Monte Cassino

Today is the 70th anniversary of the Battle of Monte Cassino. The Polish Forces under General Władysław  Anders finally succeeded in taking the mountain topped by a monastery. One thousand fifty two Polish soldiers died in the battle.

 

My mother's step brother fought in that battle. He was not yet 16. He had been taken from his home together with his family in 1940 by the Soviets. His grandparents were simply killed. They were dropped off in a frozen forest. They asked, "Where do we live?" only to be told, "There are trees, you can build houses." They had brought no tools to cut down the trees.

They asked, "What do we eat?" The answer was similar, "There are rabbits." Yet somehow a few survived. His brother, who was 3 when he was taken, was "too young to live." His father also died before making it to freedom.

Yet my uncle and his mother, who married my widowed grandfather, did. And my uncle then joined the General Anders army, even though he was under aged. He stayed in the British army after the war and was in one of the last units to leave Palestine before it became Israel. He later was sent to Korea. Meanwhile his mother came to the US via Mexico.  He then left the British army to join the American army, spending additional time in Korea, and then going on to teach at the Monterey language school.

Still a young man, he used his GI bill benefits to complete his education and became an electrical engineer.

He and my mother were close until her untimely death. She always loved poppies. We had hundreds in our yard.

Slavery today, here in the US

As a physician, I can't even count all the times that I saw an injured worker who came in with two or more employer representatives. Most of the time, I am sure this is simply out of concern, but sometimes it may not be innocuous. Sometimes that injured worker is held as a slave and the others with him are there to make sure he doesn't tell anyone of the conditions he works under. This is a new realization for me.

Not long ago, I read the book, "The Slave Next Door," by Kevin Bales and Ron Soodalter, and began to realize that sometimes things aren't so innocuous, even here in the US. I had heard about the sex trafficking of minors, garment sweatshops in LA and tomato growers in Florida, but never thought that a slave might be sitting in front of me. I now have gained awareness of this situation, but still don't know how to approach such a patient. 

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Clearly, one can't ask in front of the employers. One must make up a pretext for privacy and have a hospital employed interpreter if necessary. The employer supplied interpreter may be yet another guard. The reason for privacy could be the need to do a pelvic (for appropriate specialties) or rectal examination.  Then, I have sometimes asked, as I do when I suspect a battered wife, "Are you safe? Are you OK? Anything you want to tell me? Anything else you want me to help you with?" but have not yet gotten a response of someone asking for help in such a situation. (I have had battered women and teens tell me they need help.)

Yet, I know that one must be aware of a pathology before one can identify it, whether it is a disease of the body or of the culture. I can see my awareness growing, in that I now suspect it, even when simply reading the medical records where it is stated that "two employers and the employer's interpreter" came with the patient. It also gives me the greatest reason to need a hospital or clinic employed interpreter, or phone service.

It is necessary for physicians to become aware of the problem so that there is a chance of recognizing and addressing it.

Mother's Day

My mother was a very generous woman. I remember that she was always helping others. When I was small, she was very involved in resettlement of Displaced Persons. Today, I wrote up a memory. I don't remember the name of the other woman, nor all the details, so just made her a composite of several that I remember.

 

 

 

The Changing Room

 

It was a cold, dreary day when we picked up Mrs. Nowak. She was dressed in the only dress I had seen her wearing, a threadbare, pale green and tan plaid shirtwaist dress with long sleeves which hung loosely on her frame. I hadn’t seen her in any other dress since she arrived in Colorado during the summer. My mother greeted her in Polish. She greeted me in broken English. She wanted up to make us breakfast, but my mother insisted we should get going since we had a drive ahead of us. “We’ll eat when we get there.”

She relented and took out her coat. It, too, was threadbare, once red, now faded unevenly, with a black collar. It, like her dress, was probably worn when she got it second hand.

Her daughter was off at school and her husband at work or maybe sleeping since he worked two jobs. She usually worked nearly every day as well. But today was her day off. My mother wanted to take Mrs. Nowak to buy her some clothes, she knew Mrs. Nowak was proud and wouldn’t easily accept charity.

As we drove, my mother and Mrs. Nowak chatted. I wished I could understand, but could only catch a word here and there since I hardly knew any Polish. I mostly just watched the snow. Sometimes a big, fluffy flake would stick to the window in a way that I could see its’ structure, before merging with the others. I loved the trip to the big department stores in Denver. They had so much more than the stores in Boulder, which was still a small town then. Fancy clothes and toys, and this time of year, fantastical Christmas displays, often with moving parts, not just mannequins dressed in the clothes of the season. I was hoping for a new party dress in velvet, maybe dark blue this year. Even then I loved dark colors and jewel tones.

Finally we got to the department store parking lot and picked a spot as close as possible due to the weather. I wanted to go in the front door to see the displays, rather than the side door by the parking. The women relented. The display seemed so magical, with giant nutcracker’s opening and closing their mouths, and mannequins of children sitting under a giant Christmas tree opening packages, some as big as the children.

But we had not come to see the displays today. Instead we headed inside to the restaurant. Mrs. Nowak ate slowly, taking time with each bite. “I can’t eat fast anymore. I have trouble swallowing, still. It’s from the lye.”

“Take your time.” My mother slowed down her eating and looked at me, expecting me to do the same. “We came for the day.”

After we ate, my mother paid for the food and then we headed for the women’s department. Mrs. Nowak looked admiringly at the dresses, fingering them and walking past. My mother noticed a few that she looked at the longest and picked them out. Mrs. Nowak turned to her and said that she couldn’t afford any of them, but my mother persisted, “What harm can it be to try them on?”

“I guess it couldn’t do any harm.” Mrs. Nowak finally agreed. We went to the changing room, choosing the largest since there were three of us. There, Mrs. Nowak took off her coat, hanging it carefully on a hook. She then took off her dress carefully, leaving only her slip. Then I noticed it. She tried to hide it from me, but could not. There was a number tattooed on her left arm.

 

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.