Wednesday, February 14, 2007

[Note taped to the front door, at eye-level]

I'm taking a break from blogging, for a bit. There are some things in my life that require my attention, at the moment, and I find my engagement here is distracting from what I must do there.

I'll be back soon enough.

In the mean time, I'll leave you with something I linked in a comment to Schad on Wikifray - one of my favorite SouthPark moments.


Monday, February 12, 2007

A mall located about a mile from my house was the scene of a shooting: six people dead.

Earlier tonight, about a mile from my home, a man walked into a shopping mall and started shooting. At last report, there are six people dead (including the shooter) and several critically wounded. An off-duty police officer from a neighboring community was in the mall at the time, and shot and killed the man. No information yet on the shooter’s identity, or the identities of his victims.

At least 20 shots were fired, with the man stopping and reloading several times. It appears his primary weapon was a shotgun – the deadliest weapon at short range.

I’m glad I wasn’t eating dinner at Trolley Square tonight.

**CBS story, with a few more details, here, and here's another. The man was 18-years-old. I'm sure videogames will be blamed again.

Saturday, February 10, 2007

What war does to people.

[Disclosure - I found this quite disturbing].

We put people in situations where they end up making inhuman accomodations in order to survive; then we question their character, because they seem so dishonorable compared to what we'd like to believe we'd be, were we in their shoes.

In any case, it's very bad news for everybody involved.

I found it here (credit where it's due, and all that).

Tuesday, February 6, 2007

ParentingTrauma Revisited

The sky’s clear over Atlanta this afternoon, and as I land, I’m wondering how far Birmingham and Montgomery are from the Atlanta airport: nearly equidistant at about 150 miles, according to the mapping/gps software on my laptop. I wonder if I might ever take the time to visit some friends thereabouts, if they were receptive.

The sun’s down by the time I take off for Burlington, Vermont, where I understand it’s much colder. I’ll be taking the ferry across Lake Champlain tonight, and sleeping in New York. I’ll drive along Cumberland Bay, which always makes me think of my then three to five-year-old son sitting on my lap, watching “Shining Time Station”, while someone was singing about “Cumberland Downs.” Memories of my children always seem kind’ve sad, these days. I miss the times when my son was small enough to sit on my lap (he towers over me, these days). I love him just as much now, but you get to be closer to them when they’re younger. My daughter is much more petite, and almost fits on my lap still at 13. But she’s growing up, and the times of watching television with my arm cradling around her are about over.

When my children were young, I was a much more avid sports fan than I am now. It was the era of John Stockton, Karl Malone and Jeff Hornacek, and I watched as many Jazz games as I could catch. Rick Majerus had come to the University of Utah, and quickly built a basketball dynasty, of sorts. During my second year of graduate school, the Jazz were looking particularly hot, and I had some reason to hope this might be the year they finally reached the championship. But I had a lot going on that year – I was still working a lot (medical education, mostly), the coursework during that second year was taxing, and I had a half-time internship at the University Counseling Center competing with all of my other obligations. Plus, my daughter was born that year. I didn’t have a lot of time to watch basketball.

We’d been trying to conceive for some time, and had finally graduated from Clomid to Metrodin – a significant escalation in the fertility follies, courtesy a new specialist; we joked my son was a gift from God (the odds against that pregnancy are pretty staggering), while my daughter was a (pricey) gift of modern medical science. From the time of her birth, though, her health was a little shaky (and still is). Her mother had been unable to breastfeed, and she had such horrid constipation on milk-based formula that we thought we’d try soy. The result was several months of diarrhea, and she wasn’t gaining weight like she should’ve. Talking it over with her pediatrician, we decided to switch back to a milk-based formula and give it another go.

There was a basketball game on that night we were going to change formulas again – I think we were playing the Rockets. I don’t remember with certainty, but what I do remember is the game went into triple-overtime. This turned out to be significant – I told my wife I’d go to the store and pick up some Similac after the game, but the game didn’t end until nearly midnight. My daughter had already had her last feeding and gone to bed. I brought a can home, and my aggravated wife said she’d make the switch in the morning.

My daughter was five months old at the time. She’d never had horrid colic like my son and was sleeping fairly well, though she’d wake up around 5 am. We’d make her a bottle, but were able to get her back down for a couple of hours with the assistance of a marvelous new invention: the battery-powered baby swing. When I went to work that morning, I didn’t think twice when I saw her asleep, rocking in her swing, because that’s what I saw every morning when I went to work. Her mom was nursing a cold. She was grateful for whatever extra sleep she could get.

I was working at the VA that day, and got a call from my wife at about 11:00 am. She’d been awakened by a phone call, and was puzzled our daughter hadn’t gotten fussy while she was talking. When she went to check on her, she was still in the swing, but her color had gone gray and she was horrified to find her only minimally responsive. When her mom picked her up, she found my daughter covered with a diarrhea of a peculiar character – orange jelly (which I learned soon thereafter is a grave symptom, in an infant). I told her to take her immediately to the doctor, but when she did, the doctor directed her immediately to the emergency room at the nearby children’s hospital; she didn’t dare wait for an ambulance. I met them there.

The immediate concern was an intestinal torsion (a section of bowel loops, crimping off both ends and cutting off blood supply - the bowel becomes necrotic very quickly), and an abdominal X-ray showed her bowels had shut down completely. They were able to revive her with oxygen, thankfully, though she was obviously in acute distress. Her mother was unable to tolerate the trauma, so I was the one holding my daughter’s hands during the medical tests that followed (the upper and lower GI studies being the most invasive), rocking her, singing to her, trying to comfort her.

By the time the lower GI was conducted, peristalsis had resumed (no torsion), which was a tremendous relief. Nobody could tell us what had happened, however. They performed a spinal tap to check for meningitis (negative). The ICU physician, a rather large and overwhelming man, was convinced she’d experienced what he called a “dive reflex” event and gone into shock (when some sea animals dive, their bodies expel the blood from, and shut down, their bowel). The gastroenterologists scoffed. We kept telling people about the change in formula, but nobody (including the gastroenterologists) gave any credence to the idea such a catastrophic medical event could’ve been due to an allergy.

They kept her in ICU for five days, without incident, and then on the medical unit for two more. Physicians consistently grilled my wife and I. They took samples of our formula and had them analyzed. Eventually, they decided she should just go home, but just to be on the safe side, they decided to challenge her with some Similac in the hospital before we took her. They gave her two teaspoons. In the course of about twenty minutes, I watched my daughter slip into unconsciousness again.

What I didn’t realize at the time, BTW, is that medical staff had become suspicious of us. It wasn’t until years later that I realized some of the questioning, and probably the lab analysis of our formula, were conducted not only as an investigation of my daughter’s condition, but also as the initial steps in an investigation of her parents. Someone was concerned about the possibility of Munchausen’s by proxy (in a stroke of amazing coincidence, I got some partial verification of this from the spouse of one of the treating physicians, who started in the same graduate program several years later). When we took her to an allergist, she was appalled by the amount of formula they used in their challenge. My take: they wanted to be absolutely sure, before they began lowering the boom on us.

My daughter had a milk-protein allergy, which (as is usually the case, apparently) also meant cross-reactivity to eggs, nuts and soy. We made her baby food ourselves, in the blender. She eventually outgrew the milk, egg and soy allergy, but we have reason to fear challenging her on nuts. Her allergist indicated this is the one she’d be least likely to outgrow, and when she was about eight, she ate some honey-nut cheerios at a neighbors house; her mouth and throat broke out in a mass of little sores and blisters. Also, while she was getting her abdominal X-ray during that crisis, they brought a young child into the same treatment room in anaphylaxis. She’d been in the waiting area for some unrelated reason, and a stranger had given her one of their peanut M&M’s. Our observation of that child’s distress left and the difficulty they had reviving her left quite an impression.

From a more detached perspective, the experience was instructive on a number of levels. I became involved in some cases of alleged Munchausen’s by Proxy several years later, and I soon realized the bullet I’d dodged not only so far as my daughter’s medical crisis was concerned, but also in the trauma of a hospital-instigated CPS investigation.

As I became more involved in cases of child abuse and neglect, I had ample reason (and opportunity) to reflect on (and observe) the nature and impact of abuse on children. If it were only the physical injury the child suffered, one would expect that many of the children from that hospital would be psychologically damaged by the experience of their medical treatment. Instead, what you find is children who are sometimes surprisingly well-adjusted who have experienced repetitive injury and medical trauma, while others who experience abuse-related injury of much less significance are often quite scarred. Medical treatment can be horribly invasive – my daughter’s certainly was. That it takes place in the larger context of caretaking seems to make all the difference.

A friend read my post the other day, in which I contrasted my daughter’s medical studies that day and sexual abuse, and asked about it – why I’d make such a contrast, or where such a thought had come from. I don’t know that I’ll ever really get past the trauma of that experience, but I’m not really sure I want to. Each day since has been a rare and precious gift.

I still find it staggering that I almost certainly owe her life to my appreciation of a basketball team, and a game that took a triple-overtime for the Jazz to win. There’s a lesson in there somewhere, I’m sure – something about the importance of caring for the caretaker, or something, but I’m not gifted enough to articulate it.

Saturday, February 3, 2007

Loose associations:

When words won’t suffice:

Fuck. Fuck, fuck, fuck fuck fuck.


Arousal/attribution ad nauseam: Few things demonstrate attachment as much as someone showing up on your blog and spouting epithets: just because they care enough to do so.

The opposite of love is indifference. The opposite of hate is indifference. How can anyone not understand the relationship between love and hate when there are so many divorced couples running around? Are they not paying attention?

Israel: I disagree – Israel does have the right to exist; it just doesn’t have the right to exist in, uhm, Israel. What we should have done: purchased Baja California for our Jewish friends and let them set up shop there. It would’ve benefited both Mexico and “New Israel” economically (and probably socially), and certainly stabilized things in the Middle East.

Besides – wouldn’t you rather live in Baja? It’s not too late – they could start building settlements next week*!

Online relationships: There is no reason to believe they are not just as potent as flesh/blood relationships. Projection vs. perception: These days, I’m in the perception camp. While on the one hand you might think the unidimensional quality of online interaction means the degree of projection going on dramatically increases, it’s possible that much of what’s absent is noise and distraction.

Perception, though, is a tricky thing. I see people rubbing each other the wrong way in a dramatic way, and it’s pretty clearly related to feelings of kinship they wish they didn’t have. See above point on arousal/attribution.

Writing posts: I think writing posts is like catching a wave: timing and momentum are critical. You know how you can feel a post coalescing in the back of your head? You observe something and then it percolates on the backburner for awhile, until suddenly you can smell a fine stew being cooked up.

For me, lately, this has been happening while I’m driving – like, on extended road trips. I’m either going to have to start dictating, however, or cultivate a way of remembering the momentum, along with the ideas. By the time I get around to writing, I’m stuck with a bunch of half-baked concepts and a hollow bewilderment surrounding what, exactly, I had been thinking.

Which is why I haven’t posted anything on Wikifray in a month. And why I’ll be posting this. What’s one more off-topic, I figure?

Switters: I don’t get it. Not the humor, but the critics (and the critics of his defenders). That some find him unfunny: not surprising. The world has never lacked for concrete thinkers of the humor impaired variety. Think Switters unfunny? There’s plenty of room for differences in taste. Think Switters bigoted? That’s just insulting – also insulting to those of us who find him funny (guilt by appreciation?). One might find “The Protocols” funny, if one were of a particularly dark bent, and were able to find that level of paranoia and hate (and the people who promulgate it) funny. If one were to find it funny because of the arguments contained therein were funny, then that might mean something else.

Ghassan apparently doesn’t know how to distinguish the two.

What do you think Mel Brooks was laughing at? Or Vonnegut? They clearly thought something was funny. Are they anti-Semitic?

Online relationships part deux: We seem to be less forgiving of the foibles of people online than IRL. I think it’s easier to treat people badly when you never have to look them in the face. Also, we take a leap of faith when we interpret someone’s behavior. Silly to think some of those leaps aren’t misguided, but where’s the corrective mechanism? In person, I can see whether someone’s apology is accompanied by a frown, or a smirk.

Personal: Got my daughter for today and tomorrow. I took her out for brunch, and was subjected to her characteristic rapid-fire barrage of observations, stories and jokes. [Sample here.] It's always like that - I never tire of it. I marvel we’re genetically related at all. She just came in to share a funny line from her latest teen read; “What is it with you and Jesus: does he, like, turn you on?”

A couple of teens were caught making out in a church basement. “No kissing ‘till you’re eighteen” I say. “No way!” she shouts, so I respond “Fine! Twenty then!” and tickle her. It’s an old joke.

Spanking and abuse: Children, even infants, are incredibly perceptive. The difficulty with enforcing child abuse statutes is that it’s impossible to define abuse in an objective way. When my daughter was five months old, she was subjected to both an upper and lower GI. When my son was a toddler, I tripped while carrying him and he ended up with a mild concussion. The implications for these injuries are far different than if I’d smacked my son on the head with a frying pan, or had forced something up my infant daughter’s anus for purposes of some obscene gratification.

Anti-spanking legislation is just another example of priorities being set out of convenience. Child abuse statutes typically include physical abuse, sexual abuse, neglect and emotional maltreatment. You know how hard it is to substantiate a case of emotional maltreatment? In Utah, the only times I saw it happen were when a parent threatened suicide in front of their kid, and one particularly egregious case in which a preschool-aged girl actually began to identify herself using terms like “spoiled little cunt.” The damaging aspect of abuse – all abuse – is in the ephemeral “emotional maltreatment” dimension.

Short answer: parents modulate environmental input in such a way that children are not overwhelmed, and it is this role in which children internalize what they’re receiving as part of identity formation. Think about that for awhile, and then think about the implications of sexual abuse, or neglect (which is far more problematic, identity development-wise, than physical abuse). We learned to take care of ourselves like our parents were taking care of us. Psychopathology is a gift of love given to children by their parents. [Lorna Benjamin, again. That was a great class.]

Spanking, in itself, is not (in my opinion) problematic. From an ethical standpoint, I understand the argument; why should it be acceptable to treat a defenseless child in a manner that would result in criminal charges, if the victim were an adult?

The answer is: Why is it legally acceptable for that surgeon to slice open my abdomen, when the same behavior would land someone else in jail?

Context makes all the difference. I once had to soak a very antisocial guinea-pig’s paw in a mixture of Epsom-water and hydrogen peroxide every day for about a month [long story]. By the time the month was over, we’d bonded. Even that guinea pig got the difference. My kids didn’t like it when I took their Bandaids off, either. That they knew I was doing it as part of caretaking made all the difference.

But some people have an awfully peculiar and problematic take on what constitutes appropriate caretaking. And there’s the rub, isn’t it**?

*If a free-and-clear title to Baja were not an acceptable solution, I would wonder to what degree the concept of Israel’s right to exist had been pure varnish, to gloss over their desire to regain holy ground. This is a different position – one I believe is far less defensible.

**Could be a metaphor for editorial discretion on the Fray.

Thursday, February 1, 2007

Terrible news...

I took a psychopathology class from a curmudgeonly and fascinating woman named Lorna Benjamin once. She wanted to change the world for the better. She was on a one-woman crusade to change the manner in which psychologists view psychopathology. She revived the concept of a circumplex model (this would be Tim Leary’s good idea – the one he didn’t pursue because he got, well, distracted). It’s a rare pleasure to be taking a class like that from someone who not only knows the material, but knows the material behind the material. Lorna was a tough cookie (and probably still is – the past tense is just because I haven’t seen her in over a decade). She didn’t graduate a student for years and years after she got there; picking her to chair your committee was reportedly the height of rash vanity.

Lorna spent one of her precious class periods talking about the meaning of life – a subject integral to the topic of psychopathology. She also spent time talking about the role of will in the development and course of psychopathology. It was her opinion that there are brilliant people walking around maintaining ego-integrity through sheer force of will. She may be right – I didn’t find out until years later that one of the most brilliant, compassionate and gifted therapists I worked with suffered from psychotic depression; nearly intractable psychotic depression, actually. She told me about it, sitting in her office one day. She told me about how the medication she took gave her migraines, and how sometimes it was a tough decision just to stay alive. Lorna knew her well – she may have been in that class with me. I confess I can’t remember. She was finishing as I was starting, so most of our overlap was subsequent, and in a different setting. Maybe I’ll write about her another time.

Lorna’s discussion about the meaning of life revolved around the pictures or her grandchildren she circulated around the class that day. My son was still a toddler, then. I talked about what it was like being a parent – anguish and ecstasy. Everything else has paled, in comparison.

So once I found the substance for my latest in a series of trite comments today, and came back to the blog to post it, I found Topazz’s message about Isonomist’s son – the 19-year-old son whose Leukemia had recently returned. Isonomist – a Fray friend, and someone I care for, and respect. Topazz related her son had a cerebral aneurysm today, and is not expected to live.

Perhaps it was related to his chemotherapy. Perhaps Leukemia predisposes one to aneurysm: I have no idea. All I know is my brave friend from New York, who has been facing the potential death of her son from leukemia, is now facing the imminent death of her son – a son she describes as brilliant and unique. A son she describes in the way I might describe my own son.

So, I’m grieving tonight for Isonomist, a good friend I’ve never met, and imagining the way I would feel were he my son, or daughter, and how one more death on this planet of billions can shake the universe from it’s moorings. And I’m trusting in her will, to keep her bound in the face of the most awful of pressures, even though she lose an essential piece of her being.

Everything that ever was remains crystallized in the fabric of the past, and the people we love remain connected to us – even when separated by distance, or time, or unbreachable gulf of circumstance, or even death: and continue to influence us because they’re never really gone from us – they’re part of who we are. And a comfort when they’re gone, I hope; seems a bond so strong should leave more than a void in absence.