Thursday, September 30, 2010

When History Begins

So I was cruising around the local antique mall a couple of weeks ago, and I couldn't help but notice the "oldies" music that was playing: "The Lion Sleeps Tonight," "Get a Job," and others of that sort. Engaged in conversation by one of the regular workers there, I noted how quickly I thought I'd find the music selection irritating, but then (perhaps putting my foot a bit in my mouth), I observed that the songs that were playing were oldies when I was growing up, while for many of my students, music of the 1980s now has the status of "oldies."

It got me thinking about just when I really remember first paying real attention to music, which I think must have been around 1978 or 1979: Blondie's "Heart of Glass"; Heart's "Crazy on You," and The Police's "Roxanne." I remember asking my older brother once, just what kind of music was it that they were calling "Heavy Metal," and he said "Nazareth," but whether he meant "Hair of the Dog," or "Love Hurts," or both, I was still a little unsure.

Then, just a couple of weeks ago, teaching the Science Fiction and Fantasy class, I had a similar experience: one week I was teaching Joe Haldeman's classic The Forever War, and the next we were viewing Ridley Scott's Alien. For me, one of these was, essentially, an "oldie": Haldeman's novel, even though it was published in 1974, is one of those things that was already a classic when I started really paying attention, and even though I didn't actually watch Alien until the late 1980s, I remember when it came out in 1979 very clearly: In space, no one can hear you scream (though, as I pointed out to my students, apparently you can hear ships exploding).

But anyway, that's my argument in this post: for me, history begins in about 1979.

Oddly, it seems to be true whichever direction I think about it. From my perspective now, stuff between 1979 and 2010 is mine: I lived it and I know it, and the artifacts and texts from these years take their place in my own personal chronology in more or less straightforward ways. Stuff before about 1979, I can only place through a much more active effort of historical understanding and imagination. History, the real past (as opposed to the present), starts in 1979 and extends right on back.

At the same time, I feel like my internal sense of chronology for things from about 1979 to now gives me an intuitive feel for this era that I feel compelled to label as historical. In contrast, things from before 1979 exist in a kind of undifferentiated mass of oldies: I have no idea if "The Lion Sleeps Tonight" came before or after "Get a Job," and I'll never know unless I look it up. Only the stuff that fits in my chronology has a real history for me, in the sense of having a context that gives it meaning, and everything else has just always been there, lurking in the background of my history, a history of the imagination.

It's a strange way of looking at things, I suppose, for someone whose professional work often focuses on things more than a thousand years old. But that moment when I first started paying attention to things, that moment when I guess I stopped seeing the world as a kid, really seems to have been a kind of watershed moment, and 1979 is when history begins for me.

Friday, September 24, 2010

You dropped a bomb on me

I recently posted here about the eye inflammation I've been experiencing in conjunction with my Behcet's Syndrome. As I mentioned, I'd been seeing a very kind, if wacky Groucho-Marx lookalike opthamologist for treatment. Well, on a followup visit in late August, he discovered the inflammation was back, and admitted to being stymied. He suggested I go see another opthamologist at the Eye Institute, a guy who's allegedly an expert in autoimmune and inflammatory eye problems.

As soon as Doctor #2 (an apt name, as you'll see) walked in the room, I recognized him as the first opthamologist I'd seen there three years ago, when my rheumatologist wanted me to get a baseline checkup. In the words of my great-grandfather, the man's an idiot--one of those pompous doctors who talks past you, to his resident, the entire time he's in the room with you.

As he'd done the first time I saw him, he immediately started spouting about how much experience he'd had with Behcet's, and how I wasn't the typical patient. He asked if I'd ever had a genetic test for HLA-B51, a genetic abnormality that some people with Behcet's have that indicates a predisposition to the disease. I had, and it was negative.

Dr. #2 sneered. "How about HLA-B27? Did they test for that?"

I wasn't sure, I replied.

"I don't think you have Behcet's at all. I think you've been misdiagnosed, and what you really have is Reiter's Syndrome. I'm going to have you get tested for HLA-B27, because that would indicate Reiter's instead."*

(Bear in mind that he's really addressing all of this to his resident, who's clearly supposed to be impressed by Dr. #2's brilliance.)

So, he has the resident fill out the order for the bloodwork, and tells him to add a couple of other tests that he tells the resident (not me) are "standard."

Here's where I made mistake #1: I should have asked exactly what those tests were. I did ask if he would call me with the results, and he said he would if they turned out to be positive; otherwise, I wouldn't hear from him.

Had the bloodwork done. Ten days or so went by and I hadn't heard anything, so I figured everything turned out fine.

Then last Tuesday I got home from work and saw that there was a voice-mail message. When I retrieved it, the first message was from someone (not Dr. #2--maybe his resident) at the Eye Institute telling me to call him immediately, and giving me his pager number, but giving me no indication about what the issue was. That call came in at 8:30 a.m.

The second message, which had come in around 4:30 p.m., was from my primary-care physician, who left an even more mysterious and alarming message, saying, "I'm sure you're concerned about this and have lots of questions, so please feel free to call me at home this evening."

Now I'm worried. I called her home number and got the machine, so I left a message saying I don't know what she's referring to because nobody's told me why they're trying to contact me, and that I'm freaking out a little.

Around 8:30, she called me back, and as I sat there on the couch next to Tom, she lobbed a bomb right into the center of my life: apparently, one of the tests Dr. #2 had ordered came back showing that I'd tested positive for syphilis.

"They want you to be admitted to the hospital right away, and you'll probably have to be there for two weeks, because the treatment is an IV antibiotic drip that needs to be administered every four hours. I also think you should know that the county health department is probably going to come around to ask you a lot of very personal questions."

My head is reeling. Is this some kind of sick joke? I was looking to the left in case a car came around the corner, and meanwhile a semi-truck blasted in from the right and flattened me.

"What? What? Are you kidding?" I don't think I've ever been less articulate in my life. "Two weeks? How?"

She says she can call and have them get a bed ready for me right now, and talks me through the lumbar puncture procedure that she says they'll probably do first. It's like she's talking to me from the other end of a long, echo-y tunnel. The impression I get is that if I don't voluntarily go to the hospital, the county health officials will come and drag me there.

Here's where I did one of the only sensible things I did: I told her that I needed some time to make arrangements, and would check into the hospital the following morning.

Then I have to get off the phone and turn to my husband of thirteen years and tell him I've tested positive for syphilis. And that by the way, I'll be in the hospital for the next two weeks. And of course, he'll have to be treated, too.

Let me just say that Tom was, as always, a rock, and thank god, because other relationships might have been (and have been) destroyed by this news.

But I didn't get any sleep that night.

Sensible things #2 and #3: I called my sister, who talked me off the ledge, told me about a friend of hers who'd had a false-positive syphilis test, looked up stuff online and found out that false positives are pretty common for folks with autoimmune disease, and even got me to laugh by telling me what a great excuse it would be for any crazy behavior: "Sorry I got all syphilitic on you!"

I also e-mailed my former rheumatologist in Denver and asked her if I'd ever had the test under her care, figuring that if there was an older, negative result on record, that might help out.

The next morning, the hospital called me bright and early, saying they had a bed ready for me, so come on down. In the meantime, I'd put in a call to my rheumatologist here, and when I explained to the nurse who answered that I'd been told I had to be admitted to the hospital that morning, I was relieved when she said she'd pass the message on right away.

Within about ten minutes, the phone rang, and it was my rheumatologist. She's a no-nonsense kind of person, and talking to her felt strangely like I imagine it feels to talk to your lawyer when you've been arrested. Finally, someone who wasn't panicking (and making me panic). She was 99.9% sure it was a false positive, and didn't understand why the additional testing needed to be done in the hospital. I'd still need to check in, but she said, "Just pack as if you were going to a hotel for a couple of days. Bring your own pillow. I'll see you over there."

The relief was tremendous. Not complete, for sure, but why hadn't she been the one to give me the news in the first place? What was all the overreacting about? Hadn't any of these people talked to each other?

Around 10 a.m. I checked in to the hospital and went up to the 8th floor, where they put me in a private room and told me to have a seat. And there I sat, for 45 minutes, before anyone came by.

Finally, the nurse came in. At that very moment, my cell phone rang.

It was my rheumatologist: "OK, I talked to the head of infectious disease, and he's sure this is a false positive. So you don't have to check into the hotel."

"Well, I'm already in the hotel room."

"Hmm. Well, let me talk to him again and see what he wants to do. But for the moment, let's just assume that we're going to do the confirmatory tests on an outpatient basis. I'll call you back."

I hung up and explained this to the nurse, just as her pager went off and she got a message to the same effect. So she left the room to go make a call from the nursing station to find out what's going on.

A couple minutes later, Tweedle Dee and Tweedle Dum--aka the floor resident and his med-student flunkie--walk in. "Ms. Hathaway, we're here to take some information from you and to get your vitals and everything. So, what's going on?"

"Well, technically, I'm not actually a patient," I say, explaining that it looks like I'm going to be discharged. And frankly, I just don't want to tell this story again to these guys.

But the resident persists. "Well, until we know for sure, let me just take some information from you."

Mistake #2: I should have just told him to f#@k off. I mean, he was perfectly nice and all, but really--he didn't need to know, at least not right then. But I went ahead and explained the whole story, which was actually beginning to seem a little funny, and when I got to the point where I said, "And so they think I have syphilis," he turned to the med student and in a pseudo-sympathetic stage whisper, says, "I think you'd better shut the door."

Fast forward through about half a dozen more cell phone calls, pager alerts, and mixed messages, and they finally give me a lab order and send me off to have blood taken for the second round of tests. And I'm out of the hospital two hours after I was admitted, twelve hours after being told I'd be there for two weeks.


I mean really: W. T. F.?

The two additional tests they ran both came back negative, as my rheumatologist expected they would. I got an e-mail back from my former rhuematologist in Denver expressing shock that anyone's first reaction was to admit me to the hospital before consulting with an infectious-disease specialist and running further tests. The most basic Google search instantly turns up information explaining the prevalence of false-positive syphilis tests not only in people with autoimmune disorders, but with lots of other conditions, as well.

Why on earth had everyone jumped to the worst possible conclusions, and immediately proposed the most dramatic and extreme treatment?  I mean, the one upside of managed care is that it usually insists on starting with the cheapest, most basic intervention possible before hauling out the big guns.  Here we went straight from border skirmish to nuclear winter.

The Health Sciences Campus here at WVU has come under a lot of fire for its lack of coordination and communication, and its incessant territory wars. I guess it all seemed like the usual petty academic squabbling until I got caught in the middle of it.

And I know that this situation isn't unique to WVU, either: this was my first experience with the scary machine that is health care these days. Once you get caught in its gears, you feel pretty much powerless to extract yourself. I remember my bitter sense of betrayal after my dad's brain surgery last fall, when we didn't learn until afterward that he wouldn't be allowed to go home once he'd recovered, but would have to be admitted to a rehab center. And once there, being told that if he couldn't meet certain benchmarks, he'd have to go into a nursing home.

It's amazing how quickly one's body becomes public property in these situations...and my situation was certainly far, far less dire. But it still felt like I'd been sentenced to prison without a trial.

I've learned the hard way that even when you're panicking and the voice of Medical Authority is booming orders at you, you still need to advocate for yourself. I should've done it the day I saw Dr. #2. But at least I had another doctor who was willing to go to bat for me when it mattered most.

Still, I lay it all at the feet of Dr. #2.  Why didn't he call me to deliver the news himself?  And in the eight hours between his resident's message and the one from my primary-care physician, why didn't anyone think to include my rheumatologist in the conversation?  Or do some basic research to find out what the real liklihood of the test results being accurate was?

I'm glad that it now seems mostly like a funny story, if a maddening one.   For sure, I'll never go back to Dr. #2's office again, and if I ever see him around town, look out:  I might go all syphilitic on him.

*Turns out that Reiter's Syndrome isn't even considered accurate terminology for that disorder anymore.  More evidence of Dr. #2's so-called "expertise." 

Wednesday, September 8, 2010

Clunkers, junkers, and beaters--oh my.

Last weekend Tom and I traveled to his parents' house near Newark, Ohio, to celebrate their 50th wedding anniversary.  In honor of the occasion, Tom's dad wanted to drive his restored 1953 Studebaker to the Granville Inn, where the celebratory dinner was being held, since it was the car that he drove to his wedding in 1960.  Or, at least, parts of it are the same car.  He also has a 1955 Studebaker he's been working on, so Tom's older brother George volunteered to drive it, too, especially since it was International Drive Your Studebaker Day.  A nice bit of karma, that.

Just the weekend before, Tom and his Dad drove the '53 and '55 cars to the 18th Annual Studebaker/Packard Show in Tallmadge, Ohio, and George drove his '63 Studebaker Lark down from Michigan.  It was a hot weekend, and needless to say, none of these cars have air-conditioning...or power steering...or a radio or comfortable seats.  When Tom got home on Sunday, the first thing he said when he walked in the door was that our 1997 Honda Accord drives like a dream compared to the '55 Studebaker.

Now, that's saying a lot, since the Honda is teetering on the brink of officially being a beater.  I'm not enough of a motorhead to describe the precise distinction between a "clunker," a "junker," and a "beater," but I'm fairly sure that of the three categories, what we have is a beater:  it's still in pretty good shape, both mechanically and cosmetically, but it's not the kind of car you want to put a whole lot of money into anymore.  It works, it makes some unhappy noises--though none that are alarming or that wake the neighbors--and no one is ever going to steal it.  Beater.

As the above photo of the dash indicates, it's got a lot of miles on it.  165, 295 to be exact.  When we bought it used in 1999 (a story in  itself, which I'll save for another time), it only had about 20,000 miles on it.  So we've racked up a lot in the eleven years we've owned it.

And as you can see, the check engine light is on.  The check engine light has probably been on more than off in the history of this car.  In fact, the '97 Accord was recalled a number of years ago for its problems with false "check engine" alerts, but whatever they did to it at the dealership didn't solve the problem.

As with the boy who cried wolf one too many times, we no longer pay the slightest attention to the check engine light.  Maybe it'll go out on its own eventually, maybe we'll take it to an auto parts store and have them reset it, maybe we'll just ignore it until one day we end up on the side of a lonely road as a plume of steam shoots heavenward from under the hood.  Like the aches and pains of middle age, the check engine light may mean nothing or everything.  Either way, it's not worth shelling out $80 to the local Honda dealership to get a diagnosis.

Tough love:  that's what you give a beater.  My brother Phillip, a Honda mechanic, is of the firm belief that you don't need to fix stuff until it's really broken.  (But he does preach the importance of routine maintenance, like oil changes, tire rotation, and belt replacements.)

Phillip also says that the greenest car is the one you keep on the road--that junking a perfectly serviceable, low-emission car for a brand-new hybrid is a zero-sum game in terms of the environment.  Sure, you may have taken a less fuel-efficient car off the road, but you've also just added to the landfill and acquired a new vehicle that presumably took a lot of energy to manufacture.

These were among my many thoughts as Tom and I drove behind the two Studebakers on Saturday afternoon.  Especially as we struggled to keep up with them.  Let me tell you, those two nearly sixty-year old cars, with their V8 engines, kicked our Honda's sad little @$$.

The poor Honda really struggles with steep hills these days, which is a hazard when you live in West Virginia.  Every time I'm chugging uphill with some giant SUV barreling up behind me, I'm torn between wanting to apologize and wishing I had one of those "Don't laugh--it's paid for!" bumper stickers.

And there's the sad proof that you're driving a beater:  when you actually understand why people put those bumper stickers on their cars.

But:  we haven't had a car payment in seven or eight years, and I don't relish the idea of having one and being out that three- or four-hundred dollars a month.  And we don't have a garage, so the idea of buying a brand-new car just to park it on the street full time seems a little ridiculous.

Nevertheless, I do feel a pang every time I see one of these babies tooling around town.  Someday the Honda will pass from "beater" to "junker," and when that day comes, Ms. Mini:  you will be mine, all mine.

With thanks to Jane for reminding me of those lyrics.

Wednesday, September 1, 2010

The telephone is ringing--is that my mother on the phone?*

This morning I had another one of those moments that makes me feel middle aged...and glad of it.

I took the PRT (Personal Rapid Transit) over to the Evansdale campus for a meeting.  For those unfamiliar with the PRT, it's a sort of monorail system with unmanned cars that shuttle to and from five different stations around Morgantown.  They hold about 12 people total, and are usually populated by undergrads going back and forth from classes on the downtown campus and the dorms on the Evansdale campus.

It's always interesting to ride the PRT early in fall semester, since the vast majority of dorm-dwellers at WVU are freshmen, and thus most of the PRT riders are freshmen as well.

One of the many things WVU freshmen have to get acculturated to is the etiquette of the PRT:  sit or stand?  Are you allowed to interject into someone else's conversation, since you're standing six inches away from them, or are you supposed to pretend you're not listening?  And can you talk on your cell phone or not?  Even students who might have had some kind of big-city subway experience aren't sure whether the standard subway-rider etiquette applies, since your fellow riders aren't necessarily complete strangers, even if they are at the moment.

This morning, as the lone non-student in the car**, I noted that most of my very young-looking fellow riders still seemed a little uncomfortable.  It was a quiet ride, though in a few weeks I'll undoubtedly be overhearing the usual conversations about annoying roommates and neighbors, amusing drunken exploits, and football football football.

What I really noticed, though, was that to a person, every student had a cell phone clutched in one hand, except for the lone guy who was eating a snow cone.  At 9:30 in the morning.  I love that guy.

It being week two, no one was using their cell phone during the trip.  But despite the fact that they all had backpacks or pockets where they could stow said phones, they held on to them as if letting go would somehow disconnect them from the life force itself.  It reminded me of the way my nephew clings to the TV remote:  try to wrest it from him when he's asleep and he'll wake up instantly and look at you as if he'd caught you preparing to murder him.

As I looked on this scene, I wondered where my own cell phone was.  In the outside pocket of my bookbag, where it sometimes lives?  No, I thought:  it's at home, in my purse, turned off.  And my iPod Touch is on the nightstand, recharging.

I was unplugged, and not only was I OK with that, I prefer being unreachable much of the time.

Of course, I'm not accustomed to being plugged in 24/7 like this generation of students is.  I've often thought that my own freshman year might have been a lot less traumatic if e-mail, the web, and cell phones were available then.

After my experience with the helicopter dad last week, a number of friends on Facebook shared their experiences detaching from their parents when they left for college, most of which fell along the lines of Lynn and Heather's experiences:
"My parents said goodbye, hugged me, and then I got on the plane."
"I left for college on a train with a suitcase, a small trunk, and an airline carry-on containing a small terrarium with a lizard.  I did not suffer unduly."
For me, the scariest thing when my parents left me at college was knowing that I had no way of getting ahold of them for days:  they were driving back to Ohio, and of course they didn't have a cell phone, or phone numbers for places they'd be staying. And aside from the pay phone in the dorm, I didn't have a phone, either.   I suppose if I did, I'd probably have been clutching it like my life depended on it, too.

The irony is that the potential to be in immediate, constant contact doesn't seem to have diminished either students' or parents' anxieties.  In fact, the New York Times recently featured a story about colleges that have instituted formal "parting ceremonies" to ease the transition.

I don't have kids.  I won't presume to understand what it must be like when they leave the nest.  But I will say that I do wonder whether that acculturation process would be quicker, and healthier, if students were a little more unplugged from their past, and a little more plugged into the present. 

But then again, one of the great personal challenges of college is figuring out how to link your past with your present, and eventually with your future.  It takes a long time to discover, as my friend Becky wrote in a song lyric once, that "who you are now will depend on the people you've been."

In the end, though, I guess I'm glad I went to college during the technological stone age.  Yeah, all those tools might have made things easier at the time, but then I would never have all the letters from that time, all the evidence of the person I was then.  After all, I still depend on her now.   No cell-phone call record could capture her essence so well.

* If you know the song whose lyrics inspired the title of this post, then you went to college during the stone age, too.

** Which is pretty typical:  faculty and staff seem to be even less willing to rely on public transportation than the students.