You can’t run from trouble…

Posted: May 20, 2012 | Author: | Filed under: literature | Tags: , , , , , , , , , , , | 22 Comments

It’s a quiet Sunday morning, and I’m alone with my thoughts. I’m up earlier than I might have chosen, thanks to one hungry little piggy. After a Friday night of interrupted sleep and a Saturday full of tennis, errands, swimming laps and a late dinner with a favorite cousin, I may well have stayed in bed a while. However, savoring a slumbering house amidst hte sunlight pouring in through the trees and hearing the sweet sound of birdsong while sipping a cup of strong coffee is better than sleeping in.

Plus it gives me time to read my book, Shantaram, which I’ve been dying to dive into but haven’t found the time. It’s been likened to Cutting for Stone, one of my all-time most favorite books ever. If it’s half as good as CFS, I’ll be one happy reader.

Quick synopsis of Shantaram: Mr Lindsay, our protagonist, has escaped from an Australian prison and fled to Bombay. There he meets Prabaker, a native of the slums who renames Lindsay “Lin” and becomes his always-smiling, eternally joyful guide to the big city. Lin falls for Karla, a mysterious woman with sea-green eyes, and pursues her amidst the backdrop of a lively bar called Leopold’s. Lin is “a magnet for trouble, a soldier of fortune, and a picaresque hero” who delves into the black-market world of false documents. I’m not very far into the 944 pages of adventure, but am intrigued.

As I settled in to read this fine morning, I came across an especially well-written passage, which brought me up short. Lin is talking to his new friend Didier in the bar about some of the more unsavory patrons among them. In an effort to avoid being overheard by the bad guys, Didier was “speaking out of the corner of his mouth, like a prisoner under the eyes of the wardens.”

A nice metaphor, for sure, but it gets better:

“In Australian prisons, that whispering technique is known as side-valving. The expression spoke itself clearly in my mind and, together with Didier’s mannerism, the words put me back in a prison cell. I could smell the cheap disinfectant, hear the metal hiss of the keys, and feel the sweating stone under my fingertips. Flashbacks are common to ex-prisoners, cops, soldiers, ambulance drivers, fire fighters, and others who see and experience trauma. Sometimes the flashback is so sudden, and so inappropriate to the surrounding circumstance, that the only sane reaction is foolish, uncontrollable laughter.”

I had a flashback myself last week, and while it didn’t lead me to foolish, uncontrollable laughter, it almost set off a full-blown PTSD attack. I was rushing out the door to get one kid to school and head to the gym, my usual weekday routine. I’m a stickler for taking my own cup to the gym instead of using the styrofoam ones provided. As if our bulging landfills need another cup tossed on the heap. In my haste to get out the door, I grabbed a straw for my cup and scooted out into the garage and into the car. It wasn’t until I was into my workout and gulping water like a crazy person that I realized the new batch of straws I’d bought were bendy straws.

Big deal, right? Bendy straws can be useful, especially if one is reclining while drinking. Or if, say, one is hospitalized for countless days after a post-mastectomy infection. Yessiree, folks, a simple, innocent bendy straw sent me straight from my normal routine of a morning workout directly to the days of being captive in a hospital bed, held hostage by a nasty mycobacterium. Just as Lin was instantly transported from a bar in Bombay to the hated Australian prison cell, I was back in the hospital bed, raging with fever and sick, sick, sick while a nasty bug set up shop under my newly implanted tissue expander. A one-way ticket to Crazy Town in hand, I took the express train down (bad) memory lane.

I wasn’t even thinking about infections, hospitals, antibiotics, or breast cancer when the flashback struck, but I suppose that’s the nature of flashbacks. Triggered by sights, smells, or sounds or, in my case, straws, flashbacks take over and not only interrupt our present business but also disrupt the rest of the day with their nasty after-effects. Interesting how bad memories are just as powerful as good ones. Unlike the good memories, which fill us with warmth and comfort, bad memories suffuse our souls with fear, anxiety, and panic.

The bendy straw that triggered this particular flashback went straight into the trash, and I tried my best to go about my day like a normal person. Finish the workout, chit-chat with my fellow gym rats, reserve a tennis court on the way out, get in the car, drive to the grocery store, fill my cart, unload the loot, take a shower, pick up kids, supervise homework, prepare dinner, clean the kitchen. From the outside, I looked like a normal person doing everyday tasks, but inside I was anything but normal and was once again a cancer patient, fighting my way through uncertainty, confusion, and balls-out fear. In that moment, cancer made me its bitch, and there wasn’t a single thing I could do about it. The only thing keeping me from a total meltdown was knowing that this flashback would pass, that the terror brought on by a simple bendy straw was fleeting.

But as I talked myself off the ledge with soothing reminders that this too shall pass, I know just as certainly that while the terror will pass, it will also return. Again and again, this flashback will haunt me. Perhaps each time it becomes less rapacious, less capable of felling me in one swift motion, but it will return.

“You can’t run away from trouble.  There ain’t no place that far.” ~Uncle Remus

The Tennis Partner

Posted: March 11, 2011 | Author: | Filed under: breast cancer, literature | Tags: , , , , , , , , , , , , , , , | 9 Comments

After reading Cutting For Stone, I was hungry for more from author Abraham Verghese. Wow, was this a great book. Like some of my other all-time favorite reads, it took me a while to get into this one, but once I did, I was so well rewarded. I felt a little bereft when it ended, another sign of a great book. The characters were so richly drawn, they truly seemed like real people, and I was sad to think I wouldn’t know what happened to them for the rest of their “lives.”

I’m not crazy; this happens with good books, and I’ve heard other people say the same thing so I know I’m not crazy. At least not in this case.

I searched in vain for more books by Abraham Verghese and although he’s written prolifically for such esteemed magazines as The New Yorker and The Atlantic Monthly, he doesn’t have dozens of novels at the ready for voracious readers. He has written a book called The Tennis Partner, however, which I quickly scooped up on amazon.com. 

Verghese is an infectious disease doctor and has been a professor of medicine at Harvard and Stanford, in addition to being a bestselling author. The Tennis Partner tells the story of Verghese’s friendship in El Paso, TX, with David, a medical student who is a recovering drug addict. Their friendship grows amid a shared love for tennis, and they both find the game to be “an island of order in the midst of personal chaos;” in Verghese’s case, his crumbling marriage, and in David’s case, his drug addiction.

One of the things I love so much about Verghese’s writing is his innate ability to describe a scene in such a way that makes it familiar and easy to visualize. For instance, when writing about moving to El Paso, Verghese says “This is the great promise of moving: that if you fold your life into a U-Haul truck and put it on the road, you will be given a clean plate with which to approach the buffet.”

Beautiful prose. Simple and clean, yet so on-the-money descriptive.

It’s a great story, not just because of the tennis. Both men were struggling with different things in their lives, yet tennis became the equalizer. Verghese says, “In the way we controlled the movement of a yellow ball in space, we were imposing order on a world that was fickle and capricious. Each ball that we put into play, for as long as it went back and forth between us, felt like a charm to be added to a necklace full of spells, talismans, and fetishes, which one day add up to an Aaron’s rod, an Aladdin’s lamp, a magic carpet. Each time we played, this feeling of restoring order, of mastery, was awakened.”

I get that. Wow, do I get that. One of the reasons I wanted to get back to playing tennis as soon as I could post-mastectomy was to impose order on a disorderly life. And guess what? 9 days post-reconstruction, I already can’t wait to get out on the court and put this mess in order.

One line in the book has really stuck with me, and I carry it with me in my game. David and Abraham are battling it out on the court, David being the more experienced and younger (read: more spry, less creaky, and speedier) player. He always manages to best Abraham, and after yet another victory explained his winning strategy. It’s very simple. “Remember, the one with the fewest errors wins.”

True, so true, and not just in tennis.

I love tennis, and I’m fascinated by how the human body works. I’ve written about this before, and now that my latest surgery is in the rear-view window, I’m again impressed with and amazed by how our bodies react and heal.

I’m also fascinated by doctors. Surgeons, especially. Not in the “reverence for the white coat” aspect of previous generations, nor because of the fact that they perform a very difficult job. There are lots of hard jobs out there, and I’m sure there are plenty of things other professions require that docs wouldn’t handle well.

It’s more a fascination with what makes them tick and how their minds work. I always want to ask my specialists, why did you choose oncology? why did you choose plastic surgery? I’m overly curious (some would say nosey) about the minutia of their jobs: how many patients call them after-hours? how long does it take to repay med school loans? what do you do to unwind and feel like a regular person? I mean, after say, a 7-hour surgery in which they restore order to a hellacious mess of a chest wall, do they wash up, drive home in traffic, pop a beer and veg out? Or do they refrain from drinking, even after a long day, because they can be called into surgery at any moment?

Verghese writes quite eloquently about the physician as a regular person and of medical humanism. He’s an old-fashioned doctor in a modern world, and he teaches new-fangled doctors his ritualistic bedside observations. He believes medicine is a passionate and romantic pursuit, not just a science.

Kinda reminds me of my own infectious disease doc telling me that in my case, because of the post-surgery infection, he was practicing the art more than the science of medicine.  A lovely thought after months of exams, tests, and hospitalizations that had left me feeling like a piece of meat. Not Grade A meat, either.

As I prepared for my most recent surgery, I remembered a lengthy but compelling passage from The Tennis Partner. Even though my pre-surgery to-do list was a mile long, I found myself flipping through the book to find this passage. I wanted to re-read it, as if absorbing these words into my brain would somehow transfer into the surgeons’ hands as they cut me open and tried to repair the damage that had been done. It took a few minutes, but I found it.

Verghese was treating a young woman in El Paso with mysterious symptoms and no clear diagnosis. He writes about how as he entered her hospital room,  he was looking for more than just physical manifestations of an illness:

“I was attentive to the aura of the room, vigilant for her icons — a doll, rabbit-ear slippers, a prayer card, her own nightgown. I inhaled discreetly so that her scents, all the eructations and effluvia that were hers, the redolence that night spell the name of the disease lurking below, could land on the free nerve endings of my olfactory nerve. Smells registered in a primitive part of the brain, the ancient limbic system. I liked to think that from there they echoed and led me to think “typhoid” or “rheumatic fever” without ever being able to explain why. If the diagnosis eluded us in the first few days, her chart would thicken as pages of computer printouts bearing witness to the blood urea, the serum creatinine, the liver enzymes, and other soundings accumulated. But no computer could make the mind-pictures I could form if given the right clues: a liver hobnailed by cirrhosis; a spleen swollen like a giant and angry thumb from mononucleosis; a smooth-walled cavity in the lung apex within which a fungus ball clatters like a bead in a baby’s rattle.”

I love the “eructations and effluvia” especially. That’s some good alliteration.

I also really identify with the patient, and know that I too have a chart that has thickened with computer print-outs and such. Not that it’s a contest, but I bet my chart is thicker than hers.