In 2009, I wrote my first novel She during National Novel Writing Month or NaNoWriMo as it’s popularly called. It was just the thing I needed to help me write as my brain injury had robbed me of initiation, of the thing that gets you organized and doing things. I went on to have She edited and published over the next two years.

In 2010, I tried out ScriptFrenzy, NaNoWriMo’s smaller script-writing cousin. I wrote a screenplay adaptation of my first award-winning book Lifeliner. I didn’t show it to anyone; I didn’t feel it or I was ready yet. Then in November I participated in NaNoWriMo for the second time and wrote Aban’s Accension — now at Iguana Books waiting and waiting and waiting to be edited.

In 2011, I joined ScriptFrenzy again, this time writing a stage play on the insurance game. That one I’d like to do something with, but am not sure what. Yet. And leaving it practically to the last minute, thinking I’ll never be ready in time, even though I had been doing background physics reading for months, I launched myself into my third NaNoWriMo and third novel, Time and Space, which I’m currently revising.

2012′s ScriptFrenzy this past April was a purely creative exercise for me. I began with a title and an idea. I had no outline, no sense of how it’d end. It was … interesting. But I liked the flexing of my purely creative muscles. This radio play is for my eyes only. On the other hand, I’m looking forward to writing a book in November intended for public consumption. I already know the ending, the basic story arc, as I’ve been pondering it for awhile. However, in between then and now is Camp NaNo.

The folks who run NaNoWriMo started Camp NaNo last year. I thought about joining but went nahhh. This year, the person-who-organizes-me sat me down in January and said let’s get you writing regularly. Add Camp NaNo to your schedule. Okay, but I have no idea what to write. You’ll think of something, she retorted in that-don’t-give-me-silly-excuses way.

Okay then.

She recommitted me this past week to doing it. She was right too, I do have an idea. I’ll talk about it later. First, I gotta go check out how this Camp operates.

I have no idea what this all means.

Health is — stupidly — a provincial issue. I can sort of see why different provinces may want to educate their subjects, I mean people, differently. But last I saw, human beings who live in Ontario are biologically, physiologically, and anatomically the same as those living in Alberta. But we seem to believe a doctor trained in Saskatchewan won’t know how to treat human beings living in Québec. Or that human beings living in New Brunswick don’t suffer from the same diseases or need the same kinds of treatments as those living in British Columbia.

I don’t know what our Fathers of Confederation were thinking when they made health a provincial responsibility.

In spite of how this illogic treats Canadians unequally and in some cases disastrously so, provinces are jealous over health. They don’t want to share it with the federal government. It’s okay for the federal government to give them money to spend on it, and maybe it’s okay to have national medicare rules about who can pay for what, although that’s changing after the Supreme Court ruling, but they don’t like the Feds telling them what to do with the money. If province A wants to spend it solely on cancer, and province B wants to spend nada on cancer but only on heart disease, then they get to do that, and the Feds can’t do anything. Or don’t, for fear of treading on toes.

It’s all about power. Not about the overall health of Canadians.

Yet here we have a national strategy on mental health. Yes, Canada was apparently the only major nation without one. But we also don’t treat health as a national responsibility. Since when are the provinces going to harmonize their approach to mental health — or physical — so that an Ontarian suffering from major depression can know that if they move to Nunavut they will receive the same treatment, the same level of care? Since when will the Federal government ensure the same level of care is not less than the minimal in any province or territory? Since when will the provinces give over any power so that a national strategy on mental health really is national?

In one interview I heard the Chairman say that different provinces will implement the recommendations differently, depending on what they do now, the implication being that at the end of the day a Canadian can live anywhere in Canada and know that they will receive the same good care. Hardly. I can’t see that happening? Can you?

No, a national strategy only has meaning in this country if Canadians challenge the provinces over their absolute power over health and demand that health be national, that a doctor licensed in Nova Scotia can practise and prescribe in Manitoba, that a Yukoner has the same access to a GP or psychiatrist as a Newfoundlander, that treatments in whatever form they come in are covered equally across the country from coast to coast to coast.

People think we have freedom of speech in Canada, but lawyers routinely muzzle Canadians. Privacy legislations are used as a way to prevent people from telling the truth. Confidentiality agreements perpetuate anti-freedom of speech so we are left in ignorance about how things actually work.

I was not allowed to write or speak about my brain injury or my insurance battles. After pleading to keep a blog, I was given permission by my lawyer to do so only if I didn’t write about a whole host of things, including insurance law, health care, brain injury, me.

After all was wrapped up, it took me over a year, and only with the encouragement of a social worker, to write about my brain injury. I felt like a mole coming out into the light, blinking against it, and looking back to see if the darkness was still there, waiting to get me. I have not yet found the courage or figured out how to write about the insurance battles so many of us wage, that wearies thousands of us.

Wong must’ve been like me and managed to keep out the usual confidentiality portion of a settlement or found a way around it. After years of being silenced, she says it’s liberating to write her story. That is a lesson for me.

This past week, I still didn’t feel up to it. But time is a-ticking. And it’s, uh, time to grit my teeth and start from the top, that is word one in chapter one, and reread and revise Time and Space for the big picture items. But like anything else that seems daunting, the anticipation deceives. Once I dived in, it was way easier than I thought. Hey, it was even fun! But — it doesn’t mean that once I’d finished up for the day and sat back down at my computer the next day, that my deceiving anticipation had relented. Nope, it was just as difficult as the first time to open up that manuscript and begin reading and revising it with a critical eye. You’d think it would be. You’d think that once I knew — from actual experience — that I could do it, that I would hop to it with great eagerness. But nope. Maybe I need a few more revision days to prove to myself what I learnt back in November: Time and Space is the first novel that I truly enjoyed writing.

My rating: 4 of 5 stars

After my brain injury, PD James became a marker for me in my reading progress. Pre-injury I read every one of her books and enjoyed them tremendously for their good writing and good stories. After my injury though, with my reading ability fried, I couldn’t read any of her books. Too many characters to follow, plots that meandered beyond my ability to follow, writing at a grade level higher than what I’d sunk down to… It was rather disappointing to see her new books come out over the years and know I wouldn’t read them.

And then I was enrolled in a research drug trial in March. I felt my cognitive abilities shift, and I suddenly realised I was reading more. I dared to try a PD James. I followed my rehab therapists’ advice: read a book I’d already read, tis easier. And so I went all the way back to James’s first Dalgliesh book.

It felt quite familiar.

I’d begun reading PD James in my teens, an age when I still reread books (sometime in my twenties I stopped rereading them because as soon as I’d read the first paragraph, the entire book would flood back into my memory). And so I’d probably reread Cover Her Face a few times years ago. Also, the story is reminiscent of a couple of Agatha Christie mysteries (which I continued to reread after my brain injury), making the plot familiar in several ways. Even so, I did have some trouble keeping track of the characters, and I only solved the mystery near the end, which is better than my usual not-solving-the-mystery-at-all track record since the injury. But the writing was demonstrably superior to many of the books I’ve been reading. It was rather satisfying to sink my teeth into a book fully of layers and complexities due to the author’s good command of the language.

I enjoyed it immensely.

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The physics aspect of it passed muster with my engineer friend, and that is such a relief. It was hard the first time understanding and remembering current concepts in theoretical physics so as to launch off them and come up with ideas on how the two futures work. I feared I wouldn’t remember and understand it all if I had to go in and edit it again. Thankfully I don’t.

I know I’ll get right back into the manuscript once I start. But there’s the rub: starting, diving in, launching WordPerfect and reacquainting myself with my story. Well, I’d better get to it … Um, first though, a snack sounds good. And maybe more coffee … some chocolate …

But I get ahead of myself.

It was March 1 when this story began. I saw a new specialist and was immediately enrolled in a research drug trial for ostensibly my pain and sleep. Theory: reduce pain, improve sleep as pain and sleep are connected.

March 8 after a week of baseline monitoring, I was put on the research drug, a controlled release, long-acting version of a GABA analogue. I was told there would be different dosages. When I visited the US government’s website on the trial I was in, I discovered that they tapered the dosages up. So week one I was on the lowest dose. March 14 I went up to the middle dose. March 22 I was put on the highest dose, the one they were studying. After a week of adaptation, I was sent on my way with a monitoring watch strapped on and about a three weeks supply of the highest dose. Since March 1 I had to phone in before noon a daily diary of my pain, fatigue, and sleep. I missed a few days, either because I forgot or because the system crapped out on me and I gave up dialling in and getting nowhere. Since March 8 I also kept an evening paper diary of the exact time I took the research drug.

Every time they raised the dosage, the side effects of dizziness, sleepiness, and nausea would appear for a few days, but each time would be less problematic and by the time the next uptick in dosage was due, would be gone. The sleepiness was murder for a couple of days there, but dizziness I’m used to, and the nausea was bearable. The worst part was that I felt nothing. No difference. All these side effects, all this diary keeping, and no good stuff. I started wondering if this drug was going to do anything, and given the researcher’s questions, I think the team had begun wondering too.

And then …

Pow!

I was baking like no tomorrow. Good thing it was only a few days before Easter feasting. I was baking cookies, puff pastry, palmiers, mushroom vol au vent, pavlova — all like I had done before my brain injury. Effortless on my part and tasty on the eaters’ part. When I say effortless I mean not having to actively think each step, check and double check what I had done versus what the recipe called for, not being uncertain about whether the baking time was long enough, working successfully with my ornery oven, even doing something I hadn’t done since the 1990s: making up a recipe from baking principles to use up left-over yolks. I felt like I was being pushed on some sort of fast-moving baking impetus. It was rather weird. And startling. And amazing!

But that’s not all.

I began to walk longer distances, faster, so much so my hip muscles began to ache more from overuse.

But that’s not all.

April 1: I wrote more than I expected to, not only pages for ScriptFrenzy, but a blog post and pages for my brain injury book as well. Could be an anomaly because I have had days here and there of much writing. But it persisted while I remained on the research drug.

April 2: Baking frenzy week began with hot cross buns. For the first time since my brain injury, I got the baking time right without worrying excessively then underbaking.

April 2: My activity level shot up. I did much more than usual online and around the house in one day. My activity level remained up while on the research drug.

April 5: Making strange mistakes, yet I suddenly started dreaming up what to make for an Easter vegetarian main, and I began making it that evening. Successfully too.

April 5: My body temperature began dropping towards normal. Although it had been slowly in the last few months, this was a big shift downwards. I can take my thyroid medication in the way it’s supposed to be taken. Before and after being on the research drug, I needed to take it during breakfast so that it would not raise my body temperature. During the trial, it didn’t raise it at all when taken half an hour or more before.

April 5: I indulged in a Mayan Hot Chocolate at Soma, and it did not increase my body temperature!

April 5: Initiative returned, that is, I could act on a thought, whether the thought was to make puff pastry or to empty the dishwasher or to write a blog post. Holy cow!

April 5: “Fatigue is just friggin’ weird.”

April 5: More active than the current levels of fatigue would normally allow.

April 6: No afternoon sleepiness or down time.

April 6: I winged making icing and got it right for the first time since my brain injury.

April 8: I had increased tolerance to noise for about an hour.

April 9: I woke up without long lines of pain down my arm muscles as well as less pain in my lower back and hips.

April 9: I tolerated and even liked radio music to yoga.

April 9: I was able to read longer!

April 10: My parents told me I’m coherent, together, with it. Calmer. They do not want me to come off the research drug because they see such a big change in me.

April 13: I read on the TTC for the first time since before my brain injury, I mean really read, not just looked at words but absorbed the story, followed the plot, remembered the characters, engaged.

April 16: My sleep has improved enough or stabilized enough that I didn’t mind the sun waking me up early.

April 17: In tests at the research lab, my heart rate is in the 80s. Never has it been that low since the brain injury when taken at a doctor’s office or by a health care professional.

And then it was over. On April 17, I apparently did not qualify for the randomized part of the trial because of my fatigue levels. I gather they had not dropped enough. Well, they may not have, but that shows that by not thinking to include activity levels in the phone-in diary, they missed an important indicator of functionality. Sure my fatigue levels had not dropped dramatically — yet I was no longer having long stints of not moving in my TV chair, my activity level had shot up, and I was no longer paying the next day for high activity levels. It does seem confounding for my activity levels to shoot up yet no commensurate drop in fatigue levels. But there could be all sorts of explanations for that. Clearly, the research designers had not thought it possible that although fatigue levels could stay the same activity level could improve markedly.

But I don’t think I could’ve tolerated the high dosage level much longer anyway. There were some too-calming effects starting to appear in certain systems of my body. It is important to pee after all. On the other hand, I could not have tolerated the placebo at all, given what is going on with me now.

I was put on a tapering dose April 17. New improvements appeared for awhile:

April 18: I laughed at less stimulation. It takes a lot to make me laugh out loud, or I must be in a quiet room with no distractions to laugh. This was something ordinary, a small joke, and I laughed out loud!

April 18: I engaged more on Twitter with less effort than usual.

April 27: I was able to exercise, albeit less than two-thirds of my normal routine, on a day I went out to appointments.

I took the tapering dose (middle dose of the three different dosages) for two days then began gabapentin on April 19. Oh joy. I lost a weekend to a combination of what I would call withdrawal from the research drug and side effects from the prescribed drug. The worst of the withdrawal was my body temperature alternating rapidly from what felt like fever to chills. The side effects were the same as with the research drug but with the addition of stomach pain. Over the last twelve days, the dizziness and sleepiness went, but the stomach aches are beginning to worry me. This is not nausea. I understand gabapentin increases stomach acidity, which means I must take it with food and some sort of stomach-calming medication like Gaviscon. If that won’t help, I’ll have to take something stronger.

Worse, I am regressing. The gabapentin ain’t cutting it.

My baking is not as effortful as before taking the trial drug but it’s no longer creative and as effortless either. Pain is back under my mind control, no longer the drug’s. (I hadn’t realised how much the research drug had been controlling my pain, releasing my mind to do other things, until I transitioned to gabapentin.) Fatigue is beginning to win again; I’m having trouble breathing for the first time in months when I do too much. My activity levels are dropping, and I’m having to do an awful lot of self-talk to get things done. I suddenly realised my daily coffee fix had increased from half a cup to two cups. And I’m becoming cranky. It isn’t like before the drug either in that this crankiness feels more like rebound. I think part of it is I was liking where I was going under the trial drug. I dared to hope for the first time that maybe one day I could participate in society like a normal person again. And now I see it slipping away. That would make anyone cranky.

So what to do?

Having conducted a ton of research in his career, my father knows all about this conundrum. The latest one he’s dealing with is an experimental hormone a few of his patients took. The hormone grows the small bowel. These patients have none or are missing the critical portion. This hormone was like a miracle to them. Their bowels began to work; some were able to come off TPN completely (to read about TPN and the story behind this artificial feeding method, see my book Lifeliner). So much so that when the trial was over and the drug withdrawn, they began banging on my father’s door demanding access to it, going back to pre-hormone life was that bad. But research drugs aren’t usually immediately available in the marketplace anywhere. And this one is needed by so few people around the world, it’s essentially an orphan drug. He’s working with others to make it available.

I am not dealing with horrible bowel issues but cognitive, fatigue, pain, sleep, metabolic issues. I now know what it’s like to see a miracle disappear. And I am fortunate that, unlike the bowel hormone, an alternative exists in the marketplace to the research drug I was on. Two actually.

Gabapentin is what I’m on. It’s the cheapest alternative and covered by the Ontario Drug Benefit program (though I still had to pay full freight because of the program’s deductible). Lyrica would be a better alternative, but I cannot afford it. Some drug companies will provide patients with a research drug under compassionate grounds, but it requires a doctor willing to jump through the hoops and a drug company happy to help even though it will not accrue any benefit to them at all. So while I think about my next step, I’ve upped my gabapentin dosage and upped the amount of Gaviscon on May 1, hoping that’ll bring the good things back. Given how slowly benefits take to manifest in me, it’ll be a few days before I’ll know if it will work or not. Meanwhile, here come the dizzy side effects.

“On June 13, The Word Guild will present Canada’s top Christian writing awards for 2012, rewarding the best in Christian writing during 2011. Awards Administrator Mary Ann Benjamins reports a record of almost 360 submissions – up more than one hundred over last year!

The quality of entries remains high. Audrey Dorsch, a judge in one of the book categories, remarked, “It was very difficult to choose among the top three in the category – but that sort of difficulty says a lot about the calibre of books entered.”

[Finalists] will be honoured at the 2012 Awards Gala in Mississauga, Ontario, on Wednesday evening, June 13.

A highlight of the evening will be the third annual presentation of the Grace Irwin Award. This $5,000 award – donated by retired book publisher John W. Irwin (nephew of the award’s namesake) and his wife Eleanor – represents Canada’s largest literary prize for writers who are Christian. It will celebrate the best book published in 2011 by a Canadian author who writes from a Christian worldview. The entries for this award consist of all the shortlisted books. For the winner this will be the “icing on the cake.”

The Word Guild Canadian Christian Writing Awards Gala will be held at the World Vision headquarters, 1 World Drive, Mississauga, Ontario, on Wednesday, June 13, 2012, at 7:30 p.m. The event is open to the general public. Tickets available at the door for $20.00, and online.”

I would like to thank an old family friend Ann Benoit for insisting – such an understatement – she practically reached through the phone to get me to surf to the website – that I enter these awards. I did not think for a moment I had a chance, but hey She is in! Now, I wait a mere six weeks, six days, 23 hours, and ten minutes for the winners to be announced.

If you’d like to see what all the fuss is about, please check out my page on She, which includes a playlist that goes with the story. Or go straight to Amazon US, UK, Canada; Barnes & Noble; kobo; or Smashwords  to order the paperback or ebook.

My rating: 2 of 5 stars

For a first novel, it was okay. But the plethora of cliches got to be a bit much, and right at the end, in the very last chapter, I couldn’t continue anymore. So I set it aside for awhile, and when I got back to it, enough time had passed that I no longer felt the build-up of the obvious and hackneyed. I was able to enjoy the final pages.

As I had read book #7 in this series before this one, I know the Jack Reacher books get better. It is heartening to know a writer can improve and does not stay the same throughout his series!

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Some write at the ghastly hour of four A.M. Some write in the evening. It’s kind of like exercise that way: there are those who like to get up and moving first thing and others who’d rather wind down a long day with a good run. But then there are some who write on the train to work, or maybe at the coffee shop during mid-morning break … or maybe mid-afternoon break. Some would never darken a coffee shop with their laptop or iPad to write, maybe the would to browse or check Twitter, but not to write.

Some prefer total quiet with no one around. Some like noisy cafes or the kitchen table with the family running around and the dog chasing them barking away. Some prefer music with their writing, any music will do. While some will be choosy, carefully going through their selection to produce just the right mood for that day’s typing or writing.

Some will sit in an armchair, a pad of paper in hand and a fountain pen or maybe some ballpoint they picked up on the subway. But others will sit only at their computer in their ergonomic desk chair, the keyboard at exactly the right height. And a few will dictate either directly into the computer using a nifty program like Dragon NaturallySpeaking while others will dictate into a handheld recorder, or these days into one’s iPhone, whenever the urge hits them.

Some are disciplined and will sit down at the same desk at the same time every single day, even holidays. Others will only write when the urge hits them. Some go for the middle, being disciplined during writing months like ScriptFrenzy yet also writing when the urge wakes them up at one in the morning.

My writing style is a bit all over and depends on what it is I’m writing. Some blog posts get written on my iPad as soon as I wake up. Others I write only on my computer in broad daylight. And still others I write on my iPad in front of the TV when the news is annoying me or when I can’t focus on what’s on but need to write but don’t want to turn off the TV. Novels I write only on my computer with no music, no radio on, writing books, dictionary, post-its, notes, and my iPad scattered around on my desk or within reach. My iPad because it has all my research and outline notes on it (backed up in other places!). This year, I’m writing ScriptFrenzy on my iPad in the early morning, at the beginning of April before the dawn but now that the dawn is moving earlier and earlier, it’s after the dawn.

What I’ve learnt: The best writing style is whatever makes you write.

Later, great commotion rends the air as robins fly out and flap at sparrows and juncos and finches that dare to fly too close to their treasured nest. Squawks split molecules and feathers float to the ground; the intruders flit off flapping their wings for all they’re worth; the robins self-satisfiedly return to their nest.

Later, a robin lands in a sea of soft greens and blossoms and runs until they find a juicy worm. It dips its head fast and pops back up with a juicy morsel dangling from their beak. Opening wide, it gulps it down, espies another wriggly morsel, hops one hop, and grabs it. Once satiated, it flies back to the nest where presumably it regurgitates the whole mess away from our eyes.

It’s all rather like writing. Building the nest in which the manuscript will incubate. Maybe a comfy chair, a new cushion, a few photos, a good set of dictionary and writing manuals. Keeping the distractions at bay, the ideas from intruding that will steal the heart of the central idea from your memory as you brood over it day after day, month after month. Feeding the hungry little thing once idea turns to typing, banging away on the keyboard day hour after hour until finally it’s ready to fly from the hidden depths of your computer into the sight of the great wide world. And all you can hope is that no one will clip its wings or eat it up but let it soar on the lift of excited atoms of air.

My rating: 4 of 5 stars

Somehow I rated this but didn’t review it! This book was recommended to me by a Michael Connelly fan, and I wasn’t disappointed. It’s an interesting concept about a sleazy lawyer who works out of his Lincoln car (hence the title) and has to face his worst nightmare: an innocent client. I liked the twists and the not-too-deep-thinking nature of it, which suited me fine in a more than usually stressful week. Books like these are meant to escape real reality. I’ve put the next book in the series on hold at the library.

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Before I begin, a note on my background. I grew up as the daughter of a clinician-researcher who is to this day, in his so-called retirement, in demand around the world, whose patients think he walks on water, and who has never in his entire academic career been denied a research grant (see my page on him, a bit outdated because I can’t keep up). During my university days, I used to talk to him a lot about research work, medical care, medical education. It never surprised me when he’d come home excited about some new research finding – and not just in his field or from research done by himself. His curiosity just about matched my own. I also wrote a book on Judy Taylor, the patient who launched his career into the stratosphere and who demanded all his skills as a researcher and physician to save her life and to give her good quality of life. So I know what good standard of care is.

I have a brain injury. Since the brain controls the entire body, mind, and emotions and since we know little about brain operations, caring for me is complex. But good standard of care even for someone like me is not.

I met a new specialist a little over six weeks ago. Seems like forever ago. He enrolled me immediately into a research study as he believed that the research drug would decrease my pain and so improve my sleep. I have pain from many sources, including fibromyalgia and the lingering effects of the seat belt injuries I sustained (again) in a three-impact car crash back in 2000 (the same crash that gave me my brain injury). The hypothesis made sense to me, and having conducted or been involved in a few research studies as the researcher, I was game to be the guinea pig for once. He sent me to his research team as they would instruct me. But he was in charge and would keep in touch with my progress through them. And I was given another appointment to see him end of May to follow up on all the tests and study results.

The first week was baseline week. Tedious but necessary. The second began the drug trial itself. I saw the research team each week as the dosage increased up to the highest dose. I have no idea what the highest dose is, or rather was. Every day I had to phone in a 24-hour diary on my pain, fatigue, and sleep. As I understand it now, the crucial parameter was my pain level over the previous 24 hours. Every evening when I took the drug, I had to fill in a paper diary, noting the time, which bottle(s), and when in relation to supper, snack, or breakfast. I was a good girl. I took my drug as instructed. Each weekly meeting was slightly different, but they always covered off two things: suicide ideation and/or actions and side effects. Apparently the suicide thing is de riguer for any drug, no matter how unlikely it was to cause suicide. I worried about it in the beginning, but as I got used to the process and the drug, I forgot about it.

Once I was stabilized on the highest dose, I went for three weeks without seeing them while still keeping all the diaries and taking the drug daily and wearing my Actiwatch, butt ugly thing that it was.

I wasn’t really feeling any different as the weeks went by. And then all of a sudden, things changed. But not the things the researchers were looking for. Problem number one for me.

They wanted to know about pain and sleep. But it wasn’t my pain and sleep that had changed dramatically, so dramatically that even my parents noticed. So dramatically that when I brought it up with my parents to discuss what I should do as today approached, they said categorically that I should not come off it. As I mentioned above, my father has conducted many research studies, many that involved his own patients. He knows the drill. He indicated that a patient knows when a drug is having an effect because it’s obvious to the patient. He’s seen and heard about it lots of times. Was it obvious to me? Yes. He indicated that his patients have been able to speak to him about what to do when they don’t want to come off it. And he explained the kinds of options available to someone like me when a drug is not commercially available.

So I called the specialist’s office last week to talk to him about the changes and about my options. Burgeoning problem number two for me.

The specialist wasn’t in. The specialist was busy. His assistant would let him know I’d called, and she suggested I try again on his patient day or I could fax a note. I’d learnt from previous experiences with others that faxing notes gets me nowhere. Physician reads it (maybe), files it, doesn’t talk to me. So I called again on his patient day. Gave my cell number. Ensured I was available to take his call anytime that day. No call. Friday I was at the hospital. I tried doing the really annoying ambush thing (but to be absolutely honest, another specialist had suggested it since time was ticking down) and asked him politely for two minutes to discuss what to do as I could not come off this drug Tuesday. The changes were too dramatic, too important to my quality of life. I didn’t get that far. He looked peeved and interrupted me. Well, okay maybe he was having a bad day and obviously stopping him in front of his office would not be the happiest moment of his life. But he hadn’t called me back.

Let’s talk about that for a moment. Physicians today do not call patients back because OHIP doesn’t pay them to. Medicare used to pay physicians and surgeons to telephone patients because the bean counters understood phone calls were part of patient care. But no longer. I had heard that if a patient initiates a call that OHIP will pay but don’t quote me on that. So if a physician calls a patient today they’re doing it pro bono, and they’re doing it because patient care is that important to them. To compare: lawyers don’t even talk to clients for five minutes sans billing them, and lawyers can have as big an effect, if sometimes not bigger, on a person’s life as a doctor can. However, I’m not just a patient, I’m a guinea pig. In a drug trial. For a drug that’s not commercially available. It doesn’t matter whether or not it’s derived from one that’s out in the marketplace, they still don’t know its full effect. Thus when a patient-guinea pig calls saying that there have been dramatic changes that have affected internal body functioning and cognition, it’s important from both a clinical and research point of view – and most of all for good patient care – to take the effing call.

He agreed to speak with me after his meeting. I stared at posters in the waiting room, made queries about an advertised non-drug research study (I need money), and was finally called in to “discuss” it with him. He’d spoken to the chief researcher about my changes – who, by the way, did not know about them all to say the least, but neither the researcher or the specialist knew that – and to his assistant – who also knew only some of the details – but he didn’t speak to me. And so he knew only part of the story because I was waiting to speak to him to tell him the discreet details. I didn’t feel like bandying them all over the place. I’d had enough of that during my insurance fight. The two people he spoke to were also unaware of my financial situation, and not being my physicians they didn’t understand how much this drug was changing my life. Problem number three; blew up in my face today.

After speaking to them about my situation and only them, he told me that I would be enrolled in the second half of the trial, that if I was enrolled in the placebo portion and after a couple of weeks didn’t feel too good, they’d discuss what to do about drug options then. It’s the best way. Bye. What about the changes? Have you seen them before? Bonus. Bye.

To recap: zero discussion with me, the primary source, about my pain levels, dramatic changes, staying on the drug, and taking and paying for its approximation.

Today, the computer told the researchers I was ineligible for the second half of the study. Big surprise. Well, it seemed to be for them. Not to me. I knew what my pain levels were. I knew that once I was no longer reminded of being in pain every verse end, I’d go back to my ignore-it-and-it-will-not-interfere-with-my-life attitude, which would not actually drop the pain levels in my diary entries enough for it to show that the drug had affected them, if you follow that. So I don’t know why they were so sure last week I’d remain in the trial. They could see my diary entries in real time, but I guess they’re not good ballparkers whereas numbers being my friend and having saved my ass many a time since my brain injury, I’d sensed it.

All of a sudden, they had to figure out how to meet my needs. They had to figure out how to get a prescription for a commercially available approximation of what I was one from the specialist. They said my pharmacist would explain to me how to take it. I said point blank how about discussing it with me now. I mean seriously, since when does a physician not discuss a prescription with their patient? They couldn’t, only the specialist could, and after awhile it became apparent, he would not be available for some time, like, hours and hours even though last week I’d received the impression he would be reachable. Well, what does it cost? Oh, no worries, insurance will cover it. I pointed out I didn’t have private insurance. Did the Ontario Drug Benefit Program or Trillium cover it?  That threw them for a loop. I’d have to ask my pharmacist, they said. What do I do if I can’t afford it? Well, I was on the tapering dose since they couldn’t get me a prescription right away anyway, that would hold me for awhile. (Like, for barely a week. Maybe.)

So I trooped off to my pharmacy. The drug is not covered by any Ontario drug program for anyone at any dosage. It should be, maybe it will be, but it isn’t. What would it cost me? Well, that depends on the dosage. A bit of a problem there. The research team hadn’t told me the dosages of the research drug; had refused to discuss the prescription with me; the specialist had not yet written it; and I had no clue. So we played with some numbers. I thought about what I could give up after I heard the dollar figures. The pharmacist suggested asking for compassionate care or use whereby the pharmaceutical company would provide me the drug gratis. She explained that the specialist has to apply and how it would work in practical terms. Problem number four.

Last week I was upset, worried, stressed. This week I’m mad. This is how the problems that arose for me translate to bad standard of care:

Problem number one:

Bad or what-has-become-acceptable standard of care is that when a patient says they are experiencing changes different than what is expected – ignore them.

Good standard of care means that when a patient indicates that a drug is affecting them differently, you discuss it immediately, not at their next appointment time. You discuss it so that the patient first and foremost feels safe because a drug can be a dangerous thing and the patient needs to know the clinician researcher has their back. You discuss it also so that you can learn from it, think about how that patient differs from the other guinea pigs, and most importantly, how best to help the patient so as to maintain and maybe even improve on the good changes. The patient’s health is top priority.

Problem number two:

Bad or what-has-become-acceptable standard of care is that when a patient-guinea pig calls, you don’t return their call because it is protocol to speak to patients only during scheduled appointment times. Then be impatient with them when they do whatever they can to get your attention because they’re that desperate.

Good standard of care means that when a patient-guinea pig calls, you return their call as soon as possible because even good changes require immediate attention to ensure the patient is not hiding side effects or is not at risk of unforeseen consequences. And if they button-hole you because you didn’t call back after their repeated calls, realise it must be really important to their life and health and well-being for them to make that extra effort. You listen; you discuss; you reassure them.

Problem number three:

Bad or what-has-become-acceptable standard of care is that when a patient-guinea pig tells you that they don’t want to come off a research drug, you don’t discuss the financial details, figuring it’s their problem not yours or you’ll deal with it when you must.

Good standard of care means that when a patient-guinea pig tells you that they don’t want to come off a research drug, you discuss what is available and ask if they have insurance. You know all about how lack of money stops treatment; you’re aware if the drug is covered or not by the Ontario Drug Benefit Program or Trillium so that you don’t send them haring back and forth between the pharmacy and hospital just to figure out how to pay for it. Even better you’re willing to discuss these things over the phone. You appreciate it when a patient has given you notice so that both you and the patient have time to find out how the patient will pay and if they need you to fill out an application for compassionate care.

Problem number four:

Bad or what-has-become-acceptable standard of care is that you’ll be caught unawares by the patient’s need for financial help and refuse to discuss it outside of scheduled appointment times, long after the research drug has left their system and they have gone back to their sucky pre-drug quality of life. Stress them too so badly that no amount of Valium will relax them.

Good standard of care is that you’ll have discussed it when the patient called in advance of the study possibly ending and be ready to resolve this problem expeditiously, or if not, to be available when the patient needs to discuss what comes next, how it works from your point of view, how long it will take. In short, make the patient feel safe, assure them they have a partner in their care and are not alone, and that things will work out. Most important: shorten their time off the drug as much as possible.

To sum up: good standard of care is predicated on a physician being able to think laterally, vertically, diagonally, sees medicine as an art not strictly a science, sees the patient’s health as the highest priority, and appreciates a patient involved in their own care. One of these days I’ll receive good standard of care. But as of now I’m on the tapering dose.

Update 19 April 2012: A go-between asked the secretary to have the physician write a note to the drug company asking for a compassionate supply. I was told to followup this morning. Bell helped. They invented call blocking. It’s the ticket to having one’s phone call answered. Did the physician not give the prescription? Nooo. Long hold. Click. The physician came on the line. Whoa. That threw me. Then I heard:  “you think you can’t afford the medication.” Excuse me? Think? Really? I had no idea I knew so much less than he about my finances. Still, he would graciously write a letter to the drug company though they, of course, would not supply me. And he would immediately telephone my pharmacy with a prescription. As in right now. Maintenant! But — I must not call his secretary more than once a month. He was insistent on that. I thought: why would I, I finally got him to listen and act. I said: he had assured me support. And then my Parsi side kicked in, and I made nice murmurings. I wanted that prescription. Given what he’d said about the multinational drug company, implying they would be a pill, I assume the letter will be perfunctory. He left me and the pharmacist to confer on when to switch from the experimental drug’s tapering dose to the prescribed established drug, how the established drug stacked up against the experimental one pharmacologically speaking (flip open books, get out the old calculator), what side effects to watch out for, how to monitor my symptoms and titrate the dose up. Nothing like a patient and a pharmacist discussing how to switch from an unknown drug to a known one to make a pharmacist’s day interesting, I bet.

The blacktop whistling underneath her wheels at great speed, she accelerates along the road the shipper has programmed into the truck’s shiny GPS. The only problem is is that the far back trailer in the triple has a tendency to yaw, sometimes sway so far over, it almost topples her off the road. She wrestles with the steering wheel, knuckles white, palms red where fingers dig into it. But she straightens the train and is soon out of New Brunswick and crossing Québec. Smooth sailing!

And then fatigue sets in. Ontario goes on forever. He is tired; his eyelids droop. He wants to stop. But the shipper has put on a clock, and every time he stops, it ticks down faster.

And then she’s through Ontario. She flies through the prairie provinces and angles northwest up the Alaska Highway. The scenery is strange, bereft, not anything like she’s seen before, but home is not far off once the gold is unloaded.

He enters the barrenness of the Yukon and bounces along into Kluane National Park, gravel chips and tar bits chinking the windshield. He’d been warned about that, about how that would signal the closing down of the time clock. He accelerates; he’s desperate to get to the destination on time.

Suddenly there it is. The weigh station. She stops with a hiss of the brakes and a flurry of dust. She steps out of the cab, and the lonely silence slams into her chest. She sucks in a deep breath, walks round the cab, and peers at the digital readout on the weigh scale. It says: wrong load. It says: you’re carrying granite not gold. It says: wrong destination.

He tears the back trailer of the triple open, and glassy quartz winks out from the boulders and rocks of granite that fill the trailer. He slams the door shut, bends over, and upchucks. He looks around for help, for another soul, for a sign. But the place is empty, devoid of even an eagle screeching against the burning sun in the Yukon’s high, thin air.

She climbs back into the cab and decides nothing for it but to return to that misdirecting shipper. But when she turns the truck back on, the GPS’s pixels flash on and off individually and in rectangular chunks. She smacks it. It flashes bigger chunks, meaningless chunks of streets mixed up. Then suddenly it shows the way. With great effort she turns the triple around on the two-lane highway and heads east. That’s where Newfoundland is, right? That’s where the shipper is.

He is lost. He finds himself somehow at the bridge to Dawson City. He decides to stop relying on the shipper’s GPS and to follow the sun instead. The sun is south, always south, and after midday, it should be behind him.

The triple eats up Megameters as she zooms along the paved highways. The GPS conks out completely, and many days are filled with slashing rain, thundering clouds, and black skies that obscure the sun. She stops at the first of many shippers for guidance. She figures shippers must know each other, have some sort of loose network. But they don’t. Still, they take pity and give out scraps of old maps. Sometimes, they take some of the boulders she’s hauling, enough that she is able to unhook the last trailer in the triple and turn it into a turnpike double. She uses their maps until they fall to crumbs under her booted foot glued to the accelerator. Then she looks for another shipper. And in between she takes pit stops and rest stops and every now and then a sixteen-hour sleep stop.

Suddenly he’s in Ottawa; he’s pulling through a gleaming chain-link gate into a new shipper’s. They remove a trailer, decreasing his haul to a semi-trailer. They provide a new GPS and a cell phone in case of emergency. He grins thanks; but they’ve turned their back already, dandruff falling lazily from their full heads of hair onto cotton-clad shoulders. Never mind. They’re busy. He gets that. He skips into the cab and roars out of there. They had said: your home destination no longer exists. But he doesn’t care. He’s happy to know at last that he’s not alone, that help is a phone call away, that they’ll direct him well.

She drives west again, maybe to Alberta, maybe to Nunavut, maybe to the far northern reaches of Vancouver Island. The new shippers hadn’t exactly specified where west. But she has confidence in them, and she cannot wait to find out.

His good mood evaporates as he jostles with Ontario drivers who think cutting right in front of a huge truck without a signal is a good thing, as he grumbles at the Ontario government who refuses to make the main highway between Ottawa and Toronto — Highway 7 — four lanes, as he screams at another reckless driver passing on a solid yellow who upon seeing the truck barrelling down on him swerves back into his lane causing the mayhem he watches in his rearview mirror.

The GPS dies again.

He calls the shipper.

Voice mail. No problem. She leaves a message and hits the road again. After awhile, she tries and tries again. Over and over, unavailable. The road no longer looks full of hope but a monotonous, seamed, cut-up blacktop; the sun a scorching harlot guide. She turns off the paved road onto one of southern Ontario’s many gravel roads. She handles the semi with ease. She brakes and watches the plume of dust dissipate around the cab.

He steps down onto the slippery gravel. He has no plans. He is lost, the only certainty is that he can’t leave the semi. He leans against its engine, unheeding of its heat. Tired of staring at the stones under his feet, he lifts his head and sees amongst the bare branches across the road a forsythia, a forsythia covered in flower after flower after flower after flower of bold yellow, a forsythia blooming in March in southern Ontario.

When Tuesday came, I was not ready to return to my regular routine and ScriptFrenzy. I wanted to continue to sit in a comfortable chair in the sun and to read the thrillers I’d borrowed from the library. I could’ve taken more time off, for sure. But I sighed deeply, sat up as the dawn jabbed me fully awake, grabbed my iPad, and got back into writing my radio play Divorce Times Marriage. I banged out several pages. I got caught up to about Monday’s goal. I couldn’t keep going though. I was tapped out, tired, taxed.

I thought: I’ll catch up Wednesday. And flopped back to zone out into a thought-screen of nothingness.

Today, I wrote and wrote and wrote. I tired. Became weary. And so I did what any tired, don’t wanna writer would do: I short-circuited the scene. I figured I must be caught up by now and so it would be okay. I entered my current page number total on the SF website, and…nope. Still behind. Sigh. Back to the Celtx app on my iPad, back to the scene I went, and this time, I wrote it properly, fully, no side-stepping of the issues like one of my characters is trying to do.

I banged out three more pages, eight in total for today, and just about caught up to where I’m supposed to be. I couldn’t type anymore. My hands ached, my shoulders hurt (what else is new?), and the scene was done anyway: the shrink said time is up for today. And you gotta obey the shrink, you know.

Thirty-four pages total so far. I’m about one-third of the way through. Phew.

My rating: 4 of 5 stars

I borrowed this ebook from the library because I’d read Lee Child’s short story [b:The Second Son|12215815|The Second Son |Lee Child|http://photo.goodreads.com/books/1328306888s/12215815.jpg|17156027], really enjoyed it, wanted to try out a full-length book of Child’s, and Reacher #7 was the only one available to borrow. I put a hold on the first Jack Reacher novel.

Like the short story, this book gripped me from the beginning. The writing is tight; the character Jack Reacher came to life right away; the suspense began from the first word and kept on going. There was a flashback after chapter one. I hate flashbacks in novels, and I’m starting to realise it’s probably because they’re not that well done — this one was. And I enjoyed it. The only thing I began to tire of was the violence. Even in a violent novel, with violent characters, there can be a smidge too much violence. That’s also the reason why the ending was stretched out. It was almost like it was written that way (well written, mind you) in order to create one more way of killing.

I absolutely did not want to power down the eReader and set aside this ebook. During one longer break, I thought about the mystery aspect of this thriller and started to see where he was going. The suspense began to drop a tiny bit for me. That’s when I had one of those lightbulb moments. Child doesn’t give you a chance to solve the problems alongside Reacher because Reacher would spend more time pondering the problem than we do reading it, no matter how slow a reader you are. And secondly, Reacher is smart. He has knowledge and experience most of us don’t have, but he also has a good sense of situations and people, he observes and listens. In short, he uses his whole brain. That’s awfully appealing, and it makes him a speedier thinker than many of us readers. It gives the reader a challenge: to keep up. The only way to do so really is to stop reading and think about it. But the way Child writes with great tension and verve, you don’t unless you have to, and so the suspense remains ratchetted up. That’s a great writing trick. I like!

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My rating: 3 of 5 stars

It’s true what the author says: there aren’t a whole heck of a lot of books, or even magazine or newspaper writings, about being a sibling to a person with autism or any disability. Most are by or about the person with autism or written from the parental point of view. For me, seeing what it’s like to live as the younger sister to someone with autism was interesting.

The way the author told this fairly straightforward story was different too. She would use the present to springboard back into the past then show how it affected her present desire and ability to have a relationship with her sister. Each chapter focussed on a different aspect of living with a sibling with autism and on how her sister’s autism affected herself and her family in that aspect. I liked the structure; I liked the idea of going back into the past then re-emerge into the present. But sometimes I got lost. The demarcation between past and present was not always clear to me. Perhaps a print book would’ve been a better format, as it’s easier to flip physical pages than virtual ones. It would’ve been easier to go back and reread the paragraphs that would clear up any confusion then flip back to where I’d left off. Other than that, it was a pleasant wander through the experiences of a sibling with a disabled sister.

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My rating: 2 of 5 stars

I was all set to like this one, really like it. Good plot, neat idea having two people working together to solve a crime, set in BC — and it’s Canadian! It began okay. And then…

Well, the obvious padding I could put up with. Books can get like that sometimes, and I usually figure it’s up to the editor to point out the obvious. The fact I wasn’t all that engaged is something I’m used to — books that grab and hold me don’t come often, and it isn’t only because of the writing style, a lot of it is because of my brain injury (though I’m starting to wonder about that as my concentration continues to improve). No, what got to me was the stupidity of the main characters, of one “detective” in particular, the one who is supposed to have been an excellent investigative reporter. There was one incident in particular that if it had been written in a separate order — and it could have been quite easily — would have cast that character in a different, smarter light. But the way the co-authors wrote it he came across as an incredibly unobservant, dumb former reporter. No wonder he doesn’t work in the field anymore (aside from the reason given), was my thought. His “co-detective,” the insurance investigator, came across as too credulous for the kind of work she does. These sharks are just that: sharks. And highly suspicious ones too. Not to be suspicious yet, moreso, be highly credulous when it came to one of the suspects stretched the bounds a bit.

I gotta say I’m getting tired of picking up new-to-me books, looking forward to sinking myself into a new mystery series, and then finding that the writing or the characters or the plots leave me flat and disappointed. Who is it who says traditionally published books are superior? They need to up their game.

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What would I write, I queried my therapist. I have no idea what to write. No idea what my play will be about! Oh, you’ll think of something, she replied breezily. Somebody else repeated what she said. Apparently, I was the only one fretting about what I was going to write. But they were the ones who were right.

Why fret when my brain seems to produce on cue.

May it always be so.

However, just because it produced — some days my conscious mind knowing what was going to happen but most days being like the first: I had one idea and suddenly my fingers tapping on my iPad’s Bluetooth keyboard have another, and they are taking my characters into a shrink’s office. Geeze. Anyhoo… just because the inner creative recesses of my mind produced doesn’t mean that the writing itself is any good. I’m in that phase writers get into where all the work sucks big time. It would be a good idea to stop, to say enough.

But because it’s ScriptFrenzy, because I have pep talks appearing in my inbox and other prod, prod, proddings, I keep writing my play Divorce Times Marriage. Not today though. I’m way ahead of schedule. Eighteen pages.

Plus I did have two characters in mind. I sort of knew what was happening between them. And I knew their relationship. That should be enough, eh?

Apparently it is. ScriptFrenzy started yesterday. I opened Celtx on my iPad and started typing yesterday. I futzed around first with trying to figure out what a radio play script is supposed to look like and wasted time worrying if I knew what I was doing. But I got down to it; I put fingers to Bluetooth keyboard and typed away. And I repeated that today, with staring at the screen instead of futzing around to begin with before I finally began to type and type and type. Eight and a quarter pages total for the two days. Not bad.

The iPad is great. You can write on it anywhere. There are no surrounding distractions on the screen or papers and pens and heave knows what else like when typing on a computer. I can even type in a darkened room — no light, means not seeing the stuff around, and so even less distraction. I do need a little bit of light to see the keyboard; still it’s dim compared to sitting in my office chair at my computer. Creativity comes easier. Or it feels like it anyway.

Eight and a quarter pages total for the two days. Not bad.

But believe it or not, people with brain injuries struggle even more than the typical North American. We struggle more because we may no longer be able to perceive that one’s stomach is painfully full as long as there is still food on the plate. We struggle more because doctors don’t acknowledge that mental work may preclude exercise. We struggle more because our metabolism has changed, is no longer the one we know, have lived with our whole lives — and again the doctors don’t even notice the change and thus cannot help.

And so when we suffer a brain injury, we have huge fatigue and understandably feel great pain and stress as a result and suddenly begin (or if did it before, increase greatly) ravenous emotional eating because our usual ways of coping with stress are gone, vamoosed with the injury. I used to read, to lose myself in a book, when stressed. Sometimes I’d eat chocolate or ice cream, but small amounts because I had such strong self-control and knew pain in the stomach meant it was very, very full. I also walked, whether to shop at my local stores or just to process what was stressing me. No more. My brain injury kiboshed my reading, my self-control, my local shopping, and my walks. Oh, I tried to read but I’d crack open a book and read and reread the same page and never get lost in it. I tried to walk but fatigue stopped me cold. Because I had so much trouble cooking, a certain someone took over and served me as much as he ate. No more did my plate hold the smaller amount I habitually ate pre-injury. And no more could I stop eating, perceive my stomach was full — not until the plate was clean. I never cleaned my plate pre-injury, much to my mother’s annoyance. And then on top of all this, my pain, physical, emotional, and mental, was great; chocolate offered relief. Good-quality large bars of chocolate. My favourites were Green & Black’s bars, and these days, I vary between them and Camino’s 80% Panama bar (but now I eat only 4 to 6g in a day).

I gained weight.

For whatever reason, I noticed yet didn’t. No doctor noticed enough to guide me back to my normal weight. Friends and family, well, all I’ll say is thank goodness for Oprah.

One could count on Oprah beginning the year with a weight loss push. She filled her January shows with practical advice on how to eat better, exercise well. She was such a cheerleader that her inspirational motivation penetrated even the thick cotton batting surrounding my mind.

I lost weight.

I came close to a decent weight but not my old, lifelong weight. And then I began brain biofeedback. No one, but perhaps fellow people with brain injury and trainers whom I wasn’t in contact with at the time, knew that intense mental work equals no energy left for exercise equals brain screaming for glucose, more than even a university student — because not only does the brain require food for the increased learning but also to keep repairing the brain, to redo the connections the mental work is demanding.

Mental work equals weight gain.

Brain biofeedback was, in a way more intense than studying at university, for it was not only repairing or creating new pathways while I was learning but it was also forcing me to learn a new way to control a computer. I mean, who has controlled a computer game with their brain before? Not me!

I gained weight.

A lot of weight.

I also gained more water. Brain repair is stressful after all, and I also didn’t know that I had exercise intolerance. I looked like the Michelin Man, like a sick person on steroids.

I felt lost. I had no idea how to lose weight. I was eating well, exercising properly, staggering home exhausted after biofeedback, yet gaining weight.

Then biofeedback ended. I had more energy, a much better functioning brain. I got a new GP. He introduced me to his trainer, who told me about brain injury, heart, and exercise intolerance. He cut my exercise down to ten minutes three times a week, and I lost water and weight. The new GP reminded me of the GI Diet. I began counting calories, not only to lose weight but to retrain my brain to eat as much as my stomach can handle not what is on the plate. And I created, refined, and stuck with my hypothalamus fix.

My weight loss is so slow, frozen molasses could move faster. I still have a tendency to gain weight, well, water, if I exercise too much (e.g., walking partway between appointments because, again, the TTC isn’t working) or think too much or, worse of all for me, am subjected to emotional stress. I try to avoid the latter like the plague but sometimes tis impossible.

It’s that time of year again, when one attempts to write in a foreign format and finish it within thirty days, the time otherwise known as — ScriptFrenzy.

My calendar told me it was time to decide what to write. For the past few months, I keep seeing the same two characters on a stage, but no plot, no beginning, no ending, no title. That’ll do.

But when I went to click on type of script in my Writer Info box on my ScriptFrenzy page, I saw “Radio” and went hmmmm. I think my characters would be happier on radio, just their voices representing them. It’s a minimalist play. With no title. Better come up with one; it’s rather crucial for ScriptFrenzy. After ditching the first two ideas I had — they had been taken in some form or another — an original one enters my mind from who knows where. Google it. No match. Awesome.

The logline section looked intimidating. Oh, the hours I’ve sweated over a logline: a 25-word synopsis of a screenplay or play or novel or…. But it was past midnight, and I was starting to hurt. So whatever comes out of my fingertips and appears on the screen is good to go, I decided.

” A woman and a man. Husband and wife. They have come to the seven-year mark when talking to strangers is easier than with each other.”

I scrolled down towards “Submit” on the edit page and hiccuped over the Poster section. Well, why not? So I whipped up a poster using Picnik on Flickr for old times sake before it’s permanently snuffed out mid-April.

And now I could “Submit” — submit “Divorce Times Marriage” my radio play idea for ScriptFrenzy. Lord knows what I’m going to write come April 1

I don’t mean the meal I had last night or the one I had the night previous to the crash that altered my life, but the last one I cooked and baked and wholeheartedly threw myself into for friends and family for 1999’s Christmas Eve dinner, the Christmas before the crash.

Pre-brain injury, I loved to cook. I loved to bake even more. And so being able to pull out all the stops for the Christmas season got the adrenaline of excitement pulsing through my veins. This meal was my most ambitious; it was challenging planning and cooking six courses, which made it all the more enjoyable for me. And I hoped pleasurable for my guests without leaving them comatose on the couch from stuffed stomachs.

I planned it weeks in advance. I set the table with all my fine china and crystal, in the proper mother-approved style, complete with stylized folded cloth napkins and centrepieces. Yup, I used to be almost Martha Stewart like before I’d heard of her!

I settled on six courses, each from different cultures, and as I recall, almost a wine for each course. I made it all vegetarian, something I hadn’t done before in a formal setting, something I wasn’t sure would satiate my guests in every sense of the word. But I wanted to show that vegetarian didn’t mean boring or earnest lentils and bean dishes only.

I made all the puff pastry in advance and stored the pastry shells in the freezer. I spent a lot of time on the alcohol, wanting the drinks to complement and enhance each course. I researched and sought out just the right Sake for a delicate Japanese soup that was either the first or second course. I trotted over to the LCBO store in Yorkville, the one I was told stocked organic red wines, where I had a long conversation with the LCBO sommelier about a particular French vintner’s obsession over the purity of his soil and vines and of keeping them as they had been in the pre-chemical era. His red wine was excellent as I recall, a knock-out partner to the wild mushrooms and sauce in puff pastry squares that was the main course (they were big puff pastry squares, and the mushrooms in their sauce were to-die-for, if I do say so myself). I then decided on an Ontario ice wine to go with dessert: little triangles of puff pastry filled with either vanilla or chocolate pastry cream. I doubt I served only those for dessert, being the baking fiend that I was, but whatever they were shall remain hidden in the mists of time.

I wish I could recall the other three courses, but in those days I barely wrote things down as my brain was a memory steeltrap: whatever went in I could instantly recall. No more today. Sigh. (Though I will say that being able to remember everything is not necessarily a good thing when everything includes the crap of life that one would rather forget.)

I don’t think I will ever be able to entertain like that again. No more elegant dinner parties; no more ice cream parties in the summer. I had no idea as I swallowed my last bite of dessert in 1999 that that meal would be the end of that part of my life.

I liked this threesome of short stories. Because it was an ebook that I’d borrowed from the Toronto Public Library, I hadn’t realised when I began reading it that it was three stories in the one book, each showing a different side of Nero Wolfe. But the revelation that I was reading shorts not one long didn’t disappoint me. Rex Stout was a master of both formats.

I have to say it truly shocked me to read about Wolfe outside his house. And not only outside it but voluntarily travelling to the country too. I liked the change, and I enjoyed too the stories where Wolfe is in his usual environment. This is a good book for those in-between-task moments when you have only minutes to read.



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Too Many Cooks is one of Rex Stout’s earlier Nero Wolfe’s books, but it’s as well put together as his later ones, which I’m more familiar with. There’s all of Wolfe’s idiosyncrasies, his food fetish (with attendant mouth-watering lists or descriptions — really, one must read these books over lunch or a one-person dinner), his fractious and dependent relationship with Archie. And then there’s Archie, the narrator. Here he shows a more flippant or flirtatious side than usual with the lady, but he is still entertaining. The mystery as usual is not that easy to solve. In fact, I didn’t, or only partially.

A Rex Stout book is a good read when you want to flow into something light yet engaging. Too Many Cooks doesn’t disappoint in this vein.



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This gent has known me a long time, starting in what I call my hell years after I had suffered a closed head injury aka traumatic brain injury. Back then, I used to see him weekly, yet when I spotted him one time in a different place, I recognized his face but could not remember his name or where I knew him from. Slowly I improved. And last year, he told me how much I’d changed since then, how I’d come alive, how I was alert, how happy he was for me. But early this week he was astonished to see something dramatically different in me and had to come up and tell me about it. He didn’t have the exact words, but it had captivated him and “alive” was the best way he could describe it.

The next day, my father commented that something had changed. He thought I was calmer, but I had been calmer for awhile (it had begun after I instituted my “hypothalamus fix”). Still, it was a close descriptor, I think, to what had happened.

The next day, a woman who didn’t know either man, said the same thing. She too said she’d seen me come alive slowly over the past several years. But this week, something different, something dramatic had happened. She too was excited to see it.

One person wondered if it was the new research study drug I was taking, the one the new sleep specialist had recommended that is supposed to reduce my pain and improve my sleep. But this drug is supposed to take awhile to take effect, my pain and fatigue levels are the same as usual, going up and down as usual, and as of when the elderly gent saw me, I had been on it only a few days. Plus the change had begun before I was even given the study drug. I had said to my acupuncturist last week, for the first time ever, my mood is OK. You don’t have to treat it today. And she concurred. She treated my pain and fatigue and suggested a longer interval between appointments.

What an amazing, dramatic improvement that even I could feel it.

I believe two things happened that made the change in me.

When I conducted my research for my book Lifeliner, I realised that Judy Taylor had survived and thrived for twenty years without eating for four big reasons, two of which were support: medical team support and family support. Of course, for Judy medical team support was vital, for without it she would die. Still, many people on TPN (total parenteral nutrition) today mayn’t be able to get a hold of their doctor outside of office hours and be forced to go to emergency if they have a problem, where they’d have to suffer delayed treatment while they explained their artificial feeding and the special requirements it entails. Not very supportive. Judy never had to worry about that. Whenever she was in trouble, she knew that her doctor, my father, had her back. It would be him she called, him in the emergency room seeing to her care. And then there was her husband. She knew with no doubt whatsoever that he would never abandon her, no matter the cost. In an emergency, she could count on him immediately zipping her down to the hospital; in daily life, she didn’t have to worry about being taken care of financially or about having a solid roof over her head. That kind of unquestioned support makes life possible and makes one feel loved, no matter how much the body is scarred and infirm. And so I knew how important support was to health when a person has a chronic illness or injury.

That’s the two things that changed for me.

1. Medical team support: I finally found last year and was able to secure a spot with a psychiatrist (whom I shall call “neurodoc”) in Toronto Western Hospital’s acquired brain injury neuropsychiatry clinic. One of the first things he said to me in the Fall with great firmness was that I could see him for as long as I needed. There was no end date. I understood with my head, but it was not enough for me to accept. You see, the best of my doctors had not stuck with me. They took me as far as they could go then discharged me, for curiosity and acquisition of knowledge to treat my particular pantheon of injury sequelae was not in their cards. Most doctors though told me “this is what I think, bye,” with what they “thought” not being very helpful to me. This month I saw the sleep specialist my neurodoc had referred me to. It was a case of I will believe it when I see it, that I believed that the referral was real. Then when I actually saw him, he emphasized at least twice to me that he would not usher me out the door if he could not solve my insomnia. He said he would support me and gave evidence of how he does support his patients, how persistent he is, how he doesn’t usher people out the door. For the first time in years and years, I felt supported by a medical team – my medical team of two physicians. I relaxed. That’s why I say I don’t think it was calm my father saw – it was relief. And it was relaxation. I no longer have to keep a vigilant eye on my health, to monitor the effect of any treatments or diet or exercise changes, to scan daily my Twitter feed or articles that come my way for solutions. Two shrinks are now taking care of that for me. Not in all areas, tis true, but in enough that it’s an humongous relief. Amazing relaxation.

2. Family support: For several years — except from every professional I saw for my health care (not insurance), whether therapist or psychiatrist — I heard without fail from most everybody in my life that I was malingering, that I must get over it, that I must move on, that I was depressed, that I was wasting time on health care instead of working. The insurance company and almost all of its hired medical mouthpieces (oh sorry, maybe I should have said independent medical experts) labelled me with anything that they could get away with – until my lawyer and proceedings debunked them, in which case they moved on to another label, except the true one: closed head injury. It was so bad that even though every professional who diagnosed and treated me said it was so obvious and I was so typical in my symptoms and functional problems that I had had a brain injury, I began to take on that malingering label. And it stayed plastered to the walls of my psyche. And then my neurodoc invited my mother to an appointment and asked her if she thought I exaggerated my symptoms, my pain and fatigue. She said “no” so quickly, there was no room for doubt. In that answer, for the first time, I had heard a family member say out loud I was truthful, that my symptoms, my functional problems, my difficulties were real, that I was so not a malingerer. I was the opposite. Saying it out loud is like shouting compared to the whispers of slowly evolving actions and email. The chains around my heart released and fell off with a clatter. The burden on my shoulders rolled off and disappeared into the maw from whence it had come. My muscles unclenched from their permanent defence against years of accusations.

That release is what everyone saw so clearly in my face, my posture, my walk, my health. Support is essential. When you withhold it from a loved one – and a patient when you as the physician make yourself unavailable or usher your patient out the door because you don’t want to think outside the box and extend yourself – you condemn the suffering person to carry a burden they can never lift off of themselves. And that burden retards healing.

Then there are the pyjamas. Maybe what’s seen in the sleep lab should stay in the lab, after all I always take my most warm, utilitarian pyjamas in my closet to the lab. Some men, uh, don’t. And most don’t wear anything over theirs, no matter how skimpy. Personally, I like a dressing gown, an extra layer of modesty. Unfortunately, it comes off as soon as one sits down in the control room for the pasting up. More on that later. But first: what am I talking about?!

The sleep study.

The sleep study is inevitable once a sleep specialist comes into your health care picture, whether you’re just an insomniac or having sleep problems as a result of a brain injury. In Ontario, OHIP will pay for a sleep study once every two years. The sleep study records your brain waves (EEG), your heartbeat and heart rate (ECG), your leg movements, your body positions, your breathing during your entire night-time (and sometimes daytime) sleep. It also includes a video and sound recording of you. It gives the specialist an objective picture of exactly how you sleep, notwithstanding the huge distractions in the process. No one ever prepares you for the experience, so I hope this will shed some light.

After checking in at the lab, I discuss my bedtime with the sleep tech. I tell him the time I usually go to bed and usually awaken. Oh no, not enough time to get a proper study, he replies. Not enough time to get proper rest either, I grumble to myself. He talks about using alarms at home inappropriately; I reply I don’t use alarms, and still I awake too early. He doesn’t get it. Someone should tell my brain, see how illogical you are waking me up so early! He tells me I’ll be second to be prepped for bed, and that’ll make lights out for me at 10:30 pm, about an hour before my usual time. The person before me will be lights out at 9:30 pm, or so that’s the theory. This is picky man, and he yaks on the phone instead, pushing mine, and the ones after me, bedtimes back. But I digress. The only other difference to my routine are the electrodes nestled in my hair, glued to my scalp and forehead. I’ll be allowed to wake up naturally. This is new. The thing I never like about these studies is they shock you awake and kick you out while you’re still half-drugged from sleep and the city is just wakening. But I’m ready this time. I’ve prepped my mind. But turns out: I needn’t have. So will I wake up at 5:00 to 6:00 am like I have been for the past week or will this be the day my brain finally decides it wants to sleep to a normal hour?

I ask the tech about snorers. My last study had the worst snorer. He was so loud, I heard him clearly through his door, the intervening control area, their door, the little hallway, and my door. They shut all the doors they could. No good. Guy was married too, I believe. If I’d been his wife I would’ve bought a separate house on the other side of town to sleep in. Luckily, this time it’s all insomniacs like me. They may snore but probably not loudly. The tech offers earplugs. I decline. I have faith in a snore-free night.

After filling in questionnaires and spending seconds checking out one’s designated bedroom, the next step is changing into one’s pyjamas. I must say I don’t like changing in a room with a camera staring down at me even though I know the camera is off (well, it’s supposed to be). I used to be able to stand behind it, but now they have those 360 ones. No hiding. Bathroom is safe though. Oh wait…inspect camera closely…it’s still only unidirectional! It’s aimed right at the bed. And there’s that nice blind spot underneath and to the side of it. I change in the blind spot with the door shut. You’d think shutting the door would be the obvious move. But there’s usually an exhibitionist in the bunch. Picky man is tonight’s and so oblivious to my presence he changes with the door wide open. I avert my gaze. He steps out into full view. Good grief, I really need shades for those pyjamas. Anywhoo…I’m second in line to be gooped up. That’s always my favourite time. Sit still as electrodes are glued on, my hair is totally ruined, and gossip with the lab tech — who’s almost always male; females if there are any are usually walking about doing stuff; but tonight there’s only one tech in this lab.

The sophisticated sleep lab I walked into when I first arrived on the Sleep Clinic floor has women behind the controls and ushering the guests to their rooms, handing them their questionnaires to fill in immediately. The control room looks like something out of a television show with its modern monitors and dark-tinted glass windows. How come I can’t be there? That’s where I was first going to go until my new sleep specialist amended the sleep study requisition form after he enrolled me in the research sleep study. So I get to be in the side wing with its pokey control room and in the bedroom with a picture of a foot in it and pasted-up warnings about bed bugs. Who thought that would be restful, the foot splashing on a pond with reaching tree branches? Or the warning?

My first sleep study experience was quite different. A beeping O2 sat monitor disturbed my sleep in my first study until the tech removed it. That was in the old sleep lab at the Western in the hospital proper. It was sound proofed like a sound studio. You walked in, and it sucked the sound out of your ears. It was grey too and separated completely from the rest of the floor. The EEG readings were recorded with flailing needles on paper unfurling across a wall. In contrast, the last two sleep labs had windows. The street sounds through their windows and, at one, streetcars clanging by, were rather disturbing. But nothing competes with the snorer. There’s always one. But back to the labs. These labs, main and side, are on their own floor tucked in a rabbit warren of rooms and halls. No windows to let in street sounds. Thank you Lord. Computers record the EEG and heart readings. The rooms are hushed, but sound carries in the air like normal, which makes it easy to eavesdrop on the convo between the tech and picky man while he’s being strapped and gooped up. Hey, a gal’s gotta do something when she didn’t think to bring anything to read because in the last few studies there was no time to read.

It’s my goop-up, I mean, paste-up time. First the tech measures my height and weight and neck circumference. Then blood pressure. Luckily one doesn’t need to take one’s sleeve off (which would mean removing the pyjama top; normally the BP cuff goes round bare skin).  And then the fun begins.

The tech asks me to hold out my arms; he wraps and clicks into place a soft black strap round my chest and tightens it. This one is more comfortable and sturdy than ones I’ve had in the past. He then wraps a matching strap round my waist. They will measure my chest and abdominal movements. Now the worst part: he places on my face a double form of that oxygen tubing lung patients wear, hooks it round my ears, and tightens it under my chin. One breathing monitor measures pressure as I breathe in and out; its prongs reach into my nose (oh, yuck and ticklish). The other is a nose-wide bent red rectangle, which measures temperature and temperature changes; it sits under my nose. He tapes the tubing to my cheeks so it won’t slide away from underneath the nose during sleep. But the prongs still move every time I flip over. Talk about a sleep disturbance. The electrodes are innocuous compared to that!

The tech has a cart with everything ready to paste on. He asks me to sit down next to it. I see about nineteen squares of gauze with a blob of paste centred on each lying ready for me. He places one on the middle of my forehead, pressing it into place with the palm of his gloved hand. He presses one each on my temples beside my eyes, one on each side of my jaw, midway between the jaw angle and chin, several on my head, parting my hair to get contact with my scalp, one on each side of my neck at the back base, and two more below and to the side on my deltoids (my upper back). These last four are how they measure heart rate and beat in women. No ECG electrodes on the chest for women. Good thing as almost all the techs who’ve pasted me up are men, and modesty is already in short supply when sitting there in one’s pyjamas.

He lifts up a tangle of very thin, coloured wires. At one end of each wire are yellowish plugs that look like laces that have been fused closed with a lighter; at the other are tiny metal circles: the electrodes. He attaches all but four of the electrodes to the paste on the gauze squares on my head and neck. He hands me the last four wires, two at a time, asking me to thread two down my right and two down my left pyjama legs. He plugs all the fused-ends of the wires into a purplish rectangle box, except for the leg wires, clips a strap to the box, slips the strap round my neck so the box dangles down my chest, and hooks the leg wires and tubing though my chest strap. Time for bathroom and bed.

Lie down on your back on the bed with its two soft pillows (two! Luxury! Last time I got one small pillow), not-tucked in sheets, and light coverlet; have a man loom over you as he takes the box off you, plugs it and the tubing into the equipment next to the bed, and places it on the bed near the edge; sacrifice your left forefinger to an O2 sat monitor that is clipped and tightly taped on; thank the techie stars that the O2 sat monitor is much smaller than the behemoth used twenty years ago; wait patiently as the leg electrodes are pasted and taped to one’s calves then plugged into the box; wait for the sleep tech to return to the control room then obey the spoken commands coming through the intercom for the calibration session; watch as the tech searches for the problematic connections, tapes them, and pulls the stomach strap down so that it is over the belly properly; finish calibration; watch as the tech turns off the light; get blinded by the red spotlight of the O2 sat monitor as move hand into field of view; lie on side, feel nasal prongs move in nose, get blinded again by that red spotlight, tuck offending hand under pillow, be very aware one is being watched and listened to, and wonder:

How the hell is one supposed to sleep?

For a very dark room (no windows), there was an awful lot of light once my eyes had adjusted to the blackness. There was the thin space between door and jamb through which light seeped, and there were two inexplicable rectangles of faint light on the ceiling above my head. There was also that damn red spotlight that shot into my eyes like an alien probe every time I shifted position and moved my left hand in the process, always accompanied by the prongs moving against the inside sides of my nose.

I didn’t sleep.

Well, I’m sure I did because I awoke with a final snap at about 6:10 am, after several awakenings, to hear the gently happy snoring coming through the wall from the next bedroom and because the tech commented on how long it took me to fall asleep and asked me if it always took me that long.

And that’s when I realized how effective my AVE unit is for getting me to go to sleep and stay asleep. Even though the nasal monitors interfered greatly, the lack of sleep and time to fall asleep wasn’t that different from how it used to be before I began using my home AVE unit. It was my sleep in the raw sans aids. God, how did I survive without my unit all those years?!

Anyway, he asked me to stay in bed on my back. The others in previous sleep studies removed all the stuff in the control area or room, but he did it while I remained in bed. After unplugging the box, thankfully the first thing he ripped off was the nasal monitors. He threw a 3-pointer side- and backwards into the garbage bin. Good to know for hygiene reasons the nasal monitors and tubings are disposable. My chest strap had slipped down but everything else had remained in place. They were all soon off. Last time, the tech used alcohol to remove some of the paste in my hair. Most don’t. This tech didn’t. He then handed me another clipboard of questionnaires. I ticked through them quickly, eager to get out of there.

The penultimate step in the sleep study process is the shower.

They provide a shower. But I prefer to use my own. It means looking rather like Frankenstein out in public. A hat that comes down to the forehead and is washable is a must. The provided washcloth and their tepid water can remove the paste on the forehead and any tape remnants but not from the hair.

At home, ensure your hot water tank is full and ready. You’ll probably drain it. You’ll need hot water to melt the paste, otherwise it’ll take much longer to remove. If you’re bald or have a buzz cut, this process will take five minutes or less. But for everyone else… I’ve tried many methods. The alcohol certainly helped but didn’t do even half the job. I first massage in a large blob of shampoo in. Don’t bother. Instead, take a big bar of soap, and while standing underneath the hot, running water, push the bar against the paste, like one pushes air bubbles out of wall paper or out of an iPad screen protector. After one blob of paste comes out, move to the next. Or, if you’re like me and get bored with one blob, move on then come back. The paste at the back will be harder to remove because it’ll be buried in more hair, especially if you have long hair. Once you think all the paste is out (it won’t be), massage in a large amount of shampoo then comb it through. Rinse with hot water. Repeat with conditioner. Comb that through too, this time with the fine teeth. Rinse with hot water. Using this method, for the first time, I didn’t discover bits of paste in my hair once it had dried, and I didn’t need a second shampoo. Now commence with your usual shower routine and soothe your scalp with cool water.

The only other addition to the process is cleaning every fabric thing you took to the sleep lab. Given that bed bugs are rising up again and you don’t know who you’re sharing the lab with, it’s only prudent. Toss them all in the washing machine, including your clothes, as soon as you walk in the door, before showering.

Last step: flake out.

My rating: 3 of 5 stars

A nice easy read in the familiar territory of a police drama with enough personal life to give it depth. When mentally taxing tasks dominate the schedule, this is the kind of ebook to read.

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No kidding.

Astute.

I don’t recall another doctor noticing that on their own or, if have, acknowledging it openly to me. I immediately paid more attention to this sleep specialist, this new one I had been referred to because my new neurodoc had found it unacceptable that my last sleep specialist had stated that there was nothing he could do for me then ushered me out the door sans support or options.

But what could a new sleep specialist do? I had not developed any new problems. My fibromyalgia was as it had been since being reawakened at the time of my closed head injury; my brain injury had healed some in the years since 2003 and had not created new sleep issues. When the new sleep specialist asked me what he could do, I replied that his mammoth sleep questionnaire gave me hope that if there’s that much progress in discerning the issue, then maybe in treatments too.

He told me a little story, the first of a few, to illustrate he understood my physician fatigue. He told me another little story to illustrate that he, regardless of outcome, would support me. He would not usher me out the door. He repeated that twice, thrice. Not even if there is no solution for me. As proof: he runs a weekly support group for people with chronic sleep problems and has done so for eighteen years.

He doesn’t give up on his patients.

The neurodoc told me the same thing a few weeks after I began to see him. They both needed me to hear that because they must’ve seen how I expect physicians to dump me, to discharge me, to not pursue options and work with me on solving my myriad health problems stemming from my brain injury (and my fibromyalgia too apparently) – for that’s pretty much what’s happened to me. The best ones take me so far and then discharge me and leave me to cope and solve on my own. The worst… Well, it’s why I searched and searched for treatments and found the ADD Centre; it’s why I created my hypothalamus fix. It’s also why I ended up in the ER back in 2007. A person who has health problems can only support themselves alone for so long before the body screams bloody murder, revolts, and flings you into the ER or psych ward.

The new sleep specialist asked me to stand up, stood up himself, edged round his table and stacks of papers and journals, bent my right arm, and pressed on the fibromyalgia tender point. I yelped. I jumped. But I somehow didn’t leave his grasp. I guess he’s used to that reaction. It had been so long since I’d had my fibromyalgia tender points tested, I didn’t clue in to what he was doing till too late. I steeled myself for the next point presses. He tested my other elbow, then two chest points, got the same response every time, stopped as he was only confirming what had been tested a bazillion times, and stated bluntly that though I had claimed to his Fellow* I didn’t have much pain, I had exquisite pain.

Oh.

At that point, the ordinary appointment morphed into a wild ride. Before I knew it, he had called the researcher in charge of (or helping to run) a multi-centre Canada-US research study he’s conducting on a new formulation of a drug whose name I’d heard of but knew nothing about; determined they had just enough time to slot me in before the study closed; and sent me to her to answer questions, have blood drawn, have an ECG done, my BP taken, answer more questions, have a Philips Actiwatch Spectrum strapped to my right wrist, given phone-in diary instructions, and sent out the door to have a rather late lunch. Very late lunch. Almost like supper lunch.

I’m now someone else’s guinea pig. How unusual…and neat (says the person who designed and/or conducted her fair share of psychological and marketing studies in university and work). In the first week they’re measuring my baseline sleep and activity. Then I will receive the drug. Although I went along for the ride with hardly a murmur – mostly because of his first statement that told me this man knows his stuff and because of his logic (more in another post on that) – I did vet the drug as is my wont. Later, I also discussed it with my father. I have a healthy skepticism of medications; I know none is without risk. The question for me is: is the risk worth it? In this case, I’m trepidatious: Will it work? Worse, will it not work? Even worse, will I have to be on it for life and will my finances be able to handle it? Still, I think it’s worth the risk.

Meanwhile, I’ve also been booked for the usual night-time sleep study. Can’t wait. Ugh. Yet despite the unpleasantness of blood tests and sleep tests, for the first time in eons, I have hope that maybe, just maybe, my sleep problems will get better. And whatever happens, I am no longer alone in dealing with my insomnia.

——-

*When you see a specialist in a teaching hospital, you usually see the medical resident first. But with an academic physician, you may see their Fellow instead of a resident. A Fellow is someone who studies under or works with an eminent physician as part of their academic training and research studies. My father has Fellows all over the globe, he’s taught so many. And because I’ve met several of them while they were here, I’m totally comfortable with them, probably moreso than with residents.

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