandmother. I had appendicitis though thought I simply had the flu. Unfortunately, my appendix also ruptured. But, fortunately for me, antibiotics are now available to treat the resultant infection, so now I am home recovering. While I was in the hospital sick with the infection, I thought of my grandmother who died of the same disease. A friend who didn't know my grandmother's story, but who also is exploring her family's past, commented that if I  had this happen to me during WWII, I likely would have died. My grandmother did die during WWII, not in Europe or Siberia, but in Ohio. I thought, too, about the 19 year old sister of one of my teachers, who also died of appendicitis during that time, at a Japanese internment camp in Wyoming.

I am indeed lucky. I have never experienced such hardships as so many others have. Instead, I have lived my life in freedom. And, when I got appendicitis, I was treated with antibiotics and am now recovering. But, I can't forget the sufferings and stories of those who were not so lucky.

Going home

Here's a piece I wrote recently about the last night in Central Asia for my children who were adopted from Kyrgyzstan about 5 1/2 years ago.



It was the night before we were to leave, to return to my home, and soon to be their home. They were now my children. I was now a mother, something I had hoped for, for years, but could only achieve through adoption. Only a few hours left in the Almaty hotel before we took a taxi to the airport. Everything was packed and already checked at the desk. I wished that I had more time to explore Kyrgyzstan and Kazakhstan.

In the few days that I had been a mother, I had learned so much. I never knew children could eat so much. They were like hummingbirds who eat three times their weight in food each day. We had snacks of dried fruit and crackers and cereal and bottles of juice. We were sitting in a empty room, just waiting the last few hours before we had to leave to catch the plane. We ordered meals from room service, succulent and flavorful lamb kebabs, and pilaf, pronounced plov, fragrant with saffron and nuts, mild yet flavorful roasted chicken and french fries, the hotel's version of food for children, and milk, their last before the plane. Each of them was so tiny at barely third percentile, at the tender ages of two and four, smaller than American children of eighteen months and three years. Yet, they could out eat most adults.  I had no idea then how much growth that food was to fuel. Katie grew an inch a month for a year, Maxim half an inch a month for a year.

Both the children and I had had a busy day. Getting their visas to return with me to California. Having all the papers checked at the consulate. And then a last bit of sightseeing in Almaty. I wish I had more time. Perhaps my grandmother and uncle came this way as they made their way from Siberia to Persia, after they had been freed. I wish I knew more, but they rarely spoke of that time. The region seemed so interesting to me, not just because my children were born here.  The children seemed to connect me to my family's past. At the time, I did not expect that their questions would make me want to explore the darker history of the region as well as the joy that it has brought me.

Like small birds, the children flitted about while they were awake and still had energy. No wonder they ate so much. After dinner, Maxim curled up beside me to sleep. He wanted to be close enough to touch, perhaps because he wanted to feel the warmth and and hear the pulse of another next to him, something he had not known for four years, since the womb. I sensed that he wanted to bond, yet feared the unknown that he was to face. He still seeks contact, though now he doesn't want his friends to see that his mother still kisses him on the forehead every day.  That night, his small body cuddled beside me was helping me to bond as well.

Katie stayed awake a bit longer. She ran repeatedly across the room away from me, then turned and with her arms thrown back like wings and then,on reaching me, embraced me as she giggled. I realized that I was entrusted with a tiny angel whose laughter was reminiscent of tiny bells. This was the child who had only taken her first steps three months earlier, who I had never seen smile before, who I was worried about being able to bond. The child the adoption doctor recommended against due to her prematurity and delay.  Yet she had clearly made the decision to bond.  And she is no longer delayed.  She was simply waiting to be loved.  Finally that night, she, too, succumbed to fatigue a slept a few hours before we were awakened to leave for the airport.

They were leaving the only home they had ever known to spend their lives with me. I was returning home from the lands of my ancestors' exile and my children's birth, a new mother of two. It would be a great adventure for all of us. The calm sound of their breathing beside me comforted me, as my touch now seemed to comfort them.

Independence Day and Waging Peace                       

Driving home late Wednesday evening, we say the aerial displays of several community fireworks displays.  I thought about how beautiful the explosions in the sky were to behold.  I also thought of the words of the Star Spangled Banner with its "bombs bursting in air" and "rockets red glare,"  which were simulated by the fireworks. 

I was one of three native-born Americans at the Independence Day gathering of family in California.  Two were born in Kyrgyzstan and became naturalized Americans through adoption.  Three were sisters who had been born in Canada.  They were ethnically Polish and had been married to Polish men, all of whom have since died.  I knew the stories of two of the men, one of whom was my uncle, since his mother later married my widowed grandfather.  They had experienced some of the worst evils of the world.

My uncle was 11 when he was taken prisoner with his family by the Soviets for the crime of being a Pole.  He later was an underage soldier who fought at Monte Casino under General Anders.  His younger brother died in Siberia "because he was too young to live" through their time in Siberia.  His father also died.  His mother survived, but barely.  One other person survived from their town which was large enough to have scheduled railway service.  Even at his funeral, a gap was left for the years 1939-1948 since he spoke so little about that time.

The husband of a second sister was liberated from a concentration camp in Germany.  He had barely avoided being sent to an extermination camp.  His mother died in Auschwitz.  All for the crime of being Polish.  Yet he told his wife and son of his experiences so they could remember.

We had traditional American food--chicken, hot dogs, potato salad, chips.  We are all now Americans.  Independence Day reminds us of the freedom we have.  But, talking about family reminds us that those freedoms are far from universal.  Yet, I believe that all people have similar hopes for their lives and their families.  We all want to be able to provide a decent life for our families.  We want a say in our government so that government acts in the interest of its people.  We want to live in peace.  Which brings me to the second part of this post.

Over the weekend, I listened to a talk about how to make peace in the world.  Clearly, humanity has fought enough "war[s] to end all war" as WWI was described.  Yet fighting wars has not accomplished the goal of ending war.  Wars continue with greater destruction, especially of civilian populations.  Such behavior brings to mind the statement by Albert Einstein that insanity is "doing the same thing over and over again and expecting different results.”  But, war is insane.  Albert Einstein realized that and preached peace. 

Most species try not to fight each other to the death, but rather only to the point of establishing dominance.  They want their own species to survive.  But humanity has nearly brought itself to the brink of destruction. First, through the arms race during the Cold War, when various computer glitches or weather balloons or the like led each side to think at one time or another that they were under attack by the other.   Thankfully, calm reactions prevailed and no counterattack was launched.  Second, through large scale environmental degradation leading to global warming, which might cause the extinction not only of our own species, but countless others.  And in the past decade there has again been consideration of the use of nuclear weapons.  But like the "war to end all war" was not successful in ending war, building weapons to discourage others from doing the same is counter-productive.

So, what is there to do?  That's where the discussion of "waging peace" comes in.  Waging peace is emphasizing helping others rather than dominating them.  It is non-violence, particularly non-violent resistance.  I have heard it said that non-violence cannot accomplish much except against a civilized country such as Britain, using the example of Gandhi.  Or, the United States, using the example of Martin Luther King.  But, many civil rights workers had their lives ended much too soon, as did many of the Black Americans they worked to help.  Similarly, the role of non-violence, led by Nelson Mandela and Desmond Tutu, in bringing down the apartheid government of South Africa is touted.  Again, many gave their lives in the pursuit of equality.  Many were jailed.  But, finally, they succeeded in ending apartheid.  Non-violence has also brought down other repressive regimes such as communism in Eastern Europe and the former Soviet Union.  Activists such as Lech Wałęsa were jailed, though finally saw victory.  Unfortunately, many others who struggled for freedom never lived to see it.  So, non-violence can also work against suppressive and violent regimes.  (It has been estimated that as many as 200 million people died at the hands of communist governments or because of their policies.)

Like in waging war, people must be willing to lay down their lives to wage peace.  History shows us that many have.  But, at least there is the hope that things can change for the better.  Fighting innumerable wars has certainly not brought an end to war.  As Coleman McCarthy said “Warmaking doesn't stop warmaking. If it did, our problems would have stopped millennia ago.” But, non-violence has certainly had some impressive achievements in the past century. I don't know if it is possible to end war, but it is certainly a goal worth trying to achieve.  There may be some despots who can only be brought down through violence.  But, overall, it seems violence begets violence.  And the cycle continues.  So, I feel that we must begin to wage peace.

Early July                                                                               

This week has been a busy one with work--a new batch of residents and recently saying goodbye to the old, Independence Day and a birthday.  Every year, these events all come together.  Unfortunately, writing must be put on hold.  So here are some photos of the flowers I got from my kids with a few more from the garden.  And I have added a short piece that I recently wrote for a writing class.  Unfortunately, my garden is not as productive nor as exuberant in its floral display as my mother's.

The house I grew up in smelled of flowers in the summer, freshly picked from my mother’s garden.  Poppies, roses, iris and lilacs were among her favorites.   We had hundreds of lilacs of every shade, singles and doubles.  Also hundreds of poppies and iris.  She loved the darker shades of both.  Her garden was one of her joys.  But it wasn’t just flowers for their beauty and fragrance.   

As much as she could, she would work in the garden, raising fruit trees of all varieties, vegetables from carrots to zucchini, and melons and strawberries.  Summer was a joy as we worked in the dirt to bring forth the produce.  And then, relax under a tree with a fresh picked piece of fruit, or simply lie on the grass and watch the clouds through the green veil of leaves and branches which swayed in the wind.  Even as a child, I remember feeling that the backyard was a piece of heaven, fenced from the world by lilacs and roses.

In the fall, as the wind turned cool and the leaves from the trees fell to the ground, we would sweep them up to compost to feed the flowers and fruits and vegetables in the year to come.  And sometimes the house would begin to smell of wood pruned from those trees which we burned in the fireplace as the nights grew cooler.  In the fall, too, my attention turned to my studies.  The house was full of books, nearly every wall was covered in bookcases.  And the books added their aroma to the mix of fragrances in the house.  Both my parents had read many of these books, and as a child, I began to add to the collection of books in the house.  

Winter smelled of homemade soups, junipers or pine or spruce and wet wool after coming in from the snow.  My mother regularly made barley, lentil or pea soup which was so filling on a cold day.  She often would prune branches of the evergreens for their beauty and fragrance which we would add to the fire sometimes in the evening.  And the smell of the smoke would mingle with the smell of chocolate or cider and cinnamon in the evenings when there was time to relax.

As the weather became warmer, crocuses would begin to pop up through the snow and then tulips and daffodils, which would find their way to grace jars and pitchers in the kitchen and living room with their beauty.  Spring was often rainy and the smell of the rains permeated the air to mix with the delicate scent of the spring flowers.

 

The fragrances of flowers or evergreens or homemade soups still take me back to the comfort and security of my childhood.  I recall it as a simpler time, a time I often long for, but to which I can never return.  The house has been changed, remodeled so that it is not the same.  The yard subdivided.  A few of the trees and lilacs remain, though it is far from the same.

Thoughts on Gardening                                                                    

This morning, like last weekend, I spent much of my time gardening.  Unfortunately, the effort has been somewhat sporadic this year since I was busy with other things when I should have been planting.  But, it looks like the plants are doing well for the most part.

Today, we had a harvest of young radishes.  Our first for the season.  The kids began to understand the effort as they tasted the first results. To come are tomatoes, peppers, peas, carrots, eggplants, cucumbers, summer squash, melons, a variety of greens and a plethora of herbs.  I do most of my gardening in either raised beds with landscape cloth under them or pots since the gophers have taken over my yard, and I can't seem to get rid of them, though I won't poison them.  The poison would be in the soil.  Instead, I would like the owl and the hawks to handle the problem.  Once I was working in the garden, dividing iris, when I heard a thump a few feet away.  I turned to see one of the hawks who live here flying off with a gopher.  I was happy that he was so comfortable with me that he flew in so close.

Relaxing after the work is done under an umbrella with a glass of iced tea and taking in the scents, hearing the birds and seeing the butterflies and dragonflies takes me back to a simpler time.  It reminds me of my mother's garden.  I was a child then, and like my children today, was more concerned with playing than with working.  But I do remember the harvests from the garden.  The strawberries, the cucumbers, the tomatoes, the corn.  Everything seemed so much more intensely flavored then.  And it still does, fresh from the garden.  And I can control the use of chemicals on my food, by not using them.  Instead, I have learned about companion planting, using other plants to confuse pests.  I think we did that in the old days too, though I was much less aware of it then.  My mother rarely used any pesticides either.

Gardening also reminds me of the time we visited relatives in Poland.  Several relatives had small farms yet worked in factories during the week.  So we helped on the farm while staying with them.  It was the peak of summer and time to harvest the wheat.  The nearby collective farm where one of the cousins lived had a combine, but for the small private farms of about 2 hectares (a bit less than 5 acres), it was not possible to own or even rent a combine for the harvest.  So the harvesting of wheat was done with scythes.  I remember spending a few evenings swinging the scythe to help with the harvest.  It was certainly heavy work but it made for a good sleep. 

And that brings me to the picture above.  The scene reminds me of my time harvesting wheat with a scythe.  The painting is by Pieter Bruegel, a Flemish painter who lived 1525-1569.  Unlike then, when only men would swing the scythe, I did as a teen. My visit to the family in Poland took me back to that time.  It showed me how little had changed for a peasant farmer.

But even the gathering and bundling of the wheat, usually done by women, was heavy work.  In fact, I liked swinging the scythe better because I was upright, rather than bent over picking up the wheat.  That seemed to me to be the harder work.

Jean-Francois Millet composed "The Gleaners" to depict the lowest rung of rural society, those who picked up what was left after the harvest.  In the original, the woman at the lower right was in the painting, working along with the other two.  The photo at left is from the Muzeum Narodowe W Krakowie, the People's Museum of Krakow.  It was posted on Facebook this week and is certainly an interesting take on Millet's classic work.  Even the gleaner needs to take a break.  Unfortunately, for many of the poor who had to glean what was left over, life was very hard with few breaks. 

Earlier in the week, I heard an interview with Raj Patel, author of Stuffed and Starved: The Hidden Battle for the World Food System (http://www.amazon.com/Stuffed-Starved-Hidden-Battle-ebook/dp/B004CFAWBQ/ref=tmm_kin_title_0).  He discussed how small farmers are literally being driven to suicide and millions are starving while 1 billion are overweight.  The mal-distribution of food is not a thing of the past, but of the present.  Global agribusiness is helping to create this imbalance.  I have yet to read the book but it is certainly on my list.

So, I'm back full circle.  To the need for small scale farming with local distribution and home gardens, not just for healthier food, but for a healthier world.