I am raised by a family of triangulating enablers and enablees.
The enablers are my mother and two uncles. They are very very smart. Let me qualify that: they are very very smart intellectually. Emotionally, not so much.
The two uncles have PhDs and are professors. They marry wives that are lessor in their view. One tells my mother that he wants a woman who is not as bright as he is. I don’t know if she is less bright, but she is a hella better athlete. I also have the impression that she had a time where she drank too much.
The other uncle marries a woman who tends to be a hypochondriac. He takes her to India, where she gets polio while pregnant. She is then a sick hypochondriac, which is very difficult. The ill can control their families by planning things and then getting sick at the last moment. On the other hand, chronic fatigue and fibromyalgia are very real and we are on the edge of figuring them out. That uncle divorces his wife and I instantly like both of them better. They stop being a weird unit and are suddenly individuals.
My mother tells me, when I am in college, “I wondered if your father was an alcoholic when I married him.” I want to hit her. She won’t leave him, she won’t stop enabling him, they scream at each other at 2 am often. Now I wonder about that and conclude that either screaming at someone was something she needed or she was an alchoholic too.
After my mother dies, I ask my uncle, what about his parents? After all, the three of them learned enabling somewhere and it pretty much has to be at home.
My uncle tells me his parents had a PERFECT marriage and that my grandmother LOVED being the wife of a physician and professor.
Um, so, then, why did she pay my tuition to medical school, uncle?
And I think about my mother’s stories. Once, she says, your Uncle Jim bet his friend Dick that Dick was too chicken to shoot a cigarette out of Jim’s mother’s mouth. Ooooo. With a rubber band shooter. Yes, my grandmother. Bob took the bet and succeeded. My grandmother roared with anger and the two boys ran like hell and hid.
And someone in the family tells me: your grandfather helped your grandmother control her temper.
There it is. The enabler/enablee.
The enablers die first. My grandfather of cancer at 79, my mother of cancer at 62. The cousins are all angry at me because I won’t follow the family rules and triangulate in a satisfactory manner, and I don’t care any more. I am ignoring them. I got my father’s banjo back and I am done. The two cousins I own land with jointly are not the worst triangulators.
I have to remind myself: for them, this is love. For some people, controlling or being controlled is what functions as love and intimacy. Fighting and tears when person A talks to person C about person B and person C then lets person B know, that is how they feel close. It is not only families, but communities. Clay Shirky’s description of a group being it’s own worst enemy describes the same patterns: identify an enemy inside or outside the group and then everyone comes together against the enemy. The enemy says the wrong thing, doesn’t worship the right god/desses, wears different clothes, looks different. And the group feels safer once the scapegoat has been killed, the guy has been burned. It would be nice if we could burn a ritual guy instead of torching each other.
The real anger is in the enabler. They control it by having the enablee express it. Then it is not “theirs”. They can feel superior to the enablee who is out of control. Sadly, the problem is only fixed temporarily and they will need their anger expressed again and again and again.
I wrote this poem a long time ago. I was thinking about how being a physician and taking care of other people let me avoid my own feelings. Doctors are trained to hide their feelings. When I was an intern, a patient died on my day off. I came back to find the person gone. No one on the team said anything. I was afraid I’d done something wrong. Was it my fault? Finally I screwed up my courage and spoke the the attending physician. “Oh!” he said, “I meant to talk to you about that patient. They had a lethal pulmonary embolus from the clot in their leg. They were appropriately anticoagulated. You did nothing wrong. This happens.”
I think the war is more of the same. Chaos, to avoid feeling. Let’s not do that. Let us grieve as a world. Let us not melt down in a conflagration. That is my prayer.
If there’s a mess And chaos Home that’s home Busy busy Run around Fire fire Fix it Crisis Now what Deal with it
No time for feelings
I don’t want chaos Liar liar
Chaos is so safe
Hero hero Put out the fire Catch the baby Confront Not a hero really Scared Hiding
If I stop the chaos I will have to feel
Maybe it’s ok To feel a little
I forgive myself I understand the chaos I can let go of it by degrees
I feel so vulnerable In the quiet clean safe place Take your time sweet self
Unfortunately, the trunk, twenty feet high, had split in half in high winds. So now it was a very dangerous very tall living cedar that is going to come down and is right next to a house.
An expert was consulted. He said the tree could not be taken down intact. Each of the four tall trunks would have to come down individually. This is terribly dangerous, because felling trees is dangerous enough, but when you are up IN the tree, it is worse.
There are four men and me. I am there with a camera. I do not help at all, I just try to stay well out of the way.
When the last trunk fell, it swung towards me and they shouted “Run!” It had slipped of the trunk and can’t be controlled as well even though there was a cable and a machine pulling in the desired direction. I ran and I am still here, thankfully.
For the Ragtag Daily Prompt: WAR. I wish we were all just working and there was no war.
No names or faces, because you know, those loggers are shy and wild, right?
I had the heart echocardiogram bubble study. Normal. I really really did not like having the mix of blood, saline and AIR injected and I COULD FEEL IT. My logical brain knew it was going into a vein, but my emotional brain kept yelling “Air embolisms kill people!” Yes, but that is arterial. My emotional brain did not care. Anyhow, it was fine.
Saw the cardiologist who said he can understand why I feel PTSD going into my local hospital. He says I should not need oxygen at age 60 with no smoking. He says “Not your heart.” Yeah, duuuude, I know. He suggests I go to the Mayo Clinic. I agree.
Meanwhile, my primary sent a referral to rheumatology to have me seen at Swedish to confirm chronic fatigue. This is to keep the stupid disability off my back. Swedish rheum doesn’t call me. I ask my primary’s office. Swedish STILL doesn’t call me. I call them, as follows.
“Hi, I was referred to Swedish rheum and I have not been called.”
“Name, serial number, date of birth, length of little toe. Ah, we just received the referral yesterday.”
“Um, I don’t think so. I was referred over a month ago.”
“Uh, oh,” scrabble noises, “Oh, uh, we got a referral in December. We were not taking new patients in December.”
“When did you start taking new patients?”
“When did you start taking new patients?”
“Oh, uh, January. But we only took the ones that called us, because after they call, we then review the notes.”
“So you ignored the referral until I call? How am I supposed to know that?”
“Oh, uh, we will expedite your referral. Maybe even today.”
So THEN I get a message from my primary that they have REFUSED the referral. Great.
Meanwhile I read the cardiologist’s note, which pisses me off. “We will refer you to Mayo Clinic since you have unexplained hypoxia and you think you have PANS.”
I send my primary a very pissed off note saying, could we please phrase this as “a psychiatrist suggested PANS in 2012 and while no one likes this diagnosis, no one else has suggested an overarching diagnosis since that time in spite of her seeing four pulmonologists, neurology, cardiology, infectious disease, four psychiatrists, allergy/asthma, and immunology”. Saying “the patient thinks she has PANS” automatically labels me as crazy and obsessed.
So, it seems I should write a book, about how the medical communities treat patients, including a fellow physician, horribly. Of those doctors, three have treated me with respect and were grown up enough to say, “We don’t know.” The neurologist, the infectious disease doc and the present pulmonologist. All the rest are dismissive and disrespectful. Oh, and the one psychiatrist, but the next one says, “I don’t believe in PANDAS.” I stare at him in disbelief, thinking “they are animals related to raccoons that live in China, you moron”. I did not even know it was controversial until that moment. Holy PANDAS, Batman.
My primary has suggested I write to the Mayo Clinic myself, and I am going to. Because the present people aren’t listening, except my pulmonologist and she is short staffed and looks like death warmed over post call every time I see her.
So it’s all annoying as hell. The cardiologist seemed pretty nice, but damn, he put the same damn rumor down about me self diagnosing. Most of the doctors apparently think I might be a tolerable person if they could just drug me with psych drugs. And from what I have seen, there are many patients who are in this situation.
I am thinking about the roaring twenties a lot. I think people went a little nuts, not because of the war, but because they had difficulty being emotionally honest about the influenza pandemic. I think we humans will do it again to forget the deaths, to go into denial, to refuse to grieve.
Yes, that is my prediction.
Be very quiet, I am hunting wabbits.
Be careful in our future roaring twenties. Money will flow like honey and people will go nuts. Hold fast, hunker down, don’t go out without your macintosh, wear clean underwear. Remember what your mother told you, remember what your father tells you. Because that was followed by the Depression and that is one risk.
I don’t know if it will start this spring or next spring. Ok, I AM hoping that my son and future daughter-in-law can get married in early May, since they’ve put it off for two years. But. The 1918-19 influenza was really three years, not two. It tailed off. Half the people in the world got it. In Samoa, half the adults died, or was it 70%? They had little exposure to infection but a ship brought it. They KNEW they were high risk, but a sailor didn’t know he was sick yet.
Why a roaring twenties? Because we want to forget this pandemic, as the last one was forgotten. Our history books say that the Roaring Twenties was about the end of World War I. We teach lots about that. We barely mention the influenza world pandemic. I am reading a book about the 1918-19 influenza pandemic published in 2018. The author says that it is only now, 100 years later, that we are starting to really tell the stories of that pandemic. She gathers stories from all over the world, including stores of different infection control strategies in two cities. One guessed right and one guessed wrong, and in the wrong one, way more people died.
I read about that 1918-19 pandemic after influenza nearly killed me in 2003. I was 42, healthy, a physician, a mother, an athlete. I had NO risk factors except stress. Now it looks like it was a PANS reaction, but at the time, neither my doctor nor I could figure out why I was short of breath and tachycardic walking across a room for two months. Fatigue, chest pain, tachycardia, shortness of breath. Hmmm, what does that sound like? My partners thought I was faking and I was so sick that I could barely communicate. The stresses were my mother dying of ovarian cancer in May 2000 and my marriage being pretty on the rocks and me working way too hard. My psychiatrist said I should take time off. I said, I can’t. He said, you’d better. Then I got flu. “See?” he said. The body decides, not the conscious brain. He was correct, damn him.
The book I read in 2004 looked dry and medical from the outside. It had pages and pages of footnotes. It had photographs of Los Angeles. They knew the influenza was coming towards them like a wave and they tried to get ready. Bodies under sheets were stacked five deep in the hallways of the hospitals. It hit that fast. People, usually age 20-50, turned blue and fell over dead. WHY? It was the immune response. The 20-50 year olds had a better immune response than the 50 and older and their lungs would swell until there was no airspace left. Even then, that pandemic death rate was only 1-2 % in the US. But it was so fast and spread so quickly that everything was disrupted because it was the workers that were deathly ill and at home and there was no one to work.
People wore masks in public, except for the mask refusers, but not in their homes. So entire families would get ill. I don’t think they had figured out viral loads yet. If you are the last one standing, and you are trying to take care of a spouse and six children, you were high risk from viral load and exhaustion.
The Roaring Twenties WAS a way to grieve, it’s just a dysfunctional one. The stages of grief: denial, bargaining, anger, grief and acceptance. My sister said that acting out and revenge ought to be added as stages of grief. She died of breast cancer after fighting it for 8 years. Roaring is denial and bargaining and acting out and revenge, all at once. Everyone grieves differently, remember that. There is not an order to the stages of grief and you don’t do them once. You do them over and over and over.
I am a Cheerful Charlie, right?
War is one way to forget/deny/act out. Let’s not do that. Let’s not have a civil war of forgetfulness and denial.
I went for a walk at Fort Worden this week and did not walk on the beach. I was wearing work shoes not suitable for sand. I went up the bluff to the bunkers instead. The bunkers are so quiet in the winter, without all the tourists.
It was very dark yesterday by 3:00 pm. We are so close to the solstice now.
Beloved, thank you for these dirty dishes.
Thank you that I have hands to wash the dishes.
Thank you that I have water, clean water, hot water and soap.
Thank you that I have a sponge and a sink.
Thank you that I have a home, that it has not burned or flooded or been destroyed by war.
Thank you that I had food to feed my family and my self, to dirty these dishes.
Thank you that I have food to put on clean dishes today and tomorrow.
Please, Beloved, help me bring food to those who need it, clean water, soap, dishes, homes.
Please, Beloved, open our hearts to others in need.
Thank you, Beloved, for these dirty dishes that now are clean and for the circle of life they represent, clean to dirty to clean again.
The Olympic Peninsula only has one wild fire currently, but the sunset last night was lit by smoke.
When I was in residency, one of the obstetrics-gynecology faculty asked us, “Women died in childbirth. What did they die of?”
We were silent. Stumped. Infection? Well, when there was no infection control and the male physicians went from room to room with no hand washing, yes… but….
Preeclampsia? No. Not that common. Eclampsia? Ditto.
“What if a woman is in labor and the baby is stuck? What do they die of?”
“The uterus contracts until it ruptures. It contracts until it is thinner and thinner. If there is fetal malposition or a hand presentation or transverse or certain breech positions, the uterus ruptures and both bleed to death.”
We were all silent.
When I hear people bemoaning caesarean section and too much surgery and too many interventions…. I remember what women died of. All the stepmother stories. In the 1797 diary I am reading, the “lady” dies of a fever. She is 24 years old. There is no surprise, just sorrow. The author writing is the same age and grew up with her and grieves, but goes on.
We would like to think this is in the past, but it isn’t. It still is going on, right now, in poverty stricken areas and war zones where the hospitals have been destroyed, the medical people have left, there are no services…
When I was still delivering babies, I would tell patients: my ideal labor plan is the baby comes out and I hand it to you. And the placenta comes out and the baby nurses and I don’t seem to be doing much. But that is not always what happens. I do not have control nor do you. I will only intervene if I think it is your life or the babies life or both….
The picture is me on my maternal grandfather’s lap. I was one very lucky baby. My mother had tubuculosis through the pregnancy. She coughed blood in her 8th month. If there had not been medical care and a Tuberculosis Sanitorium to be born in, I would not be here.
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