Tag Archives: story

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Alcohol myths

I am back working in Colorado and a recurring theme this month is alcohol and alcohol myths.

Myth: If I only drink on my days off, I am not an alcoholic. Nope. People can binge one day a week and still be an alcoholic. A standard “dose” of alcohol is 12 ounces of 5% beer, 5 ounces of standard wine or 1.5 ounces of liquor. But what if someone drinks 8% beer, 12 ounces? Well, that’s 1.6 standard drinks. An 8% 16 ounce beer? That is 1.6 times 1.3, so 2.08 drinks. Perhaps we should have an app that calculates this. And locks the car ignition when we are over the limit.

How much alcohol means that we are an alcoholic? The guidelines right now in the US say 7 drinks per week maximum for women, 14 for men, no more than one in 24 hours for women, no more than 2 in 24 hours for men and no saving it up for the weekend. Here: https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/basics-defining-how-much-alcohol-too-much#pub-toc3. However, alcohol is bad for the liver, bad for the heart, bad for the brain, and increases cancer risk. There is not a “safe” amount.

What is binging or heavy drinking? For women—4 or more drinks on any day or 8 or more per week, For men—5 or more drinks on any day or 15 or more per week. The rate at which people drink is also part of this.

MYTH: If I don’t throw up, I’m not an alcoholic. Now that’s an interesting one. When we drink, alcohol is absorbed into the blood and goes through the liver. The liver has enzymes which break alcohol down into aldehyde. Aldehyde is a carcinogen, causes cancer. Aldehyde is broken down by other enzymes into acetate and then to carbon dioxide and water. Some people break down the aldehyde quickly, fast metabolizers. They can drink a lot and not throw up because they break the aldehyde down fast. However, the process inflames and kills liver cells. If they keep drinking, the liver slowly dies, and this is cirrhosis. Eventually they will not be able to break down alcohol fast because the liver makes the enzymes. Then they will start throwing up.

Other people make enzymes that are slower or make less, and they get sick and have alcohol poisoning more quickly. The fast metabolizers are at higher risk for cirrhosis and the slow ones for liver cancer, but they can get either.

MYTH: “My blood pressure is fine.” I spoke to a person who stated that their blood pressure was ok during pregnancy so they did not have high blood pressure. The chart shows very high blood pressure for the last three years and I didn’t look back further. I ask, “Did you stop drinking alcohol while pregnant?” “Of course.” When NOT pregnant, this person admits to 4-5 drinks a day. Also, the history in the chart states that they had blood pressure complications in pregnancy. I did not have time to go through the chart and look at that, but this person is in denial. I think of denial as the addiction taking over and the addiction lies. It lies to me but it also lies to the person. They want to believe what they say. They want everyone else to believe what they say even if it is patently a lie and ridiculous. A woman who says a friend gave her something, she didn’t know what it was, for a headache. “How did you take it?” I asked, looking at the urine dip results. “I snorted it.” “So what things do you snort for a headache?” She was positive for cocaine and pleading ignorance was ludicrous. Another person has a positive urine drug screen for multiple things. “Can I try again?” Pause. “Sure.” I say. The first one is a false sample and I am very curious to see what the real sample will have. It has nothing. He is then surprised that I won’t fill his prescription and offer inpatient drug rehabilitation. Come now, sir, you got a urine sample from a dealer when you sold the medicine I gave you for something else. Your dealer must have been annoyed or gave you the wrong sample. When someone is really out of control, they do not have convincing lies and the only person they can convince is themselves. It is interesting to watch someone be all outraged that I do not buy the story, accusing me of discrimination or hating them or hating their race or whatever. They attempt to accuse and distract. It is harder for families because they desperately want to believe their loved one, even when the evidence shouts the opposite.

What does blood pressure have to do with alcohol? Alcohol drives blood pressure up and pulse, especially when it is wearing off. Severe alcohol withdrawal is delerium tremens and people can have such high blood pressure that they have a stroke or a heart attack or encephalopathy — a poisoned brain. They can hallucinate or have seizures and it is very dangerous. “Very dangerous” means they could die or have permanent disability. Tobacco, cocaine, methamphetamines, all raise blood pressure. The number one cause of death in the United States is the heart, but it’s not just from hypertension and weight and cholesterol and inactivity. Addictive drugs have a huge contribution.

There is nothing cheap about the cost of addiction in our country.

For the Ragtag Daily Prompt: cheap.

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On guard

My nurse’s breath catches. “Oh, no,” she says.

I am new here. Less than a year. “What?” I say.

“We have Janna Birchfield on the schedule.”

“Who is Janna Birchfield?”

Tonna leans back in her chair at the nurse’s station, a high set desk that runs behind the front office. We have new glass barriers along it to make it more hipaa compliant. It is also more claustrophobic. She throws her pen down. “She’s one of the most hostile people here. She’s known for throwing a brick through her second doctor’s plate glass window.”

“Ah,” I say.

“She was Dr. M’s patient but apparently she and Dr. K got in a screaming fight in the hallway. She is banned from that clinic. So we are the last clinic in town.”

My nurse knows the local stories and she has seen a lot. She doesn’t have a lot of unconscious monsters. Yeah, there is some impatience and some anger there, but she’s pretty good. No real fear, nothing cringing at her feet.

“Hmm. Let me talk to Marnie.” Marnie is our office manager.

Marnie and I talk. I read the last notes from Dr. M and an account of the screaming fight with Dr. K. I call Dr. K. I don’t know of anything that scares her and she is tough. I rather enjoy envisioning her yelling back at this patient.

The day arrives and Mrs. Birchfield is put in a room. Vitals are done. I go in.

Janna Birchfield is big. She weighs about twice what I do, and it’s muscle rather than fat. She looks solid. Not like a body builder, just strong. She tops me by nearly a foot. She looks sullen and unfriendly.

And I am looking at her monsters. Three are guarding a fourth, at her feet. Fear is there, anger is the biggest and posturing, like a body builder, in front. The third is morphing back and fourth: envy and hostility. The fourth is in a stroller, guarded by the other three. Asleep? Unconscious? Well, yes, duh, but it’s not often that a monster is so undeveloped that it is still an infant. Not good.

“Hi, Miz Birchfield. I am Dr. Gen.” I hold out my hand, moving slowly and smoothly. Her monsters alert, fear flinching and anger ready to punch. I stand with my hand out. She eventually touches it, glaring.

“Hi,” sullen.

“We need to talk about the clinic rules first.” I say calmly. Anger puffs up and her shoulders rise as the monster swells and takes control, her elbows rising and hands are fists. Her eyes don’t turn red, but nearly. “I have heard about your argument with Dr. K.”

Furious voice, “She screamed at me. She’s a horrible doctor! She got me thrown out!”

I am smooth and calm, “I am not going to discuss Dr. K,” I say. Honestly, it’s even more fun to think of Dr. K taking this on and not budging an inch. Dr. K is my size, small. “In this clinic, I need you to understand that you are not allowed to yell at anyone at the front desk, in the hallways or on the phone.” Anger flees immediately, small again and she looks confused. “You may not yell at the staff, at the other patients, or at anyone on the clinic property.”

“Why would I agree to that?” she says. She is mostly confused because I am not scared or angry. I am not behaving the way she expects, the way most people behave around her.

“If you are upset, the only people you can yell at are me or the office manager and you need an appointment.”

“They are rude to me!” Basically she means everyone. “You can’t make me do that!”

“Take it or leave it.” I say. “You need to agree and keep the agreement, or we will discharge you immediately. If you say no, leave now, and I won’t charge for the visit.”

Her monsters are confused. Anger has shrunk back down and they are conferring, heads together. Confusion has shown up as well, morphing though different colors and stripes, stars and paisleys. She stares at me, frozen hostility. I just wait, sitting in front of my laptop, serene. This is going well. She isn’t yelling and she hasn’t left.

“What if they are mean?” she says.

“You will make an appointment with me or the office manager, and we will help you.”

“Ok,” she says. The monsters are still surrounding the carriage, but really, now confusion is in charge. We work through the rest of the visit, as I get to know her a little. She has had a hard, hard life.

I let the front office and the nurses know the rules. The office manager and I let them know that this is a contract with the patient and she has agreed. They feel protected. They feel protected enough that they are nice to her. She behaves and starts, infinitesimally, to relax. She is still angry and hostile in the exam room but it’s not directed at me. It is directed at the entire world, the rest of the world outside the clinic. I try to help her medically but also let the monsters have their say. The visits start with anger and hostility but tend to subside into confusion. I am not getting at the fear or whatever is in the stroller. It is one of the large old fashioned ones, heavy, navy blue, where an infant can lie flat. Clearly it does not fold up to go in a car or anywhere else convenient. There are no toys hanging from the top or across it, no stuffed animals. Only a form under the blankets, always still.

I may reach that form, or not. I do not know.

For the Ragtag Daily Prompt: paleontology.

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Honey and the ants again

The next two times Honey feels the ants biting from the inside feeling are also on obstetrics.

Both times it is a VBAC. Vaginal birth after cesarean. The woman has has a cesarean section in the past and is trying for a vaginal birth.

Both times, Honey gets the biting ant feeling. There doesn’t seem to be anything wrong with the woman in labor, the nurse is relaxed, the fetal heart monitor looks ok.

With the first one it is the younger male obstetrician who is on call. He is a big man. He sits and peruses the monitor strip outside the room, taking his time. “There were some decelerations back here, but the heart rate looks fine now. Do you really want me to consult?”

Honey can’t stand still, the ants feel so bad. She tries to sound professional and calm. “Yes, this is a VBAC. I would like you to go in and meet her.” She is trying not to shoo him towards the room. He shrugs and gets up, not quite slouching towards the room, Honey trying not to jump up and down in impatience behind him.

In the room, he introduces himself. Again, Honey has not told her patient. The obstetrician says, “Dr. B. asked me to stop by since you have previously had a cesarean section, but everything looks fine.” Two minutes later she and the nurse and the obstetrician all alert as the the fetal heart rate monitor chirp slows, dropping from the 120s down to 60. THERE IT IS! thinks Honey. It stays down, they have the mother roll on her side and pop oxygen on her. It comes back up, but that is that. Off to the operating room. Again, they don’t have to do a crash cesarean. This time it is not clear what was wrong, but everything comes out well.

On the third round, it is the older male obstetrician. He looks at the strip and is calm and goes right into the room. He introduces himself and everything looks fine. Honey is wanting to dance from foot to foot from the ants. Again the fetal heart rate drops, right as the obstetrician gets up to leave the room. The nurse has the woman roll to her side and adds oxygen. The calm obstetrician gives Honey a look and has the nurse get the surgical consent. The heart rate is back up and off they go.

Honey wonders. Ants? Little voices? She knows that we all pick up information from body language and information that is not conscious. That could be a scientific explanation. Information that is not quite conscious. Honey decides that she really does not care what the ants are. When those voices speak, she listens. Who cares what it is, as long as it works.

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What is the word? “Fictionalized”, from fallible, friable memory.

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Honey and the ants

Honey is in her second year working. She escapes clinic because she has a labor patient. In the daytime! Not on a weekend or at 2 am! Hooray!

She has to hang out, because this is baby number five, so it could come really really fast. Everything is cool. The mom has more experience than she does, nearly. Well, Honey has done more deliveries, but has only had one baby.

Honey starts to feel itchy. Agitated. It’s not skin at all. Something is bugging her. She goes in and out of the room. The nurse seems totally unperturbed, but Honey feels like ants are attacking her, from the inside. She goes out the room and studies the rhythm strip, the baby’s heartbeat. There is a printer feeding out in the central nurses station.

Screw it, thinks Honey. I make look stupid, but I don’t care. She calls the obstetrician. It’s the woman who is on. Honey is a Family Medicine physician. They are in rival clinics. “Hi,” says Honey, identifying herself, “I need a consult on this woman.” She reels off the medical details, Gravida 5, Para 4, all vaginal deliveries, no complications. “I just feel like there is something wrong. There isn’t anything really bad on the strip. But I need you to come.”

The woman obstetrician comes. She sits and studies the heartbeat strip. Honey still feels like ants are biting from inside. The OB puts the strip down. “There is nothing on this that would get you in trouble. But you’re right: something is wrong. Come on.”

Honey has not told the patient that she’s calling the obstetrician. The patient might be annoyed. They go in the room. The obstetrician introduces herself. “Dr. B called me to consult. We have a bad feeling. We want to do a cesarean section.” Honey is sure the patient will say no. She is wrong.

“Me too,” says the patient. “Do it.”

They do the paperwork and move quickly to the operating room. Not a crash cesarean, not an emergency, so spinal anesthesia, not general. Honey assists.

They are in. There it is. The umbilical cord is wrapped four times around the infant’s neck. It has not tightened down. Honey has goosebumps as they gently unwrap the cord and do the delivery. The baby is fine, no problems, apgars of 9 and 9. They complete the surgery, mom is doing fine too. Honey still feels rattled but the ants have gone away.

The mother is relieved when she wakes, glad they did it, glad to hold her fifth child. The obstetrician is in charge of post operative and Honey is managing the baby. They don’t really talk about it, everyone acts as if it’s all routine. If the cord had tightened down, everything still could have been ok, but it would be a crash cesarean section, general anesthesia, more risky for everyone. It could also have not been ok.

Honey is relieved to go home, adrenaline draining away and leaving her very very tired.

Honey decides that she will listen to those ants, that feeling, any time it shows up.

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Based on a true story, at least, on memories, that are unreliable. Aren’t they?

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Shapes and songs

The Ballad of the Shape of Things is one of those songs that I learned very young and from my cousins, so I did not know who recorded it. Another “dead girl song” only this one is a “dead guy song”. I loved the puns: “They say he died of the chickenpox. In part I must agree, one chick too many had he.” I also liked songs with words I didn’t know: transom, in this one. We were fairly bloodthirsty kids and happily learned songs about death, unfaithful lovers, murder, betrayal, noble suicide to save the highwayman, and so forth. My Darling Clementine, another dead girl song. We had a very educational childhood in song.

We needed the triangular “garment thin that fastens on with a safety pin” explained at the end of the song, because the cloth diapers we’d experienced were rectangular. I find memorizing things that rhyme and especially if there is a story and a tune, much easier than memorizing the varied side effects of drugs such as ACE inhibitors. The story behind the side effects escapes me, though maybe there is one! Think of that, a ballad of the ACE inhibitors, with each one having its individual good and bad effects! I am certain that I could make up a story, even if we don’t really understand all the effects.

For the Ragtag Daily Prompt: triangle.

Here is a side effect song, though not quite what I have in mind.

The photograph is my sister Chris and me, at my father’s 70th birthday, 2008, taken by my friend Malene.

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The cover of a book

“The cover of a book is only skin deep.” -Malcolm Kenyon Ottaway

My father came up with that one. It sounds like it makes sense until you think about it a bit. He and my mother did tons of wordplay and they would conflate adages. That’s “Don’t judge a book by its’ cover.” and “Beauty is only skin deep.” (I don’t agree with the second. The complex interiors of people have their own beauty. We just don’t have pageants for small intestines and hearts and brains.)

Don’t burn all your bridges, look before you leap and we’ll cross that bridge when we come to it. We morphed those into Don’t burn your bridges before you cross them. Another I’ve heard is this:

The older we get, the more we learn
which bridges to cross, which to burn

Honestly, I am terrible at burning bridges. I think it comes from being passed around as an infant and feeling abandoned or a sense of loss and grief. I am practically incapable of really burning a bridge. At most I can put up a guardhouse with a tollbooth. Not that anyone ever tries, really. People mystify me and apparently that is not going away ever.

I love this old adage, too:

Make new friends, but keep the old
One is silver and the other gold

For the Ragtag Daily Prompt: adage.

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Mind

Facing a wall or lying in bed
breathe slow: four seconds in
one two three four
four seconds out
one two three four
keeping count

or facing a wall sitting
on a zafu, bell rings to start
how can forty minutes be so long?
fall asleep and body weaves
waking me up OH don’t hit the wall
adrenaline then slithering down
towards sleep again

zen mind, blank mind?
my mind wanders off again and again
what is for dinner? grocery list?
that annoying thing or person
at school or work
the mind busy as a squirrel
burying nuts and digging them back up

bring the mind back again
again again again
to the breath the wall letting go
of this well trodden mind trail
only to have the mind wander off
down another: this with briars
and falling into a pond
that has ice and cold

back shake like a dog
shake it off
focus on the breath the wall again
vivid multicolor cats
with paisley and stripes and spots
there is the BELL
forty minutes

Bow to the wall
and stretch
get up
ready zafu for the next time
meditation
mind

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Written today for the Ragtag Daily Prompt: blank.

The translation that I originally learned is here.

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the pale reflections of our bitter selves

they are neglected, you know, by most
the worse self, the worst self, the dark
the impulse to yank the moon from the sky
when she slides down the stair, to see who’s there

there are few poems written to the dark
impulses, the demons, the underside of our hopes
and dreams, the nastiness, the grief, the anger
we are kept in the dungeons below the basement

below the belt we band together huddle
in a pile of claws and unfeathered wings and teeth
wishing for a blanket, to be held, rocked
loved, wishing for the mothers who left us

the fathers who denied us, pushed us away
so that we knew and know what to hide
what to deny, what part of ourselves to kill
we try and try but few do

and then they are mourned, people say
they don’t understand but ask the demons below
and oh, they do, they do! maybe the next plane
will be kinder and love the demons

the bitter self, the dark self,
that longs so badly to be loved
that longs forever to be loved
that is not loved this round

this round

written 11/24/2023

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1932 Letter

My cousins sent me a packet of letters. Some are from my mother to her mother, but this one is from… well, see if you can guess.

Dear Mother and Father,

We got in the car and Grandfather and me sat in front and Grandmother sat in back. Grandmother said, “Do you want your window closed?” and I said, “No.” Then, in a few minutes after that I said, “I am getting kind of chilly.” Then in a few minutes after that I tumbled over the back of the seat into the back seat. Then I shot my pistol out the window and tried shutting it again but it wouldn’t go. Then I waited awhile and then I shot off my pistol again and it worked. Then I shot off my pistol again in a few minutes after that but somehow it didn’t work. And then after awhile it started raining.

Then we got home. After a little while Eva May came over. Then after awhile Jimmie came. Jimmie brought over his gun with him. He had a long gun.

After supper I took my sparklers over to Jimmy’s and Eva May’s house. They invited me over before supper and then I started lighting my sparklers. I lit one after another and in a few minutes I said, “I’ll go over and get my pistol,” so I did.Then I went back for awhile and then I came home and stayed and we had the rest of my sparklers in the house. And then we all went to bed pretty early.

This is postmarked July 6, 1932 Decorah, Iowa. It cost .03 cents in stamps to mail. It was sent to Mrs. Temple Burling, 3434 Arden Ave, Hollywood, Illinois. The handwriting is quite beautiful. The letter is signed “Bobby” in quite different handwriting. The letter was sent from “Bobby” — Robbins Burling, age 6, as the narrator, with one of his grandparents transcribing to his mother (my grandmother) Mrs. Temple Burling (Katherine White Burling). I think it is a charming letter and so like a kid, with the repeats: “and then in awhile”. I am going to send it to “Bobby’s” grandson, who now has a child of his own. Here is the rest:

In the morning I got up and got dressed. Before I got up I was real quiet because I thought they were asleep because they were so quiet and they thought I was asleep because I was so quiet. Then finally they came past the door and when I knew – it they were awake – and they knew it – I was awake. And then I got up and got dressed.

Then after breakfast Grandmother and me went out and weeded. In a few minutes I said, “I’ll get the hay off the lawn for you.” so I did. I told her if she thought it was worth a penny and Grandma said, “Yes.” And then I said, “Do you think it’s worth any more than a penny?” and Grandma said “Yes.” In a few minutes we came in and she gave me a cent.

I left the penny in my hand and Jimmie came over and called me and we decided that we would make giant fingers and then as we were making giant fingers we decided we would make funny masks but we didn’t. We decided to make Chinamen’s hats but we didn’t.

Jimmie wore his hat in a funny pointed way and I wore mine with a round hole in the middle and kind of crooked too. And we went out to scare the girls and at first we didn’t scare girls but we scared Jimmie’s mother and we didn’t scare the girls after all. He went out to scare a man and he told me he’d be back and I got an idea while he was gone but he didn’t appear.

And then we went out and did some errands – got some peanut butter and then went to the library to see if they had any Dr. Doolittle books and they did. At first they asked if we’d read Dr. Doolittle at the Circus and I said, “I have.” and they put that back and looked some more and found another and asked me about that and it was called Dr. Doolittle and the Movie. Then at night Grandma read me some. We read part of it while I was in bed and then I started talking to Sixen and fell asleep finally and work up next morning. Then we had breakfast and I raked some more and I got another penny.

Bobby

For the Ragtag Daily Prompt: letter.

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Story morph

I’ve been seeing some embroidered stories. They are based on a true story, but the details are wrong or exaggerated.

One is an old friend of my sister. He notices a chair in his garage and contacts me. Now, my sister died in 2012. He says the chair is from Grandmother Tessie and that my sister told him “It’s the only thing I have left from my grandmother.” He wants the chair to go to my sister’s daughter and he may be willing to have it recovered for her.

He sends me photographs. Touches your heart, doesn’t it?

Except that Tessie was not our grandmother. She was my maternal grandfather’s mother, so my great grandmother. I have never seen the chair before and it would have to be late 1800s or bought late in her life. It does not look that old, though it looks chewed. Also, we all got boxes of stuff from my maternal grandmother Katherine, to the point where we all agreed it was ok to get rid of some of it. We offered it to each other first. Seven cousins and I got two pitchers. I asked my mother, “Why two pitchers?”

“After your uncles and I picked what we wanted, we lined up seven boxes. Then we went pitcher, pitcher, pitcher, pitcher. There were enough to send everyone two.”

Oh. My grandmother was a serious packrat. I got a silver plate pitcher and sugar bowl that look like they are from the 1930s, art deco. I had never seen them before they came in the box. So they are not attached to my memories of my grandparents at all, but I like them very much.

I send the chair message on and I don’t know if my niece will want the chair. Nor do I know if it was great grandmother Tessie’s chair. I had an enormous box of tablecloths and pulled thread doilies and so forth after my parents died. I would bet money that there was something from Tessie Temple in there. I offered it to both my children and my niece. They each took one tablecloth and napkins. I kept a few and got rid of the rest.

The other day I noticed that one cloth that I kept is signed Margaret White. She was my maternal grandmother’s oldest sister. I have Margaret’s small leather sewing kit as well, made in Germany and stamped with her name. I’ve had that since my teens and used it until the leather corners are wearing down. My mother said that my grandmother found her sister Margaret difficult, but I don’t know if that is true either.

At one point I emailed with a family member found on Ancestry.com. This is my paternal grandmother’s father’s half-sister’s descendant. She said the family rumor was that they were related to John Philip Sousa. I said, “My great grandfather, Fredrik Bayers, played saxophone in John Philip Sousa’s band.” She said, “Oh, that must be where that story came from.”

Are these stories benign or not? With social media and the ongoing trials of various people from both the government and investment schemes, the stories seem less benign to me. If my niece wants the chair, I think that is very kind of my sister’s friend to make the effort to get it to her, but the story was rather garbled. It makes me want to be careful with the stories I tell.

Peace.

The photograph is from 1965 or 1966, of my grandmother Katherine White Burling, me, and my sister, Christine Robbins Ottaway. I would guess that my grandfather took it.