Going Through Surgery Quotes

Most medical students go through a brief period when they develop all manner of imaginary illnesses – I myself had leukaemia for at least four days – until they learn, as a matter of self-preservation, that illnesses happen to patients, not to doctors.

Imagine you are sitting down in a chair and on a screen before you you are shown a bloody, ripping film of yourself undergoing surgery. The surgery saved your life. It was pivotal in making you you. But you don't remember it. Or do you? Do we understand the events that make us who we are? Do we ever understand the factors that make us do the things we do? When we sleep at night - when we walk across a field and see a tree full of sleeping birds - when we tell small lies to our friends - when we make love - what acts of surgery are happening to our souls - what damage and healing and shock are we going through that we will never be able to fathom? What films are generated that we will never be shown?

You go in through the front door of the hospital and depending on how successful your treatment is determines whether you leave through the front door or in a box out of the back door.

7. Yoke-breaking: Whenever you plead the Blood of Jesus, people and things are set free from any kind of yoke. 8. Overcoming power. 9. Door-opening power to open every door that has been closed against good things in the life of a person. 10. Creative and re-creative power. Anything that is supposed to be in the life or body of a person, or has been removed through surgery or witchcraft, can be recalled back into existence by the Blood of Jesus. 11. Renewing power. 12. Battle dissolving power that makes the enemies go in disarray. 13. Promotion power and energy. 14. Breakthrough power. 15. Miracle receiving power 16. Poison destroying power. Many have been poisoned physically or spiritually. The Blood of Jesus neutralises such poisons and flushes them out of the system. 17. Mountain-moving power 18. Demon-paralysing power.

Why do foreigners always ask about clothing?” one woman doctor asked. “Why does it matter so much what we wear? Of all the issues in the world, is that really so important?” Another said: “You think we’re victims, because we cover our hair and wear modest clothing. But we think that it’s Western women who are repressed, because they have to show their bodies—even go through surgery to change their bodies—to please men.

If I walk out of my office today and get hit by a drunk driver, that will not be my fault. But it will be my responsibility to deal with the outcome. I am the one who has to go to the doctor and get surgery. I am the one who will have to go to the physical therapist. I am the one who will have to grieve. And I will be the one who has to work through the anger and do the forgiving. Those things are all my responsibility, even though I did not choose to get hit by a drunk driver. Unsafe people do not do that hard work. They stay angry, stuck, and bitter, sometimes for life. When they feel upset, they see others as the cause, and others as the ones who have to do all the changing. When they are abused, they hold on to it with a vengeance and spew hatred for the rest of their lives. When they are hurt, they wear it like a badge. And worst of all, when they are wrong, they blame it on others. Denial is the active process that someone uses to avoid responsibility. It is different from being unaware of sin. When we are unaware, we do not know about our sin. Denial is more active than that. It is a style and an agenda, and it can be very aggressive when truth comes close. People with a style of denial and blaming are definitely on the list of unsafe people to avoid.

Only now, he thought, now that I know I have a father, do I feel his absence: the place where he should have been and was not. Before, I thought everybody was one-armed, like me. Now I feel the surgery. The crunch of bone when it is sundered, the sliced flesh and the tubes of blood cut through, shocking the bloodrun and disturbing the nerves. They dangle and writhe. Singing pain. Waking me with the sound of itself, thrumming when I sleep so deeply it strangles my dreams away. There is nothing for it but to go away from where he is not to where he used to be and might be still. Let the dangle and the writhe see what it is missing; let the pain sing to the dirt where he stepped in the place where he used to be and might be still. I am not going to be healed, or to find the arm that was removed from me. I am going to freshen the pain, point it, so we both know what it is for.

Be big enough to offer the truth to people and if it short circuits them I think that's tragic. I think that's sad but, I will not strike no unholy bargains to self erase. I wont do it. I don't care how many people fucked up their lives. I don't care how many bad choices people have made. I don't care how much pettiness they've consumed and spat out. I don't care how much viciousness , rage, abuse, spanking they've dealt out. I am gonna tell the truth as I see it and I'm going to be who I fucking am and if that causes the world to shift in it's orbit and half the evil people get thrown off the planet and up into space well, you shouldn't of been standing in evil to begin with because, there is gravity in goodness. So, sorry; I have to be who I am. Everyone ells is taken. There is no other place I can go than in my own head. I can't jump from skull to skull until I find one that suits bad people around me better. I don't have that choice. So, be your fucking self. Speak your truth and if there are people around you who tempt you with nonexistence , blast through that and give them the full glory of who you are. Do not withhold yourself from the world. Do not piss on the incandescent gift of your existence. Don't drown yourself in the petty fog and dustiness of other peoples ancient superstitions, beliefs, aggressions, culture, and crap. No, be a flare. We're all born self expressive. We are all born perfectly comfortable with being incredibly inconvenient to our parents. We shit, piss, wake up at night, throw up on their shoulders, scream, and cry. We are in our essence, in our humanity, perfectly comfortable with inconveniencing others. That's how we are born. That's how we grow. That's how we develop. Well, I choose to retain the ability to inconvenience the irrational. You know I had a cancer in me last year and I'm very glad that the surgeons knife and the related medicines that I took proved extremely inconvenient to my cancer and I bet you my cancer was like "Aw shit. I hate this stuff man." Good. I'm only alive because medicine and surgery was highly inconvenient to the cancer within me. That's the only reason I'm alive. So, be who you are. If that's inconvenient to other people that's their goddamn business, not yours. Do not kill yourself because other people are dead. Do not follow people into the grave. Do not atomize yourself because, others have shredded themselves into dust for the sake of their fears and their desire to conform with the history of the dead.

Another Damasio patient, “Elliot,” was a successful husband, father, and businessman until undergoing brain surgery on a tumor. The surgery damaged his frontal lobe and thereby affected his ability to carry through on plans. He would embark on a project only to lose sight of his goal in doing so. For example, asked to sort documents, he would go overboard: “He was likely, all of a sudden, to turn from the sorting task he had initiated to reading one of those papers carefully and intelligently, and to spend an entire day doing so. Or he might spend a whole afternoon deliberating on which principle of categorization should be applied.

You’re safe, I remembered whispering to Quintana when I first saw her in the ICU at UCLA. I’m here. You’re going to be all right. Half of her skull had been shaved for surgery. I could see the long cut and the metal staples that held it closed. She was again breathing only through an endotracheal tube. I’m here. Everything’s fine . . . I would take care of her. It would be all right. It also occurred to me that this was a promise I could not keep. I could not always take care of her. I could not never leave her. She was no longer a child. She was an adult. Things happened in life that mothers could not prevent or fix. —JOAN DIDION, The Year of Magical Thinking

I thought back to when I'd first stepped in Mimsy's garden and time has stopped, and I felt that strange joy. A crack in the universe. A shift in reality. I felt that now, too, like someone had performed surgery on my soul and tucked this strange new thing deep inside me: this knowledge of the world and what mattered in it. How there were places where you could go to escape the dark, terrifying world, at least for a little while. How beautiful things-small beautiful things-food and plants and flowers-how they could change you. That food wasn't about numbers and calories and nutrition, but beauty. That these beautiful things could be a key to unlocking a world inside you, a place that you couldn't before reach. It could be protection, an armor, a way to survive the darkness. A way to walk through the world when you wanted to hide in bed all day and night.

Only now, he thought, now that I have a father, do I feel his absence: the place where he should have been and was not. Before, I thought everybody was one-armed, like me. Now I feel the surgery. The crunch of bone when it is sundered, the sliced flesh and the tubes of blood cut through, shocking the bloodrun and disturbing the nerves. They dangle and writhe. Singing pain. Waking me with the sound of itself, thrumming when I sleep so deeply it strangles my dreams away. There is nothing for it but to go away from where he is not to where he used to be and might be still. Let the dangle and the writhe see what is missing; let the pain sing to the dirt where he stepped in the place where he used to be and might be still. I am not going to be healed, or to find the arm that was removed from me. I am going to freshen the paid, point it, so we both know what it is for.

For inspiration, I would turn again and again to Lieutenant Jason “Jay” Redman, a Navy SEAL who had been shot seven times and had undergone nearly two dozen surgeries. He had placed a hand-drawn sign on the door to his room at Bethesda Naval Hospital. It read: ATTENTION. To all who enter here. If you are coming into this room with sorrow or to feel sorry for my wounds, go elsewhere. The wounds I received I got in a job I love, doing it for people I love, supporting the freedom of a country I deeply love. I am incredibly tough and will make a full recovery. What is full? That is the absolute utmost physically my body has the ability to recover. Then I will push that about 20% further through sheer mental tenacity. This room you are about to enter is a room of fun, optimism, and intense rapid regrowth. If you are not prepared for that, go elsewhere. From: The Management.

What to Make a Game About? Your dog, your cat, your child, your boyfriend, your girlfriend, your mother, your father, your grandmother, your friends, your imaginary friends, your summer vacation, your winter in the mountains, your childhood home, your current home, your future home, your first job, your worst job, the job you wish you had. Your first date, your first kiss, your first fuck, your first true love, your second true love, your relationship, your kinks, your deepest secrets, your fantasies, your guilty pleasures, your guiltless pleasures, your break-up, your make-up, your undying love, your dying love. Your hopes, your dreams, your fears, your secrets, the dream you had last night, the thing you were afraid of when you were little, the thing you’re afraid of now, the secret you think will come back and bite you, the secret you were planning to take to your grave, your hope for a better world, your hope for a better you, your hope for a better day. The passage of time, the passage of memory, the experience of forgetting, the experience of remembering, the experience of meeting a close friend from long ago on the street and not recognizing her face, the experience of meeting a close friend from long ago and not being recognized, the experience of aging, the experience of becoming more dependent on the people who love you, the experience of becoming less dependent on the people you hate. The experience of opening a business, the experience of opening the garage, the experience of opening your heart, the experience of opening someone else’s heart via risky surgery, the experience of opening the window, the experience of opening for a famous band at a concert when nobody in the audience knows who you are, the experience of opening your mind, the experience of taking drugs, the experience of your worst trip, the experience of meditation, the experience of learning a language, the experience of writing a book. A silent moment at a pond, a noisy moment in the heart of a city, a moment that caught you unprepared, a moment you spent a long time preparing for, a moment of revelation, a moment of realization, a moment when you realized the universe was not out to get you, a moment when you realized the universe was out to get you, a moment when you were totally unaware of what was going on, a moment of action, a moment of inaction, a moment of regret, a moment of victory, a slow moment, a long moment, a moment you spent in the branches of a tree. The cruelty of children, the brashness of youth, the wisdom of age, the stupidity of age, a fairy tale you heard as a child, a fairy tale you heard as an adult, the lifestyle of an imaginary creature, the lifestyle of yourself, the subtle ways in which we admit authority into our lives, the subtle ways in which we overcome authority, the subtle ways in which we become a little stronger or a little weaker each day. A trip on a boat, a trip on a plane, a trip down a vanishing path through a forest, waking up in a darkened room, waking up in a friend’s room and not knowing how you got there, waking up in a friend’s bed and not knowing how you got there, waking up after twenty years of sleep, a sunset, a sunrise, a lingering smile, a heartfelt greeting, a bittersweet goodbye. Your past lives, your future lives, lies that you’ve told, lies you plan to tell, lies, truths, grim visions, prophecy, wishes, wants, loves, hates, premonitions, warnings, fables, adages, myths, legends, stories, diary entries. Jumping over a pit, jumping into a pool, jumping into the sky and never coming down. Anything. Everything.

In these moments, I acted not, as I most often did, as death’s enemy, but as its ambassador. I had to help those families understand that the person they knew—the full, vital independent human—now lived only in the past and that I needed their input to understand what sort of future he or she would want: an easy death or to be strung between bags of fluids going in, others coming out, to persist despite being unable to struggle. Had I been more religious in my youth, I might have become a pastor, for it was the pastoral role I’d sought. — With my renewed focus, informed consent—the ritual by which a patient signs a piece of paper, authorizing surgery—became not a juridical exercise in naming all the risks as quickly as possible, like the voiceover in an ad for a new pharmaceutical, but an opportunity to forge a covenant with a suffering compatriot: Here we are together, and here are the ways through—I promise to guide you, as best as I can, to the other side.

KNEE SURGERY I’D FIRST HURT MY KNEES IN FALLUJAH WHEN THE WALL FELL on me. Cortisone shots helped for a while, but the pain kept coming back and getting worse. The docs told me I needed to have my legs operated on, but doing that would have meant I would have to take time off and miss the war. So I kept putting it off. I settled into a routine where I’d go to the doc, get a shot, go back to work. The time between shots became shorter and shorter. It got down to every two months, then every month. I made it through Ramadi, but just barely. My knees started locking and it was difficult to get down the stairs. I no longer had a choice, so, soon after I got home in 2007, I went under the knife. The surgeons cut my tendons to relieve pressure so my kneecaps would slide back over. They had to shave down my kneecaps because I had worn grooves in them. They injected synthetic cartilage material and shaved the meniscus. Somewhere along the way they also repaired an ACL. I was like a racing car, being repaired from the ground up. When they were done, they sent me to see Jason, a physical therapist who specializes in working with SEALs. He’d been a trainer for the Pittsburgh Pirates. After 9/11, he decided to devote himself to helping the country. He chose to do that by working with the military. He took a massive pay cut to help put us back together. I DIDN’T KNOW ALL THAT THE FIRST DAY WE MET. ALL I WANTED to hear was how long it was going to take to rehab. He gave me a pensive look. “This surgery—civilians need a year to get back,” he said finally. “Football players, they’re out eight months. SEALs—it’s hard to say. You hate being out of action and will punish yourselves to get back.” He finally predicted six months. I think we did it in five. But I thought I would surely die along the way. JASON PUT ME INTO A MACHINE THAT WOULD STRETCH MY knee. Every day I had to see how much further I could adjust it. I would sweat up a storm as it bent my knee. I finally got it to ninety degrees. “That’s outstanding,” he told me. “Now get more.” “More?” “More!” He also had a machine that sent a shock to my muscle through electrodes. Depending on the muscle, I would have to stretch and point my toes up and down. It doesn’t sound like much, but it is clearly a form of torture that should be outlawed by the Geneva Convention, even for use on SEALs. Naturally, Jason kept upping the voltage. But the worst of all was the simplest: the exercise. I had to do more, more, more. I remember calling Taya many times and telling her I was sure I was going to puke if not die before the day was out. She seemed sympathetic but, come to think of it in retrospect, she and Jason may have been in on it together. There was a stretch where Jason had me doing crazy amounts of ab exercises and other things to my core muscles. “Do you understand it’s my knees that were operated on?” I asked him one day when I thought I’d reached my limit. He just laughed. He had a scientific explanation about how everything in the body depends on strong core muscles, but I think he just liked kicking my ass around the gym. I swear I heard a bullwhip crack over my head any time I started to slack. I always thought the best shape I was ever in was straight out of BUD/S. But I was in far better shape after spending five months with him. Not only were my knees okay, the rest of me was in top condition. When I came back to my platoon, they all asked if I had been taking steroids.

Whatever you focus on is your reality. You tend to move in the direction of what you’re focused on--especially when it’s bad. I remember when I was about nine years old, staying with my grandma and grandpa at the lake, I was playing with my cousins at this construction site. Not the safest place to play, which I suppose is what attracted me to it. I saw a two-by-four with a nail sticking out of it, and I remember running and thinking, Oh man, wouldn’t it be terrible if I fell on that? A few moments later, it actually happened. I tripped and the nail went straight through my knee. I ended up going to the hospital with a two-by-four stuck to my knee because we were afraid to pull it out. The nail was about a centimeter away from cutting a vital tendon that would have required major surgery. So I was really fortunate in that regard. But I couldn’t help thinking that my focus on this nail created the situation. I’ve learned since then that we all have the power to create our own destiny. On some level, we ask for things that happen to us in our lives. You have to know what you want, then be aware of the thoughts you hold in your mind. Negative ones--fear, anger, jealousy, frustration--will undermine you. If you see the nail tripping you up, it will.

For me, the biggest conflict with the surgery date was that it fell on the same day as Cole’s junior/senior formal at school. The formal had been a big night for Reed two years earlier, with the highlight being a special ring ceremony. Juniors receive their senior rings and ask two special people in their lives to turn the ring on their finger. Reed has asked me to be one of those two people for him, which was a special honor for me. If Cole wants me there, I will reschedule Mia’s surgery. “Cole, who are you planning on having turn your ring?” I asked. “I didn’t get a ring, Mom. I really don’t want one,” Cole replied. Seriously? I thought. Boy, are you your father’s son or what? “All I really care about is getting some really good pictures.” I knew Cole was telling me the truth. He is not about fanfare or rituals. But he did want to remember the night. “Absolutely! I’ll make sure we have plenty of pictures of you,” I exclaimed. As it turned out, I think he was the most photographed student that night. Since I could not be there in person, people texted, e-mailed, and tagged me on Facebook with pictures of him. Again, my friends and Cole’s friends’ parents did what they could to help us through this difficult time. Something as simple as taking pictures was priceless to me. Yes, Cole was completely fine with my not being at the formal, but he was also sad that he could not be at the hospital for Mia. I assured him that there’s never a good time for surgery, and he shouldn’t feel guilty about attending his event--all of us wanted him to go and have a great time.

As we were getting Mia’s things ready for her discharge, her nurse started to excuse herself to get a wheelchair to transport Mia to the car. Instantly, Mia said, “I’m not riding in a wheelchair.” “Yes, you are, Mia. It’s a hospital regulation,” I said, believing that was true. “Mom,” she protested, “they said I’m supposed to walk as much as possible. I’m walking to the car.” I saw a certain look in Mia’s eyes as she made this announcement, the look that says “I am going to push hard for this.” I knew she was determined, and I would fight a losing battle to try to talk her out of it. “I’m walking out of here,” she said again. I guess the medical staff noticed that look too because they allowed her to try to walk, with a nurse close beside her. Seeing that little girl limp her way down the hall, holding Reed’s hand, was one of the proudest moments of my life. I was absolutely amazed by her spunk and determination. I grabbed my cell phone from my purse and snapped a picture. She is such a fighter, I thought as Jase and I followed her. Visually, she looked roughed up, as though she had been through about fifteen rounds in a boxing match. But in that moment, she showed a level of toughness and resilience I have never seen in a child. Remembering the information we were told on that first visit to ICI when Mia was seventeen days old, that she would need physical therapy to help her walk again after this surgery, I thanked God as I watched our daughter walk right out of the hospital twenty-four hours postoperation! When we got into the car, Jase asked Mia, “Well, what do you think about that?” “I’m a little tired, but I made it,” she replied. Indeed she did.

The children crowded about the women in the houses. What we going to do Ma? Where we going to go? The women said, We don’t know, yet. Go out and play. But don’t go near your father. He might whale you if you go near him. And the women went on with the work, but all the time they watched the men squatting in the dust–perplexed and figuring. The tractors came over the roads and into the fields, great crawlers moving like insects, having the incredible strength of insects. They crawled over the ground, laying the track and rolling on it and picking it up. Diesel tractors, puttering while they stood idle; they thundered when they moved, and then settled down to a droning roar. Snub-nosed monsters, raising the dust and sticking their snouts into it, straight down the country, across the country, through fences, through dooryards, in and out of gullies in straight lines. They did not run on the ground, but on their own roadbeds. They ignored hills and gulches, water courses, fences, houses. The man sitting in the iron seat did not look like a man; gloved, goggled, rubber dust mask over nose and mouth, he was part of the monster, a robot in the seat. The thunder of the cylinders sounded through the country, became one with the air and the earth, so that earth and air muttered in sympathetic vibration. The driver could not control it–straight across country it went, cutting through a dozen farms and straight back. A twitch at the controls could swerve the cat’, but the driver’s hands could not twitch because the monster that built the tractor, the monster that sent that tractor out, had somehow got into the driver’s hands, into his brain and muscle, had goggled him and muzzled him–goggled his mind, muzzled his speech, goggled his perception, muzzled his protest. He could not see the land as it was, he could not smell the power of the earth. He sat in an iron seat and stepped on iron pedals. He could not cheer or beat or curse or encourage the extension of his power, and because of this he could not cheer or whip or curse or encourage himself. He did now know or own or trust or beseech the land. If a seed dropped did not germinate, it was no skin off his ass. If the young thrusting plant withered in drought or drowned in a flood of rain, it was no more to the driver than to the tractor. He loved the land no more than the bank loved the land. He could admire the tractor–its machined surfaces, its surge of power, the roar of its detonating cylinders; but it was not his tractor. Behind the tractor rolled the shining disks, cutting the earth with its blades–not plowing but surgery, pushing the cut earth to the right where the second row of disks cut it and pushed it to the left; slicing blades shining, polished by the cut earth. And behind the disks, the harrows combing with iron teeth so that the little clods broke up and the earth lay smooth. Behind the harrows, the long seeders–twelve curved iron penes erected in the foundry, orgasms set by gear, raping methodically, raping without passion. The driver sat in his iron seat and he was proud of the straight lines he did not will, proud of the tractor he did not own or love, proud of the power he could not control. And when that crop grew, and was harvested, no man had crumbled a hot clod in his fingers and let the earth sift past his fingertips. No man had touched the seed, or lusted for the growth. Men ate what they had not raised, and had no connection to the bread. The land bore under iron, and under iron gradually died; for it was not love or hated, it had no prayers or curses.

Quote from "The Dish Keepers of Honest House" ....TO TWIST THE COLD is easy when its only water you want. Tapping of the toothbrush echoes into Ella's mind like footsteps clacking a cobbled street on a bitter, dry, cold morning. Her mind pushes through sleep her body craves. It catches her head falling into a warm, soft pillow. "Go back to bed," she tells herself. "You're still asleep," Ella mumbles, pushes the blanket off, and sits up. The urgency to move persuades her to keep routines. Water from the faucet runs through paste foam like a miniature waterfall. Ella rubs sleep-deprieved eyes, then the bridge of her nose and glances into the sink. Ella's eyes astutely fixate for one, brief millisecond. Water becomes the burgundy of soldiers exiting the drain. Her mouth drops in shock. The flow turns green. It is like the bubbling fungus of flockless, fishless, stagnating ponds. Within the iridescent glimmer of her thinking -- like a brain losing blood flow, Ella's focus is the flickering flashing of gray, white dust, coal-black shadows and crows lifting from the ground. A half minute or two trails off before her mind returns to reality. Ella grasps a toothbrush between thumb and index finger. She rests the outer palm against the sink's edge, breathes in and then exhales. Tension in the brow subsides, and her chest and shoulders drop; she sighs. Ella stares at pasty foam. It exits the drain as if in a race to clear the sink of negativity -- of all germs, slimy spit, the burgundy of imagined soldiers and oppressive plaque. GRASPING THE SILKY STRAND between her fingers, Ella tucks, pulls and slides the floss gently through her teeth. Her breath is an inch or so of the mirror. Inspections leave her demeanor more alert. Clouding steam of the image tugs her conscience. She gazes into silver glass. Bits of hair loosen from the bun piled at her head's posterior. What transforms is what she imagines. The mirror becomes a window. The window possesses her Soul and Spirit. These two become concerned -- much like they did when dishonest housekeepers disrupted Ella's world in another story. Before her is a glorious bird -- shining-dark-as-coal, shimmering in hues of purple-black and black-greens. It is likened unto The Raven in Edgar Allan Poe's most famous poem of 1845. Instead of interrupting a cold December night with tapping on a chamber door, it rests its claws in the decorative, carved handle of a backrest on a stiff dining chair. It projects an air of humor and concern. It moves its head to and fro while seeking a clearer understanding. Ella studies the bird. It is surrounded in lofty bends and stretches of leafless, acorn-less, nearly lifeless, oak trees. Like fingers and arms these branches reach below. [Perhaps they are reaching for us? Rest assured; if they had designs on us, I would be someplace else, writing about something more pleasant and less frightening. Of course, you would be asleep.] Balanced in the branches is a chair. It is from Ella's childhood home. The chair sways. Ella imagines modern-day pilgrims of a distant shore. Each step is as if Mother Nature will position them upright like dolls, blown from the stability of their plastic, flat, toe-less feet. These pilgrims take fate by the hand. LIFTING A TOWEL and patting her mouth and hands, Ella pulls the towel through the rack. She walks to the bedroom, sits and picks up the newspaper. Thumbing through pages that leave fingertips black, she reads headlines: "Former Dentist Guilty of Health Care Fraud." She flips the page, pinches the tip of her nose and brushes the edge of her chin -- smearing both with ink. In the middle fold directly affront her eyes is another headline: "Dentist Punished for Misconduct." She turns the page. There is yet another: "Dentist guilty of urinating in surgery sink and using contaminated dental instruments on patients." This world contains those who are simply insane! Every profession has those who stray from goals....

MATHEMATICAL MIRACLE Some years ago, I heard a story which has been making the rounds in Midwest A.A. circles for years. I don’t have any names to back up this story, but I have heard it from many sources, and the circumstances sound believable. A man in a small Wisconsin city had been on the program for about three years and had enjoyed contented sobriety through that period. Then bad luck began to hit him in bunches. The firm for which he had worked for some fifteen years was sold; his particular job was phased out of existence, and the plant moved to another city. For several months, he struggled along at odd jobs while looking for a company that needed his specialized experience. Then another blow hit him. His wife was forced to enter a hospital for major surgery, and his company insurance had expired. At this point he cracked, and decided to go on an all-out binge. He didn’t want to stage this in the small city, where everyone knew his sobriety record. So he went to Chicago, checked in at a North Side hotel, and set forth on his project. It was Friday night, and the bars were filled with a swinging crowd. But he was in no mood for swinging—he just wanted to get quietly, miserably drunk. Finally, he found a basement bar on a quiet side street, practically deserted. He sat down on a bar stool and ordered a double bourbon on the rocks. The bartender said, “Yes, sir,” and reached for a bottle. Then the bartender stopped in his tracks, took a long, hard look at the customer, leaned over the bar, and said in a low tone, “I was in Milwaukee about four months ago, and one night I attended an open meeting. You were on the speaking platform, and you gave one of the finest A.A. talks I ever heard.” The bartender turned and walked to the end of the bar. For a few minutes, the customer sat there—probably in a state of shock. Then he picked his money off the bar with trembling hands and walked out, all desire for a drink drained out of him. It is estimated that there are about 8,000 saloons in Chicago, employing some 25,000 bartenders. This man had entered the one saloon in 8,000 where he would encounter the one man in 25,000 who knew that he was a member of A.A. and didn’t belong there. Chicago, Illinois

I lost my first patient on a Tuesday. She was an eighty-two-year-old woman, small and trim, the healthiest person on the general surgery service, where I spent a month as an intern. (At her autopsy, the pathologist would be shocked to learn her age: “She has the organs of a fifty-year-old!”) She had been admitted for constipation from a mild bowel obstruction. After six days of hoping her bowels would untangle themselves, we did a minor operation to help sort things out. Around eight P.M. Monday night, I stopped by to check on her, and she was alert, doing fine. As we talked, I pulled from my pocket my list of the day’s work and crossed off the last item (post-op check, Mrs. Harvey). It was time to go home and get some rest. Sometime after midnight, the phone rang. The patient was crashing. With the complacency of bureaucratic work suddenly torn away, I sat up in bed and spat out orders: “One liter bolus of LR, EKG, chest X-ray, stat—I’m on my way in.” I called my chief, and she told me to add labs and to call her back when I had a better sense of things. I sped to the hospital and found Mrs. Harvey struggling for air, her heart racing, her blood pressure collapsing. She wasn’t getting better no matter what I did; and as I was the only general surgery intern on call, my pager was buzzing relentlessly, with calls I could dispense with (patients needing sleep medication) and ones I couldn’t (a rupturing aortic aneurysm in the ER). I was drowning, out of my depth, pulled in a thousand directions, and Mrs. Harvey was still not improving. I arranged a transfer to the ICU, where we blasted her with drugs and fluids to keep her from dying, and I spent the next few hours running between my patient threatening to die in the ER and my patient actively dying in the ICU. By 5:45 A.M., the patient in the ER was on his way to the OR, and Mrs. Harvey was relatively stable. She’d needed twelve liters of fluid, two units of blood, a ventilator, and three different pressors to stay alive. When I finally left the hospital, at five P.M. on Tuesday evening, Mrs. Harvey wasn’t getting better—or worse. At seven P.M., the phone rang: Mrs. Harvey had coded, and the ICU team was attempting CPR. I raced back to the hospital, and once again, she pulled through. Barely. This time, instead of going home, I grabbed dinner near the hospital, just in case. At eight P.M., my phone rang: Mrs. Harvey had died. I went home to sleep.

I’m still in the big Jacuzzi tub when the power flickers--once, twice--and then goes out, leaving me in total darkness, chin deep in lukewarm water. I don’t know why, but it all hits me then--Nan’s surgery tomorrow, shooting that moccasin, this stupid, never-ending storm. I start to cry, deep, gulping sobs. I know it seems childish, but I want my daddy. What if things get worse? What if the house starts to flood? Or the roof blows off? As much as I hate to admit it, I’m scared. Really scared. A knock on the bathroom door startles me. “Jemma? You okay in there?” “I’m fine,” I call out, my voice thick. My cheeks burn with shame at being caught crying in the dark like a two-year-old. “Do you want a candle or something? Maybe a hurricane lamp?” “No, I’m…” I start to say “fine” again, but a ragged sob tears from my throat instead. “It’s going to be okay, Jem. We’ll get through this.” I sink lower into the water, wanting to disappear completely. Why can’t he just go away and let me have my little meltdown in private? Why, after all these years of being a jerk, does he have to suddenly be so nice? “I got both dogs dried off,” he continues conversationally, as if I’m not in here crying my eyes out. “They’re in the kitchen eating their supper. I think Beau’s pretty worked up.” I continue to bawl like a baby. I know he can hear me, that he’s right outside the door, listening. Still, it takes me a good five minutes to get it all out of my system. Once the tears have slowed, I reach for my washcloth and lay it across my eyes, hoping it’ll reduce the puffiness. A minute or two later, I drag it away and wring it out before laying it over the edge of the tub. It’s still dark inside the bathroom, though I can see a flicker of light coming from beneath the door. Ryder must have a flashlight, or maybe one of the battery-operated lanterns I scattered around the house, just in case. I wonder how long he’s going to stand three, waiting for me. The lights flick off, and I think maybe he’s finally left me in peace. But then I hear a muffled thump, and I know he’s still out there, probably sitting with his back against the door. “Hey, Jem?” he says. “You saved my life, you know--out there by the barn. Most people couldn’t have made that shot.” I squeeze my eyes shut, but tears leak through anyway. I hadn’t wanted to kill that stupid snake, but if it had bitten Ryder and we hadn’t been able to make it to the hospital in time… I let the thought trail off, not wanting to examine it further. “Thank you,” he says softly. “I owe you one.

The children crowded about the women in the houses. What we going to do Ma? Where we going to go? The women said, We don’t know, yet. Go out and play. But don’t go near your father. He might whale you if you go near him. And the women went on with the work, but all the time they watched the men squatting in the dust–perplexed and figuring. ... The tractors came over the roads and into the fields, great crawlers moving like insects, having the incredible strength of insects. They crawled over the ground, laying the track and rolling on it and picking it up. Diesel tractors, puttering while they stood idle; they thundered when they moved, and then settled down to a droning roar. Snub-nosed monsters, raising the dust and sticking their snouts into it, straight down the country, across the country, through fences, through dooryards, in and out of gullies in straight lines. They did not run on the ground, but on their own roadbeds. They ignored hills and gulches, water courses, fences, houses. The man sitting in the iron seat did not look like a man; gloved, goggled, rubber dust mask over nose and mouth, he was part of the monster, a robot in the seat. The thunder of the cylinders sounded through the country, became one with the air and the earth, so that earth and air muttered in sympathetic vibration. The driver could not control it–straight across country it went, cutting through a dozen farms and straight back. A twitch at the controls could swerve the cat’, but the driver’s hands could not twitch because the monster that built the tractor, the monster that sent that tractor out, had somehow got into the driver’s hands, into his brain and muscle, had goggled him and muzzled him–goggled his mind, muzzled his speech, goggled his perception, muzzled his protest. He could not see the land as it was, he could not smell the power of the earth. He sat in an iron seat and stepped on iron pedals. He could not cheer or beat or curse or encourage the extension of his power, and because of this he could not cheer or whip or curse or encourage himself. He did now know or own or trust or beseech the land. If a seed dropped did not germinate, it was no skin off his ass. If the young thrusting plant withered in drought or drowned in a flood of rain, it was no more to the driver than to the tractor. He loved the land no more than the bank loved the land. He could admire the tractor–its machined surfaces, its surge of power, the roar of its detonating cylinders; but it was not his tractor. Behind the tractor rolled the shining disks, cutting the earth with its blades–not plowing but surgery, pushing the cut earth to the right where the second row of disks cut it and pushed it to the left; slicing blades shining, polished by the cut earth. And behind the disks, the harrows combing with iron teeth so that the little clods broke up and the earth lay smooth. Behind the harrows, the long seeders–twelve curved iron penes erected in the foundry, orgasms set by gear, raping methodically, raping without passion. The driver sat in his iron seat and he was proud of the straight lines he did not will, proud of the tractor he did not own or love, proud of the power he could not control. And when that crop grew, and was harvested, no man had crumbled a hot clod in his fingers and let the earth sift past his fingertips. No man had touched the seed, or lusted for the growth. Men ate what they had not raised, and had no connection to the bread. The land bore under iron, and under iron gradually died; for it was not love or hated, it had no prayers or curses.

• No matter how open we as a society are about formerly private matters, the stigma around our emotional struggles remains formidable. We will talk about almost anyone about our physical health, even our sex lives, but bring depression, anxiety or grief , and the expression on the other person would probably be "get me out of this conversation" • We can distract our feelings with too much wine, food or surfing the internet, • Therapy is far from one-sided; it happens in a parallel process. Everyday patients are opening up questions that we have to think about for ourselves, • "The only way out is through" the only way to get out of the tunnel is to go through, not around it • Study after study shows that the most important factor in the success of your treatment is your relationship with the therapist, your experience of "feeling felt" • Attachment styles are formed early in childhood based on our interactions with our caregivers. Attachment styles are significant because they play out in peoples relationships too, influencing the kind of partners they pick, (stable or less stable), how they behave in a relationship (needy, distant, or volatile) and how the relationship tend to end (wistfully, amiably, or with an explosion) • The presenting problem, the issue somebody comes with, is often just one aspect of a larger problem, if not a red herring entirely. • "Help me understand more about the relationship" Here, here's trying to establish what’s known as a therapeutic alliance, trust that has to develop before any work can get done. • In early sessions is always more important for patients to feel understood than it is for them to gain any insight or make changes. • We can complain for free with a friend or family member, People make faulty narratives to make themselves feel better or look better in the moment, even thought it makes them feel worse over time, and that sometimes they need somebody else to read between the lines. • Here-and-now, it is when we work on what’s happening in the room, rather than focusing on patient's stories. • She didn't call him on his bullshit, which this makes patients feel unsafe, like children's whose parent's don’t hold them accountable • What is this going to feel like to the person I’m speaking to? • Neuroscientists discovered that humans have brain cells called mirror neurons, that cause them to mimic others, and when people are in a heightened state of emotion, a soothing voice can calm their nervous system and help them stay present • Don’t judge your feelings; notice them. Use them as your map. Don’t be afraid of the truth. • The things we protest against the most are often the very things we need to look at • How easy it is, I thought, to break someone’s heart, even when you take great care not to. • The purpose on inquiring about people's parent s is not to join them in blaming, judging or criticizing their parents. In fact it is not about their parents at all. It is solely about understanding how their early experiences informed who they are as adults so that they can separate the past from the present (and not wear psychological clothing that no longer fits) • But personality disorders lie on a spectrum. People with borderline personality disorder are terrified of abandonment, but for some that might mean feeling anxious when their partners don’t respond to texts right away; for others that may mean choosing to stay in volatile, dysfunctional relationships rather than being alone. • In therapy we aim for self compassion (am I a human?) versus self esteem (Am I good or bad: a judgment) • The techniques we use are a bit like the type of brain surgery in which the patient remains awake throughout the procedure, as the surgeons operate, they keep checking in with the patient: can you feel this? can you say this words? They are constantly calibrating how close they are to sensitive regions of the brain, and if they hit one, they back up so as not to damage it.

One of his surgical assistants—Jonathan Williams, who replaced James Watt after Watt refused to go along with Freeman’s plan to do lobotomies in his office, without a surgeon present—later told a story about a patient who had been brought to Freeman for a lobotomy. The day before the surgery, though, he’d gotten cold feet and refused to go through with the operation. He locked himself in his hotel room. Freeman, contacted by the patient’s family, drove to the hotel and convinced the patient to let him in. Using a portable electroshock machine he had designed and built for himself, he administered a few volts to the patient to calm him down. According to Williams, “The patient was…held down on the floor while Freeman administered the shock. It then occurred to him that since the patient was already unconscious, and he had a set of leucotomes in his pocket, he might as well do the transorbital lobotomy then and there, which he did.

A decade earlier, her seventy-four-year-old father, Jack Block, a professor emeritus of psychology at the University of California at Berkeley, was admitted to a San Francisco hospital with symptoms from what proved to be a mass growing in the spinal cord of his neck. She flew out to see him. The neurosurgeon said that the procedure to remove the mass carried a 20 percent chance of leaving him quadriplegic, paralyzed from the neck down. But without it he had a 100 percent chance of becoming quadriplegic. The evening before surgery, father and daughter chatted about friends and family, trying to keep their minds off what was to come, and then she left for the night. Halfway across the Bay Bridge, she recalled, “I realized, ‘Oh, my God, I don’t know what he really wants.’” He’d made her his health care proxy, but they had talked about such situations only superficially. So she turned the car around. Going back in “was really uncomfortable,” she said. It made no difference that she was an expert in end-of-life discussions. “I just felt awful having the conversation with my dad.” But she went through her list. She told him, “‘ I need to understand how much you’re willing to go through to have a shot at being alive and what level of being alive is tolerable to you.’ We had this quite agonizing conversation where he said—and this totally shocked me—‘ Well, if I’m able to eat chocolate ice cream and watch football on TV, then I’m willing to stay alive. I’m willing to go through a lot of pain if I have a shot at that.’” “I would never have expected him to say that,

Star Struck We headed for home, my mind filled with questions about the man, and the message I’d somehow received. Reason fought against intuition. He was just an ordinary guy. Or was he? In the months to come, I overcame my fears and visited the doctor. I underwent three cardiac catheterization operations, and a successful triple-bypass surgery. Through them all, I knew I’d be al right. Years have passed since that day. But the peace he projected has remained with me. God sent me comfort in a way I needed, in a form I could understand and trust--an ordinary-looking man. He gave me the courage and the confidence to take care of my health problems. My angel. And even though I can’t see him, I know he’s still watching. I know things are going to be all right. How can I be so sure? Because there’s still work for me to do. He told me so. -Nancy Zeider

The Scriptures tell us that right and wrong do exist. Our duty is to do what is right, and it is not too difficult to discern. For example, look at the issue of transgendered people and using bathrooms. Just because someone is confused, doesn’t mean we give up our common sense. Many who have had sex-change surgery want to change back. They have big regrets. They may change their looks on the outside, but their chromosomes stay the same on the inside. Figuring out which bathroom to use should be a pretty simple matter, if you think about it. God has given each of us a certain kind of plumbing. Guys go to one bathroom and ladies go to another. You see, bathrooms are supposed to be biological and not social. But, of course, there is much more to this agenda than meets the eye. This is the breakdown of the family. This is an assault on what God says is right and wrong. God says man and woman in marriage, and the world says any combination of genders in marriage is fine. The Bible says to have kids within a heterosexual family, and the world says to have kids within any kind of family structure you want. On a recent plane flight, a guy named John was sitting next to me. He loved logic. Everything had to be logical for him. When I asked him, “If you could have any job on planet Earth and money wasn’t an issue, what would you want to do?” He didn’t hesitate. He said, “Philosophy professor at a university!” I already knew this was going to be a good conversation, but his reply was icing on the cake! Then out of nowhere he asked me, “What do you think about gay marriage?” This seems to be the only question on people’s minds these days! Some people are interested in your answer; others just want to label you a bigot. Whether or not they want to categorize you doesn’t matter; our job is to tell people the truth. So I asked him, “When people get married, how many people get married?” He responded that he didn’t understand my question. So I said, “When you go to a marriage ceremony in India, China, Russia, Canada, or the United States, how many people are in that ceremony?” He replied, “Two.” I then continued, “Where did the number come from?” You should have seen the look on his face. He didn’t have a clue. I let him know it came from the oldest writing ever on the subject of marriage. It came from the Jewish Torah, and in the book of Genesis, it says: Therefore shall a man leave his father and his mother, and shall cleave unto his wife: and they shall be one flesh. Genesis 2:24 The interesting thing was that John knew the verse! When I said it out loud, he finished it by saying, “one flesh.” Someone had taught him that verse at some point through the years. Then I said, “Whoever gets to tell you how many people can get married can also tell you who gets to be in that number.” He loved the logic. But, of course, God is logical. That is why it is logical to believe in Him. I also read somewhere: Whoever designs marriage gets to define marriage! That is a good statement, and I have been using it as I talk with people about this subject.

There’s a ritualization to some of these recovery modalities that shouldn’t be overlooked. In a recent editorial, Jonas Bloch Thorlund from the University of South Denmark deconstructed why arthroscopic surgery for meniscal tears remains popular, despite compelling evidence that these procedures are essentially placebos, no better than sham surgery.11 Thorlund notes that surgery represents a ritualistic activity that fosters expectations, much like the way shamans do. There’s the journey to a healing place (the hospital), anointment with a purifying liquid (the presurgical skin prep), and an encounter with the masked healer. As I read this description, I felt a glimmer of recognition, thinking about my experiences visiting recovery centers. In each case, you’re greeted by an empathetic caregiver who walks you through a series of rituals that require various forms of preparation and waiting. It makes me wonder how much power resides in the simple act of putting your trust in a healer and taking part in the ritual on offer.

39 SYLVIA Victoria is dressed in a billowy flower-printed dress that I found in her closet. Something tight is out of the question because of her feeding tube and it would not have been flattering with the way she often slumps in the chair. I have a feeling the dress used to be more snug on her, but now it hangs loose on her bony frame. I also spent some time on her hair. I combed it out and put in the oil treatment again, and it looks lush and shiny. I thought about trying to tie it back, but I think it’s most flattering when it’s loose. Now I’m working on her makeup. I put a layer of pink lipstick on her crooked lips, and now I’m doing my best to cover the scar on her left cheek. I don’t think there’s anything I could do to conceal it entirely, but it looks a lot better than when I started. Victoria is allowing me to put on the makeup, but she looks utterly unenthusiastic. I can’t entirely blame her. As much as I chatter about how much fun this will be, I’m not looking forward to it either. Part of me wants to duck out and leave Victoria and Adam to have Thanksgiving alone as a married couple. But the more I read of her diary, I feel like that is not what Victoria wants. She doesn’t want to be alone with him. And I don’t want her to be alone with him either. “There.” I dab on the last of the concealer—I’ve used half the container and the scar is still very visible. “All done.” Victoria just stares at me. “You look beautiful.” I grab the mirror I found in the bathroom and hold it up to her face. “Take a look.” Victoria glances briefly at the mirror, then turns away. She never seems very happy when I show her a mirror. She either looks away or frowns at herself. Sometimes she touches the scar. I wish Adam had shelled out for her to get plastic surgery. I know he thinks she doesn’t notice, but he’s wrong. “I just…” I chew on my lip. “I want you to know that I’m not going to… I mean, Adam is your husband, not mine. I’m going to tell him tonight that I’m not going to…” For the first time since I came in here, Victoria’s eyes show a spark of interest. “It’s not right,” I say. “It was a mistake and I’m sorry. I’ll tell him tonight.” “Be…” She’s focusing so hard on what she wants to say that some drool comes out of the right side of her mouth, smearing her lipstick. “Be… care…” For once, I know exactly what she’s trying to say. Be careful. I leave Victoria to find some nail polish in the bathroom. That’s the last thing I need to complete her look for the evening. I want Victoria to look really beautiful tonight. Like her old self, as much as possible. It’s important to me. Maggie must have moved the nail polish when she was cleaning. I look in the usual place in the closet within the bathroom, but it’s not there anymore. I search through the other shelves, trying to find the bag of multicolor nail polish tubes. I find more makeup, but not polish. But one thing I do find surprises me. It’s a black bag of medications. I never was sure where Adam kept Victoria’s medications. He always just seems to have them ready to administer. I pick up a bottle from the black plastic bag and see the date of the most recent refill. It was less than a month ago.

In my twenties, when I was in medical school and still training hard, lifting weights almost daily, I experienced a mysterious back injury that required two separate surgeries (one of which was botched), followed by a long and very difficult recovery. For several months I was almost unable to function, surviving on large amounts of pain-killers. I couldn’t even brush my teeth without excruciating back pain, and I spent most of the day just lying on the floor. It got so bad that my mom had to fly out to Palo Alto and take care of me. The thing is, people think it’s terrible when someone in their twenties has to go through this (and it is), yet they almost expect it for someone Sophie’s age.

Could it be that ideas become lethal if you go through with the surgery?

A couple of weeks after Mia’s bone graft surgery in January 2014, she received a letter from Congressman Trent Franks of Arizona on official United States congressional letterhead. Mia was so excited about the letter that she stood on the fireplace hearth (the living room stage) and proceeded to read it to the entire family. In the letter, Congressman Franks told Mia that he, too, was born with a cleft lip and palate and underwent many surgeries as a child. He told her he understood how she felt and told her not to get discouraged because he recognized how she is helping so many people. He invited her to Washington, DC, to receive an award from Congress for service to her community. As soon as she had finished reading it to us, she exclaimed, “Can we go?” Knowing how Jase puts little value on earthly awards and how he likes to travel even less, I responded with a phrase that most parents can understand and appreciate: “We’ll see.” Mia immediately ran upstairs and tacked the letter to her bulletin board, full of hope and optimism. How could Jase say no to this? Oh, she knew her daddy well. He couldn’t, and he didn’t. That summer, Mia, Jase, Reed, Cole, and I spent a few days together visiting monuments and historical sites in Washington before meeting Congressman Franks on July 8 in his office on Capitol Hill. Mia’s favorite monument was the Lincoln Memorial because she had learned about it in school, so it was cool to see it “for real.” It was really crowded there, and people were taking pictures of us while we were trying to read about the monument and take photographs ourselves. Getting Jase out of there took a while because of so many fans wanting pictures--he’s very accommodating. That’s why it surprised me that this was Mia’s favorite site. I’m glad she remembers the impact of the monument and didn’t allow the circus of activity from the fans to put a damper on her experience. Congressman Franks presented Mia with a Certificate of Special Congressional Recognition for “outstanding and invaluable service to the community” at a press conference held at the foot of the Capitol steps. Both he and Mia made speeches that day to numerous cameras and reporters. Hearing my ten-year-old daughter speak about her condition and how she hopes people will look to God to help them get through their own problems was an unbelievably proud moment for me, Jase, and her brothers. After the press conference, Congressman Franks took us into the House chamber where Congress was voting on a new bill. He took Mia down to the floor, introduced her to some of his colleagues, and let her push his voting button for him. When some of the other members of Congress saw this, they also asked her to push their voting buttons for them. Of course, Mia wasn’t going to push any buttons without quizzing these representatives about what exactly she was voting for. She needed to know what was in the bill before she pushed the buttons. Once she realized she agreed with the bill and saw that some members were voting “no,” she commented, “That’s just rude.” Mia was thrilled with the experience and told us all how she helped make history. Little does she know just how much history she has made and continues to make.

Before long, something unexpected happened to test my newfound faith. Mom had to go in for a simple, twenty-minute surgery. I went with Dad to the hospital, and we waited while she was in the operating room. Forty-five minutes went by, and no one came out to tell us anything. Then a nurse came out, and one look at her face told me the news was not good. “Look, there’s a problem,” she said. “We haven’t been able to wake her up. She’s gone into a coma. We have a machine breathing for her, and we think she’s going to be okay, but she needs to wake up.” Dad looked at me, his face white and his eyes big and scared. We had no idea what was going on, but we knew it was bad. Really bad. He grabbed my shoulder and said through tears, “We’re fixin’ to pray for your mom right now.” I’d never heard him pray as fervently. He was frantic and telling God about how much we needed Mom in our family. We knew her life was at stake, and we both were scared she would never wake up. The rest of the family came to the hospital, and we gathered, praying our hearts out. We finally got in to see her, and the sight of Mom on a respirator, her chest rising and falling with the help of the machine, freaked us all out. Eventually, we found out what had happened. There had been a mistake, and Mom had been given too much anesthetic, sending her into a serious coma. Two days later, after many tears and huddles with family and desperate prayers, Mom came out of it, woke up, and started breathing on her own. I knew deep in my heart that she could have died, but God had chosen to answer our prayers, and that really built my faith. I was such a new Christian that I’m not sure how I would have reacted if something would have happened to my mom. I also felt like it drew me closer to my dad, as we had been the first ones to hear the news and to pray for her together. I saw a side of him I didn’t see very often, how much he loved and needed my mom and how much he trusted God to help him in a very bad situation. No matter whose fault it was, we were just relieved Mom made it out alive. She recovered from the experience, and with her cooking during those months, my appetite came back, and I gained fifty pounds. I even got a little chunky, so I started working out so I could look and feel better. Those three months of house arrest were probably the best days of my life. My thinking had changed, my heart’s desires were back on track, and I had hope for the future.

I carry a heavy burden in my heart and on my shoulders in this life. Not as a martyr; only as someone who loved someone more than herself. And, set my love one free due to a heavy price of a disease called cancer. I knew as I am sure today, that I could never tell my love & my future at the time the truth because it would mean he would lose the happiness that she wanted for him; his children to be and would only be a disappointment to him in the long run. So years go by; she fights her battles; and suffered over the years through pain of surgeries and treatments; and spent good days in her life like they would be her last. Until she found his book on Goodreads; that broke her heart and sadden her to see his anger still exist and knowing she never told him why set him free. In her perspective; it is better for him to hate her and be happy in his current life; than to know the truth of how much she did indeed love him even more than herself because she wanted only his complete happiness.

Jase, Mia, and I arrived at the hospital early the next morning to what seemed like a replay of Mia’s surgery one year earlier--same hospital, same preoperative area, and same room setup. Over the next few minutes, her room filled up with people, including Reed and his girlfriend of three and a half years, Brighton, who had both driven in from college. Mia loves being silly with them, and I snapped a picture of the three of them. Mia’s cousins also surrounded her to play a game of Old Maid, thanks to the deck Mamaw Kay pulled out of her purse. Everyone was cracking jokes, taking pictures, and, well, just being themselves. All this activity helped keep Mia, as well as me and Jase, thinking positively and staying upbeat. Mia opted to not take the goofy juice this time. She told me she wanted to be awake and alert so she could tell everyone goodbye as she was being rolled back through the operating doors. Whoa! I wasn’t so sure about this. Jase thought it was very brave of her and that we should let her do it. Reluctantly, I agreed. Dr. Sykes, the anesthesiologist, said he would tell her every single thing he was going to do before he gave her enough gas to first make her silly and then to put her to sleep. She was all for it. However, as Dr. Sykes rolled her away, tears formed in Mia’s eyes. I had to keep myself from shouting my thoughts: Wait! Are you sure about this, Mia? You don’t have to go in like this! Let’s rethink this goofy juice thing! I watched Mia’s face closely to catch the slightest glimpse of her wanting to change her mind. There was none. Even though she was scared, she pushed through, and Jase and I let her. We both followed the gurney with tears in our eyes, but she never saw them.

There’s no other option?” “Plastic surgery.” He glanced at her. “Completely change your face.” “No other viable option?” “Not that I’m aware of, but next town we go through, we can stop and see if the library has a copy of Hiding from the Mob in Ten Easy Steps. Maybe there’ll be some tip in there that I’ve missed.” She shot him a dark look. “Very funny.” He laughed. “Actually, it was pretty funny. George really would’ve liked it.

Star Struck Our group visited the laser light show, an attraction mixing music and beams of bright colors as they formed constellations and abstract shapes. An awe-inspiring performance, but as it ended, I noticed the stranger, eyes still focused on me. I turned away quickly. “Look--over by the door. There he is again.” I gestured for my friend to sneak a peek in the direction of the man. “Where?” She squinted, her head pointed straight at him. “I don’t see him--maybe he left.” Frustration tinged my voice. “He’s right there--hasn’t moved an inch. He’s almost smiling at me now. Please don’t try to say I’m imagining him.” Fear mounted in me. Was I being stalked? I tucked the thought away, determined to enjoy this time with my companions, to relax in the gentle warmth of the sun. As our excursion neared its end, I glanced to the left, at the wall of a building, devoid of gates or doors of any sort. The man leaned against it, looking at me. This time I stared back, determined to show a bravery I didn’t feel. Hidden in pockets, my hands trembled. A calm smile and deep compassion shone on his face as we locked eyes for what felt like minutes, but probably lasted only seconds. Then--I don’t know how to explain it--it was as though a burst of conversation swept from his mind to mine. “Everything’s going to be all right.” I felt an intense warmth head to toe, as though embraced in a spiritual hug from the inside out. “There’s work ahead.” I took a deep breath, maintaining the eye contact, listening. He continued to smile with his eyes. “I’ll be watching.” I nodded slowly, softly. I understood. And felt safe. A friend tugged on my arm, pulling me toward another monument. I turned my head back for a glimpse of the man, but he was gone. I scanned the building once more, searching for openings he could have exited through. There were none. I shook my head. I knew I’d seen him. And he’d seen me. I was certain he was real. I still felt his warmth. We headed for home, my mind filled with questions about the man, and the message I’d somehow received. Reason fought against intuition. He was just an ordinary guy. Or was he? In the months to come, I overcame my fears and visited the doctor. I underwent three cardiac catheterization operations, and a successful triple-bypass surgery. Through them all, I knew I’d be al right. Years have passed since that day. But the peace he projected has remained with me. God sent me comfort in a way I needed, in a form I could understand and trust--an ordinary-looking man. He gave me the courage and the confidence to take care of my health problems. My angel. And even though I can’t see him, I know he’s still watching. I know things are going to be all right. How can I be so sure? Because there’s still work for me to do. He told me so. -Nancy Zeider

Terrible things were ahead of her: Jacob would go to Vietnam. Her father's surgery had made him an old man. And how would she bear the empty world without her mother in it? There was college to look forward to, boyfriends, marriage, maybe children of her own, but terrible things, too, were attached to any future. What you needed, she thought, was Susan's ability, her courage, to fix your eyes on the point at which the worst things would be over, gotten through.

The psychiatrist R. D. Laing, at one of the first conferences on Buddhism and psychotherapy that I attended, declared that we are all afraid of three things: other people, our own minds, and death. His statement was all the more powerful because it came shortly before his own death. If bare attention is to be of any real use, it must be applied in exactly these spheres. Physical illness usually provides us with such an opportunity. When my father-in-law, an observant Jew with little overt interest in Eastern philosophy, was facing radical surgery not so long ago, he sought my counsel because he knew of some work I was engaged in about stress reduction. He wanted to know how he could manage his thoughts while going into the surgery, and what he could do while lying awake at night? I taught him bare attention to a simple Jewish prayer; he was gradually able to expand the mental state that developed around the prayer to encompass his thoughts, anxieties, and fears. Even in the intensive care unit after surgery, when he could not tell day from night, move, swallow, or talk, he was able to use bare attention to rest in the moment, dissolving his fears in the meditative space of his own mind. Several years later, after attending Yom Kippur services, he showed me a particular passage in the prayer book that reminded him of what he had learned through his ordeal. A more Buddhist verse he could not have uncovered: A man’s origin is from dust and his destiny is back to dust, at risk of his life he earns his bread; he is likened to a broken shard, withering grass, a fading flower, a passing shade, a dissipating cloud, a blowing wind, flying dust, and a fleeting dream. The fearlessness of bare attention is necessary in the psychological venue as well, where the practice of psychotherapy has revealed just how ingenious and intransigent the ego’s defenses can be. Even when they are in therapy, people are afraid of discovering things about themselves that they do not wish to know.

While technical problems may be very complex and critically important (like replacing a faulty heart valve during cardiac surgery), they have known solutions that can be implemented by current know-how. They can be resolved through the application of authoritative expertise and through the organization’s current structures, procedures, and ways of doing things. Adaptive challenges can only be addressed through changes in people’s priorities, beliefs, habits, and loyalties. Making progress requires going beyond any authoritative expertise to mobilize discovery, shedding certain entrenched ways, tolerating losses, and generating the new capacity to thrive anew.

Why does it matter so much what we wear? Of all the issues in the world, is that really so important?” Another said: “You think we’re victims, because we cover our hair and wear modest clothing. But we think that it’s Western women who are repressed, because they have to show their bodies—even go through surgery to change their bodies—to please men.

As we’ve seen, up to 25 percent of employed seniors from our top universities are heading to financial services each year. Our financial services industry (and to a lesser extent its attendant legal industry) plays an equivalent role to the oil industry in Saudi Arabia in terms of talent attraction. You can see a similar dynamic at work in other fields with fixed slots. There were 682 orthopedic surgery residents in the United States in 2012. That number is set because there are only so many funded residency slots in teaching hospital programs throughout the country.4 If I were to kick butt in medical school and get one of these residencies, I would be on the way to becoming an orthopedic surgeon, probably the most coveted residency due to money, lifestyle, low morbidity of patients, gratification from restoring mobility, and other factors. But let’s say that I didn’t make it and fell short—there would still be 682 orthopedic surgeons five years from now because the next guy would have gotten that slot. We’re all competing to fit through the same finite gate. The value difference if I perform really strongly and get one of these coveted spots is not one more surgeon—it’s the gap between me and the 683rd person who didn’t get it (and perhaps went into a less prestigious or less lucrative specialty). From a value creation standpoint, it’s not ideal for a massive level of talent to be going to existing enterprises that have captured large economic rents or where people are fighting for a set of finite slots. The rents and slots will stay essentially constant. Contrast this with new business formation. If I were to say, “There are only going to be 682 new successful businesses started in the United States next year,” people would instantly regard that as ridiculous. It’s unknown and unknowable. But we all know that if another enterprising team comes along and starts a cool company, that number goes up by one.

Drewe set to work manipulating history. In one brazen but typical ploy at the National Art Library, he razored apart a catalog from a 1955 show at a London gallery that had since gone out of business. Then he created new pages with photographs of Myatt forgeries, added captions in the proper typeface, inserted the false pages among the real ones, reassembled the catalog, and set it back on the shelves. The scheme, which focused not on the paintings themselves but on the documentation that proved the paintings’ bona fides, was ingenious. Why bother going through surgery to change your fingerprints if you can change the fingerprint records in the FBI files?

You know what lasers are?” “No,” I said stuffily. “Not lasers, or masers, or atoms, or molecules, or flashlights—” He raised an eyebrow, then the other one. “You may think you know what a laser is, but you do not, you simply do not, my ignorant friend. You may know that laser is an acronym for light amplification by stimulated emission of radiation, which describes a concentrated source of coherent light all of the same wavelength, and you may realize that with lasers men can drill holes through little jewels and also bounce signals off the moon and make holograms, and you may be vaguely aware that men even now perform delicate retinoneural surgery—weld eyeballs, to you—and even more delicate microsurgery on single cells, and do other exciting things such as etching halftone plates and fixing decayed teeth. But you do not know what a laser is.” “I’ll bet I’m going to find out.” “It is your great good fortune. Soon lasers will be all over the place, coming out of your ears. They’ll be used for swift bloodless surgery, for invisible death rays that slice open the enemy, knock down satellites, carve legs of lamb. They’ll carry thousands of phone calls on one beam of light, zillions of television sets on one laser beam—” “Sets?” “—stations. Channels, signals. What do you care?” “I don’t.” “But I haven’t told you the greatest thing,” he said. “Can I stop you?” “During the demonstration earlier tonight, Dr. Fretsindler—that’s Fretsindler of M.I.T.—had a big hunk of granite on the stage. He banged it with a hammer, smacked it with a chisel, and naturally nothing happened.” “Then why are you telling me all this?” “Nothing was supposed to happen, Sheldon,” he said cheerfully. “That was the point. But then Fretsindler aimed some new kind of infrared laser—already had it on stage—at the damned boulder.

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Thanks, Neel. I’m so sorry to put you through this again.” “Of course. It makes these things kinda fun.” He grinned and straightened his rimless glasses. If he was surprised that she was here, he hid it well and she loved him for it. “Nisha wants you to wear the green one.” He nodded at the green garment bag Trisha had taken from him. “But she thought you should have choices.” They smiled knowingly at each other. If Nisha had decided on the green one, the green one it would be. Trisha was currently wearing standard-issue blue scrubs with a coffee stain that spanned her entire torso, which pretty much summed up her fashion expertise. “Which shoes?” she asked. Neel handed her a box and glanced at the stain painted across her chest. “Tough surgery?” He pointed to the cobblestone path that circled around the side of the house. She followed him toward the pool house. “Hit the wrong artery. You wouldn’t believe the force of the blood.” “You’ve been watching Kill Billagain, haven’t you?” “It’s surgeon catnip. I can’t stop.” Smiling, she twisted around and pushed the door to the pool house open with her back. “Is Nisha going to come and help with my hair?” Because if she didn’t get to tell her sister about the grant in the next two minutes, she was going to burst. Plus, she had to know how Nisha had managed to break it to their father that she was going to be here. “Your hair looks just—” Neel’s cell phone buzzed and he looked down at it. Her own phone sat dead in her pocket. She’d forgotten to charge it. “I’m not supposed to tell you your hair looks nice. Nisha’s sending someone. And you’ve got to hurry. There’s an angry emoji. She can’t believe you’re late.” He kept his face carefully neutral as he dumped the rest of the items he was carrying on the couch. As he headed for the door, he stopped and turned around, reading off his phone again. “She says it’s okay. Don’t worry. Smiley emoji.” Neel did the most adorable subtle eye rolls he thought no one saw. “And she wants you to know you won’t be sorry you came.” He looked up from his wife’s message, the slightest flush on his cheeks. “An emoji’s winking at you, and fanning itself. And—oh, for heaven’s sake. Just hurry up and get in there. Apparently, there’s a butt in there you have to see to believe.

I just want you to know," my father said, "I forgive you." "For what?" I said. "For everything." It was just unbelievable. I had taken care of my mother when she was ill. I had taken care of my father after his heart surgery. Had they paid me? Had they worried that this might be a hardship for me? Had they asked my brother to take time off the tenure track to help them? And now, here it was my winter break, I had friends going on trips, Hong Kong, Myanmar, but no, I'd told them all I couldn't go because my father had said he wanted to visit me. So I let him come and gave him my bed, and I drive him across the Bay to visit his crazy old friends and play the filial game, and now this! When I was a teenager, he'd spent money on my brother for a car, a motorcycle, a three-wheeler even, and I wasn't allowed to go out after dark, and the housework I'd done, and the cooking, and who had to work her way through college? I felt the old familiar anger settling into my stomach again, and I remembered why I'd wanted to move far away from my family in the first place, vowing to stay away. I took a deep cleansing breath, the kind the therapist recommended when she talked about family dynamics and repeating the cycle and breaking the cycle, and I exhaled slowly over my teeth. I tried to count to ten but only made it to five. "I forgive you too," I said tightly. "You're welcome," my father agreed. "No, I said I FORGIVE YOU. I didn't thank you.

It wouldn’t be fair to say that my father had pushed me to become a doctor because he didn’t—at least not overtly. I had wanted to follow in my father’s footsteps from the very beginning. But ever since I was a child, he had very carefully nudged me in the specific direction of heart surgery by basically discounting every other profession in the world. He would say, “Son, what’s more important than keeping people’s hearts beating?” I thought I was so clever that once I had said, “What good is a beating heart without a functioning brain?” He had, of course, very quickly replied, “It’s as good as any beating heart. The important thing to note is that you can keep even a nonfunctioning brain alive as long as you have a beating heart. Doesn’t work the other way around, does it?” There had been about five minutes in my junior year of undergrad, when I had come home after reading about the use of power tools in orthopedic surgery, during which I had said to my father, “I think orthopedics is going to be my thing, Dad.” The next day he had brought home a trunk full of items from Home Depot and one extra-large cow femur bone. He then ran the cow bone over with his car in the driveway until it splintered, cracked, and broke in several places, and then he gave me a bag of tiny screws and bolts and a cordless drill. “Have at it, kid.” I had spent sixteen hours straight in the garage without so much as a drink of water. By the time I had finished, I was exhausted and thoroughly spent but proud of the fully assembled cow bone, which I paraded through the house. My mother was mortified and told my father he had created a monster. He just laughed from the couch, hollering back to me, “Looks pretty, but will it support sixteen hundred pounds?

As one board-certified endocrinologist (Dr Ramona Krutzik) explained it, Fox’s advantages included the bone density she had accrued from her time as a man, the muscle mass she will have accrued from those years and the testosterone imprint on the brain which does not go away through taking androgens or having surgery. All this could give Fox not just a physical edge but also a potential aggression edge.

When a doctor recommends you take a test or have some surgery, ask whether the doctor would suggest that his or her spouse or children go through such a procedure. Contrary to popular belief, doctors can't cure everyone. So why cause unnecessary pain with surgery? I think music and animal therapy can help more than most doctors imagine.

Nevertheless, making up twisted stories was what she was all about, and really, the only thing she was good at. As well as keeping something from others is also what she was about to. Then one day it all changed, I got a knock on my front door, and by the time I got there, the woman was gone. They're sitting on my doorstep as my granddaughter… there she was alive in my sight. She was seven years old at that time; I recall that she was completely nude crying on my porch, and all she had on was Lily’s other childhood ribbon in her hair. Then when I saw the ribbon, I knew what happened. Then she leaped into my arms, and it was love for me from that point on! I remember that Kristen had smashed fingers, and cut up legs, they used a taser gun on her… as well as her butt and vulva were bleeding from being chewed, fondled, and penetrated repeatedly. She was sold many times by Ava and was used as a slave for others' thrills. She had to have virginity restoration surgery to regain her innocence so that someday she can be deflowered to whom she wants. She was only seven years old when the doctors put her under to do that, yet it was the right thing to do, for her. The doctor, Dr. Fennel, said that he never saw anything like what he saw with her in his whole time in practice. I did not care how much it cost, I knew what it was like to have that taken away and I did not want that for her to go through in her life.

I glanced down at her stomach. The tank top she’d worn under my sweatshirt was fitted. From what I could tell, her stomach hadn’t gotten bigger than it was a few weeks ago. In fact, it looked a little smaller. I wondered if that meant the fibroids were shrinking. Could they respond to weight loss like the rest of her? It didn’t seem likely. I wanted to feel her abdomen, see if I could use my medical training to figure out what was wrong. But she never let me touch her stomach. “When is your surgery scheduled?” I asked. She took a sip from the soda. “Two weeks ago.” “When are you going to reschedule it?” She shrugged. “I don’t know. Not anytime soon. It’s a six- to eight-week recovery. I have nobody to take care of me—” “I’ll take care of you.” She pressed her lips into a line. “I need to be with Sloan.” I sat back in the seat, shutting my eyes. I needed her to fucking take care of herself. Did what she had going on have to do with her condition? But insulin came from the pancreas. What did uterine tumors have to do with a pancreas? I wondered if whatever caused this had been lurking for some time. If she never let herself get hungry, she’d never get hypoglycemic. She was always really good about eating. She might not have ever let it get to this point before. “I’m okay,” she said. I opened my eyes. “No, you’re not. You look sick. You’re pale. Your pulse is weak. You almost passed out back there. You could have had a seizure. What if you had been driving?” Protectiveness coursed through me. She was mine. I needed to be able to take care of her, and she wouldn’t let me fucking do it. It defied all the laws of nature. It was wrong. We were in love, and I was supposed to be there for her.

fourteen years old. She is my best friend. I’ve lived with her longer than I’ve lived with my wife, but I know that she’s not going to be around for much longer. She’s old. She’s been hobbling a bit. She’s already survived a ruptured disk and back surgery. She’s reached the end of her expected life span. This might be the last time that we walk in the rain together. So I stand on that corner in the pouring rain and soak in the moment in all its glory. It is beautiful. Crazy and absurd but beautiful.

And while we’re at it, you may have guessed that I also love Ambien; NyQuil (none of this melatonin shit); wine; tequila; piña coladas; margaritas (vodka is for people who want to punish themselves); CBD gummies (I’m solely there for the gummy); a rogue pill a friend has left over after a surgery; half-and-half with a splash of coffee, two Splenda, and three pumps of peppermint; candy; Cinnabon; Wetzel’s Pretzels; Annie’s Pretzels; furry slippers and fuzzy robes; trashy magazines; garbage television; unconfirmed gossip; spas; lasers; luxury; healers of all stripes; extravagant gifts; surprise parties; choreographed dances with friends at any age; karaoke; musicals; Christmas decorations that include a “table tree;” naps; joining gyms I will never go to; hiring trainers I pay up front and then never go to; starting radical diets I never follow through on . . . I overspend, I overeat, I overdo.