Is this a tree?

Is this a tree?

I would not call this a tree. I would call it a cone. It contains seeds. It is not a tree.

A pregnancy is called an embryo until 8 weeks after conception and then a fetus until birth. It is not a baby, any more than a seed is a tree. Here is a link to a picture of the embryo developing:

https://en.wikipedia.org/wiki/Human_embryonic_development#/media/File:HumanEmbryogenesis.svg

It’s a bit difficult to call the embryo a baby.

After 8 weeks (10 weeks from the last menstrual period) the developing pregnancy is called a fetus. It cannot survive outside the womb. A term pregnancy is 37 weeks, and the due date is at 40 weeks. The earliest survival, certainly not natural, is around 24 weeks. This takes heavy intervention and technology, a premature infant on a ventilator for months. There is risk of damage to the eyes from high oxygen and risk of spontaneous brain bleed and cerebral palsy, because the newborn can weigh half a pound. Once born, the fetus is termed a baby.

This is important from a medical standpoint and pounded into us as physicians. WHY? Because in a trauma situation, the life of the mother comes first. In Obstetrics and Family Medicine, the life of the mother comes first. In Oncology, the life of the mother comes first. My sister was diagnosed with stage IIIB ductal breast cancer at age 41. She was engaged and it turned out that she was pregnant. She wrote this essay on her blog, Butterfly Soup:

The hardest loss of breast cancer.

She had an abortion and chose chemotherapy, because it was her or the fetus. If she had chemotherapy pregnant, at that time she was told that it would probably kill the fetus or cause terrible birth defects. If she held off on chemotherapy for seven months, her oncologist thought she would die. She had a very very aggressive cancer and she already had a daughter who needed her.

She lived until age 49, with multiple rounds of chemotherapy, radiation, gamma knife radiation, whole brain radiation. And she lived until her daughter was 13. Without the abortion, her physicians thought she would have died when her daughter was 7.

My ethics in medicine are that patients have autonomy. I would NOT have wanted my sister to choose to refuse chemo and try to bring a baby to term while dying of breast cancer. However, it was HER CHOICE, not mine. It was private and no one else’s business and how dare people make moral judgements about another person’s medical choices. I give my patients CHOICES. They can choose not to treat cancer and go into hospice. They can choose surgery or refuse it. They can choose to treat opioid addiction or refuse. They may die of a heroin overdose and I grieve. I try to convince them to go to treatment and I give them nalaxone to try to reverse overdoses. I refuse a medication or treatment that I think will harm my patients, but my patients have autonomy and choices. That extends to women and pregnancy as well.

It is NOT a baby in the womb, however emotionally attached people are to this image. It is an embryo first and then a fetus. And in a car wreck, the woman comes first and the fetus second.

For the Ragtag Daily Prompt: explain.

behavioral health, cancer, and the immune system

There are more and more articles about immune causes of “behavioral health” diagnoses.

The latest I’ve read is about schizophrenia:

https://www.nature.com/articles/s41598-020-63776-0

Auto-antibodies are antibodies that we make against something else that then attack a part of ourselves. The most well know version of an auto-antibody is Rheumatic Fever, where an antibody to streptococcus A attacks the joints or skin or heart. I had a patient in Colorado who needed a new heart valve at age 10 or 11 because of Rheumatic Fever.

I have written a lot about PANDAS and PANS (respectively Pediatric Autoimmune Neuropsychiatric Disorders Associated with Strep A and Pediatric Acute Neuropsychiatric Syndrome) because an older psychiatrist was suspicious that I have PANS. I have had pneumonia four times and it is accompanied by anxiety and fear, part of which turns out to be hypoxia and tachycardia. I think a heart rate of 135 makes just about ANYONE feel anxious. It feels awful.

But what about other Behavioral Health Diagnoses? Remember, we are on the DSM V, the fifth manual of psychiatric diagnoses. We have not had markers or a clear cause. That is, we are aware that serotonin is low in the intracellular spaces in the brain with depression but we don’t know what the mechanism is, what the cause is and what exactly is happening in the neuron or brain cells. A paper on a particular rat neuron said that there were 300 different types of serotonin receptors on that neuron. Blocking one type caused rats to act in an obsessive compulsive manner. But there are 299 others and then combinations. Whew, there is a lot to be learned about the brain.

Fibromyalgia can be caused by autoantibodies, at least some of the cases: https://www.sciencedaily.com/releases/2021/07/210701120703.htm

Chronic fatigue: https://pubmed.ncbi.nlm.nih.gov/34441971/

Lupus and fibromyalgia overlap: https://pubmed.ncbi.nlm.nih.gov/9207710/

Autoimmune disorders are more common in women. We think this is because of pregnancy. The woman’s immune system has to tolerate a pregnancy where half the genetic material is from the father. Yet the immune system also has to recognize “not me, infection” and be able to distinguish that from the pregnancy. This is tricky. The most common autoimmune disorder currently is believed to be Hashimoto’s Thyroiditis, where there are self antibodies to the thyroid. Post covid could potentially beat this out.

Chronic fatigue and fibromyalgia have been orphan diseases in that we do not have an inflammation marker that defines them. The ESR (erythrocyte sedimentation rate) and CRP (um) are usually normal. These are often elevated in rheumatological disorders. Not having a marker doesn’t mean that the muscles are not painful and doesn’t mean that the fatigue is not real.

I am hopeful that we are on the cusp of a true revolution in medicine, with more understanding of the immune system and behavioral health disorders, as well as post covid, fibromyalgia and chronic fatigue. I worked at the National Cancer Institute in the 1980s before medical school, with Steve Rosenberg, MD. He was trying to get the immune system to fight cancer.

Now there has been a cancer treatment with 100% success: an immune treatment for people with rectal cancer with a particular immune profile. This is AMAZING! https://www.zmescience.com/science/experimental-trial-cancer-complete-remission-02725735/

Only 18 patients, but 100% success! No surgery.

The patch for the National Cancer Institute shows a man fighting a crab: Cancer, the crab. Dr. Rosenberg talked about Sysiphus, who was rolling a stone up a mountain eternally while it rolled back on him. From here: Later legend related that when Death came to fetch him, Sisyphus chained Death up so that no one died. Finally, Ares came to aid Death, and Sisyphus had to submit. In the meantime, Sisyphus had told his wife, Merope, not to perform the usual sacrifices and to leave his body unburied. Thus, when he reached the underworld, he was permitted to return to punish her for the omission. Once back at home, Sisyphus continued to live to a ripe old age before dying a second time.

Maybe the stone has reached a resting place. Blessings and peace you. Please peace me.

mother

It is my mother’s birthday today, May 31. She died in May 2000. Helen Burling Ottaway and I miss her daily. Hugs to all the mothers and the fathers and everyone who has lost their mother one way or another.

I took this photograph in the mid 1980s, borrowing a camera from a friend.

website ethics and mine

Two days ago I wrote to the owner of the website that “separated” me for “not explicitly breaking the rules”.

I have not gotten an answer.

Doesn’t matter, you say. I disagree. I think our ethics matters and it matters on line. Isn’t that part of what we are fighting about?

Let’s drill down. The editors stated on this obscure not to be named site that they were tightening rules and removing write-ups that should be logs or are just not high enough quality, and letting the writers repost them as logs. So far they have removed over 250 of my writeups. Ironically, I was one of the two most prolific writers in the last year. Let’s kill the golden goose because she’s annoying, won’t we? The other writer has not been “separated”.

I note that they have removed my write up called “birth of ——–“. Now, this interests me. This was a well received write up, had up votes, and was the start of a category. The category was people explaining how they chose their on line name.

So: the editors are liars and abusing their power. They have removed a well received and well liked write up because they have personal animosity towards me. I have protested the removal of 250+ writeups and asked that they be reposted as logs. No answer.

The other writeups in the how I chose my name category are still there. So this is PERSONAL and the editors of the site are unethical.

Therefore, I hope the site dies. Or gets rid of those editors. I think I want it to die, even though it has writing by my sister. This does matter. As a species, we will either learn to be fair and human on line as well as off line, or we will end in conflagration. The site will certainly not be there if we start lobbing nuclear bombs at each other. The owner works for the US government. Why is he/she not paying attention to this obscure website that he/she owns?

Whether or not the world burns this month, if the editors are manifestly unfair on the site, the site will die and deserves to die. I wish that I could have my sister’s drafts before it shuts down.

I ended my email that is not answered with this: Good luck. I hope that ethics matters to both of us.

Thank you.

on line site name

_______________________

I will not name the site here or anywhere again, until and unless those editors are shut down and the site becomes ethical.

We are fighting this fight as a species, as humanity. We have to learn to be as ethical on line as we are in person. Well, you say, some people AREN’T ethical. Yes, that is true. As a rural physician, my goal is to take care of ANYONE WHO COMES IN. The emergency room physician cares for the family of four hit by the drunk and the drunk too, even if there is a dead child in the family of four. We set our judgement aside and do the best for each and every patient, regardless of the story. At least, that is the goal. It is the highest goal I know of.

Blessings and be your ethical self on line. As my children said to me when I threw their father out of the house once, “We don’t care what he does. We want you to be polite to dad no matter what.” And they were RIGHT! We answer to ourselves and to the Beloved and to our children.

Blessings.

The photo is me and my sister, dancing before my wedding in 1989. She died of cancer in 2012.

V is for La Vague

I am blogging from A to Z on women artists.

My father would pretend to speak French, but he spoke terrible French. Right after high school my mother went to Europe with her parents. They traveled and she stayed in Paris, doing art. Her French was much better than his.

Helen Burling Ottaway was influenced particularly by Japanese art and the empty space on the page. We have an ancestor named Morris Temple. I have a photograph of him in his Civil War uniform and of his wife. He was the owner of Temple Pumps. However, the family story is that he was more interested in Japanese art then pumps and proceeded to “run the company in to the ground”. I do not actually know if this is true. My maternal grandfather’s mother was Tessie Temple, and Morris Temple was her father. My middle name is Temple and my cousin is Fred Temple Burling II but goes by Temple, as my maternal grandfather did. He was F. Temple Burling I.

My mother started a series of paintings of Mount Rainier after she moved to the Pacific Northwest in 1996. I think that she planned to do fifty views or one hundred. She did not get to finish the series but I do have some of them. La Vague and the views of Rainier are tributes to other artists that she loved.

This is an etching where more than one color is applied to the plate. This is a proof, so she is still messing around trying to decide what she wants as final colors for the edition.

ATOZBLOGGINGCHALLENGE2022 #art #Women artists #Helen Burling Ottaway #ATOZCHALLENGE #Christine Robbins Ottaway #APRILATOZ

For more information about the #AtoZChallenge, check out this link.

P is for Paper over

I am blogging A to Z about artists, particularly women artists and mostly about my mother, Helen Burling Ottaway. Today’s post is about my mother and my sister: another woman artist. Christine Robbins Ottaway.

I do not have much of her fine art. She was a landscape architect and historic preservation expert and worked for Caltrans. She also wrote, on her blog Butterfly Soup, and in other places.

The painting is an oil, by my mother Helen Ottaway, done when my sister was 14. This painting seems especially creepy to me, the oranges and blues. I love the painting but it is frightening as well. My sister could write terrifying stories. Here is my poem about one of her stories. The title of her story is “We don’t make good wives”.

Paper over

They are papering over your memory
They want the clean version
The inhuman perfect version
I remember the violent sea serpent
Related to Aunt Nessie: me, I think

He stole your skin, you say
But you lure him to, posing
On the shore naked
And let him take you home
And impregnate you

And then you have six daughters
What did he expect? you say
Cold blooded and beautiful
White skin and greenish hair
Who all can swim like fish
and all seven search
Until you find the skin
and then away

You say, he took my skin
Now I have taken his

Let them paper over your memory
Let them pretend you were sweet
I hold your words in my mind
And I love you wholly

__________________________________

ATOZBLOGGINGCHALLENGE2022 #art #Women artists #Helen Burling Ottaway #ATOZCHALLENGE #Christine Robbins Ottaway #APRILATOZ

For more information about the #AtoZChallenge, check out this link.

Egg art

I have been collecting eggshells for a while. I am not sure exactly what I am going to do with them, but this is my first piece of egg art. I keep thinking about the large sugar eggs with the window, with small figures inside, that we got as children. I am saving real eggshells and bits of feather and fluff and pine cones and shells. With Easter tomorrow, I may dye some eggshells.

My mother loved dying eggs. We did not go to church but both my parents sang masses and the record player was just as likely to play Bach or Brahms or Carl Orff as the Loving Spoonful or Bob Dylan or The Beatles. We did elaborate egg dying, with wax and multiple layers of color. The complicated planned ones were often not pretty. It was the ones that we weren’t particularly trying that were often gorgeous. We always had both blown and hardboiled eggs. We would have “egg wars” when we wanted to eat one. We would each hold an egg and tap them together hard. The winner was the one with an intact egg. We ate the less pretty hardboiled ones first and the prettiest last. Mmmmm, egg salad and deviled eggs, yum.

For the Ragtag Daily Prompt: eggs.

J is for joy

I am blogging A to Z about artists, particularly women artists and mostly about my mother, Helen Burling Ottaway.

I am nearly done traveling and I am running out of photographs of Helen Ottaway’s work! J could be for jonquil but there are none in this watercolor. But I think it is a joyous and messy bouquet, typical of my mother. She would complain about her garden, how it was riotous chaotic beauty rather than neat rows. But I loved her garden and her bouquets and her paintings, untamed and joyous!

This watercolor is from 1994, the year before my parents moved from Alexandria, Virginia to Chimacum, Washington. My grandmother’s house two doors down from my parent’s house was sold. Someone came to my parents’ house and said, “They are ripping out the garden!” The new owners tore out the beautiful and elaborate garden that my grandmother had paid her granddaughter in law to design and build. Many uncommon plants, torn out and in a pile on the sidewalk. The whole neighborhood of gardeners turned out to take the plants home and replant them. The garden was replaced with bushes and two rows of marigolds down the path. I suspect that that household was shunned by the neighborhood gardeners for years after that and I wondered if my grandmother would haunt them. I do not have marigolds in my garden! My mother shrugged and said, “Well, they own the property.” but she could barely stand to walk by it.

I think the bouquet is from my mother’s own garden, a mix of humble and more exotic flowers. I love the purple and it gives me joy.

ATOZBLOGGINGCHALLENGE2022 #art #Women artists #Helen Burling Ottaway #ATOZCHALLENGE

G is for greenish blue

G for greenish blue. I am blogging A to Z about artists, particularly women artists and mostly about my mother, Helen Burling Ottaway.

Greenish blue is a stretch, but this is a blue crab. They are greenish blue. I wrote the poem and my mother did the etching. I was thinking of a cooked crab, but H. Ottaway did a live crab. I went with her to the crab restaurant, where she explained that we wanted one live crab. “One live crab?” said the restaurateur. “Yes, one live crab.” The owner shook her head, but sold us one live crab.

At home, my mother got the crab out and put it on the floor. The cat was intrigued. The crab was NOT happy. I took photographs of her drawing the crab and making the etching. Apologies for the reflections but I am not at home, so I can’t retake these!

Three photographs: Helen Ottaway drawing a blue crab on the floor, the crab and Helen running an etching on the press.

You can see the crab and her drawing it, as well as the etching press. I took the photographs in the mid 1980s.

Our poem/etching collaboration was a delight! She said that she would illustrate poems as long as they rhymed. “No free verse,” she said. “I don’t like it.” So, the poems had to rhyme. We did ten different ones. I am so glad that we did, since we didn’t have nearly enough time together!

ATOZBLOGGINGCHALLENGE2022 #art #Women artists #Helen Burling Ottaway #ATOZCHALLENGE

memorial

Today is my sister’s birthday, Christine Robbins Ottaway. She died of breast cancer in 2012 at age 49. She had gotten stage IIIB breast cancer at age 41. She went through mastectomy, chemotherapy and radiation and was clear for two years. Then it recurred and she returned to treatment, rounds of chemotherapy, a gamma knife radiation, another gamma knife and whole brain radiation. She was very very strong and tough and fought the cancer right up until the end.

This photograph was taken at my father’s 70th birthday party, in 2008. My friend Maline took the photograph. She and other old friends gathered and we sang the family folk songs.

Here is a drawing that my mother Helen Burling Ottaway did in 1978 of Chris. My mother always had a sketchbook. This is one she sent to me, because I was an exchange student in Denmark that year. At Christmas I received the wonderful sketchbook with my mother’s comments. My sister was 14 when I went to Denmark and I was 17.

Chris Ottaway by Helen Ottaway, 1978