ionetics

Unreliable and possibly off-topic

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Tuesday, May 27, 2008

Balance

It's Rob who says everything balances up. And Lo! It came to pass!

My hard-working colleague was uncharacteristically off or working at home last week. She was back this morning in good time to watch me roll in late, as is not uncommon. When she asked me to hang about for a 'quick word', I'm expecting some (deserved) censure of my timekeeping, esp. because she's been noticeably irritable in the last few weeks.

But no- she has some news. She is unexpectedly preggers. She is unexpectedly very preggers.

I'm careful not to betray any reaction till hers can be gauged. But as she talks, her face start to shine with happiness and clearly it's the best news ever. She's 18 weeks gone- halfway through- without having suspected a thing.

Today I learned she's been undergoing investigations of her 5 month amenorrhoea at the high-falutin', five-star Dept of Reproductive Medicine of the local teaching hospital. Bloods have been taken for hormone assays, to assess her for ?premature menopause and to exclude nasties like a pituitary tumour. Both she (a very bright life-sciences graduate) and the high-falutin' docs had rejected the most common cause of amenorrhoea in their differential diagnoses, since an IUD boasts a 99.5% success rate at preventing pregnancy.

It was a new GP, passing on my colleague's spectacularly normal hormone assay results, who suggested excluding the obvious. A urinalysis there and then saw the twin lines form in the hCG test's window, and that's when it started to snowball.

God bless the NHS, within 2 days she'd had an ultrasound to estimate dates, to seek the wandering coil and to exclude an ectopic pregnancy. GP couldn't palpate a pregnancy (and she's not showing at all), so estimated dates at 8-9 weeks. Um, no. On ultrasound no coil anywhere, but a huge, beautiful, sound and entirely unexpected intra-uterine foetus of 18 weeks gestation, waving hello to its parents. She showed me the scans, which brought tears to my eyes for her happiness, the beautiful babbiness and the memory of mine. This will be the best thing that ever happened for her, and, smart woman, she already knows it. Now she needs to learn to take a lunch-break.

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Sunday, May 25, 2008

Varieties of the black spot

Mum tells me that it comes with age, that signs and portents of the Black Spot will become increasingly frequent.

This week, I received an abnormal smear report, a friend's friend is found incidentally to have a brain tumour and Peter Ballocks is diagnosed with an oesophageal mass.

My abnormal smear is not the black spot- maybe a tiny grey comma, if that. It's a pre- pre-cancer warning that will be treated and go away. That's what the cervical screening program is for. I may write about this later as a health education topic and a warning for the next generation, but it's of no real health concern as long as appts are attended.

The friend's friend had a head MRI scan during participation in a research study as a normal control subject. This showed tissue projecting into his fourth cerebral ventricle, with radiological appearances of a subependymoma. If you had to select your own brain tumour, this is the one you pick- slow-growing, non-infiltrating, excellent prognosis. He'd had a neck MRI 6 years ago, and although not picked up at the time the mass was present then- same size and location, then as now asymptomatic. It's not causing any structural/mechanical problems (e.g. hydrocephalus) so he will probably opt to watch and wait. The 4th ventricle lies between the cerebellum and the brainstem, and sticking a knife in there raises a possibility of damaging the autonomic control centres that regulate heartbeat and breathing. For the moment, his tumour will be a silent companion and symbiot. It's not bothering him, so he won't bother it.

Peter Ballocks' tumour is not a harmless stowaway. It's got so big and greedy to grow that it's stopped him swallowing. When he tries to eat solids it makes him throw up, so he sticks to alcohol and milk. He's lost a lot of weight in the last 3 years. Last year he became so persistently obnoxious (behaviourally) that H-etc. kicked him out, and he moved back down to the Borders.

I've had a working diagnosis of Korsakoff's psychosis for Peter for some years (a B-vitamin deficiency provoked by alcohol, which destroys the brain's mammillary bodies and kills memory), but now I wonder if he has another stowaway in his brain, thrown off from the oesophageal tumour. This Friday, the growth in his gullet is so big the endoscope couldn't get past it. He'll be sent for scans next week to image his stowaway's size and assess the extent and location of metastases.

H-etc doesn't visit here, so it's safe to write what isn't yet said. Oesophageal cancer is not a one you'd pick. By the time symptoms precipitate investigation it's usually too late for the docs to do much. In 80% of cases, surgery, chemo and radiotherapy are not worthwhile, causing more symptoms than they solve and little improvement in life expectancy of any decent quality. Survival rate at 5 years- 5%.

All I can do is let H-etc. (the 'etc.' stands for 'who is very good to me') know that my phone line and door are always open, day and night. I can be the nagging bitch on the Western General Hospital's phone line, who makes sure she and Peter B. have access to specialist oncological services and to Marie Curie when the time comes. I can try to help her talk through the guilt feelings that will probably well up once his prognosis becomes clear. Luckily, I know that Peter Ballocks, for all his charm and once-intelligence, was a fucking nightmare to live with, pre-dating this neoplasm, and she didn't divorce him over nothing. I'm good in a crisis, as long as it's not mine.

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Saturday, May 17, 2008

'Grief', Matthew Dickman

I read this poem a couple of weeks ago (New Yorker mag) and was bowled over, so shall pass it on. Posting this is in no way a sign of distress (I'm actually quite chipper), but an appreciation. I found previous drafts on the internet, but this really is my favourite version.


'Grief'
by Matthew Dickman
New Yorker 5th May 2008

When grief comes to you as a purple gorilla
you must count yourself lucky.
You must offer her what’s left
of your dinner, the book you were trying to finish
you must put aside,
and make her a place to sit at the foot of your bed,
her eyes moving from the clock
to the television and back again.
I am not afraid. She has been here before
and now I can recognize her gait
as she approaches the house.
Some nights, when I know she’s coming,
I unlock the door, lie down on my back,
and count her steps
from the street to the porch.
Tonight she brings a pencil and a ream of paper,
tells me to write down
everyone I have ever known,
and we separate them between the living and the dead
so she can pick each name at random.
I play her favorite Willie Nelson album
because she misses Texas
but I don’t ask why.
She hums a little,
the way my brother does when he gardens.
We sit for an hour
while she tells me how unreasonable I’ve been,
crying in the checkout line,
refusing to eat, refusing to shower,
all the smoking and all the drinking.
Eventually she puts one of her heavy
purple arms around me, leans
her head against mine,
and all of a sudden things are feeling romantic.
So I tell her,
things are feeling romantic.
She pulls another name, this time
from the dead,
and turns to me in that way that parents do
so you feel embarrassed or ashamed of something.
Romantic? she says,
reading the name out loud, slowly,
so I am aware of each syllable, each vowel
wrapping around the bones like new muscle,
the sound of that person’s body
and how reckless it is,
how careless that his name is in one pile and not the other.

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Friday, May 16, 2008

The Circle


So we held the celebration for the dear departed dad last weekend, at St Mark's Unitarian Church. The Unitarians are great because they don't care what or if you believe, and their kirk is spare on religious imagery but big on the soaring ceilings, leaded windows and acoustics of a sacred space.

There was no officiation, but several of dad's friends and family spoke about him, his young compadres from the Greek Dancing Group performed some folk dances, and we played some 20th C music he liked. No photos taken, no video- there and gone, except in memory.

Was up at his grave Friday lunchtime with my sandwich and latest issue of Pick-Me-Up. Said hello to dad and to that cheeky robin who's the bouncer there, ate my lunch and read my dreck in the sunshine. I leave my pebble on the plot, touch my fingers to his temporary plaque in goodbye, then back to work.

This is my favourite photo of dad with mum. It's 1967 and their first date, at the Renaissance Fair in San Francisco. Dad's already in his Greek dancing costume, mum in a hippie medieval dress she made from an Indian bedspread. They are 24 years old. In 4 years, they will leave California for a frozen Scotland of binmen strikes, 3-day weeks, power cuts, incomprehensible weedgie accents, paraffin fires, Scottish country dancing and a brand new life. He sings to her, "Will you go, lassie go?" and she says yes.