Moving Right Along

I have NO IDEA what happened here.

It's kind of like the chalk outline at a crime scene, though, isn't it?

Artifacts of Trust

This week, Love Thursday comes on a Friday here at Moving Right Along.  This is because I napped all day yesterday, and then my true love came home from work, we got a month's worth of recycling finally out to the curb in time for today's pickup, and then, when I was about to go off to type this, my true love pointed out the irony of my needing to spend time writing a Love Thursday post about how wonderful he has been to me lately when I could instead be spending time with him.  I had to concede that he was right and that this could wait.

But now let me tell you how wonderful he has been to me lately.  I really need the world to know.

For the control freak that I am, the hardest thing about having a brain tumor was handing my life and fate over to other people.  Completely.

Because my brain tumor was caught when it was, I still had just enough presence of mind to know that I needed to assign someone the legal right to make decisions for me.  My true love and I have cohabited nearly 13 years but are not married, and Massachusetts is not a common law state, so if I didn't fill out documents granting him that right immediately, it would pass to my siblings.

My siblings are good people, but until recently, largely unknown to me and vice versa.  Except for the wedding I attended in September, we really haven't spoken much in the last 20 years, and I didn't know if they would even be available to help me, let alone whether they would know enough about me to make correct decisions.  My true love, of course, knows absolutely everything about me, and his knowledge is not just detailed but up-to-date.

Of course, as every semi-responsible adult should, we already had documents like this from before my last surgery and also from before his.  Having worked for assorted lawyers here and on the west coast for over 18 years, I know the value of such documents, and any time one of us is about to go under general anaesthesia, we make new ones.  We really should do it more frequently, though, and by the way, so should you.  They do expire, and also our needs, philosophies and desires evolve -- which is why these documents expire; it's actually a rather wise law.  People change.  You don't want to be subject at age 50 to the consequences of your 22-year-old self's world views.  Trust me; you really don't.

In my case, even 45 is already so different from 40.  I've learned some stuff, you see.  And I was so sure of what I "knew" at 40!  But I digress.

I used to be married to someone extremely bad for me.  Before him, there was an intermittent stream of many, many men about whom I cared little and who cared little about me.  There were whole years at a time with no one at all.

Now I have my true love, and you'd better believe I don't take him for granted.  He is one of the most amazing gifts of my life.  I am quite sure I don't deserve him.  I also have no idea what he could possibly have done to deserve to be saddled with me.  We only met because I wandered into a bookstore/café one day because I had missed a bus and needed to fill the hour before the next one came.  There he was with his beautiful eyes eating chili and sassing the counter help.  We fell in love in the next six months over sarcasm and cappuccino.

Monday, incidentally, was not just my birthday but also the anniversary of our first real date.  But that's not the only reason why I'm writing about my true love for this particular Love Thursday.  I'm writing about him because his actions exemplify one of the cornerstones of a real, live, not-out-of-a-fairy-tale, true love:  absolute trust fulfilled by absolute trustworthiness.

The thing that is most magnificent about my true love is that I can literally trust him with my life.  I have always known this on some level, but what we just went through together has proven it beyond the shadow of a doubt.

You know those documents I mentioned above, the ones I needed to fill out so he could have the legal power to care for me?  This is the best idea I can give you of what those documents looked like when I signed them.

That document?  That's my Massachusetts Health Care Proxy.  That's the document that gave my true love (and my fabulous sister as an alternate in case something happened to him) not only the right to talk to my doctors about my case, but also ultimately the power to decide whether I lived or died and in what condition.

I also filled out a document called a Durable Power of Attorney. 

This gave my true love the power to sign documents for me, and it was revocable so I could just go back to being in charge of my own life as soon as my faculties returned.

This was very important because there are a lot of documents that need to be signed when you need to have things done for you in hospitals.  Also, I may have been incapacitated for a long time, and who would do my banking and things of that nature?  As you can see from the previous photo, I was not going to be able to read any of them for at least a little while, maybe forever.  I also had memory and comprehension issues, so even if I could have recognized written language or seen out of both eyes at once, a lot of the time I couldn't sustain concentration to the end of a single sentence or remember what had just been said to me within the previous ten minutes.  I couldn't remember people's names, either, people I knew well and people I'd just met.  It was terrifying.

Between diagnosis and surgery, I was on decadron, and it did help reduce my brain swelling enough that I could read and write for about three days before my surgery, and could even remember some of the stuff I'd forgotten.  I still couldn't see out of both eyes at once, and I still couldn't think in a straight line or remember very well from one hour to the next things that were happening each day.  I was completely manic on decadron, so I would be up for 20 hours straight, talking and emoting all over the place.  I was completely unfit to manage the slightest aspect of my own care.  I could toilet myself and feed myself, and when we both got a stomach virus the day after my diagnosis (because things never go wrong one at a time), I knew to throw up in a bucket, but anything more complicated than the strictly immediate and biological was well out of my grasp.

My true love dropped out of this semester at Harvard Extension to take care of me.  He will not be getting his course fees back, and will probably have to repeat the whole year.  He did it before I'd even left the hospital that diagnosed me.

After surgery, as a direct, natural, and expected consequence of surgery, there was swelling in the brain again, so I was again thrown into temporary illiteracy.  There was no guarantee that it would be temporary, and until the swelling went down, we would not know for sure.  So my true love continued to organize my care.  He also wrote hilarious status notes to all my friends and family.  This is what he wrote after my surgery:

Subject:  Post-op news

Like how I'm picking up the hospital lingo? Post-op?  Wait, maybe I learned that watching M*A*S*H, or ER back when Juliana Marguilies' character was still dating George Clooney's.  Speaking of which, anyone seen  Laura Innes' cast picture? Yumm.  In any event, the more I hang out at hospitals the more I am convinced they need me.  I mean, I've already had a semester of undergraduate neurobiology, why not?  Oh, wait, you are probably reading this thinking  you'd hear news about Sara.  <sigh> Fine, but someday I'll have my own friends and they'll be cool.

Sara went in for surgery later than we originally told you.  Apparently they schedule a lot of operations to start at 7AM, but that's just to keep the computer system from suffering under the stress of it's own cognitive dissonance, unable to distinguish between it's program and reality.  But, I digress again.  Sara really went in at 9:30, with the operation itself not starting until around 12:30.

Surgery proper took almost exactly 3 hours.  Sara had a great experience with her anesthesiologist, enough so to make me just a little jealous.  Oh, right.  Sara.  Anyway, according to her neurosurgeon, Sara's tumor came out like a muffin from a teflon pan [my words, not his, but since most on this list are bakers, not surgeons, I'm translating, e-mail me for the power point slides].  The tumor was only a little sticky, and no infiltration into the brain proper.   The small part that stuck to the dura mater (that's the hard outer protective layer for those of you new to brain surgery) he "coagulated" which I believe means "froze like a 10 year old caught with a lighter."   The location and ease of removal makes the good doctor less sure the tomor is actually melanoma, which is probably a good thing and explains why Sara is still alive, and only showed one such mass in her brain. 

L. (the sibling present) was in to see her soon after she was wheeled into recovery.  I got there late, but I'm not going to tell you that story.  Anyway, she was alert, verbal, and verbose.  I could barely see the bandage on her head, but she's got ice packs, oxygen and IV's going.  We chatted for about 5 minutes when she started to fade away.  We said our good nights, and promised to return with her toiletries, toys and anything else she needs tomorrow morning.

More as time allows.

{my true love}
Medical Information Specialist

He wrote this one when I was released from the hospital:

Subject:  The Saturday Evening Brain (Late Edition)

As I thought might happen, Sara has charmed, manipulated and lied her way out of the hospital a day early.  Her charms allowed her to convince the inexperienced, if not naive, young resident at the hospital that there was nothing wrong with her in the first place, she had just gone in to submit her resume, and some how ended up in a hospital gown.  Perhaps if the good surgeon had been so kind as to make a more visible scar, his assistant would not have been so easily fooled, but with such a small incision, anyone might mistake Sara for a visitor.  Well, what's done is done.  Sara has been sprung, and is at home, watching Harry Potter, making scones and trying to convince me that there was nothing with her int he first place also.  A ridiculous argument since I've wanted to have her committed for years.  Her sister L., who is apparently so naive she should have gone to medical school too, brough her home, and is now awaiting a flight home to California, where she will hopefully not be as easily fooled by her mate who seems to have the flu and poison oak, and her dog, which seems to have spread it around the house.

Bon Voyage, L., and Godspeed.

{My True Love}

Many people wrote me good wishes.  I was, of course, unable to read them, but he read me all of them and sent me copies in the expectation that someday I would be able to read them myself and reply to them.  (If I haven't replied to one of yours, please forgive me; I'm quite behind.)  He sent another reassuring note to my friends about my silence:

Subject:  Staples, Magnest and Sara Oh My!

Sara has been home for over a day now, her meds are making her so jittery that a dirty dish has a half life of about 15 minutes before it finds itself scrubbed clean.  The same can be said for Sara, who's done a tremendous job of returning to her normal daily routine, though since she is starting it at 2 AM now, I'm not sure she should be given too much credit.  I mean, we could all do more if we only slept 4 hours a day too!  She blames the drugs, but we know that what's making her hyper are my attempts to subliminally hypnotize Sara into hosting a liberal talk radio show/podcast  with me is what's really making her nervous.

Lastly, Sara would like you to know she's doing well, but her biggest annoyance is her inability to read as well as she used to, so for the time being, don't expect her to read or write very much.  Also, if I sell your names, phone numbers and e-mail addresses to Masserati claiming you are all well heeled e-commerce executives looking for something more exciting to drive, it's not her fault.

And then, finally, when I was almost myself again, there was this one:

Subject:  Sara's Recovery, and my personal liberal rant

Sara has been back home since last Saturday, and things are returning more or less to normal.  The dishes are starting to stack up normally, and she's even gone grocery shopping.  Now, for those who don't know, Sara is a "lister."  That is, she likes to make lists, and share them with people.  By people I mean me, and by sharing I mean she told me everything she was going to buy at some point over the last week.  And I politely nodded and said "sure dear, that's fine", hoping it wasn't all some elaborate trap, that sometime later she wouldn't break out in a fit of anger and hurt becuase I didn't remember some detail which seemed so important to her.

However it never occurred to me the sheer VOLUME of groceries Sara would bring back into the house.  She got D. to take her shopping, and about six hours after they left, she comes back with enough groceries to feed a small Ethiopian village (including pets) for a month packed into D.'s little four door.   I'm sure if D. has suspension problems over the  next month she'll be asking us to pay for them.   I'll just remind her now that Sara's debts are her own.

So, my point to all of this is that Sara really is doing fine, and returning to the routine she wanted to have for months with gusto.  Her online shop is back up, her studio is getting warmed up, and her dependence on Decadron and it's insane apetite inducing effects are also gone.  I suspect she was still under it's effects somewhat when she went shopping though.

Also, in case any of you are finding the current Democratic presidential candidates too conservative for you to actually get excited over, you might want to check out my latest liberal rant, here at:  http://entropyparadise.blogspot.com

Those of you who find McCain too liberal, should skip reading my post and go ahead and send a copy to the Department of Homeland Security.  Just save yourself the heart attack now please.  Oh, unless you are a True Conservative, in which case you're already appalled at the deficit spending, and the Iraq war and need a way to incite the quiet conservatives to take back their party.  Neo-Cons need not apply.

Do you see why I love this man?  Even if he weren't completely trustworthy, he's freakin' hilarious, and brilliant (and a liberal!  so dreamy!), and always always himself, not trying to be someone he thinks you'll like better or admire more (unless he's messing with you, and by the way, he's not above messing with you).  He's not an icon, he's a guy, a guy who really loves me, for no good reason I can identify.  But he's also completely trustworthy.  And he's really proved that this month.

When I was being discharged from the hospital, the nurse explained to my sister my complicated drug schedule, which involved weaning me off the decadron so as not to shock my system with its sudden withdrawal, and then when we got home my sister explained it to my true love.  I was right there each time and couldn't follow or remember any of it at all, and this distressed me greatly.  I didn't know which parts of my condition that day would be temporary, and didn't even know how long it would be before I found out.

However, my true love was on top of it, as deep down inside I knew he would be.  I had to take drugs at odd times, every six hours, then every eight, then every twelve.  Even though he was very, very tired himself, at first, when I couldn't read or remember anything reliably, he would either stay up with me until it was time to take a pill, or he would set his alarm and get up to make sure I took it, sometimes having to wake me up.  As I got a little better, he began leaving the drugs for me on the kitchen counter.

You see what he did?  He gave me a glass for the water, and in it he put a little Ziploc baggie with the pill(s) and an index card on which he'd printed with black Sharpie marker what I was taking, how much, and what time I needed to take it.  Because of the very drug I was taking most, I was in the kitchen a lot, eating and cooking and washing dishes.  Because it was almost a week before I could read really well, and because I was getting no sleep to speak of, this was pretty much all I could do.  So I would see these glasses several times before it was time for me to ingest the contents.

Every time I saw them, my heart about burst with love.  Because every single one of these was a love letter, a caring act of someone who deserves my trust.  He'd gone to the trouble to work out what I needed, even calling my doctors to confirm that what he'd been told was correct; when the steroids were practically poisoning me, he worked out an accelerated wean; and he knew that even if I couldn't remember or understand from one minute to the next, being who I am I would want to know what I was taking and how much.  And he made sure I could see when to take it, in big, clear, dark print, facing forward, and that I would see that every time I saw the glass, and that would help me remember to do it so my recovery wouldn't be complicated or delayed.

When I was better and again able to take charge of my own care, he gave me this notebook.

Inside this notebook is every single document generated around my brain tumor to date, even prescription packets.

There are even printed pages from my true love going out onto the internet to research various things, including the drugs I was prescribed.

I put it to you, dear readers:  Has any woman ever been better represented?

Usually in so-called "romantic" love -- though if it lasts as long as it's supposed to, what we commonly think of as "romance" ends up having little to do with it -- when we talk about trust, we think of things like trusting someone not to hurt us, not to cheat on us, not to spend the household money on drink, etc.  At least, these are the things that pop into my head first.  This, though, this ability to entrust yourself to another person and just know that s/he will do the right thing -- the right thing for you -- and more, and do it lovingly, willingly, and without hesitation except to be sure it really is the right thing, this is the kind of trust that only comes with true love, and even then not everyone has it because you just can't choose whom you will fall in love with.

How grateful am I, then, to have my true love, someone I could hand over my life to and not have the slightest fear that he would do anything but help and protect me?  Many people have no one like this in their lives, and I did not have anyone like this in my life for many, many years.  And again, like free brain surgery, it's not like I've done anything in particular to deserve it.  I was just in the right place at the right time.

No he doesn't have any brothers or sisters, and alas, the tiny bookstore/café where we met has long been out of business.  And no, I will not share, except with the cat, who had the good sense to pick him out of everyone in the neighborhood to be his savior and protector, too.

That's a smart kitty.

And we are both extremely lucky to have found someone we can both love and trust completely.

What They Knew, When They Knew It, and Why We Weren't Told Sooner

Ha!  Bet you thought this was going to be a political post, right?  Something about the war maybe?  Fooled you!  This is about the pathology of the second evil brain I was growing tumor they pulled out of my head on March 13.

Friday afternoon I had a follow-up appointment with my fabulous brain surgeon.  He was going to look at the healing progress of my incision, maybe but not likely take out my staples, and give me the findings of what I believe he called the "tumor board," a panel of experts who would look at the pathology of the resected tissue and give recommendations for further action.  This appointment did not happen.

What happened was that we got two automated phone calls from Lahey Clinic.  The first reminded us of this follow-up appointment.  The second, which arrived on our answering machine on Thursday, peremptorily informed us that we had another appointment "at Lahey Clinic," no more specific than that, half an hour in advance of this other one.

My true love got on the phone on Friday.  We were told we had to go see someone in the financial office before we went to see my surgeon.  "We had a referral for the surgery," my true love pointed out, "and everything is okay with that, right?"

"Oh, yes," he was told.  "There's no problem there."

"Um, okay."

So we did what we were told.  We went to Lahey.  If I were legally allowed to drive that soon after my surgery (which I wasn't; they want me to wait a full two weeks post-surgery), I would have gone to this appointment myself; I really was feeling that much better, and really did have all my faculties back by then.  So I told my true love that I could handle the financial officer myself, and he went off to do something else at the admissions desk.  I'm not sure what, but I have the impression that if you go to Lahey for anything you have to drop by the admissions desk first, get checked in and told where to go.

The financial officer was a plump blond woman in her 30s or 40s who seemed to be very put out just generally.  I imagine she encounters all kinds of frustrating scenarios in her week, and this was almost 4:00 on a Friday afternoon, Good Friday no less, which is a day of great meaning to a lot of people here and one which most people prefer to work only as a half-day.  So I don't really blame her for her peevishness.  What I do blame her for is how adamantly she insisted on what proved to be a wrong idea.

"You need to have a referral for today's appointment."

"We got a referral before I had surgery."

"Well you need another one for today, but you don't have one, so you can't have the appointment unless you sign a sheet accepting financial responsibility for the appointment."

"Well then we have a problem, because I don't have a job, assets, or an income, and I'm not signing any such thing."

"Well then I can't let you have the appointment."

"Um, honey?" I called, poking my head around the column dividing the financial office from the admissions desk.  "I guess I need you after all.  Something about a referral."

At some point in their conversation, we learned that "The surgery was inpatient.  This appointment is outpatient.  They're totally different."  This was told to us in a voice and with a face indicating we should have known this already fergodssake.  I was told that it was my fault this had happened because I "chose to go out of network."

I laughed.  "No I didn't."

My true love laughed.  "No, she really didn't."

See, the financial officer had not seen me in my hospital bed two and a half weeks before, hopped up on decadron, scared for my life and missing 40% of my words, begging my fabulous brain-surgeon-to-be to move his practice over to Emerson, the best hospital at which I've ever been treated and the one to which I now run first whether I've accidentally sliced open my hand and need stitches or have a headache so bad it actually scares me even though I've been getting migraines since I was three years old.

But, whatever.  Right.  I chose to go out of network.  Okay.

Once upon a time I ran the Friday morning seizure and headache clinics over in the greater Friday morning neurology clinic over at Massachusetts General Hospital.  When patients showed up without referrals for their appointments, I would hand them the phone and they or I would call their primary care physicians' offices.  The administrative aides in those offices would call the insurance companies and get the referrals over the phone, on the spot, or call me back with the referrals, usually within fifteen minutes or so.  So,

"Let's call up Dr. D's office," I suggested.  "Maybe we can fix this over the phone right now."

The financial officer looked at me blankly like I was on drugs.

My true love looked at her, looked at me, and said, "No, you know what?  I don't think we're going to be able to fix this right now."

"Oh, yeah, I guess you're right.  It's almost 4:00 in the afternoon on Good Friday, after all."

My true love then, just for kicks, began to ask the financial officer what went wrong and how we could avoid scenarios like this in the future.  I snorted, "Not like there'll be a future; this is my last appointment here.  Everything else is going to happen over at Emerson after today."  But he continued gently asking, as if there were a point.  This very much confused the financial officer, who reddened and sputtered a bit initially and then explained her take on what had happened, but I was past listening and already out the door in my mind so I don't know exactly what she said beyond what I have already told you.  We thanked her and left her office.

Because I have run a clinic, I know that people -- doctors, nurses, PAs, etc. -- actually prepare for this kind of meeting, and I felt bad about not showing up.  I worried that my wonderful surgeon and his team would think I had blown them off.  So on my request, we went upstairs, and I explained to my surgeon's staff what had happened.  I told them I would call my primary care physician on Monday and get a referral and make a new appointment.

They were very surprised that this had happened to me.  "You call us just as soon as you get that number, okay?"

"I will," I told them.  "I just wanted to apologize for the mix-up and the wasted time."

"No need," they assured me kindly.

After that, my true love and I went to Starbucks.  After that, we went to the local mall, where I had Chick-Fil-A for the very first time in my life and eventually we bought an ice cream maker at Macy's.  After my initial rage, and then laughter with my sister on the phone over the preposterousness of all this, I actually felt pretty calm, not put out very much at all.  Whatever the thing in my head had been, it would still have been come Monday, and there was certainly not going to be anything to do about it over the weekend, if ever.

Monday I called my primary care physician's office.  I was informed that it was my fault for going out of network, that I needed to get the referral from my surgeon's office, and that I should really call Network Health, the free-to-me, Commonwealth-sponsored insurance plan I was also told I am paying for, to get the referral and also find out what my benefits were.  This was very odd, because (a) I have never heard of anyone but administrators in primary care physicians' offices obtaining referral numbers, and (b) the woman who told me this was the same woman who got the referral number for my surgery for my true love as my health care proxy when I was too mentally incapacitated to interact with doctors office administrative aids myself.  But I played along.

I called my surgeon's office.  "We don't get referral numbers," I was told.  "We never get referral numbers."

"I didn't think so, but this is what I was told to do."

"But you don't need a referral number anyway.  You're on 'global post-op,' so this visit was covered by the initial surgical referral.  Both the doctor and his PA were very surprised to hear that this had happened, and the PA wants to speak with you."

The PA and I exchanged apologies, condolences, and expressions of pissed-offedness.  Then I made an appointment for 9:00 this morning to have her look at my incision, probably take out my staples, and tell me what the hell that thing was anyway.

My true love dropped me off on his way to work.  I was going to walk, but he was going in to the office anyway for the first time in a week, and he worried that I would be too fatigued if I had to walk both there and back.  Now that I am off decadron, a crazy-making steroid prescribed for brain swelling, I actually am capable of a normal amount of post-brain-surgery fatigue, sometimes dropping with no warning into six-hour naps.

"So?  What was that thing, anyway?"

"Oh, it was melanoma."

"F*CK!"  I shouted.  Then, quietly, "Sorry."

"No, it's okay.  I was very sad when I heard."

"Yeah, that's a big bummer.  But you think you got it all, clean margins whatever that means for brain stuff, and there aren't any others in my brain that you can see right now, right?"

"Yes, he's very happy with the way it came out, just that little bit sticking to the membrane which he thoroughly burned."

"Scorched it."

"Yep.  And no, there aren't any more.  So what he thinks the thing to do is just keep an eye on it, have you come in in a month and get an MRI, and then have you come in in another three months and have another MRI, and then see what it does."

"Okay.  I can do that."

"He's going to call you to talk it all over with you."

"That's very kind of him."  And it is.  See, my not having that appointment at Lahey on Friday and him talking to me on the phone mean he and Lahey don't get paid for this consultation.

The PA took out my staples, which she was probably going to do today anyway.  I regret only that I forgot to ask for them so I could make jewelry out of them, but my mind was already kind of racing forward to what I would do next.

Then I walked home.  I walked home in a prosthetic limb which is now too big for me because I've lost 10 pounds since September just getting off my ass more and watching my diet, and then I lost another 10 pounds in one week having a brain tumor and being put on steroids.  This means that every step I take my leg falls off unless I wear my velcro strap and narrow-leg pants tight enough to keep it from falling too far when I lift my leg.  It also means that every step I take on my right side is supported by my girl parts and my butt hole across a narrow strip of the flexible polycarbonate my socket is made of.

But it was a beautiful day, and I had some nervousness to work off because every time I am told that whatever it was that just got tested or hacked out of me was indeed another melanoma it shakes me to my core, every time even though you'd think I'd be used to it and totally cool, suave and unsurprised by now.

All the pictures illustrating this post came from that walk.

I went home and waited for the doctor to call.

"It really looked exactly like a meningioma," he told me.  "And it was exactly like a meningioma in cell structure and architecture.  But then the lab did some stains and found a protein which only occurs in melanoma.  So it was a very strange kind of melanoma."

(Or, as my true love had told me when I told him, "It was the f*cking luckiest f*cking brain melanoma ever."  And don't I know it.)

They still have no idea how old it was, how fast it grew, why it got all inflamed all of a sudden or anything else.  There really is nothing to do but watch and wait.

So.  Nothing has really changed.  I have a bunch of masses in my lower abdomen/pelvis that could be cysts, fibroids, or melanoma, or some combination of all three, or something else entirely.  I will be getting a PET scan to find out what other cancerous masses I have in my body right now, how many, and exactly where.  Because of a hereditary peri-menopausal hell which I had already begun to experience, so bad that it caused my sister, my aunt and my grandmother all to have hysterectomies when it happened to them, I had already been planning to go see someone about that this year, just like weight loss and increased fitness had me already thinking of calling my prosthetist about getting fitted for a new leg.  But then I got a brain tumor, so now everything has to be sped up before I can decide what, if anything other than watching and waiting, I want to do -- everything but getting a new leg, which, though suddenly more urgently desired, will have to wait until I find out what I need to find out and decide what I need to decide because what I do may also change my weight further.

The three weirdest weeks of my life with some of the most magnificent gifts and terrifying horrors and bizarre annoyances I've ever experienced have passed, and nothing has changed except that I have, well, new homework assignments.  Sort of.

I can't really complain.  Other people have it so much worse than I do.  And yet I must confess, I'm pretty dazed and very tired.

I think I will spend tomorrow reading other people's voices and mostly not talking myself.

Sorting.  Sorting.  Sorting.

The machine is sorting.

Meanwhile, it is spring, and the hundred daffodil bulbs I planted two autumns ago to beautify an ugly parking strip are returning.

And soon there will be lilacs.

It's My Birthday and I'll Bake Something Healthful If I Want To

Today I am 45 years old and damned happy about it.  As is my wont, I made myself a little cake.

My true love, devoted servant of that slut Little Debbie, disdains my birthday cake.  He says it takes too much chewing, and that it reminds him of the scrubby sponges I buy for use around the kitchen and bathroom.  He has even gone so far as to say that he might rather eat one of those because at least they have no calories.

My true love does not have my memories.  When I was a child, my fabulous older sister (a high-powered financial guru who dropped everything in her Northern California life to come to Massachusetts and be my surrogate mom for a week while I was having brain surgery two weeks ago) used to take me everywhere she went in Southern California.  Okay, maybe not quite everywhere, but to all the beaches and all the little health food stores and snack stands sprinkled along their edges, places run by hippies that sold things like homemade whole grain fruit bars and date shakes.  This cake, which is based as usual on a recipe my mother left me but converted into something that might actually be good for you, is a nostalgic tribute to those excursions, and those treats.

It is not for people who prefer refined white sugar and light, fluffy, factory-produced cakes of even texture that require nothing of the devourer but a willing pancreas.

It is also not for cats.  Sam, here doing his best impression of a Steinlen painting while watching hopefully for rodents, wishes I had made it out of beef.  Or filled it with live mice that ran out when I cut into it.

Tough luck, guys.  And yay, more for me.

Malibu Summer Memory Date-Nut Loaf Cake

(all ingredients organically grown, of course, where they are the kind that are grown at all)

2 C whole wheat flour
1 T sodium-free baking powder
1 C pitted dates
grated peel of one whole orange or lime
½ C honey, molasses, and maple syrup in roughly equal portions (because I didn't have a full ½ C of any one of them, but drips and drabs of all three)
½ C rapadura sugar
2 jumbo eggs
two big handfuls of pecans, crumbled in your fists
1 t cinnamon
1 t allspice
1 t cardamom
½ sea salt
1/3 C unsaturated, no-trans-fat, all-vegetable shortening
scraped out guts of one whole vanilla bean
¾ C original flavor soy milk

1.  Preheat oven to 325°F.

2.  Grease a loaf-shaped baking dish with that same non-threatening shortening, and line the bottom with some lovely brown parchment made of recycled paper.

3.  Measure flour, baking powder, cinnamon, allspice, cardamom, and salt into a small bowl and whisk together until they are evenly blended.

4.  Chop dates and, in another small bowl, mix with crumbled nuts and grated citrus peel until everything is evenly distributed throughout, and set aside.

5.  In a big bowl,  cream rapadura and shortening.  Add eggs one at a time, beating well after each addition.  Stir in fruit-nut-peel mixture, vanilla and honey-molasses-maple syrup mixture until everything is pretty evenly blended.

6.  Stir in dry ingredients, alternating with soy milk, blending until evenly mixed.

7.  Pour into loaf dish and bake for 90 minutes or until tester shows dry.  (Check at 1 hour.)

Friday evening, when I was denied my follow-up appointment with my brain surgeon because of an insurance mix-up (more on that tomorrow, after I have gone to my replacement appointment and finally found out what the heck that thing was), we went to the mall and bought an ice cream maker.  I was going to make my first batch of vanilla ice cream last night, but my true love was cold, so we had Mexican hot cocoa instead.  (Incidentally, we consumed this while watching a foreign movie with subtitles, something I couldn't do a month ago.)  If I am very, very virtuous, my first frozen dessert, just to complement this delicious, moist, dense, healthful -- and yes, highly textured -- cake, will be nonfat frozen maple vanilla yogurt.  If I'm not feeling so virtuous, it will be vanilla ice cream made with naughty, naughty whole cream.

Honestly, I could go either way.

Your Tax Dollars At Work!

Love Thursday (which has been resurrected by Shutter Sister; thank you, SS!) returns to Moving Right Along this week with a bang.  A huge ringing bang.

Look at the gift I have just been given.  Well, maybe don't look if you get icked out by such things.  On the other hand, if you enjoy looking at such things, click to enlarge by all means!  It's a little blurry, though.  It's hard to take pictures of the back of your own head even under the most ordinary circumstances.

Isn't it beautiful?  It's one of the most beautiful gifts I have ever been given.  Actually, it's a lot of gifts, from a lot of people, and it's going to take me quite some time to list them all out for you.  It may take me years.  For today, though, in case the beauty is not immediately obvious to you, let me just begin to explain.

One week ago today, I was given free brain surgery with all the trimmings by a genuinely world-class team of kind and compassionate -- and highly specialized -- neurosurgical experts, courtesy of the Commonwealth of Massachusetts.  I had come to the emergency room the week before that highly altered and with a two-month-old headache that just wouldn't quit.  Turns out I had a brain tumor the size of a golf ball.

Miraculous.   I just showed up needing this insane amount of quite expensive, complicated help, and you gave it to me, freely and graciously, with exactly the same level of service and compassion I would have gotten had I been the child of a foreign potentate brought in on a private jet.  (And I know this for a fact because I have worked in local hospitals and personally served children of foreign potentates.  None received better care or more deference than I have enjoyed in the last three weeks.)

So.  Thank you, Massachusetts.  Thanks to you and your subsidized health care for the impecunious within our borders, I can read and write today.  This is especially impressive when you realize that I could do neither one a little over two weeks ago.

Like most people, I have done nothing particular to deserve your help.  Like most people, I have also done nothing to deserve a brain tumor.  This stuff just happens to people, all kinds of people, all the time.

Like many people, I could never afford insurance to cover it.  Never.  Even with the best private insurance I ever had, the amounts not covered would have devastated me financially.  And the confusing paperwork and conflicting stories from the insurance company, plus the collection calls from all the service providers' automatically-summoned-after-X-number-of-days bill collectors would have started within weeks of my surgery.  Even with every responsible measure of a responsible person in place to mitigate the fallout in just such an event, this is how it usually goes for many many people, maybe even most in this country, when something this big just happens to them through no fault of their own.

Many of us have long been arguing that helping each other is exactly what our collective resources as humans are for.  Helping each other.  Not killing each other or trying to quantify each other's monetary value.  Thank you so much, Massachusetts, for being part of this country that agrees.

So how 'bout it, rest of America?

So I'll bet you didn't realize this, but the whole argument about socialized medicine?  It boils down to love.  Do you love America?  Great.  Now do you love what America is made of, Americans?  Do you really?  Well, how much?

Do we love this country and each other enough to figure out a way for every single person in America to have what has just been given to me?  Or are we too busy judging and measuring and lying to each other about what things really cost to make this kind of possibility a reality for every single person?

Every single person deserves this level of help and service.  Every single one.  I only got it because of luck, finding the bad thing at the right time in the right place with an amazing surgeon and his team just happening to be available to me right at this moment, strictly the luck of the draw.

Oh, and because I live in Massachusetts.

In Massachusetts, we are often rude and cold in demeanor, careless of the environment, and even atrocious drivers.  You know what else we do, though?  Bottom line, we love one another enough individually and conceptually to put our money where our politics, philosophies, and religions are and really take care of each other, or at least to try.  Yes, if you live somewhere else in the country, it is very likely that we pay higher taxes than you.  Nobody likes paying taxes.  But nobody here likes people to die of treatable and preventable medical conditions.*

As one who's been on the receiving end in such a big way this time, I cannot express my gratitude.  Thank you so much, Massachusetts, for the amazing, beautiful gift.

I love you, too.

__________
* I don't pay taxes myself right now, personally, because I don't make enough money at the moment, but I have, too, for many many years, and barring catastrophe will again -- because I'm probably going to live.  Because my fellow citizens of the Commonwealth paid for it.  Even without the love, can you see purely economically how much better this works than just telling people to "sink or swim," "you get what you earn," and "those are the breaks"?  Do you see?  Even if you can't feel the love, surely you can see the pragmatism?  More healthy citizens = bigger tax base.  So simple.

Dare I say it seems like a no-brainer?