Welcome To The Dollhouse

First Haircut

2010-09-07T14:46:46Z

Up until recently, I’d not seen a reason to cut Zizi’s hair. Her curly tresses were delightful, even though the twice daily combing was not the most fun for either of us. Yet now at 3, when wet her hair reached the top of her butt-butt. That was fine for braids, but not so fine when she wanted to wear her hair loose. It was too much to contain with headbands or clips. Even if I tried to leave it open, the teachers would end up braiding it at school. So with reluctance (yes, I have that black person hair cutting thing), she headed to Superstarz Kidz Salon for her first haircut.

I really didn’t want to be *that* parent rolling in with the dSLR for photos of the event, so I managed with my iPhone. Yes the images are crappy, but ça y est.

She was so happy to be able to sit in a pink jeep watching Dora the entire time.

After we got back home, I managed to break out The Precious for a couple of pics of the new do:

Don’t you just want to eat her up?!

Welcome Home, Sistah

2010-08-27T16:46:57Z

Something about South Africa makes me believe in the improbability of blood memory, the concept that our historical roots and connections reside in some spectral remnant within our consciousness, wakening only when we visit places significant to our history…to our story. How else to explain the resonance, the sense of belonging, that overwhelms me whenever I step off the plane onto South African soil?

This may sound too far-fetched for those who know me as a data-driven empiricist. But I have yet to arrive at a scientific reason that explains the pulsating thrill of home coursing through my blood vessels with each beat of my heart during each minute I spend in the Republic of South Africa.

Like most African-Americans and Caribbean-Americans, the continent of Africa is undoubtedly our Motherland. We learned that as children. Africa is the cradle of humanity, after all. And most of we darker pigmented folk definitely originated from this cradle.

As a child of the 60s during the Black Power movement there was passion that I remember for a connection with Mother Africa. From sporting dashikis, to necklaces of the continent striped in red, black and green, to Ron Karenga and his creation of Kwanzaa, we attempted to cross the 8000 mile divide of our Middle Passage. I remember dancing to the spinning 45s outside the record store on Prospect Avenue in the Bronx. Miriam Makeba singing Pata Pata and Manu Dibango, long before rap was rap, chanting in Soul Makossa. I had no idea what countries these singers came from or what strife existed there, but the music moved me because it was African…the place that was the home to us all.

Manu Dibango – Soul makossa
Uploaded by madafonka2. – Watch more music videos, in HD!

Unfortunately, around the time I was 7, I moved to the San Fernando Valley in Southern California, and lost what little connection I might have had to africentrism. I became indoctrinated in the Western concept of Africa. You know what this means…Africa as one giant, backwards country filled with grass huts and scantly clad people with bones through their noses. My dear mother sneered at her West Indian roots, so you could only imagine what she felt about Africa.

And for me, this transition to California and life with her was such a painful one. I was a 7 year old third-grader whose mother expected her to be an au pair for her 2 year old sister and 2 month old brother. And in school I was the target of such abuse for being different, for being black, and for being dark-skinned. It was my first time hearing the n-word, my first time being teased for my color, and my first experience with being told to “go back to Africa!” The other kids feared touching me because the black might rub off. Even the teacher took umbrage at being given the black kid for her class. She told my mother at the parent-teacher conference, “You might have gotten to be a doctor, but your daughter is too stupid to amount to anything.” Of course, Mom took this out on me for making her look bad. It was not the time, you might surmise, that I took pride in being black.

Fast forward to my first year at Le Lycee Francais de Los Angeles. Jimmie Walker and Redd Foxx were the representations of black America on television. I spent most of my time trying to blend into the woodwork. Please don’t notice me, my color, my hair, my difference…please! Ah, one of the few chocolate chips in a vast sea of vanilla. I dreaded anyone noticing my race, because that noticing was never good and generally involved an application of the n-word. But then came the television event of the decade! Of the century! Of all time! Then came Alex Haley’s Roots. Suddenly everything was shot to hell.

At first, I mistakenly didn’t think it would be so bad after the first Sunday night installment. It was gripping and powerful in its depiction of the cruelty of the slave trade, the Middle Passage, and life as 3/5ths of a human being. But by the next day in school my classmates began coming up to me with true sorrow on their faces. “I’m sorry for what my people did to your people,” they would intone with the utmost gravity. What are you, now an 11-year-old incognegro, supposed to say to that? “On behalf of my people everywhere, I forgive you?” Somehow that didn’t seem right.

In truth what I wanted to say was, “Why are you burdening me with this, your guilt? All I want is to be left alone. I’ve got enough crap on my own plate!” Those words were never said, though. I’d just offer a pained, confused smile and walk away, wishing I could just hide…maybe for the rest of my life.

Luckily people and societies evolve. The next major evolutionary period was heralded with the start of The Cosby Show. Black professionals, married, functional with children? Did such people exist? Well, duh! I told you that we didn’t all live in junkyards or the projects! We moved beyond the depictions of black life created by Norman Lear and onto the post-racial era. (Of course, those of you who know me understand that I use the term post-racial oh so facetiously.) But The Cosby Show changed everything…like a shift from records to CDs. Suddenly Roots became a memory and slavery and its consequences were something that happened long, long ago. Every person of color had the potential to live The Cosby Show dream…or so a whole lot of majority people I knew seemed to think. Sigh… Let me not go any further off on this tangent.

Now this digression from Africa to my sorry history with my ethnic identity has gone on long enough. Let’s conclude the matter by saying that I eventually threw aside the neutral grey cloak that I hid behind to embrace my inner sista-gurl during my college years. There’s something about being around a tiny number of scary-smart, overeducated black folk at an Ivy League university that can end up setting things right in a confused gurl’s head. Later, upon attending an HBCU for medical school (and that’s an historically black college or university, for those not in the know), I got teased a lot with the, “it’s a good thing you chose to come here to an HBCU for med school so that you’ll finally learn what’s it’s like to be black” ridiculosity from many of my classmates. I just smiled politely, thinking, when are you more aware of being black, when you are 7% of the student body or 97% of the student body? You do the math. The net of it was that I found my place, my politics, and my sociocultural home.

However, though there is amazing peace to be found within the black American diaspora, there remains a sense of otherness within many of us here. We recognize how different we are from what is conjured in the mind when the word “American” is envisioned. Sure, we are American, but our difference requires a qualifier, “African.” Yes, everyone knows that there are black Americans, Latino Americans, and American Muslims. Yet when you have a casting call for Americans, our faces aren’t generally the ones first considered. There’s a lingering sense of otherness I’m not sure will ever leave me in America. And yes, I am aware that we have a black President. Puleeze do not pull that out to illustrate anything against what I’m saying, for the love of the Goddess!

Right…so back to South Africa.

The first time I visited, back in 2005, the circumstances were very different. I wasn’t sure what to expect traveling there for fertility treatments as half of an interracial couple. I think I was expecting the South African version of that old Chuck Conners movie that haunted my cross-country traverses, Nightmare in Badham County. (And remember that it’s the sista who dies in the end…enuf said) I don’t think I was just being paranoid. If you look at the parallels, life immediately after slavery was no picnic for blacks, so it seemed to me that life post-Apartheid would be uh, challenging as well.

Luckily what I found, at least in the areas that I visited, was a country that had truly shined light onto its dark ugliness with the hope of not repeating its racist past. No, it was not some hidden away utopia without conflict or strife. Poverty remained profound with unemployment at staggering rates. There were huge infrastructural issues to be overcome. Yet everywhere I went, from the townships to the high-end spas, people seemed to be buoyed in some measure by hope. I suppose that if you can overcome one of the last bastions of state-sanctioned racism, there is a feeling that perhaps infrastructural issues can also eventually be overcome.

Between my now three visits to the Republic of South Africa, I became enthralled by its history: from the San people, to the Boer Wars, to official Apartheid (1948 to 1992). And then there is my hero worship of Papa Nelson Mandela. It started with my visit to Robben Island, the prison where they sought to break his spirit, to my most recent visit to his Vilikazi Street home, and the powerful Apartheid Museum. I am in awe of the man’s strength, his passion, his patience, and his capacity to unite a country. Oh yes, he had many allies and did nothing singlehandedly, but still, I must give Papa Mandela his due.

The funny thing is that I loathe history! I can barely remember what happened when in my own country, but for some unknown reason, South Africa affects me in ways that I cannot explain.

It hit me again during a dinner two weeks ago in Cape Town. I was meeting with some scientific leaders, one Afrikaner and one white Catholic (I had just learned that during Apartheid there was equal if not worse animus between Afrikaners and Catholics/Anglican/British descendants as there were between whites, colored and natives). The Catholic woman had just declared quite firmly, “I’m a 52-year-old white woman who was born in South Africa during Apartheid. By this very definition that makes me racist. There’s no way around it.” I found myself wondering whether people in the US could ever be so clearheaded about the natural human tendency toward racism and the many other “isms” we have. She bantered back and forth with the other physician and then turned to me and asked, “What part of Africa is your family from?”

I responded with a blink, wondering if I had misheard the question. This wasn’t a US-type “go back to Africa!” epithet. Nor was it one of those stupidwhitepeople questions I’ve gotten like, “so, did you grow up in the ghetto?” This woman actually wondered whether I knew my connection to the Motherland. Whoa! Snap!

Finally I stopped the internal dialogue and answered, “I have no idea,” with a sad shake of my head.

“Really?” she asked.

“Really,” I replied, “Most of us black Americans don’t know our African origins. We lost that bit in slavery.”

“Well,” she said with a sad shake of her head, “it must be terrible not having a connection to the place you came from.”

Maybe it was the wine, or the noise, or the lack of sleep, but suddenly I felt an uncomfortable dizziness. Her words kept reverberating in my head: it must be terrible not having a connection to the place you came from it must be terrible not having a connection to the place you came from it must be terrible not having a connection to the place you came from itmustbeterriblenothavingaconnectiontotheplaceyoucamefrom!

My homeland. A disconnection. Sure, I am American but at the same time I am other in America, different. My family comes from St. Kitts in the former British West Indies, and I feel a stronger connection to my West Indian heritage. But beyond that…what is my connection to the land of my ancestors? Am I Xhosa, Zulu…what blood runs in my veins? And why does it pulse stronger whenever I am in South Africa? Is it possible that my blood holds memory that my consciousness does not?

I wish I had answers…concrete, empirical answers that could satisfy both scientist and mystic. I suspect there are none to be had. All I can say is that when I walk down a street in South Africa, whether Soweto township or Camps Bay beachfront enclave, a black South African will always greet me with, “Welcome home, sistah.” And I know from the thrum of the blood coursing through my vessels, that I am absolutely, undoubtedly home.

Children of Soweto

2010-08-17T00:46:05Z

Please visit Eclectic Journey Photography for some shots from Johannesburg.

Toilets Confuse Me…Again

2010-08-06T20:11:51Z

Greetings to all my bloggy-friends from lovely Johannesburg, South Africa. I’m sure that some of you were hoping for a photo-blog posting of the sights here, but I’ll have to disappoint you. Other than Nelson Mandela Square shot with my iPhone, I haven’t even taken out The Precious for any sightseeing. Maybe tomorrow. But for tonight I’m writing for someone to help me with my latest scat repository bewilderment.

Maybe I’m not too bright.

Maybe I just overthink these things.

Maybe I’m just not supposed to use the potty outside the US…but once again, I’m having toilet confusion.

I’m embarrassed to admit that this is my third entry in the ex-US toileting confusion series. The first time was in 2006 when I shared my puzzlement about the protocol for using the bidet. The next time it was my 2007 trip to China where I was madly confused about why I was supposed to pee on the orchids. This time, however, it’s about the secret workings of these nonsensical non-US toilets.

Wait, wait, wait. Let me clarify. I am not confused by the what goes where part. That is pretty idiot-proof.

See? I even managed to label the pee-pee and poopy depository in this photo from my hotel bathroom. So from my handy-dandy labeled image you can see that the toilet bowl is pretty obvious (though it does lack the proper quantity of water that I prefer). It is the flushing apparatus that has left me head-scratching. I mean come on. The toilets that I’m used to have one flushing lever: one! This one has two individual flushing buttons of disparate sizes that work individually and in concert. But why? What is the rationale here? I must sort this out.

One option that I’ve considered is the variation in flush size hypothesis, depicted here:

That would be slick, right? You’d vary your flush size based on how much, uh, waste you were trying to get rid of. Of course, without any measuring apparatus, I am unable to validate this hypothesis properly. And visually, well, toilet flushing is toilet flushing. I’m not the Rainman of toilet water swirl patterns, you know.

The next hypothesis is a variant of the first. This theory reserves the smaller button for pee-pee, the larger button for poopy, and the two together for every-orifice crisis time as depicted thusly:

Again, sounds eminently plausible, but I’ve found that the two buttons together do not produce the tsunami of toilet water I’d expect would be needed for the multi-orifice crisis and I suspect that the yuck brush would still end up needing to be employed. This is indeed bothersome.

The last theory is what I suspect is the true answer. I’ve diagrammed it here:

My suspicion is that all of these buttons do the exact same thing. Why they were made different sizes and able to be pushed at the same time is mainly, in my not so humble opinion, to screw with my head! After all, it’s a freaking toilet. All it’s supposed to do is flush, not dance the hokey-pokey.

So there you have it, ladies and gentlemen…my toilet flusher analysis in a nutshell. Three buttons…one function…but designed to cause confusion in overthinkers like myself.

Now who dares tell me different?!

The Next Big Thing

2010-07-30T20:32:09Z

Yes, I’ve been a bit scarce of late…not blogging as much…not knitting…not keeping my peeps up to date with the goings on in Liana-world.

Well, I’m finally ready to reveal the reason why (though it is still a work in progress).

Friends, I give you the next big thing …(for me, at least).

Enjoy!

How Do You Help A Friend?

2010-07-26T17:18:47Z

How do you help a friend who willfully denies the crisis that is her life?

That’s the question I posed to myself last Friday after reaching a point of utter incredulity in my conversation with Nadia (name changed for privacy).

“Are you fucking with me or are you utterly demented?” I had just asked in response to her latest statement in our increasingly escalating discussion.

Her statement was so insanely ludicrous, even for Nadia, a person I’ve known for 4 years who has the unique ability to say things so mindblowingly naïve, bizarre and wrongheaded that repeated exposure had rendered me immune from slackjawed surprise…or so I thought. But this time, we weren’t talking about something of little consequence like the time she looked for research in her nursing assistant textbook and on the web about how the limbic system worked for the express purpose (learned after much prodding and suggestions of neurobiological resources in med school libraries) of figuring out how she could turn off the love she was starting to feel toward a man who was not good for her. Only Nadia could believe that there was some limbic on/off switch that we could just flick for feelings to just stop. That’s how her mind works. As she always says, “It seems so simple.” What I’ve told her more times than I can count is, “Nadia, whenever you start with ‘It seems so simple’ just stop yourself and understand what I’ve always told you: 99 times out of 100, nothing is as simple as you think it is.” This situation is much more critical, I’m afraid. And I’m at a loss as to how to help her.

I’ve known Nadia for the past 4 years. She’s an immigrant from Eastern Europe who has lived in the states for almost a decade. I mention where she’s immigrated from only to distinguish her from brown or black immigrants who often see America quite differently than she sees it. Yet her post-Cold War view combined with a sense of entitlement does frame her current scenario, so it is relevant to this story.

When I met her she was married with 3 kids, all boys. During the deep phase of my infertility she got pregnant with her fourth, a girl. That was tough for me, though she didn’t understand it. Yet even within her it-doesn’t-make-sense-so-I’m-not-going-to-pay-it-any-attention framework, she understood that the tears of this Strongblackwoman are not shed lightly, so even she was gentle with me. That meant a lot. And, as luck would have it, Zara was born 3 months before her daughter. We ended up bonding a lot around that as well. I couldn’t stand her husband, but then again this uberfeminist doesn’t do well with domineering bullies who love ordering people around. Gratefully I didn’t see him much.

Nadia is a kind, eager to help, devoted friend. She is also a person who frames life as it should be rather than how it actually is. As such, it took me a while to learn that her husband and father of 3 of her 4 kids was actually not her husband martially at all. And that he beat her. (Upon learning this, it took all my restraint not to go shiv him myself since I take a very dim view of spousal abuse…a very dim view.) Of course she framed all this from the classic “it’s my fault” point of view. It was like watching a bad Lifetime movie, but it was deadly serious. She was completely dependent on him and saw no way out (again, typical). I opted to do what a friend could do for someone in that situation: provide support, resources, and encouragement to form an escape plan.

The long story short of what happen almost 2 years ago is that he escalated, she called the police and let him get arrested. The she dropped the charges so that he could pay the bills, but then he escalated again. Cycle repeated few more times until she was thrown out of the house with oldest kid as he kept “his” children. Then she was done. She left him in jail but still was without money to pay the bills. After 6 months of his being in jail she didn’t object to his release, believing that he would start paying child support. “Why wouldn’t he support his children?” (Remember what I said about her simplistic mindset.) He didn’t. More ugliness. Restraining orders. But fast forwarding to today, he remains out of the house barred by a restraining order, though the nastiness continues.

But my freak out last Friday concerns not him, but something else really dear to her heart: her house. Again, when you find out the truthy truth and not the Nadia truth, you find out a lot. The main piece is that the house is in her name but stupid-ex is on the mortgage and the second mortgage (one that has a prepayment penalty, no less). Nadia couldn’t afford to pay her mortgage after idiot boy was kicked out of the house. So (get this) she just didn’t pay it. For 17 months!

If you are anything like me, your stomach dropped to your feet upon reading that last bit. But if you are like Nadia, your mindset is what’s the big deal? I started school to become a medical assistant so that I could begin to pay the mortgage. If the bank is just patient, they will have their money. I’m not a deadbeat. I’m doing what I need to in order to pay them back. And she did write them a letter or two explaining this plan and her hardship. Having graduated in June and getting a job, she is all set to pay back her debt. So what’s the problem?

Well if you were at all an inadvertent witness to the phone call I heard two weeks ago between her and someone at the bank, you would see that it is a big problem indeed. They want their money and they want it now. And her main defense during the call consisted of shrieking, “Do you want me to starve my children?” This went on for about, oh, 45 minutes. She would say something like, “You want your money. I want to give you money. What’s the problem? You get your money and I keep my house for my children!” Then there would be listening, next her asking, “Where am I supposed to get that money?” followed by more listening and then, “I don’t have money to feed lawyers!!” finally cycling back to “Do you want me to starve my children.” I wanted to stop it, but realized that I had to step back and let her handle it as she saw fit. Yet I just kept seeing that she just didn’t get it. She really didn’t get it.

I learned midway through our friendship that this Happy Happy Land that Nadia seemed to live in was not an actual place but was borne from a feature of her personality (psychopathology?) that I call willful positive reframing. I first figured that out after the umpteetenth time she described how wonderful her childhood/adolescence was in her country while not two seconds later letting an incident slip that would, for most of us, lead to some subsequent trauma, before moving on to more Happy Happy Land talk. Yet when I called her on the incident, and how it affected her, it was clear that she had willfully reframed it away from trauma into something that was but a mosquito bite in the grand scheme of life. But I wasn’t buying it. After that I noticed that each time we got into a deep discussion about her life, choices, and ways to avoid making the same mistakes (our pseudo-therapy), by the next time we saw each other, her actions/behaviors/feelings had all been reframed into I was right and everything/everyone else was wrong. Even her marriage…if you ask her today, she’ll tell you that she realized that he was wrong for her and just decided to leave (finger snap). Her mind has scrambled reality into a place where nothing bad happens based on her decisions and choices. This is what I refer to as willful positive reframing.

Now I can get back to last Friday’s frustrating exchange. I was so shaken after hearing her end of the conversation with the bank that I pulled out all the stops to find out what she could do. I called lawyer friends. I got local numbers for housing relief. I even sent her suggestions about discussing the situation with the criminal attorneys who handled her abuse case. I sent all the information all the while fretting and freaking out about what’s going to happen to her and the kids. Yet when I saw her on Friday, I asked her how the resources had panned out.

“I haven’t called any of them yet,” she said evenly.

And then my head exploded. “What do you mean ‘You haven’t called?’” I blurted.

“I haven’t gotten to it yet,” she answered.

It was at that point that I realized one of us was not connected to reality. “Wait a minute! So I’m running around trying to move heaven and earth figuring out how to keep you from being foreclosed and you do nothing?!”

“I paid them $3000.”

“And did they say that was OK? Did they say that you’re no longer in foreclosure?”

“They haven’t said anything,” she replied with half a smile.

“You cannot think that this means everything is OK, Nadia!”

“I haven’t heard from them again, so…”

“That only means that you’re living there on borrowed time! What the hell?! Are you just going to wait until the sheriffs show up and start tossing all your belongings into the street?!!” I was getting totally worked up now.

“Psh,” she scoffed, “No one would ever evict a woman with 4 children from her house!”

It was at this point that I looked at her really closely and asked, “Are you fucking with me or are you utterly demented?”

You see in the Happy Happy Land of her reframing, women with children never get evicted. “How could that happen?” she asked quite seriously.

It hit me then that her denial as coping mechanism is keeping her from seeing the freight train heading straight to her face.

“I just don’t see the problem,” she continued. “I have money now and I want to pay. Why is there a problem?”

“Because you didn’t pay for 17 months!”

“Yes, I had a hardship. It happens. Now I’m ready to pay.”

In Happy Happy Land it is that simple. The bank has lots of money. They should be understanding of her situation.

The train is barreling down right at her and she thinks it’s just a glorious summer day. How do I help her (and the kids) get out of the way?

PS She told AdoringHusband that “for some reason” the bank won’t accept the money she’s been trying to pay them. But oh well, must be a problem on their end.

Kill me now.

Tales of a Teendoc

2010-07-15T20:38:55Z

You might have noticed by now, my dear readers, that I am a bit of a storyteller. I just love recounting the funny, the emotional, the angry, and the evocative tales from my life. Yet there is one area that has been almost completely off limits, and that is the tales from my many years as a teendoc.

The main reason that I’ve not blogged these stories is that contrary to when I am sharing such tales in person, I cannot be sure that blog readers who do not know me as well are as clear about the enormous respect I have for my patients and their families. Caring for teens for those many years was such an honor. At the risk of sounding truly hokey, taking care of teens was much more than a job or even a career…it was a calling. It was something that I loved doing and something that I found myself almost naturally skilled at doing. The kids were part of my heart (and soul). And because of that, I would never, ever want any of my stories to be seen as being at the expense of any kid or parent.

Yet, as I was reminded again last night by my dinner companions, these stories are often hysterically funny and fun and should be shared. We can allow ourselves to laugh not at the kid, but at the absurdity of the scenario, or my dumbstruck reaction, or any other good natured enjoyment of the humor in everyday life. My hope is that I’ll be able to craft my recounting skillfully enough that you’ll share in the wondrous adventures of adolescent medicine, without any wrong notes being hit. And with that brief introduction, let me begin.

Teens (and Their Parents) Are Funny

There’s a lot of laughter in adolescent medicine. It helps the kids relax, the parents chill, and can diffuse tension like nobody’s business. I used to have a lot of standard riffs to break the ice, like asking my new male patients, “When was your last menstrual period?” (completely deadpanned). You should have seen the looks! Some guys were like, doesn’t she know I’m a guy? While others gave me the is there an idiot sitting in front of me? look. Yet a few younger guys would ask, “should I have a period?” And then I’d be like, “I’m just making sure you’re paying attention,” with a chuckle. The kid and the parent would relax into their chairs a bit more, smiling as if to say, she’s not as boring or goofy as the other docs. They hadn’t seen nothing yet.

But the hard part for me was when the teen (or parent) would say something that was dead serious, yet at the same time was hysterically funny. During these times, I had to learn to maintain my equanimity. It was not an easy task.

Once when I was a medical student, I was talking to a mom and her kid about his bowel habits. Things had been pretty uneventful until she looked at me and said, “You know, sometimes he goes to the bathroom and makes a number 2 and then the steam comes up from the toilet…is that normal?”

My head is like, WHAT THE FRACK?!! STEAM?!! FROM THE TOILET BOWL?!!

Instead I said, “Huh, steam. Interesting. Does that happen often?”

She started giving me an answer and I was talking to myself: don’tlaughdon’tlaughdon’tlaughfortheloveofgoddon’tlaugh! As she went through the intricacies of the steam rising after his defecation, she concluded with, “You know how that happens, right doctor?” By now, the laugh was perilously close to the surface. I was truly struggling (and feeling ashamed at the same time).

“You know, I’ll bet Dr. Conley can explain it better than I can,” I managed. “Let me get him.”

I stumbled out the door, closing it hastily behind me. I took two steps down the hall and started laughing so hard that I slid down the wall to the floor. Dr. Conley was like, WTH? But I was simply unable to speak. After another minute I regrouped enough to recount the conversation.

“When the what comes out of the toilet?” he asked, dumbfounded.

“The steam,” I answered, perilously close to another giggling fit.

“Where’s her toilet?” he asked, “in Alaska?”

And with that, he got up and we returned to the room where he had no giggling fits and managed to keep a straight face answering the questions. This, my friends, is the difference between a trainee and an attending physician. Eventually I learned this equanimity myself.

My 13-year-old patient said to me, “My friend likes to masturbate with a sausage. Is that OK?”

She was waiting for the shock, the outrage, the evidence that I’m not as cool as I pretend to be. My face gave nothing away. “What kind? Polish? Italian?”

She grinned and shrugged.

“Well as long as she’s not leaving it in there for hours, it should be fine.” I concluded.

Now truthfully I had no idea whether she really had a sausage-humping friend or whether this was a grand test of how much she could trust this new doctor with her questions and truths? The bottom line is equanimity always. And usually, I was the master.

Sometimes, though, things do come so far out of left field that you may react a little bit…after all, I’m not a robot, right?

A mom and her 14-year-old daughter were in my office. I was getting the history from the kid like I usually do. At the end of my questions for her, I turned to the mom and asked if she had any concerns that I didn’t cover already. And then she said it…

“Well you need to examine her breasts because to me they feel like gristle inside.”

WHA??!!! went my head. But I sat back, put down my pen and said smiling, “Ma’am, there are so many things wrong with what you just said, I don’t even know where to begin.” We both laughed. “My first question, ‘why are you feeling your daughter’s breasts?’ and my second one, ‘gristle?! Did I seriously hear that?!’”

We all ended up having a good laugh and the visit was really productive (with some teaching about boundaries, not doing BSE on 14 year olds, and, oh yeah, boundaries).

You might now wonder whether there has ever been a time when I was just unable to contain myself and laughed at the expense of a patient. I’m sorry to say that yes, one time my equanimity failed me terribly. I still feel bad about it, though I believe I did make amends to this long-time patient.

Tanya was a young lady I had cared for since she was 12 years old. She had some minor immune problems and was very slightly developmentally delayed. She and her sister lived with her grandmother, a woman who thought I walked on water. I thought she did too, so it was a mutual admiration society. But on this visit grandma was quite upset. It seems that Tanya, who had recently turned 18, had begun acting out. She described a multitude of risky behaviors while Tanya sat in the other chair laughing. All she wanted to contribute to the conversation at that point was, “I’m 18. I don’t have to listen to anyone.” Hmmm, seemed like a behavioral intervention was in order.

When I had Tanya alone, I decided to tackle the sexual risk behaviors first. You work in the order of what’s going to kill them first, and with her immune disorder, STIs posed a major risk.

“So Tanya,” I began, “you know how it works in here. Our talk stays private except for 3 things. Do you remember what those 3 things are?”

“Suicide…um…abuse…um…I always forget the 3rd one,” she giggled like a 10-year-old.

“If you’re going to hurt someone else,” I helped her out. “So I’m concerned about the things your grandmother talked about when she was in here. Sounds like when you turned 18, you decided to start having sex and doing a bunch of other things.”

“Yeah,” she replied petulantly, “I’m an adult. I can do what I want.”

“So how many people have you had sex with since you turned 18 three months ago?”

“You really don’t want to know,” she said coyly, like a kid being asked how many cookies she had taken from the cookie jar.

“Well I do want to know,” I said gently. “I always want to keep you safe and healthy, but you have me a little worried. So can you tell me please?”

“Twenty-seven,” she said while peeking through her splayed fingers covering her face.

Holy crap, I thought to myself, but my face remained neutral and engaging.

“Do you think that’s a lot?” she asked timidly.

“What do you think, Tanya?” I deflected.

“I dunno,” she shrugged.

“So why do you have sex?” I asked, deciding to try a different approach. I always try to get to the whys of the behavior.

“I like it,” she answered, the defiance back in her voice.

“What do you like about it?”

“Everything.”

“Well do you have orgasms when you have sex?”

“What’s that?” she asked, furrowing her brow. I expected that response. So I decided to get more colloquial.

“Do you come when you have sex?”

She thought for a moment, still looking a little confused, but then she abruptly brightened. “No Dr. C. I don’t come. I go over there…”

And this was where I momentarily lost it. I laughed. Not a fall on the floor, pee on yourself type of laugh, but a surprised chortle. Her face wilted. My brain was like holycrapLianafixthisnow!!!

“Sweetie, I’m so sorry for laughing and I know that you weren’t trying to be funny, but that was the cutest thing I’ve heard all day. You just cheered me up so much. Let me explain what I really meant…”

In short order, her smile was back and we were back on good footing, at least until I got her grandmother back in the room and made some pointed suggestions to her about what she should do regarding keeping herself and Tanya’s sister safe until Tanya regained some behavioral control. Despite that, when I saw Tanya 3 months later, she had returned to pre-18-year-old Tanya, sweet, compliant and more respectful. There she remained until she aged out of my practice at 23.

I’m so ashamed of my laughter, but damn was that funny!

Adolescent medicine…live the adventure!

Which One to Choose? or More Zizi Goodness!

2010-06-30T23:39:05Z

It’s time for a photoblog post, and this one requires audience (reader) participation. There is a magazine cover photo contest that I would like to enter a photo of the Zizimonster, but she looked so cute in this recent shoot that I cannot decide which photo to submit. That’s where you all come in. Help me decide on the best, cover-ready image of the Jubbins (yes, that is her nickname and it’s a long story why…) Here are your choices:

From Zara

These photos have been processed in a variety of styles so please don’t judge on the processing alone. Thank you!

Note: There is a poll embedded within this post, please visit the site to participate in this post's poll.

My Love Connection Debacle, For Your Viewing Pleasure

2010-06-23T15:03:09Z

I cringe as I type this post. I’m serious. The 47 year old me is looking back at that 26 year old me and thinking, what the hell? Were you on bad drugs or just loopy in the head?

But a promise is a promise. And a long, long time ago, I promised my 3 blog readers that when I finally transferred my old videotapes to DVDs, that I would share with the world the spectacle of my Love Connection appearance. Well, actually…I did get the DVD made last August, but it’s taken me some time to smack myself stop the avoidance and get this out there. So, since I am a woman of my word, please enjoy these 13 minutes of my hellacious debacle with Chuck and Charlie.

I hope you won’t think less of me in the morning…

And no, the woman in the static image below is not me. Really!

Click here to view the embedded video.

Crookedfoot Revised

2010-06-16T19:01:33Z

Hello friends,

I’m still hobbling along on my crutches, my foot casted until June 29th. I cannot begin to explain the difference between using crutches at age 12 (when I sprained my kneecap doing The Drop to Groove Line in the audition for the school talent show) or using them in the 4th grade (when I broke the side of my foot jogging in place with my eyes closed) with using crutches as a full grown woman of 47. In a nutshell, it sucks. It really, really sucks. Getting anywhere takes way too much effort. You start to wonder whether you really need to go to the bathroom since it is about 10 miles away. And yeah, everything is miles and miles away. The cafeteria? Fifty miles down the hall. Then, guess what? You can’t even hold a damn tray or take out container! So you stand there looking pitiful waiting for someone, anyone to help (and y’all know how much I enjoy asking for help, right?) I even had to rent a car because I’m unable to drive The Beast, with its manual transmission. (And AH doesn’t feel like learning on my brand new clutch, god love him.)

The good news is that Crookedfoot went from looking like this: (Scary, huh?)

To looking like this: (Much better!)

Now if someone could just get me outta this stupid cast, I’d be much, much happier. And my shoes are waiting patiently for me.

At least a dear friend pointed me to Casttoos, so that I can trick out this boring white cast (and no, you can’t even write on them anymore).

UPDATED TO ADD:

I’m so rocking my Casttoos!