Take my brain, please!

I just took a big dose of (probably useless) Ambien and decided to revise this post. I can only hope the medication makes the writing more interesting because the first time around was kind of a snooze for this one.

I had my every-six-weeks appointment with the psychiatrist today. I try to be pleasant when I go, but today I didn't have the energy to be chatty, so I didn't even try. If there's one place you should be free to show your mood, it's in the psychiatrist's office.

He asked what was up, and I just said, "Nothing."
"Is that a good nothing or a bad nothing?"
"It's just...nothing. No changes. I'm really tired." (Because I am too overwhelmed with drugs to add in that trozodone you prescribed. It sounds like a dinosaur.)

I think he was worried because I wasn't my bubbly self. Sometimes, I just can't put on that persona, no matter how desperately I want to. Lately, I rarely want to, but I still manage to dig deep and put on that face of normality so I can be convincing when I fake interpersonal engagement. Such is the problem with fall. And my work schedule.

Last year around this time is when I ran out of money. My malaise must have triggered a memory for the doc because he went into the special locked closet of pharmaceutical wonders and brought me about 30 sample boxes of EMSAM patches. Wa-hoo. He handed me the bag and I said the only thing I could think of : "Trick or treat."

The doc shrugged and said, "And Christmas comes early." I thanked him for his generosity (keeping in mind that there are only like five people in the entire city on this medication. It's not like there's a mad rush for samples). I think he was just trying to get me to show some enthusiasm. Smiling was not even on the menu today.

The doc asked if I wanted or needed anything else. What a stupid question. "Yes, Dr. Steve! I want a new brain! This one doesn't work right. It's defective and I want a replacement. Is there a warranty??"

He laughed and said, "May, your brain is just fine. You have a great brain. People like your brain. We just need to keep it tuned up. Why don't you like your brain?" Has he been sleeping all this time?

My brain complicates my life. The neurotransmitters don't work right, the frontal lobe has issues, and that damned amygdala needs an overhaul, and it should take its totally lame friend Mr. Hipocampus with it.

Dr. Steve told me to buy a light box for SAD therapy. I told him I had read all about it just like he told me to, but I wasn't feeling motivation to spend the big bucks, especially when the sun is free.

"May, May, May! Reading about it and using it are not the same thing. You need photons, lots and lots of photons! Unless you're going to sit outside for 30 minutes every single day, the light therapy won't work. It only works if you actually expose yourself to it. It's a discipline, like playing an instrument or learning a language. If you don't practice every day, your brain can't hold onto what it's gaining. Buy the light box, May."

Honestly, it's not just the price that puts me off. One of the most significant side effects of light therapy is...insomnia. Could I possibly sleep less than I do now? Why do I even bother to own pajamas?

Missing Person

Joanna, Joanna, where have you gone? I miss you. I've called and sent cards and email, but there hasn't been any response in about six weeks.

You're the only dependabe thing I have. You're the comfort when I feel like I'm cracking. You listen to me babble when the meds don't work. You tell me fascinating stories about science and whitewater rafting. I have no stimulating conversation here.

Please come back, or at least tell me where you are.

Around here we preach tolerance

What shall I bitch about today? So many possibilities. I’ve been on a roll about religion, so maybe I can revisit that since I had a confrontation of sorts about it on Friday.
I was surfing around on the Internet and I found this great line of stuff by a company called Bitchwear.com. Unfortunately, I'm writing this at work (shhh), so I can’t pull up the site and show you a picture. Anything even remotely naughty is blocked from out Internet access here.

So, here’s the thing. Why is it that people who are zealous about their religion want to tell you all about it, but have no interest in learning about your beliefs? Is this a universal truth? Why do these people think it’s at all appropriate to cram their ideas into someone else’s head with the arrogant attitude that only one religion should exist on this planet? How can it be that billions of people are making a collective mistake by not joining up? And why is brainwashing and ad nauseum Bible thumping (or Koran, or whatever) not perceived as obnoxious by the people who do it?

Last week I facilitated a training for community members as part of the outreach program I oversee. One of the immutable rules of the program is no prosthelytizing. The people we serve have been through enough, and many of them were persecuted for their beliefs. Those who endured torture or conflict dug deep into their hearts and put their faith in their God to get them through horrific experiences. Who the hell gets to tell them they’re going to suffer eternal damnation because they aren’t Christian? Besides, mine is a federally funded program, and the separation of church and state is taken pretty seriously around here. If you want to preach about the god you adore, go join a church group, but stay away from my clients.

There’s a big difference between preaching and promoting your religion compared to trying to convince people they need to drop what they believe and join you. The whole issue of “my religion is right and yours is blasphemy” makes my stomach clench. We all have the right to what we believe, and why can’t it just be left at that?

I got into this tizzy because of a woman at the training. She sent me an email telling me why she does not wish to volunteer in my program. Apparently, I am a squisher and squasher of Constitutional rights, with a particular preference for stomping the First Amendment. Irony again. I am a staunch believer in freedom of speech and freedom of religion, but when I’m sending you out to help someone with language and acculturation, you just do not get to use that opportunity as a wholesale excuse to convert heathen souls. Those souls have a constitutionally protected right to the pursuit of their own happiness.

Here is a copy of the message that was sent to me. I haven’t changed anything except the font. (I’m the one who has a supposed mental illness, but I run stability circles around this woman even on my worst day.) I later realized that this woman has about 20 Websites of her very own where she only writes about religion or abortion. She's on disability, so apparently, this is what she does all day.

Mrs Voirrey, I appreciated you allowing me to learn outreach as a volunteer. I have considered carefully your statement that "proselytizing for religion" is not allowed. I thought about how important the US Constitution and the First Amendment is that gives U.S. citizens the freedom of religion, speech, press, and worship of GOD. I thought even more about my committment to the Living LORD JESUS that is first and foremost in my life. I do not think it is wise for anybody to "waive" their Constutional liberties in order to keep the peace of a volunteer agency or for that matter, for any reason. I cannot agree to the terms that you implied i.e. that forsaking the Commandment of JESUS to teach all nations [Matthew 28:19-20] is a requirement for the "privilege" of volunteering! I am certain that I know myself very well and I would talk about GOD and as I watched the movies of the refugees that you showed there, I noted immediately that they referred to either GOD directly or to a "faith" in the understood GOD they referred too. I had an interest in that but don't need more problems in my life. I don't want to give time to a project that attempts to deny the existence of GOD or that violates mine or anyone else's Constitutional and First Amendment liberties on a regularly planned and constructed methodology. Citizens of this country, which Refugees intend to be obviously or they would not endure what they endure to get to this country, should be taught that they are able to talk about and write about GOD anywhere and they don't have to fear being arrested or subjected to persecution in this country for that reason. That is the supposed intent of the First Amendment and if you don't know it I ask you to google it! Of course there are people in this nation persecuted on a daily basis in the public schools for being Christian and being bold to say so. I thought on this all week before replying and decided I cannot and will not forsake GOD to please you or anyone else! signed gp[RN]

Heartless

Why is empathy something people expect to see manifested in a very specific, prescribed way? Is it possible to empathize in a way that, although unorthodox, is still genuine?

The person I work for is wracked with worry. A man she knows professionally--someone I know peripherally--has been severely depressed for quite some time. He's in financial trouble, he cheated on his wife, she left him, and he started to fall apart when his wife got into a serious relationship with someone else. At that point, he ended the relationship with the woman he had been seeing while he was still married. Although he had no real problem cheating on his wife, he could not tolerate the thought of her being happy with someone else.

The guy has been in a downward spiral for a year. He was on medication but it didn't work and he didn't follow up with his doctor. He refused to go into therapy. His behavior has been erratic for months, and he has what I can only describe as an agitated depression.

He's been sending out clear suicide signals for weeks. My boss has repeatedly told me how worried everyone is. I haven't heard anything about what anyone was doing to actually help this man. But they're all very worried, very worried.

At some point in the middle of this week, he quit his job. Nobody has seen him, although he called at least two people and told them he needed to see them--just for 15 minutes--but he never showed. His wife had the police go over to his house, but although he wasn't there, nothing seemed amiss. I'm not sure what that means, exactly.

My boss was teary-eyed when she told me all of this yesterday. I kept a poker face. She implied I didn't care. I wasn't sure what to say. I have well-defined beliefs on this subject, and they tend to be unconventional. Finally I said, "People will do what they want to do. If he is going to kill himself, it has nothing at all to do with anyone except himself. He's in pain and he wants it to stop. Do you understand that?" She said she did, but I suspect she was still processing that. I went on, "Suicide isn't really something you do to other people; it's something you do for yourself. If he has refused help at every turn and made himself unavailable for intervention, then there's nothing to be done. He has made a decision, the decision that he doesn't want a future. As an adult, he has the right to do that. I would say that given the length and severity of his current emotional state, this is not an impulsive or unreasonable decision on his part. He has the right to decide when he's had enough, as do any of us."

My boss looked at me with a mix of distress and possible confusion. She started to say something and then she stopped. She thought my answer was detached and somewhat clinical. I assured her that, in fact, my empathy was very much intact and functioning. I reminded her that my perspective came from very personal experience. I thought about the difference between empathy and sympathy. Empathy is when you see the situation by imagining yourself in the other person's place. Sympathy is when you feel sorry for someone because they are in that situation.

Do I feel sorry for him? No, not really. I feel sad that he found himself in terrible pain but without the kind of support he needed. That's a completely new pain on top of one's suffering. I believe that's the root of my empathy. I understand how it feels to know that dying is a far more palatable option than any of the others before you. Nobody should be able to decide the outcome for you, although they will try--not necessarily out of love, but just on principle.

I guess we'll find out what happened on Monday.

Schooling the seminarians

Last night, I spent almost four hours teaching a class to graduate students from a local theological school (not Catholic), Some will go into traditional ministry, some will go into counseling, some will go into social work. All are approaching their work with a decidedly Christian spin.

I teach this class three times a year, and actually, I like it a lot. It's just really intense. This group tends to have challenging questions and they see things from a perspective I don't usually visit myself.

One of the things I particularly enjoy about teaching this class is that the students really grapple with issues related to faith. They don't just swallow doctrine undigested. They look at the realities of faith in practical application. They ask good questions. I suppose this is in part fueled by the fact that these are graduate students and that they are also theologians, not a Bible study group. In fact, in the years I've been doing this, I've heard them quote authors, philosophers, social historians, and great theologians, but I have never heard them quote even one line of scripture. It's comforting to me that they are always encouraged to keep asking questions.

My class focuses on refugee resettlement and how the incredibly complex issues inherent to this population are likely to present in the students' professional practice. Last night, I brought six adult refugees with me. All arrived in the U.S. within the last six months. They told their stories in a room that went still and silent. As I made the critical points in my presentation, I asked each newcomer to expand on my thoughts based on his or her own experience. Frankly, the presentation kicked ass, if I do say so myself.

And that brings me back to the issue of God. One of the students asked me if refugees continue to practice their faith in this country. I explained that, in fact, the refugees are encouraged to do so. They are told in orientation that every religion is represented in the U.S. and therefore, there is place for everyone. Just as their religion will be respected, they need to respect the other religions practiced here. I also explained that one thing we know from research is that when the displaced and resettled were asked what helped them survive the ordeal, almost universally, the answer was, "my God and my faith."

At the end of the evening, the professor asked that one his students lead the group in a prayer. I should know this is coming, but it always takes me by surprise. I wasn't sure how my group would react. Four are Muslim, one is Buddhist, and the other is Catholic. I scanned the room and saw that all of them had bowed their heads respectfully and were humbly engaged in prayer themselves. Although I no longer pray, I am gracious enough to bow my head and be patient and still during that moment.

The student who led the prayer thanked the good Lord for bringing such a valuable and insightful class to the group. He prayed that our newcomers would continue to embrace the hope and strength that helped them survive thus far, and that they would still be supported in the second part of their challenging new life. Then he prayed for me. He thanked God that I had found the work I do and that He had infused me with the wisdom and skill of a talented teacher. He prayed that I would continue to receive God's guidance and support to keep doing this important work. He asked God to always give me the strength and compassion it must take to do my job. The prayer ended with an enthusiastic "Amen."

I stood there for a second, shuffling my leftover handouts. I didn't know how to react. I'm not sure what to make of this kind of thing, and I'm really not used to hearing someone pray for me. I don't believe in God, but I do believe in the power of energy, good and bad, especially in the collective. If 24 people can gather their positive energy and channel it toward me, then I do think that I will be infused with...something. Something benevolent that requires no commitment to any deity. That works.

What is God?

I am an atheist. It's a belief set I acquired later in life, but I don't know why I didn't get there sooner.

My parents tried to raise me Catholic. I went to Catholic school starting with kindergarten. There was First Friday Mass, Holy Days and Mass, May Procession and Mass, confession, sacraments, uniforms, knee socks, and guilt about things I couldn't even understand.

Boys on one side of the room, girls on the other. Boys in one line, girls in the other. Boys on one half of the playground, girls on the other, with some invisible force field keeping the two groups apart. Line up, line up, line up. Shortest in front, everyone in order by height. I was first in line throughout elementary school.

Every school day started with a prayer. Homework was stamped with an inked angel, either lauding "Jesus is happy," or "You can do better." Sometimes my work was only worthy of a big "C" scrawled at the top of the paper, indicating that my work was merely "correct."

Despite years of nun exposure, Catholicism just didn't stick. I was unable to cozy up to a belief system that constantly reiterated that I was and always would be less valuable than a man. I refused to embrace that idea. It seemed to me that in the Catholic world, I was always being berated, told to feel humble, or paying to pray.

During Catholic Mass, the collection basket comes through twice. I suppose that after the sermon, we were supposed to feel so infused with the holy spirit that we would only be able to express it by parting with our hard-earned allowance. One of the things I liked about church was the abundance of candles. They were everywhere and they were usually lit. It wasn't the presence of God's spirit that attracted me to the candles; it was the beautiful, twinkling flames and warm glow of the wax. I was particularly taken with the votives at the front of the church. Rows of little candles in red glass jars were lined up in an ornamental ironwork rack, kneeler in front. Of course, it was the Catholic church, so there was a coin box on the front of the metal rack. If you wanted to light a candle and say a prayer, you were supposed to put some coins in the box as an offering to God. It wasn't until I was much older that I figured out that you didn't actually have to pay to talk to God, and that the candles were supposed to represent a soul lost to this world that we were encouraging to move on into heaven with the help of five cents and a sincere prayer to God or the Virgin Mary. Take your pick.

Throughout my life, I've seen good and bad, wonderful and horrific events. I have suffered and watched others suffer. When I began to question my faith in an all-knowing, all-seeing, all punishing and disdaining God, I was told that believing was critical to my future comfort in this world and the next. When I questioned how God could allow the horrible suffering in our world, I was told that man was given free will. It didn't make sense to me. Nobody I knew would ever choose to suffer, starve, be raped, murdered, or blasted out of their house by a bomb. Where's the free will in that?

Ah, in the Catholic religion, this was God's way of proving that those who just weren't faithful enough could not count on his support. Eventually, I had to discard the willing suspension of disbelief. It wasn't working and my sense of logic far overpowered my desire to feel a connection to a fatherly figure who, if he was overseeing my life, had obviously fallen asleep at the controls.

Around the time I turned 40, my life started to unravel. My mind started to unravel. My finances went to shit, and it seemed as though nothing could go my way. I prayed a lot. I got sicker. I prayed more. My life became even more complicated. My father started dying a slow, agonizing and very undignified death. I prayed for a cure, the right treatment, or his swift death, but was granted none of them. My mind snapped, my brain went to Jello, and God was nowhere to be found. Prayer wasn't worth crap. Maybe I had stopped putting money in the coin slot too soon, but I'd been buying my own candles for so long, the ones at church seemed unnecessary.

Ditching God felt dangerous at first, but eventually, I felt liberated. My life didn't change much post-God, although I suppose the possibility of eternal damnation still awaits me in my as-yet-unproven-to-exist after-life.

I find it interesting that people are always happy to tell you about their religion, or at least to mention which faith they ascribe to, yet any atheist I've ever met has only admitted to their lack of faith in hushed tones or with requests not to divulge the fact. Is there shame in being an atheist? There's no shame in other ideologies, so what's the issue with this one? I am not ashamed. I am proud to know that I can think for myself, draw my own conclusions, and get through life without manufactured guilt.

What do I believe?

• I believe in science, proof, or at the very least, plausible explanations.
• I believe it is more important to walk the walk than to pay lip service to something you're supposed to believe.
• Be fair.
• Be kind.
• Help when you can.
• Try.
• Be generous.
• Try to like whomever you can, but just accept that you can't like everyone.
• Do the right thing.
• Ethics count.
• Keep an open mind.
• Listen
• I believe that what I believe is nobody's business.

Looking for the positive spin

Last year I resolved to try to find something positive in situations that irritate me. The issue with the parking garage at work is very much on my mind, so here are three things I've come up with.

• The view from the roof is lovely, just lovely.
• Parking is close to the post office, so it will be more convenient than ever to mail stuff.
• All of the parking spaces are close to the elevator.

People are a complex mystery

In the course of my day, I am in the constant company of a broad cross-section of humanity. I work with people in an intense and emotional field. Actually, I have three related jobs that are all quite different. What ties them together is that they are all based in compassion and a desire to help make the world a kinder, gentler place.

We live in a world rife with cruelty and suffering. People who could do the right thing make a conscious choice to embrace the darkest and most heinous behavior. Nature may wreak havoc in our world, but more often than not, the worst moments are man-made.

My work surrounds me with two distinct populations: People who have suffered beyond comprehension, and people who wish to facilitate the healing process. The paradox of human behavior is woven throughout my day, leaving me at once discouraged and encouraged. No sooner do I find myself filled with despair and mourning the lack of human decency when I witness the true depths of human caring.

This morning I was asked to explain, in simple English, what was happening in California with the fires. I told the story, recited the numbers, and explained the conditions that had made the fires so incredibly volatile. Twenty-one people looked at me. Twenty-one people who had been on the receiving end of those man-made horrors. Twenty-one people who had lost everything, absolutely everything, yet survived and were starting over a continent or two away. One voice spoke for all of the concerned faces. “Are the people in California in a safe place?”

“Yes,” I said, “they’re in shelters or with family. They’re safe.” There was a moment of silence, just a breath in duration, and the next question was almost a whisper. “How can we help? What can we do? Do they need anything?”

The room was so still, I felt as if the Earth had stopped spinning. Equilibrium. Grace. Compassion. What kind of spirit must a person harbor to be battered, broken, and bereft of life’s comforts, and yet upon hearing of another’s misfortune, feel fortunate and in a position to help someone else survive?

People are beautiful sometimes. And then I’m reminded that they aren’t.

Later in the day, I was sitting in the bland, circa-1980s apartment of an ethnic Hazara family from Afghanistan. Surrounded by five siblings and their parents, I gathered bits and pieces of educational and family history. Abdul, the father/husband, explained to me that his body was broken down at just 42 years of age. He told me that the Russians, followed by the Taliban, had devastated the part of Afghanistan where he lived, and the constant stress of war, the lack of heating fuel for his home, the gas from the bombs—all of it—had taken its toll on him and his family. Abdul fled Afghanistan in a split-second, life-or-death decision and wasn’t able to have any contact with his family for the next nine years.

Abdul’s oldest daughter, a gorgeous 18-year old with a sculpted face and slanted, almond-shaped eyes, had developed a seizure disorder as a result of the chemical warfare. She also had obvious symptoms of post-traumatic stress disorder, including nightmares that made her scream in the middle of the night. She was unable to attend school, and she now believes herself to be too damaged to participate in life’s opportunities. Abdul has the nightmares, too, and is prone to repeating his trauma stories again and again with rushed speech and short breaths, as if talking faster will keep him one step ahead of being caught by the bad memories. Abdul understands the disorienting break in the most basic rules of trust. He has been tortured.

Driving home, I tried to reconcile the conundrum that we humans are. We are capable of almost unimaginable cruelty, and yet we can also dig deep for compassion to try and heal people we’ve never even met. We are beautiful. We are frightening. We are able to choose. I wish more people could see the value of choosing compassion.

Too much irony for one life to hold

I work in the heart of the city, right smack downtown amidst the people, the traffic, and the noise. There is no place to park. It never bothered me because I was lucky to have parking provided by my employer—for free. It was a bit of a walk from the parking lot to our building, but as long as I was organized and didn’t leave anything behind coming or going, it was manageable.

Two years ago, we got kicked out of our parking lot. The city needed it as part of the building site for a huge public works project. The city couldn’t take the land outright, so they found us an alternate location that they swore was just as good. Except, now it took more than twice as long to walk from our building, and entering and exiting the garage required nerves of steel and superior driving skills because the only way in and out was via a tight, corkscrew ramp. The walls of the ramp were scarred and smeared with the evidence of lesser drivers who had not been up to the task of negotiating five levels of continuous spirals.
I hated the garage, I hated the walk, I hated the amount of time I had to plan into my day to get to and from there, and I really hated the maze of closely spaced intersections I had to get through, especially when they were backed up all the way to the garage.

The city finally agreed to include space for us in a new parking structure, since it was getting expensive to pay rent in our first alternate space. Today was our first day in the new parking location. You know it’s time to get suspicious when management says, “You’re lucky to have free parking downtown. Don’t forget that…”

It is a 20-minute walk from the roof of the parking garage—the really swell area of the garage reserved just for us—to my office. This includes a treacherous path through a huge construction site and ends with having to cross a major, insane intersection where there’s, like, an accident a week. When I crossed this morning—with a group—not one of the ten cars turning right stopped for us, the pedestrians in the crosswalk. We couldn’t make it to the other side until the light had actually turned red and the turning cars could no longer enter the intersection. So now I not only have to factor in an additional 40 minutes of commuting time a day (an extra four hours per week), but I must also risk my life crossing one of the busiest streets in the city.

Finally, the ironic part. I am petrified of police. Can’t stand ‘em, don’t think most of them want anything more from their job than to exhibit testosterone-induced displays of power and if I’m involved, intimidation. Have yet to meet a cop who took the job to help instead of say, just to show who’s in charge. Maybe others believe differently, but I can only draw my conclusions from my own experience. I have anxiety attacks if I am in close proximity to cops anywhere, including on the road.

Imagine my delight at finding out that our new parking structure is actually part of the police station. Just fuckin’ shoot me. It may be time to consider public transportation.

See, that's what I've been saying about Zzzzzz's

This article is from Live Science. You can see it in its original context by clicking here.

Emotions Run Amok in Sleep-Deprived Brains
By Charles Q. Choi, Special to LiveScience
posted: 22 October 2007 12:02 pm ET

Without sleep, the emotional centers of our brains dramatically overreact to bad experiences, research now reveals.

"When we're sleep deprived, it's really as if the brain is reverting to more primitive behavior, regressing in terms of the control humans normally have over their emotions," researcher Matthew Walker, a neuroscientist at the University of California, Berkeley, told LiveScience.

Anyone who has ever gone without a good night's sleep is aware that doing so can make a person emotionally irrational. While past studies have revealed that sleep loss can impair the immune system and brain processes such as learning and memory, there has been surprisingly little research into why sleep deprivation affects emotions, Walker said.

Walker and his colleagues had 26 healthy volunteers either get normal sleep or get sleep deprived, making them stay awake for roughly 35 hours. On the following day, the researchers scanned brain activity in volunteers using functional magnetic resonance imaging (fMRI) while they viewed 100 images. These started off as emotionally neutral, such as photos of spoons or baskets, but they became increasingly negative in tone over time—for instance, pictures of attacking sharks or vipers.

"While we predicted that the emotional centers of the brain would overreact after sleep deprivation, we didn't predict they'd overreact as much as they did," Walker said. "They became more than 60 percent more reactive to negative emotional stimuli. That's a whopping increase—the emotional parts of the brain just seem to run amok."

The researchers pinpointed this hyperactive response to a shutdown of the prefrontal lobe, a brain region that normally keeps emotions under control. This structure is relatively new in human evolution, "and so it may not yet have adapted ways to cope with certain biological extremes," Walker speculated. "Human beings are one of the few species that really deprive themselves of sleep. It's a real oddity in nature."

In modern life, people often deprive themselves of sleep "almost on a daily basis," Walker said. "Alarm bells should be ringing about that behavior—no pun intended."

Future research can focus on which components of sleep help restore emotional stability—"whether it's dreaming REM sleep or slow-wave, non-dreaming forms of sleep," Walker said.
Many psychiatric disorders, "particularly ones involving emotions, seem to be linked with abnormal sleep," he added. "Traditionally people mostly thought the psychiatric disorders were contributing to the sleep abnormalities, but of course it could be the other way around. If we can find out which parts of sleep are most key to emotional stability, we already have a good range of drugs that can push and pull at these kinds of sleep and maybe help treat certain kinds of psychiatric conditions."

The findings are detailed in the Oct. 23 issue of the journal Current Biology.

Why There's No Such Thing as a Good Night's Sleep
Top 10 Mysteries of the Mind

May I please be excused?

I cannot go to the meeting. Now that I see the agenda, I know that it's best if I just use the meeting time for something else.

My heart damn near stopped when I saw that they would be there--and for a 45-minute presentation. The time is too long, the room is too small, and there's no easy way for me to run if panic overwhelms me. I'm sorry, but I just can't do it. As it is, I cannot even look at them, let alone be in the same room. I will hyperventilate. My heart will beat through my chest. I could stroke out. I cannot guarantee I won't have a meltdown or start sobbing uncontrollably.

Please don't make me go. I would have to take handfuls of Xanax, but then I wouldn't be able to drive home. I think it's better if you just let me skip this one. There is only so much I can be expected to handle with grace. This is beyond my scope of possible composure. There is just no way. Not yet.

A blast from the past

I've been organizing files on my computer, with particular care being given to my journal entries. Although I may struggle with my imperfections, and although I don't feel like the poster girl for self-love, I have managed to make some progress from the frustrating, dark days of a year ago. In fact, just to put things into perspective, here is my journal entry from one year ago today, exactly.

I feel like crap, and I don't think it's a meds thing. I am functioning just fine, top form, productive as ever, dependable me. Keep that in mind as you read.

But I feel like crap. I am overwhelmed by the realities of Bipolar Disorder. The godawful expense, the reality of knowing it's never going to go away, the burden I know that I am for my husband, the fatigue of trying to never let it show, the huge feelings of failure because I'm not as good as I used to be at accomplishing things, the doctor visits, the insurance battles, the blood work, the betrayal of abandonment by almost everybody I know who knows, the side effects of meds (I'm now breaking out in itchy hives that look like bug bites. To quote my dh: What the hell is that??), the weird dreams, all of the goddamn sleep issues, the weight gain, the loneliness, the unpredictability of the moods and the meds, the humiliation of having to borrow money, maybe declare bankruptcy, and beg for medication, and all of it.

I feel like there's a lot I'm not articulating here. I don't even feel depressed, necessarily, but I am just overwhelmed, disgusted, and exhausted from trying to put on a good face and lots of effort.

I refuse to see anyone, and I mean anyone, in a social context. I can't tolerate people being close to me anymore, not that anyone seems interested in doing so. I refuse, just refuse, to tell anyone anything that isn't superficial or work-related. I can't trust anybody with anything personal. That's pretty recent but very powerful. I'm sick of being the good friend and getting nothing back when I'm most in need. People, be gone. I never thought I would see the day that I had to pay somebody to sit down and talk with me, and all the other people who had any interest were virtual.

I want to be done with my financial troubles one way or another, sell my car, quit my job, go to sleep and never deal with another thing. I know the saying that what I'm thinking is a "permanent solution to a temporary problem," but I see nothing temporary here. The struggle never stops, does it? The BP doesn't go away, does it? Does the toll lessen? The answer is no, no, and no.

At first diagnosis, I was really unstable and muddled, and I felt like I just needed to be dead. Now, I'm very clear headed, and all I see is a life of trouble for me and anyone associated with me. There's not enough good here to make this worth the struggle. I do not love myself in a way that makes it worth my while to keep on dealing with this situation. I'm a problem solver, and I detest having a problem I can't solve, let alone learn to live with in harmony.

I'm not going to do anything imminently, but the day is coming, the day is coming. I'm unsalvageable, I think. I function but I don't work. I'm not looking for sympathy at all--just a place to say what I feel so that when the day comes, I'll know that I articulately explained my motives.

I expected to feel this way when I was depressed, not when the clarity came.

So much lost time

My therapist worries about me. A year ago she worried about me, too, but the reasons were completely different. Last October, I was barely functioning; I had a hurting, chemically unbalanced, chronically misfiring brain. Frankly, it sucked.

I am very quick to snap to attention when I see news of bipolar disorder on TV or in a magazine. When Oprah covered the topic recently, I was thrilled. Anything that sheds light on the disorder with facts and insight is a step in the right direction. My only criticism of Oprah's show was that nobody really made the point that BP is not an emotional problem--it is a very real, very physical, organic problem that requires lifelong medication. To leave out these facts is a disservice to those of us who have the illness.

I'm troubled even more every time I hear someone define bipolar disorder as nothing more than a person experiencing extreme moods varying between intense highs and lows. That isn't inaccurate, but oh, that it should be so simple. For me, moods are the least of my problem. It's all the hard-to-define crap in between that gets us in trouble. There's paranoia, racing thoughts, irrational beliefs, anxiety, inappropriate behavior, insomnia, and my personal favorite, an inability to shut up while, unfortunately, being completely and totally tactless.

Which brings me to last year. As of the spring of 2006, I'd been getting BP-specific treatment for about two years but I was getting worse, not better. My doctor took the bold step of taking me off of most of my medications. The pharmaceutical companies that make those drugs will tell you that they are not addictive; therefore what I experienced was not withdrawal, rather, it was a step-down reaction. If you ask me, whatever my reaction was, it was grossly understated in the literature.

About 15 months ago, I started using transdermal selegiline, otherwise known as EMSAM. This is what my doctor promises is a "very powerful antidepressant." This is a good thing, and EMSAM is a worthwhile leap of faith for people like me who can't take SSRIs and who don't respond to anything else, including tricyclic ADs. The downside is that it takes forever to kick in. It took months before the effects were noticeable, and I was backsliding that entire time. Just as I started to feel relief, something terrible happened. I ran out of money.

Due to an enormous insurance glitch, I was paying close to $600 per month for pharmaceuticals alone, with an additional $200 for office visits. I decided to cut back on my medications until I could scrape together enough money to refill my prescriptions. I ran out of money before I got to the part about the refills. Then I ran out of meds. After months of gaining ground, I was suddenly falling right back down the rabbit hole.

I was sad. Deeply, terribly, profoundly sad. It hurt to breathe. My body felt like it was affected by some freakish super-gravity that made it difficult to push myself through the day. Light hurt my eyes and the dark made my mind race. I was chronically heartbroken and keenly aware that nobody cared. My insomnia was brutal but when I did sleep, I was plagued by nightmares. My doctor didn't see how bad things had gotten largely because throughout the whole ordeal, I remained "highly functional." But I wasn't functioning at all. I was dying. At least, it felt that way.

I've said it before, and I still believe it that BP won't kill you--it will only make you wish you were dead. There's a reason this illness has such a high suicide rate.

Eventually, I got the medication I needed and bit by bit, regained my health. Unfortunately, I had lost a lot of time. I lost my way and had a lot of trouble figuring out who I had been and who I had become. My soul hurt, but my head started putting itself back together. I never missed a day of work, despite the fact that being there was agonizing because I believed (correctly, I think) that people were talking about me behind my back and speculating about the changes to my personality. I'm sure those conversations did not come out of concern as much as judgment and disdain.

A year ago this time, I had no real interest in continuing to live, but I faked it. I worked, I saw people, I ran errands, and I lived what passed for a relatively normal life. I did nothing extra, though, nothing that required effort, attention, or caring.

Things have changed. I work a lot. I put in 70-hour work weeks. I have some time-intensive hobbies. I write. I do things around the house. I spend obscene amounts of time on the Internet. Along with two other people, I'm deep in the throes of starting up a kick-ass nonprofit that's going to benefit some amazing people. Except for the raging insomnia, this is all good and productive and of great concern to my therapist. I am doing too much and I know that's against medical advice. The thing is, once you've been sick and then better, and then sicker and then stable, you're always waiting for the other shoe to drop. It's a damned big shoe, too. The thud is profound.

I can't afford to be cautious. I have already lost too much time, productivity, and brain activity to something I can't really control. Slow down? Take it easy? Coddle my brain? Seriously? The fact remains that no matter how closely I follow medical protocols prescribed for my condition, the meds can fail or the brain can re-work itself so that the illness rises up again. Caution is no guarantee of continued therapeutic success. I have to keep going. I need the world to understand that no matter what, I busted my ass to keep going and I tried very hard to have worth and to contribute, even when it was the most agonizing thing to do.

I am making up for lost time, and when I surpass that deficit of worthwhile time, I will start banking credits I can fall back on when that shoe does, inevitably drop. I have a lot of catching up to do and if past experience is any indication, a lot of credits to squirrel away. Please don't hold me back.

38 days

38 days until the one-year anniversary of the worst day of my life. Obviously, I'm still traumaized by it, because I still spend part of every day having at least a few minutes of visceral emotional response to the memory.

I have 38 days to figure out how to tell the story. Perhaps if I spew it into cyberspace, the thoughts will finally leave me alone.

Snow

It's snowing. Snowing, snowing, snowing. Average date of first snow here October 15, so I guess we're on time. It's windy, too, so the snow looks even worse whipping around in cottony swirls. I hope, though, that this isn't a harbinger of things to come. I will not survive another winter like last winter. It was beyond description--surreal conditions for weeks that brought my mood down to a low that seemed impossible to recover from.

The leaves are still on the trees--in my yard, the leaves haven't even turned color yet. So far, we've lost two tree branches (ouch!) plus our shade canopy, which just collapsed in a silent implosion an hour ago.

I wanted to go out today. I have errands to run, especially after the marathon work day I put in yesterday. Up at 5:00, at work before 7:00, facilitated a high-energy training for eight hours (yes, 8), cleaned up, stopped at Hobby Lobby. My feet hurt so badly, I felt like I couldn't make it to my car. I still wasn't able to fall asleep until 12:30 and woke up at 5:30 anyway. Stayed in bed until 7:40 just on principle.

My husband is the fucking heat Nazi, so I'm chilly to the point that my nose hurts. I am from hardy stock, but a 62-degree living room on a snowy day is more than a depression-prone, SAD-diagnosed, deeply fatigued woman should be forced to bear. Last year when something like this happened, I handed my husband a ten-dollar bill and told him to turn up the goddamn heat already. He sulked for a week. It's not that we can't afford to heat the house; my husband just likes to push the envelope in a competitive way to see how low we can go to win his mythic battle to champion energy efficiency. Fuck that.

In 1973, my parents bought a newly constructed home just beyond the Philadelphia suburbs. We were off the gas grid, which meant all of the homes in the area had oil heat. The house was big and not all that well constructed. My parents had put every cent they had into this house, and frankly, it was a lot more house than they could afford. Then the oil crisis hit making prices soar, recession barreled through the U.S., and inflation was the highest in decades. Something had to give, and so it was the heat. The thermostat was my mother's domain, and we were forbidden to touch it. If we complained of the cold, she'd snap back, "Put on another sweater."

At night, my mother turned the temperature down to 52 degrees--just enough to maintain a safe temperature in the baseboard hot water heat lines. During the day, it was set at a brisk 55. Mornings were painful for me. I don't mean they were unpleasant or uncomfortable--I mean, I felt pain and unhappiness into my core. I swore that when I had my own place, I would never be cold. Unfortunately, I'm married to someone who is obsessed with automating everything to the point that I can't figure out what the hell to do to initiate a manual override. What makes people do this? I don't mean to abuse the environment or to upset the perfection of a meticulously programmed thermostat, but I'm turning up the heat. There has to be something available to me to make a crappy, cold, snowy day tolerable. I refuse to put on another sweater.

I forgot to add...

I was so deliriously tired yesterday, I omitted some things from the cranky list--the very things that inspired me to write the list in the first place.

• Women that blab blab blab on the cell phone while they are using the toilet in a public restroom. Am I the only person left on earth who finds this to be an egregious display of appallingly bad manners???
• Drivers who blab on the cell phone while negotiating the complex task of driving. What in the world is so fucking important that it's worth risking my life and the lives of every other driver sharing the road at that moment? I keep having near-accidents with people who believe they can multi-task behind the wheel. Newsflash, America: You suck at doing this, so stop it!

I feel much better now.

Cranky as hell

I am cranky. I am bitchy. I am overworked and underslept and I need some time off and it isn't going to happen, but fuck, working seven days a week is not what the doctor ordered.

To acknowledge this fantabulous mood, I must voice some of the things that crank up my crankiness at times like this. Before I do though, I must say I am intrigued that someone in Australia stopped by to read the nonsense that is so abundant in my head: the virtual brainucopia.

Things that make me clinically irritable:

• Bad drivers who have obviously never read the handbook;
• Litter;
• Poor grammar;
• Reality television;
• All Audi drivers so far;
• NPR fundraising;
• People who believe cutting back to just chicken means you're a vegetarian;
• People who don't follow instructions;
• Religious zealots;
• Items on the store shelf that are unpriced;
• White guys who talk like they're from the 'Hood;
• People who hover behind me when I'm on the phone;
• Microsoft's tendency to believe its products can and should think for me;
• Telemarketers;
• Telephone customer service;
• Poorly designed Web interfaces (such as my bank's online system);
• Lithium;
• Hand tremors;
• Insomnia;
• 31 years of acne;
• Morning;
• Condescension;
• Arrogance;
• Klutziness;
• Rain;
• Wind;
• Rain and wind together;
• Misplaced stuff;
• Gas pain;
• Racing thoughts;
• My own paranoia;
• Organized religion;
• Aggressive drivers;
• People who don't pick up their dog's poop;
• Hiccups;
• Too many commercials;
• Poorly marked addresses;
• Allergies;
• Awesome shoes sold out in my size;
• Cigarette smoke.

There's more, but I'm not cranky enough to generate more of a list.

VO2 Max

OK, there's something I didn't mention in my "things about me" post a while back. I enjoy being a study subject and participating in marketing research. Seriously. In the past few years, I was a subject in a bipolar study (which is actually a huge, NIH-sponsored deal), a study regarding new technology to measure resting metabolic rate, a small study regarding granola bars, and miscellaneous other research endeavors.

My latest foray deals with that which I hate most (no, not lithium): exercise. The criteria couldn't have fit me better: Over 35, overweight, sedentary, elevated blood pressure, and feeling guilty about it. Sign me up.

There's always some tasty reward for the rat--cash, free products, the satisfaction of knowing you are nobly representing your demographic in the quest for better products, marketing excellence, and occasionally science. In this case, I get eight weeks of a total of 24 individual fitness training sessions with two of the best-known elite sports trainers in the city, a nutrition plan, and most importantly, a $700 piece of exercise equipment. I know, I know, everybody's skeptical, but I'm not gullible by nature, so of course I checked it out.

I was told to show up for an intake evaluation at 4:30 today. Wear shorts. I sent an email. Please, can I wear stretchy yoga pants or will they interfere with the pinching of my fat, which I'll assume you'll be doing? The word comes back: yoga pants OK. I am relieved knowing I can still participate. Shorts would have been a deal breaker.

The researcher's office is a shared space inside of the local Jazzercise center. I pulled open the glass door and stepped inside. A perky blonde in workout wear appeared immediately and popped herself behind the desk. "Well hey there, how are you today?" I hated her on sight. I smiled and said I was looking for Bob. Blondie remained perky and directed down the hallway.

After the initial chit chat, Bob got down to business. We started with weight, and he tried to tell me that Mr. Scale is my friend. He noted my weight and said, "You'll weigh 15 pounds less in December." Next was a resting metabolic rate test--something I have actually done before. Bob kept checking the machine and commenting that the reading seemed high. He took a bathroom break came back, and checked the machine again. He seemed a little giddy when he said, "Hey, how many meals do you eat a day?"

I sighed and told him that it doesn't matter how much or how little I eat, I'm always hungry. My stomach growls. Since my weight never changes, I stick to a three-meals-a-day plan with a light afternoon snack. Bob's eyes lit up and he said, "When we see a reading like this, it tells us one of three things. Either you're a high-level athlete with an incredibly efficient metabolism, you're in the middle of the Kalahari, starving, or, you aren't eating enough and your body now thinks you're in the Kalahari starving. I'm guessing it's number three. Hey, May, good news! You're gonna eat more and lose weight!"

Before I go on, let me just say how nice it was to have someone validate what I've been saying all along. I love it when I'm right.


Throughout the battery of tests, our conversation was punctuated by the repeated, enthusiastic "Woo!s" of the Jazzercise class outside the door. Every time the women shouted out another "Woo!" Bob raised his arms and rolled his eyes. It was funny.

We eventually got to the test I suspected was coming but hoped was not: VO2 Max testing. This is a test that pretty much determines at what level of physical exertion you will puke or pass out. I looked at the bike, looked at Bob and asked, "What if I throw up?" Bob shrugged his shoulders and said, "I have a mop."

In this test, you put on a neoprene mask that is then attached to a tube. It feels like you're breathing through a straw, and you look like a sporty Hannibal Lechter. Very fetching. You pedal at a steady rate and every two minutes or so, the tester increases the resistance on the bike. At least they cheer you on. This process continues until you turn purple and fall over. Or something like that. I was on the verge of tears and my face was an alarming shade of crimson when Bob, obviously a man of mercy, pulled the plug.

Bob tells me I'm not as out-of-shape as I look or perceive myself to be as I sit on the bike heaving in big gulps of air and feeling like there's a lung gone missing. Apparently, I'm also a really good sport. No, Bob, I'm just a research slut who will work the maze however I need to in order to get something for free.

I had to tell Bob about my bipolar situation, but he felt that was just one more thing to make my research experience more valuable. He wants to take special notice of my lithium-induced balance issues to see if using this exercise machine improves my issues with gravity.

If I get my piece of exercise equipment, I'm going to sell it and use the money to buy something really decadent. Is that so wrong?

See? I told you my brain might explode

I have high blood pressure. This is a shock because I never had it before; in fact, I've always had oddly low blood pressure. How I came to find this out is a little strange. When I went to the doctor last month, the nurse took my BP. I asked what it was and it seemed high--and not just for me. I chalked it up to white-collar hypertension and the lingering effects of city driving.

While looking for something completely unrelated on Craig's list, I saw a posting for an exercise research study. The carrot was that participants who finished would be rewarded with a sweet Pilates machine. I downloaded the forms and went to work sharing my personal health info. I actually had more trouble admitting my weight than I did admitting I take six medications for Bipolar disorder. I came to the question about blood pressure. Hmm. I remembered the doctor appointment and decided to take another look.

For reasons I will not explain right now, we have a BP monitor at home. I set it up and sat there dumbfounded when I saw the result. I reset the machine and tried again. Same thing. Later in the day, I checked again and it was lower--141/97--but that's still considered high blood pressure. It's not even pre-hypertension; it's high BP (which I verified on the American Heart Association Website).

The AHA has a very nifty tool on its site that lets you calculate your risk of doom and brain explosion based on five factors. I love interactive tests, so I jumped right into the fun. Starting with Body Mass Index, I was reminded that by the AHA's standards, I'm obese. Is there more? Bring it on! My blood pressure is high and I'm a slug. Then came the statistics. I'm five times more likely than a normal person to suffer some catastrophic cardiovascular event.

Well, that's sobering. Perhaps the next part of the test will show me there's hope. You can estimate change in five areas, but I already do three of those things. That leaves diet and exercise. In a stubborn snit, I refused to add 30 minutes of aerobic exercise to my profile, but did concede ten pounds even though I don't believe I can achieve that without severing a limb.

Of course, my risk didn't really change, which means I either have to lose more theoretical weight or do more theoretical exercise. Neither is an appealing option.

I realize that I flirt with my own mortality by not accepting true change, but that isn't what worries me. I'm not afraid to die, but I can't tolerate discomfort. Kill me but don't make me suffer. I fear having a stroke and being left with aphasia or limited mobility. I worry about having a heart attack that leaves me too weak to function normally. Were I to need heart surgery, I couldn't sign that DNR order fast enough.

In my own defense, I know that my high BP is in large part due to one thing: EMSAM. It works exceptionally well, and if I don't take it I'm screwed. This is the MAOI that returned my will to live. How ironic that it could kill me.

I don't want to exercise, but since there's not much I can do to tweak my diet--short of ceasing to eat altogether--this may become a torture of necessity. Damn. The last time I tried to engage in physical activity, I thought yoga might suit me. I had a gym membership at 24-Hour Fitness so I bought a wafer-thin roll-up mat and left my socks at home. Somehow, I had been deluded into thinking that yoga was gentle and calming. Apparently, I had unknowingly signed up for the sadistic-Nazi yoga class because half-way through the first session I was gasping for breath and I looked like I had just stepped out of the shower. The next day, I was in so much pain, it was obvious my body had produced previously unknown muscles so I could experience an extra-intense level of pain.

I continued the classes for a month, but I kept falling over in all of those one-footed positions, plus I couldn't accept that yoga was supposed to make your body hit the Lactate Threshold. That was the end of yoga.

So, what are my options? Be miserable exercising or be miserable with a brain that could blow at any second? Such a conundrum.

Andy Rooney agrees

The day I posted the previous essay about fall, Andy Rooney made a commentary about the seasons on that night's 60 Minutes. You can read the full essay here, although I disagree with his views on summer and winter. Here's his take on fall:

I think if we had a vote, fall would probably be most people's favorite season. Some people who like fall call it autumn. I never use the word "autumn." It sounds pretentious. The down side to fall is it's the beginning of the end of everything. Flowers die, the leaves dry up and come off the trees, water in the lake gets too cold to swim in and vacations are over. First thing you know someone's trying to sell you a Christmas tree.

I need sun

I may not have mentioned this, but I grew up in the Mid-Atlantic East Coast. Now I live in an area that has more than 300 sunny days per year. Those other 65 days are problematic.

One of the reasons I never moved back East was this weather issue. I'm stunned when people tell me that fall is their favorite time of the year. Fall? Are you kidding me? This is the time of year when daylight comes to an abrupt halt, nights are cold--and eventually the days are, too--it gets windy, and worst of all, it rains. Outside my window right now it looks like something from an Ingmar Bergman film. The sky is grayish white, it's kind of dark for late afternoon, it's cold and damp and raining that pissing, misty, no-windshield-wiper-setting is-right kind of rain. Back East, this pretty much describes the entire second half of October and all of November. I used to threaten to rip the November and March pages off the calendar so those months could be eliminated completely.

Fall as a favorite season. Is this some kind of Martha Stewart-esque idealization of misery in hell? Everything is already dead or dying, people. It rains. It's dark when you wake up in the morning and dark when you leave work. It is the kick-off of carb-loading season.

I need sun. I need warmth. I need long days. I think I need to move to the Caribbean. Only eight months until the summer solstice. Not that I'm keeping track.

Where is the love?

I think I've lost the ability to love or experience love. Well, I don't experience love because I don't think there's any coming my way. I really don't. There are people who know me who would probably tell me that of course they love me, but would do nothing to actually demonstrate that. In the absence of concrete evidence, I remain very skeptical. That's pretty much how I feel about god, too.

Anyway, I was sitting here thinking about love, and I've concluded that I don't love anyone except my husband. Maybe my mother, but our history is long, troubled, and very complex. Otherwise, I have to admit, there are people I like (not many), few I care to know well, and none I have any strong feelings for. None.

The friendships I used to have died long, slow deaths when my bipolar disorder went haywire. Nobody cared, or maybe they cared so very much, they felt abandonment and criticism were the only way to show the true depth of their feelings. Once I let go of those relationships for good, I made a conscious decision to stay the hell out f that kind of personal involvement going forward. My therapist and my husband told me I was making a grave and dangerous mistake--we all need friends and a solid support system. Apparently, I don't. I thought I would feel sick with longing for that closeness that friends can provide, but the reality is, I hadn't had that kind of relationship with anyone for close to a decade.

Now I am in the position of being faced with a dilemma. There is someone who has made overt attempts to draw me in as a friend. I like Elizabeth, I really do. She's exactly the kind of person I would have become friends with if my life had turned out differently. Now I just see nothing but complicated explanations or complicated lies ahead of me. It's not possible to be my friend without being informed of my brain issues. I have no intention of ever telling anyone else, ever again, that I have a brain disorder.

When I think about this issue, and I'm not articulating it well, I have to conclude that I am incapable of connecting with anyone beyond a superficial level. I'm not unfriendly, I'm not selfish, and I'm not throwing up walls around myself. I am, quite simply, disconnected. It doesn't bother me, but my therapist keeps telling me this is unhealthy.

No. Unhealthy is making yourself vulnerable to the emotional whims of other people and believing they'll respect that. Again and again I find the same thing: People are unreliable and disappointing. There's not much I can do about that except to keep myself safe.

True threat or good marketing?

It appears to be Breast Cancer Awareness month. It's hard not to notice since we're being bombarded with pink. There has been a breast cancer story on TV pretty much every night this month. The ubiquitous pink ribbons are cropping up in the darnedest places, like on key chains, car magnets, cell phones, earrings, and even on the plastic container of bakery cookies I bought at Safeway last week. With PR like this, how could we not be aware of breast cancer?

Quick: What is the leading cause of death in American women, regardless of age or race? Think it's breast cancer? Cancer in general? Guess again. Go online and you'll find the following statistic in a number of prominent places, including Websites for the CDC and the American Heart Association:

Nearly twice as many women in the United States die of heart disease, stroke and other cardiovascular diseases as from all forms of cancer, including breast cancer.

It seems to me that instead of churning out pink ribbons, the American marketing machine should be hyping little hearts.

Why does breast cancer get so much more press when cardiovascular-related illness and deaths are so much more prevalent? Is it because cardiovascular disease is fairly preventable but Americans hate to hear that they need to eat better and exercise more? Is it easier to champion a disease that seems opportunistic and therefore engenders more sympathy by default?

So, now that you're aware of the disparity in awareness campaigns, and you obviously know that October is Breast Cancer Awareness Month, can you also identify which month is American Heart Month, founded and promoted by the American Heart Association? I'll give you a minute to think about it. Make an educated guess based on the visual symbol--a heart. Tick...tick...tick... time's up.

American Heart Month is February. Not only that, but it has been American Heart Month, by presidential proclamation, every year for the past 44 years. That's right, the American Heart Month campaign has been pumping along since 1963. National Breast Cancer Awareness Month? Hmmm...About 20 years.

I think it's good to be aware of conditions that could potentially kill us, especially if there are things we can do to avoid getting those illnesses in the first place. That being said, isn't America focusing on the wrong thing--by a lot? Pink ribbons have become big business, and that churns up a bit of cynicism in me. Maybe the American Heart Association needs a new ad agency.

For some excellent thoughts on this subject, check out: http://thinkbeforeyoupink.org/Pages/AboutTheCampaign.html I was going to recommend specific parts of the site, but really, the whole damn thing is great. Your brain might grow as you expand your critical thinking skills. Actually, if you read my blog, your critical thinking skills probably don't need tweaking at all, just stimulation.

In honor of Breast Cancer Awareness Month, I'm going braless until November (improves circulation and makes me far more comfortable).

Say *&@#! with Hallmark

The story you are about to read is 100% true. I couldn't have made this up had I tried.

I may have mentioned that I have issues with telephone customer service people. Have I mentioned that? When I need customer service, I prefer to access it via the Internet. The less contact I have with humans on telephones, the better. I am deeply offended that so many companies, especially banks, take advantage of my telephone time--which I'm using because I need help--to try and sell me something.

Nothing puts me on edge faster than when my call is routed to Bangalore. I can't articulate why, but if I must speak with someone, I want to speak with someone who has some cultural frame of reference for whatever it is that's troubling me. I also want to speak to someone who can deviate from a script and totally ad lib, if need be.

Last Thursday, I needed to order flowers for a coworker's funeral. I went through all of the steps online and was about to pay when it occurred to me that there was no way to specify what time the flowers should arrive. I took a deeeep breath and dialed the number for customer service.

(voice = American male): Thank you for calling Hallmark. How may I help you today?

(me): I'm online ordering flowers, but there doesn't seem to be any way to make sure they'll be where they need to be on time. It's for a funeral. How can I make sure the flowers arrive before 10:00 tomorrow morning?

(Hallmark Man): Thank you for choosing Hallmark. What is the name of the bouquet you wish to order?

(me): It's the pink gladiola spray for like, ninety dollars.

(HM): I need to put you on hold for a moment. (wait...wait...wait...wait...) Thank you for your patience. Ma'am, that bouquet is eighty-nine dollars.

(me): Um, OK. I knew that. Can it be at the church before ten o'clock tomorrow?

(HM) Let me look. The earliest possible delivery is October 5.

(me): Yes, I know. That's tomorrow. That's not my question. Can the flowers be at the church before 10:00?

(HM, flustered): Ma'am, it doesn't work like that...you gotta...

(me): It's OK. I just need a confirmation. If it won't work, I can go through a local florist, but I need to know now so I have time to place the order locally.

(HM) But, no, it's...I need to put you on hold for a moment.......................Thanks for your patience. Is this for a funeral?

(me): Yeeees.

(HM): OK, that's not going to be called a funeral arrangement. It's called "sympathy."

(me): Um, OK. But can the flowers be delivered before 10:00 tomorrow?

(HM): I need to put you on hold for a moment..........(wait, wait, wait)....Thanks for your patience. Where are the flowers being delivered?

(me): Do you want the address?

(HM): No, ma'am, I need to know where they're going to be delivered.

(me): I'm sorry, I don't understand your question.

(HM): Are they going to a hospital, or a private home, a cemetery?...

(me) They're going to a church.

(HM): I need to put you on hold for a moment..........(wait, wait, wait)....Thanks for your patience. Ma'am, we can take your order. What is the name of the recipient?

(me): St. John Lutheran Church.

(HM): No, ma'am, what is the name of the person who...who's having the funeral?

(me): Darlene Utah, like the state.

(HM): I need you to spell that for me.

(me): D-A-R-L-E-N-E

(HM): And the last name?

(me): Utah, like the state.

(HM): I need you to spell that for me.

(me): Really? U-T-A-H

(HM): What is the name of the delivery location?

(me): Saint John Lutheran Church

(HM): I need you to spell that for me.

(me): Which part?

(HM): The name of the church.

(me): All of it?

(HM): Yes, Ma'am.

At this point, I spelled every word of the name of the church. When I gave the address, I had to spell that, too (Elm St.), as well as the name of the city (for illustration purposes, let's say, Washington City), and the state name.

(HM): I have to put you on hold for a moment..........(wait, wait, wait)....Thanks for your patience. Now, what time is the funeral at?

(me): Ten O'clock. Tomorrow. October fifth.

(HM): Now, do you want a gift card with that?

(me): Yes.

(HM): What kind of card do you want?

(me): What do you mean?

(HM): Do you want one with flowers on it, or generic, or for sympathy...Like that.

(me): Sympathy.

(HM): Do you have a message?

(me): Yes. How long can it be?

(HM): Uh, it can be as long as you like. There's no limit.

(me): Oh, good, because online it can only be four lines.

(HM): We can make it four lines.

(me): No, that's OK. I just wanted to know if I was limited. The card should say, With deepest sympathy from friends and colleagues at Susan Smith Adult School. Darlene's love and laughter will never be forgotten.

(HM): I'm going to need you to spell that for me.

(me): Which part?

(HM): All of it, from the beginning.

At this point, May painstakingly spells every friggin' word on the card. HM responds by asking which letters should be upper case and where the punctuation goes.

(HM): I need to put you on hold for a moment. ..........(wait, wait, wait)....Thanks for your patience. Now, I can get as far as "...friends and."

(me): For the whole card?

(HM): No, ma'am, for the first line. Where would you like the line break to be?

(me): Well, I guess that break is fine.

(HM): What would you like on the second line?

(me): Well, I guess whatever comes next in the message.

(HM) Yes, ma'am, you need to dictate that message, please.

OK, this went on for almost 15 minutes. HM couldn't seem to get past that issue of four lines once I had put it in his head. Finally, I said:

(me): Look, I don't care where the line breaks are. I just want the message on the card, however it's distributed.

(HM)Yes, Ma'am, I understand. I think I can get it on four lines if you can take out a couple of words...

In all, I was put on hold more than a dozen times. It took 40 minutes to place the order. What a fucking Hallmark moron.

Is that upper case, or lower case? Where do you want the punctuation?

For awhile there, I wondered if I was being punk'd--you know--candid camera.

Faaaaalllliiiinnnnnggggg

And a deep sadness came crashing down upon me. This is the problem with the fall: first the weather changes and it isn't hot anymore, and then the daylight gets all screwed up and it's dark a lot. This arrangement usually doesn't work out very well for me.

At this point, only my therapist really knows what's going on. When we talked last Friday, I told her that I do believe it's possible to die from loneliness. I don't want to be around people just for the sake of being around people. There are too many annoying ones you have to pick through until you find one that doesn't irritate the crap out of you.

I said this last night, sort of out loud into the living room. I said, "And the worst part is, I'm alone. I have no one. Nobody to talk to, nobody to spend time with, nobody to validate my worth in the world, nobody I can trust to hold on and ride out these rough waves with me. I feel invisible."

My husband cheerily chimed in from the kitchen, "You have me." Which is a point well taken, but seriously, as my mood has been crashing, my husband hasn't noticed because he's had his head stuck in the dishwasher (well, in the dishwasher but not literally stuck) for two days because he's all kinds of fascinated with the details of our newest appliance. It's hard to have a soul-to-soul talk with someone who is totally occupied by repeatedly flipping the tines up and down on the dishwasher racks. Sometimes I think there's a little Asperger's mixed into my husband's literalist brain. I love him, I do, but his ability to get completely absorbed in technical minutiae worries me sometimes. He obsesses. How can I share my inner-most, worrisome, neurotic thoughts with someone who is busy finding great entertainment in measuring the decibel level of the new dishwasher?

I need a light box for my looming SAD. I need a different life. I could really use an upgrade on the brain. There's nothing specifically wrong these days, I just feel like generic crap. As Patsy Cline said, Crazy, crazy for feelin' so lonely; Yes I'm crazy, crazy for feelin' so blue.

I'm tired, my big project isn't coming together as I'd hoped, I feel totally isolated in that way that is always so well described in classic literature or old-school psychiatry. Isolation is actually an internal issue. I find it damn near impossible to connect with people, let alone love them, so why should I expect any different outcome than the one I'm getting? Maybe it's just my brain gearing up for the Big Fall Event. This is always when May wants to "go away," if you know what I mean.

Just to be ready for any outcome, I will continue purging closets, clutter, and the basement. At the very least, I'll get something done and have a much more efficient home.

Hang on kids, it's going to be a very bumpy ride.

Shopping: Not for the faint of heart!

I decided to try shopping. My shopping-center Mecca has a TJ Maxx, Ross, and a Tuesday Morning for good measure. It gives me chills just thinking about it. It's like they knew I'd be buying a house right down the street.

I have to tell ya, there's a whole lotta ugly out there. When did the Seventies return and for the love of God, WHY??? The faux-wrap polyester dresses were overwhelming in their ubiquitous availability. Ugly, ugly prints on almost slimy fabrics. Who wears this? I didn't like it the first time around, and I am not prepared to look like a circa 1977 secretary, thank you very much. When did disco make a comeback? OK, it didn't but the clothes are back with a vengeance. Why do all of the blouses look like maternity tops? Isn't this what I wore in the 8th grade? Make it stop, someone, please...make it stop!!!

I have a problem when I shop. If some anthropologist were to observe me, they'd have a field day. Subject approaches rack. Realizes she's in the size sixes and not the sixteens. Obviously tries to nonchalantly locate the right part of the rack. She looks through the clothes; slides hangers to the left, to the left, to the left. Ah, what is this? She has found something pretty and affordable...What is that look of disgust? Ah...It appears that some incredibly cruel person has been mixing size sixes in with the sixteens. That is mean. OK, she's looking....Subject appears to be frustrated...What's this? A calf-length black skirt. Ah-ha. Field note: When the shopping gets frustrating, our subject reverts to buying a calf-length black skirt. How many must she have by now? If only we could view her in her closet of despair...

The other option is jewelry. I must tell you, TJ Maxx has the most incredible jewelry counter on the planet. I buy a lot of jewelry. I make a lot of jewelry. I know what jewelry costs. I bought a pink leather, sterling, and fresh-water pearls cuff bracelet for $14.99, and it's Honora Pearls. This, ladies and gentlemen, is what we call a score of major proportions. If you check the Honora Website, this bracelet currently retails for $125. Holy shit, I know how to shop! I'd be more excited had I bought this bracelet for me, but it's a gift for an affluent friend, who, I'm pretty sure, has no idea what TJ Maxx is. Giggle, giggle, victory dance...

Shopping is my sport and my curse. This is why I always end up with the things I do. Black skirts are easy and make me feel like I accomplished something; jewelry always fits.

I've consumed 700 calories today. I'm hungry. Really hungry, but...I want to buy pants. As Colonel Kurtz would say, "The horror, the horror..."

The closet of horrors reality check

There comes a time in every (fat) woman's life when she must face the fiasco of her clothes closet. My closet has been crammed with clothes for quite some time now. It's something I try to ignore because the truth is, most of what I actually wear is in the basement laundry room.

This morning I decided to pull out all of the summer clothes from the closet, as well as anything that doesn't fit--no excuses, no wistful utterances of "someday."

This was one of the most depressing things I've done in a very, very long time. It's hard having to admit that 90% of what you own is either the wrong size or suited for a lifestyle you no longer have. After I pulled everything out, I was left with a sparse collection of gray, black, and dark brown clothes I don't even like but I'm keeping because they fit. It's a financial issue. I have drugs to pay for, dammit, drugs that are making me fatter than I've ever been.

I had some really beautiful clothes. Some things were expensive, others were just pretty, and all were well-matched to my pre-meltdown personality. At this point, I generally go for the things that (1.) fit, and (2.) are comfortable. This has left me with a mountain of clothes spread across my bed, a mountain of pretty things mocking everything I have become. I'd like to make a big bonfire in the back yard, or maybe prolong the agony by just stoking the chiminea on the patio, but there's a practical side of me that can only say, "Goodwill. Again." I guess sometimes I can be mature and not spiteful. Doesn't feel nearly as satisfying somehow.

This leaves me with two options for the afternoon. Go out and endure the humiliating and thoroughly frustrating act of trying to buy a few more outfits that are the elusive right size and cut for my shape, or just bury myself in the pile of reluctant cast-offs and blow my brains out. Dramatic! Like performance art with an edge. Oh, wait. I don't own a firearm and I'm pretty sure I'm on that list that says I can never buy one.

I know. Wouldn't it be great if instead of hauling people off to The Place for Defective and Misunderstood Brains, someone could run an intervention on my behalf and force me into an intensive 90-day program of liposuction, cosmetic surgery, and spa meals. Nothing could possibly brighten my mood more at this time.

Why, why, why couldn't I have been born with a freakishly high metabolism and a borderline-pathological obsession for exercise? My parents had four children with three fitting this description, but in the middle something went horribly, horribly wrong genetically and they produced me. I got me to live with for every day of my life. Just another reason I am compelled to believe there is no god--at least, not the kind that has any affection for humans.

I'm rethinking the autumn bonfire...