Dear ex-girlfriends (and by “ex-girlfriends” I mean former lovers, boyfriends, friends with benefits, micro love affairs that turned out to be bad ideas, straight girls who just wanted to see what it was like, and Neko Case in the event that I ever get that chance),
I should have written this letter before, perhaps; I’ve thought about it for a while now. I’d like to go on record regarding lessons I’ve learned, even those that came at the end, the sharp gusts of November that arrive to make way for wet Midwestern snow. But also for the breezier ones, the subtle teachings that slipped across my soul and crept into my daily life while I was distracted by your voice or your scent or your earrings. The knowledge I have gained from you far surpasses that from any other source, even Wikipedia.
I know the difference now between want and need, between help and emotional imprisonment, and between risotto and paella. I know that coffee should be dark and bitter and that everything that is worth doing should be done well. I know how to kayak, read poetry aloud, re-wire a lamp, order wine, play ping-pong, and recognize zone defense. I am familiar with T.S. Eliot, bell hooks, MFK Fisher, Allen Ginsburg and Toni Morrison. I have listened to Nanci Griffith and Miles Davis and Erykah Badu. I learned to sleep late on Sunday, to wake at four am to comfort a baby, to drive a standard transmission, shoot pool, and to make a stunning martini. I am nearly conversant in jazz, theater, film, basketball, tennis, real estate, Spanish cuisine, Dutch contributions to society, Italian motorcycles, and French cheeses. You reinforced for me honesty and hard work and integrity. You illuminated racism and gender identity and alienation and abuse and religion and a thousand other things I couldn’t have really understood otherwise.
My relationships with you made me stronger, funnier, braver and better in bed. My life is richer because I had club sandwiches with your mother that afternoon, and because I watched you care for her when she was dying. The memory of the night that we spent on Main Lawn is tangled like seaweed among my neurons, and I think of the evening at the shimmering rooftop pool in New Orleans as the moment I was born again, even though we can never return to that hotel. I don’t remember how we ended up on the floor of the Belltower, or how long it took to drive out of the snowstorm in Texas, but I remember your hair; curly, coarse, thin, ebony, beech, cherry—then your hands; slender, thick, brown, pale, confident, tentative. I would still recognize your disguised limp, your hysterectomy scar, your impossibly thin wrists, your fissured thumbnail, and the smooth nubs where they cut off the extra fingers. The recollection of the sound of your silver rings clinking against my windowsill makes me dizzy even now.
Oh, sure; I learned not to accept marriage proposals at the peaks of roller coasters (also not to accept them at all). I learned not to put too many fava beans in the pressure cooker at one time. I learned to never let a ferret into my sleeping bag again. I learned that not everyone believes that Blue is Joni Mitchell’s greatest album. I learned to send flowers the next day and to always keep the videotape.
But most importantly, I know that love has vastly more to do with forgiveness than with possession, and that wanting what we cannot have is the most toxic dream that exists. I realize that transparency and truth, although they pave the path of most resistance, are the only conditions of consequence, and for that alone, I would do it all again. Thanks.
Love, Lainie
Because I have the equivalent of a six-figure mortgage on my brain, I moonlight in urgent care to pay Sallie Mae some of the money I owe her. Urgent care in no way resembles the holistic evidence-based care using a family-centered model I was taught in residency. It is instead a combination of negotiation, exasperation, disinfection, and explanation. The explanation typically involves explaining germ theory to people who watch way too much teevee.
Just the other night, I saw four kids in the same family who were febrile, coughing, aching, stuffy headed, and not-resting. When I explained to their mother that they all had influenza A, she looked at me incredulously and asked, “Is that contagious?”
“It is indeed,” I said, signing the billing sheet.
“They’ll be contagious for a few more days most likely. Be sure you wash your hands a lot, and hopefully you won’t get it, too,” I said cheerfully, knowing that she probably would not be feeling so great tomorrow.
As I was washing my hands for the six hundredth time, I thought, is it contagious? Is she serious? In 1918 Influenza killed more people than World War I (like maybe 100 million), so um, yeah, it’s contagious, lady. In fact, it’s incredibly fucking contagious. That’s why they make a vaccine. You know, the one you can get at the health clinic, Walgreen’s, McDonald’s, oh I don’t know, anywhere? That’s why governments around the world are spending billions of dollars to avoid an epidemic, and why I have at least forty more opportunities to get barfed on tonight.
Then she wanted to know what I could give them to make it go away, and I explained clearly that what she needed was a 500 count bottle of ibuprofen, seventeen gallons of Gatorade, and a Spongebob marathon. She asked if they need antibiotics. I said nope—it won’t help, because influenza is a virus, and antibiotics can’t kill it because they only work on bacteria, but that if the kids stayed hydrated, they’d likely be fine. She said her regular doctor always gives them the pink medicine and they get better right away. I explained the difference between viruses and bacteria again, and she started to get agitated. I explained how giving unnecessary antibiotics can cause problems not only for her children, but also for others. She stormed out the door, and I understood why her regular doctor might behave as he does.
Since we’re talking about antibiotics, if I were President, my first executive order would be to decriminalize common pink eye. I cannot imagine how much money, time, and other tangible resources are squandered diagnosing, treating and quarantining pink eye for no good reason. It’s ridiculous. The vast majority of plain old red eye in kids over one month old is caused by either adenovirus or allergies. Adenovirus is relatively harmless (in the eye, anyway), and more importantly, there is nothing anyone can do to make it go away faster. Is it contagious? Sure, just like every other kid-germ. But it doesn’t matter if it’s contagious if it’s mostly harmless. So why does daycare kick your kid out when his eye is a little pink? Beats me. Why does your doctor give you drops for your kid’s pink eye? To get him back into daycare. Why do they even make drops if they don’t shorten the course of most conjunctivitis? Money, brothers and sisters, money. There is a smaller percentage of cases caused by common bacteria which can and should be treated, but those are easily relieved by an antibiotic that costs about two dollars. And yet, if you open any magazine targeted at moms or pediatricians you see some big, goopy red eye staring back at you in an ad for some kind of concoction that will cost seventy-five dollars and further contribute to antibiotic resistance, because it has a broad spectrum and should be reserved for germs that are resistant to more common drugs. Ponder that, next time you’re pinning your screaming toddler to the sofa twice a day, dripping chilly medicine all over his face in hopes that some runs into his eye.
And since we’re talking about germs, let me just be clear–weather does not make you sick. I don’t care if your baby was teleported instantaneously from the Amazon basin to the polar ice cap without his hat, his nose is congested because some other germy kid at day care wiped her nose on him, not because his dad left the hat in the car. And by the way, a good bit of nose congestion is from secondhand smoke exposure. I know–you “smoke outside.” So does everybody else.
And since we’re talking about noses, the color of your child’s snot is in no way related to the severity of her illness. In fact, if you begin to describe the color in detail, or worse yet, try to show it to me, I will stop listening immediately. I have seen every texture, color, and matter stage of nose drainage that exists, and while I am sure your child is very, very special, there is no reason to save the Kleenex for me. Also, if you tell the triage nurse that your child’s (insert common symptom) is “severe”, it in no way catapults you to the head of the line, unless the symptom is “bleeding.”
Let’s consider an example: ear pulling. Even, God forbid, severe ear pulling. Children between the ages of four months and two years sometimes pull on their ears just because they stick out from their heads, not to signal you to drive them to the emergency department in the middle of the night. In fact, for the most part, any complaint that has been present less than twenty-four hours is not a reason to seek immediate medical attention. Pediatric exceptions to this rule are: turning a color based in blue or yellow, not waking up, acute testicular pain, fever in newborns, sudden neurologic changes, and rashes that look like bruises. Also large lacerations. Not, I repeat, not insect bites. Unless you initially doubted that it was a mosquito bite, and so rubbed it with Sea Breeze, and then when it looked worse, slathered it in hydrocortisone, and when it became open and oozing, you doused it in rubbing alcohol, and so now it is a chemical burn. I understand that it seems unlikely to have been a mosquito, since you did not see a mosquito, but I have to tell you that they are very small. It’s part of their survival strategy; if they were the size of a banana, we’d see them coming.
And since we’re talking about lacerations (we were, weren’t we?), if your child has a cut that I have to sew, yes, it will scar. That is the way our skin heals. I did not invent it, and there isn’t much I can do to change it. If you wanted her to be on “America’s Next Top Model”, you should not have purchased the bunk beds from IKEA.
And while I’m at it, let me just tell you that when I feel a clump of tight, matted cervical lymph nodes on your beautiful, smart, funny, brown-eyed 6 year old who likes to play soccer, and is sitting on my exam table in his Spiderman pajamas, and you tell me that he’s had a fever for several days, and some intermittent leg pain, and yesterday he didn’t eat his string cheese even though he loves string cheese, I will suddenly pay extremely close attention to every single thing on his body, and every sound of his heart and lungs, and when I go slowly looking for other lymph nodes in other areas, I know we will need to stick a cold steel needle into his skinny little arm, and when I see the results of his white blood cell count, I will know that it is far from the last needle he or you will ever see. I’ll sit down and tell you that there are some abnormalities in his laboratory studies, and that no one will know all the answers for a few days, and that you should probably try to find a babysitter for his sister and call in sick to work because it would be best if he stayed in the hospital for a few days so that we can do some more tests. I’ll hand you the box of tissues and say I’m sorry eight thousand times, and very carefully not think about my own son sleeping safe in his bed at home. Later, while I’m driving in the dark, I’ll be thinking of your family, and the ruined soccer season, and the bone marrow biopsies, and how the other kids in second grade will soon shave their heads in solidarity. In a few months, I will stop in the cafeteria and say hello while you’re pushing his IV pole through the hot dog line, and you’ll say thanks for being so nice, and that things are going as well as can be expected. He’ll still have big brown eyes, and the Spiderman pajamas, but his childhood will be over, as will what was left of your sense of security.