Having Surgery Quotes

Sometimes I think illness sits inside every woman, waiting for the right moment to bloom. I have known so many sick women all my life. Women with chronic pain, with ever-gestating diseases. Women with conditions. Men, sure, they have bone snaps, they have backaches, they have a surgery or two, yank out a tonsil, insert a shiny plastic hip. Women get consumed.

THE WORLD IS increasingly designed to depress us. Happiness isn’t very good for the economy. If we were happy with what we had, why would we need more? How do you sell an anti-ageing moisturiser? You make someone worry about ageing. How do you get people to vote for a political party? You make them worry about immigration. How do you get them to buy insurance? By making them worry about everything. How do you get them to have plastic surgery? By highlighting their physical flaws. How do you get them to watch a TV show? By making them worry about missing out. How do you get them to buy a new smartphone? By making them feel like they are being left behind. To be calm becomes a kind of revolutionary act. To be happy with your own non-upgraded existence. To be comfortable with our messy, human selves, would not be good for business.

Now you listen to me," says Ove calmly while he carefully closes the door. "You've given birth to two children and quite soon will be squeezing out a third. You've come here from a land far away and most likely you fled war and persecution and all sorts of other nonsense. You've learned a new language and got yourself an education and you're holding together a family of obvious incompetents. And I'll be damned if I've seen you afraid of a single bloody thing in this world before now....I'm not asking for brain surgery. I'm asking you to drive a car. It's got an accelerator, a brake and a clutch. Some of the greatest twits in world history have sorted out how it works. And you will as well." And then he utters seven words, which Parvaneh will always remember as the loveliest compliment he'll ever give her. "Because you are not a complete twit.

A consequence of female self-love is that the woman grows convinced of social worth. Her love for her body will be unqualified, which is the basis of female identification. If a woman loves her own body, she doesn't grudge what other women do with theirs; if she loves femaleness, she champions its rights. It's true what they say about women: Women are insatiable. We are greedy. Our appetites do need to be controlled if things are to stay in place. If the world were ours too, if we believed we could get away with it, we would ask for more love, more sex, more money, more commitment to children, more food, more care. These sexual, emotional, and physical demands would begin to extend to social demands: payment for care of the elderly, parental leave, childcare, etc. The force of female desire would be so great that society would truly have to reckon with what women want, in bed and in the world.

If the Universe came to an end every time there was some uncertainty about what had happened in it, it would never have got beyond the first picosecond. And many of course don't. It's like a human body, you see. A few cuts and bruises here and there don't hurt it. Not even major surgery if it's done properly. Paradoxes are just the scar tissue. Time and space heal themselves up around them and people simply remember a version of events which makes as much sense as they require it to make.

I suppose nowadays it's all a question of surgery, isn't it? Of course the notion is beautiful, the idea of staying a boy and a child forever, and I think you can. I have known plenty of people who, in their later years, had the energy of children and the kind of curiosity and fascination with things like little children. I think we can keep that, and I think it's important to keep that part of staying young. But I also think it's great fun growing old.

A man is unlikely to be brought within earshot of women as they judge men's appearance, height, muscle tone, sexual technique, penis size, personal grooming, or taste in clothes--all of which we do. The fact is that women are able to view men just as men view women, as objects for sexual and aesthetic evaluation; we too are effortlessly able to choose the male "ideal" from a lineup and if we could have male beauty as well as everything else, most of us would not say no. But so what? Given all that, women make the choice, by and large, to take men as human beings first.

If sympathy is all that human beings need, then the Cross of Christ is an absurdity and there is absolutely no need for it. What the world needs is not "a little bit of love," but major surgery. If you think you are helping lost people with your sympathy and understanding, you are a traitor to Jesus Christ. You must have a right-standing relationship with Him yourself, and pour your life out in helping others in His way— not in a human way that ignores God.

The change which the writing wrought in me (and of which I did not write) was only a beginning; only to prepare me for the gods' surgery. They used my own pen to probe my wound.

...I became acutely aware of an unusual ability--a divine gift, I believe--of extraordinary eye and hand coordination. It’s my belief that God gives us all gifts, special abilities that we have the privilege of developing to help us serve Him and humanity. And the gift of eye and hand coordination has been an invaluable asset in surgery. This gift goes beyond eye-hand coordination, encompassing the ability to understand physical relationships, to think in three dimensions. Good surgeons must understand the consequences of each action, for they’re often not able to see what’s happening to see on the other side of the area in which the area they’re actually working.

I'm not sure what I am anymore... Sometimes I think I'm nothing but what other people have done to me―a big collection of brainwashing, surgeries, and cures... That, and all the mistakes I've made. All the people I've disappointed.

Healthy" and "diseased," as Susan Sontag points out...are often subjective judgments that society makes for its own purposes. Women have long been defined as sick as a means of subjecting them to social control.

Why should her lover, just because he is male, be in a position to judge her against other women? Why must she need to know her position and hate needing to, and hate knowing? Why should his reply have such exaggerated power? And it does. He does not know that what he says will affect the way she feels when they next make love. She is angry for a number of good reasons that may have nothing to do with this particular man's intentions. The exchange reminds her that, in spite of a whole fabric of carefully woven equalities, they are not equal in this way that is so crucial that its snagged thread unravels the rest.

We do not have to spend money and go hungry and struggle and study to become sensual; we always were. We need not believe we must somehow earn good erotic care; we always deserved it. Femaleness and its sexuality are beautiful. Women have long secretly suspected as much. In that sexuality, women are physically beautiful already; superb; breathtaking. Many, many men see this way too. A man who wants to define himself as a real lover of women admires what shows of her past on a woman's face, before she ever saw him, and the adventures and stresses that her body has undergone, the scars of trauma, the changes of childbirth, her distinguishing characteristics, the light is her expression. The number of men who already see in this way is far greater than the arbiters of mass culture would lead us to believe, since the story they need to tell ends with the opposite moral.

The boys could have been many things had they not been ruined by that place. Doctors who cured diseases or perform brain surgery, inventing shit that saves lives. Run for president. All those lost geniuses - sure not all of them were geniuses, Chickie Pete for example was not solving special relativity - but they had been denied even the simple pleasure of being ordinary. Hobbled and handicapped before the race even began, never figuring out how to be normal.

For the first time in history, children are growing up whose earliest sexual imprinting derives not from a living human being, or fantasies of their own; since the 1960s pornographic upsurge, the sexuality of children has begun to be shaped in response to cues that are no longer human. Nothing comparable has ever happened in the history of our species; it dislodges Freud. Today's children and young men and women have sexual identities that spiral around paper and celluloid phantoms: from Playboy to music videos to the blank females torsos in women's magazines, features obscured and eyes extinguished, they are being imprinted with a sexuality that is mass-produced, deliberately dehumanizing and inhuman.

Cosmetic surgery is not "cosmetic," and human flesh is not "plastic." Even the names trivialize what it is. It's not like ironing wrinkles in fabric, or tuning up a car, or altering outmoded clothes, the current metaphors. Trivialization and infantilization pervade the surgeons' language when they speak to women: "a nip," a "tummy tuck."...Surgery changes one forever, the mind as well as the body. If we don't start to speak of it as serious, the millennium of the man-made woman will be upon us, and we will have had no choice.

The counselor says that with more time and more surgeries, I will begin to feel normal again. She says this with a mouth that can still smile. It’s so easy to be reassuring when you have lips.

Because she bears the image of God. She doesn’t have to conjure it, go get it from a salon, have plastic surgery or breast implants. No, beauty is an essence that is given to every woman at her creation.

Weight and body oppression is oppressive to everyone. When you live in a society that says that one kind of body is bad and and other is good, those with “good” bodies constantly fear that their bodies will go “bad”, and those with “bad” bodies are expected feel shame and do everything they can to have “good” bodies. In the process, we torture our bodies, and do everything from engage in disordered eating to invasive surgery to make ourselves okay. Nobody wins in this kind of struggle.

She wished she had cancer instead. She'd trade Alzheimer's for cancer in a heartbeat. She felt ashamed for wishing this, and it was certainly a pointless bargaining, but she permitted herself the fantasy anyway. With cancer, she'd have something to fight. There was surgery, radiation, and chemotherapy. There was the chance that she could win. Her family and the community at Harvard would rally behind her battle and consider it noble. And even if it defeated her in the end, she'd be able to look them knowingly in the eye and say good-bye before she left.

If lawyers had followed the norm of no execution without trial, if doctors had accepted the rule of no surgery without consent, if businessmen had endorsed the prohibition of slavery, if bureaucrats had refused to handle paperwork involving murder, then the Nazi regime would have been much harder pressed to carry out the atrocities by which we remember it. Professions

Yes of course there's always someone worse off than you. But imagine you're in a doctor's surgery with a broken arm. The person next to you has two broken arms, the person next to him has two broken arms and a broken leg. This is all very well, but the point is that you have a broken arm and it hurts.

Any fool can write, we start learning it at school at the age of three....

The real issue has nothing to do with whether women wear makeup or don’t, gain weight or lose it, have surgery or shun it, dress up or down, make our clothing and faces and bodies into works of art or ignore adornment altogether. The real problem is our lack of choice.

Neuroscience tells us that it is highly improbable that we have souls, as everything we think and feel is no more or no less than the electrochemical chatter of our nerve cells. Our sense of self, our feelings and our thoughts, our love for others, our hopes and ambitions, our hates and fears all die when our brains die. Many people deeply resent this view of things, which not only deprives us of life after death but also seems to downgrade thought to mere electrochemistry and reduces us to mere automata, to machines. Such people are profoundly mistaken, since what it really does is upgrade matter into something infinitely mysterious that we do not understand. There are one hundred billion nerve cells in our brains. Does each one have a fragment of consciousness within it? How many nerve cells do we require to be conscious or to feel pain? Or does consciousness and thought reside in the electrochemical impulses that join these billions of cells together? Is a snail aware? Does it feel pain when you crush it underfoot? Nobody knows.

Anyone being flown to a distant city for heart-bypass surgery has conceded, tacitly at least, that we have learned a few things about physics, geography, engineering, and medicine since the time of Moses.

While all doctors treat diseases, neurosurgeons work in the crucible of identity: every operation on the brain is, by necessity, a manipulation of the substance of our selves, and every conversation with a patient undergoing brain surgery cannot help but confront this fact. In addition, to the patient and family, the brain surgery is usually the most dramatic event they have ever faced and, as such, has the impact of any major life event. At those critical junctures, the question is not simply whether to live or die but what kind of life is worth living. Would you trade your ability - or your mother's - to talk for a few extra months of mute life? The expansion of your visual blind spot in exchange for eliminating the small possibility of a fatal brain hemorrhage? Your right hand's function to stop seizures? How much neurologic suffering would you let your child endure before saying that death is preferable? Because the brain mediates our experience of the world, any neurosurgical problem forces a patient and family, ideally with a doctor as a guide, to answer this question: What makes life meaningful enough to go on living?

I wanted to say something to cheer her up. I had a feeling that cheering her up might be a lot of work. I was thinking of how sometimes, trying to say the right thing to people, it’s like some kind of brain surgery, and you have to tweak exactly the right part of the lobe. Except with talking, it’s more like brain surgery with old, rusted skewers and things, maybe like those things you use to eat lobster, but brown. And you have to get exactly the right place, and you’re touching around in the brain but the patient, she keeps jumping and saying, “Ow.

Take me back," I tell him, shifting a little. The world tilts and steadies all at once. "Alert the medics and have a bed prepared for our arrival. In the meantime, elevate my arm and continue applying direct pressure to the wound. The bullet has broken or fractured something, and this will require surgery.

I know, I know: it can be frustrating as hell. But people have an unfortunate habit of assuming they understand the reality just because they understood the analogy. You dumb down brain surgery enough for a preschooler to think he understands it, the little tyke’s liable to grab a microwave scalpel and start cutting when no one’s looking.

Healthy people, I have concluded, including myself, do not understand how everything changes once you have been diagnosed with a fatal illness. How you cling to hope, however false, however slight, and how reluctant most doctors are to deprive patients of that fragile beam of light in so much darkness. Indeed, many people develop what psychiatrists call ‘dissociation’ and a doctor can find himself talking to two people – they know that they are dying and yet still hope that they will live. I had noticed the same phenomenon with my mother during the last few days of her life. When faced by people who are dying you are no longer dealing with the rational consumers assumed by economic model-builders, if they ever existed in the first place.

Psychological research has shown that the most reliable route to personal happiness is to make others happy. I have made many patients very happy with successful operations but there have been many terrible failures and most neurosurgeons’ lives are punctuated by periods of deep despair.

We have hearing aids in order to fix our ears. We have lasik surgery in order to fix our eyes. People ... you can't fix stupid!

I’m every American woman’s worst nightmare. It’s what they spend their lives fighting against, it’s why they diet and exercise and have plastic surgery—because they don’t want to look like me.

Young women today feel vulnerable to judgment; if a harsh sentence is passed (or even suspected or projected), it is not her reputation that suffers so much as the stability of her moral universe. They did not have long to explore the sexual revolution and make it their own. Before the old chains had grown cold, while young women were still rubbing the circulation back into their ankles and taking tentative steps forward, the beauty industries levied a heavy toll on further investigations, and beauty pornography offered them designer bondage.

In the morning a new man was behind the front desk. "And how did you enjoy your stay, Sir?" he asked smoothly. "It was singularly execrable," I replied. "Oh, excellent," he purred, taking my card "In fact, I would go so far as to say that the principal value of a stay in this establishment is that it is bound to make all subsequent service-related experiences seem, in comparison, refreshing." He made a deeply appreciative expression as if to say, "Praise indeed," and presnted my bill for signature. "Well, we hope you'll come again." "I would sooner have bowel surgery in the woods with a a stick." His expression wavered, then held there for a long moment. "Excellent," he said again, but without a great show of conviction.

The night before brain surgery, I thought about death. I searched out my larger values, and I asked myself, if I was going to die, did I want to do it fighting and clawing or in peaceful surrender? What sort of character did I hope to show? Was I content with myself and what I had done with my life so far? I decided that I was essentially a good person, although I could have been better--but at the same time I understood that the cancer didn't care. I asked myself what I believed. I had never prayed a lot. I hoped hard, I wished hard, but I didn't pray. I had developed a certain distrust of organized religion growing up, but I felt I had the capacity to be a spiritual person, and to hold some fervent beliefs. Quite simply, I believed I had a responsibility to be a good person, and that meant fair, honest, hardworking, and honorable. If I did that, if I was good to my family, true to my friends, if I gave back to my community or to some cause, if I wasn't a liar, a cheat, or a thief, then I believed that should be enough. At the end of the day, if there was indeed some Body or presence standing there to judge me, I hoped I would be judged on whether I had lived a true life, not on whether I believed in a certain book, or whether I'd been baptized. If there was indeed a God at the end of my days, I hoped he didn't say, 'But you were never a Christian, so you're going the other way from heaven.' If so, I was going to reply, 'You know what? You're right. Fine.' I believed, too, in the doctors and the medicine and the surgeries--I believed in that. I believed in them. A person like Dr. Einhorn [his oncologist], that's someone to believe in, I thought, a person with the mind to develop an experimental treatment 20 years ago that now could save my life. I believed in the hard currency of his intelligence and his research. Beyond that, I had no idea where to draw the line between spiritual belief and science. But I knew this much: I believed in belief, for its own shining sake. To believe in the face of utter hopelessness, every article of evidence to the contrary, to ignore apparent catastrophe--what other choice was there? We do it every day, I realized. We are so much stronger than we imagine, and belief is one of the most valiant and long-lived human characteristics. To believe, when all along we humans know that nothing can cure the briefness of this life, that there is no remedy for our basic mortality, that is a form of bravery. To continue believing in yourself, believing in the doctors, believing in the treatment, believing in whatever I chose to believe in, that was the most important thing, I decided. It had to be. Without belief, we would be left with nothing but an overwhelming doom, every single day. And it will beat you. I didn't fully see, until the cancer, how we fight every day against the creeping negatives of the world, how we struggle daily against the slow lapping of cynicism. Dispiritedness and disappointment, these were the real perils of life, not some sudden illness or cataclysmic millennium doomsday. I knew now why people fear cancer: because it is a slow and inevitable death, it is the very definition of cynicism and loss of spirit. So, I believed.

Everyday, you get home from the shops with a bag of cat food and bin-liners and realise that, yet again, you failed to have cosmetic surgery, book a cheap weekend in Paris, change your name to something more glamorous, buy the fifth series of The Sopranos, divorce your spouse, sell up and move to Devon, or adopt a child from Guatemala.

We have achieved most as surgeons when our patients recover completely and forget us completely. All patients are immensely grateful at first after a successful operation but if the gratitude persists it usually means that they have not been cured of the underlying problem and that they fear that they may need us in the future. They feel that they must placate us, as though we were angry gods or at least the agents of an unpredictable fate.

The main aim of education should be to send children out into the world with a reasonably sized anthology in their heads so that, while seated on the lavatory, waiting in doctor's surgeries, on stationary trains or watching interviews with politicians, they have something interesting to think about.

I stand by the bed where a young woman lies, her face postoperative, her mouth twisted in palsy, clownish. A tiny twig of the facial nerve, the one to the muscles of her mouth has been severed. She will be thus from now on. The surgeon had followed with religious fervor the curve of her flesh; I promise you that. Nevertheless, to remove the tumor in her cheek, I had to cut the little nerve. Her young husband is in the room. He stand on the opposite side of the bed and together they seem to dwell in the evening lamplight, isolated from me, private. Who are they, I ask myself, he and this wry mouth I have made, who gaze at and touch each other so generously, greedily? The young woman speaks, "Will my mouth always be like this?" she asks. "Yes," I say, "it will. It is because the nerve was cut." She nods and is silent. But the young man smiles. "I like it," he says, "It is kind of cute." "All at once I know who he is. I understand and I lower my gaze. One is not bold in an encounter with a god. Unmindful, he bends to kiss her crooked mouth and I am so close I can see how he twists his own lips to accommodate to hers, to show her that their kiss still works.

Still have your passport?" I feel my coat once more. "Got it." "Good." And then his hand is inside my pocket.My heart spazzes,but he doesn't notice.He pulls out my passport and flicks it open. WAIT.WHY DOES HE HAVE MY PASSPORT? His eyebrows shoot up.I try to snatch it back,but he holds it out of my reach. "Why are your eyes crossed?" He laughs. "Have you had some kind of ocular surgery I don't know about?" "Give it back?" Another grab and miss, and I change tactics and lunge for his coat instead. I snag his passport. "NO!" I open it up,and it's...baby St. Clair. "Dude.How old is this picture?" He slings my passport at me and snatches his back. "I was in middle school.

I have maybe a half-hour before the next surgery. Want to go and get a cup of coffee?” What I want is to meander eight kilometres down the canals with you from Kirov to your Fifth Soviet door. I want to get on the tram with you, the bus with you, sit in the Italian Gardens with you. That is what I want. I will take the cup of coffee in your hospital cafeteria.

Mainstream ideas of “healing” deeply believe in ableist ideas that you’re either sick or well, fixed or broken, and that nobody would want to be in a disabled or sick or mad bodymind. Unsurprisingly and unfortunately, these ableist ideas often carry over into healing spaces that call themselves “alternative” or “liberatory.” The healing may be acupuncture and herbs, not pills and surgery, but assumptions in both places abound that disabled and sick folks are sad people longing to be “normal,” that cure is always the goal, and that disabled people are objects who have no knowledge of our bodies. And deep in both the medical-industrial complex and “alternative” forms of healing that have not confronted their ableism is the idea that disabled people can’t be healers.

Venus to Tig: "I'm afraid, Alexander, that I may have fallen in love with you." Tig doesn't know what to say, so Venus says it for him: "I'm a man. I am a man who knows she's a woman. And that's exactly where I'm supposed to be. It's the criss-cross that I've come to love. I don't want the surgery. I don't want to undo what God has given me. I know how beautiful I am.

When I went on my first antidepressant it had the side effect of making me fixated on suicide (which is sort of the opposite of what you want). It’s a rare side effect so I switched to something else that did work. Lots of concerned friends and family felt that the first medication’s failure was a clear sign that drugs were not the answer; if they were I would have been fixed. Clearly I wasn’t as sick as I said I was if the medication didn’t work for me. And that sort of makes sense, because when you have cancer the doctor gives you the best medicine and if it doesn’t shrink the tumor immediately then that’s a pretty clear sign you were just faking it for attention. I mean, cancer is a serious, often fatal disease we’ve spent billions of dollars studying and treating so obviously a patient would never have to try multiple drugs, surgeries, radiation, etc., to find what will work specifically for them. And once the cancer sufferer is in remission they’re set for life because once they’ve learned how to not have cancer they should be good. And if they let themselves get cancer again they can just do whatever they did last time. Once you find the right cancer medication you’re pretty much immune from that disease forever. And if you get it again it’s probably just a reaction to too much gluten or not praying correctly. Righ

...it was complicated, she wasn't thinking only of herself but me too, since we'd both been through so many of the same things, she and I, and we were an awful lot alike-too much. And because we'd both been hurt so badly, so early on, in violent and irremediable ways that most people didn't, and couldn't, understand, wasn't it a bit… precarious? A matter of self-preservation? Two rickety and death-driven persons who would need to lean on each other quite so much? not to say she wasn't doing well at the moment, because she was, but all that could change in a flash with either of us, couldn't it? the reversal, the sharp downward slide, and wasn't that the danger? since our flaws and weaknesses were so much the same, and one of us could bring the other down way too quick? and though this was left to float in the air a bit, I realized instantly, and with some considerable astonishment, what she was getting at. (Dumb of me not to have seen it earlier, after all the injuries, the crushed leg, the multiple surgeries; adorable drag in the voice, adorable drag in the step, the arm-hugging and the pallor, the scarves and sweaters and multiple layers of clothes, slow drowsy smile: she herself, the dreamy childhood her, was sublimity and disaster, the morphine lollipop I'd chased for all those years.)

Leola Mae Harmon. I saw a movie about her on the Lifetime channel. Leola was an air force nurse who was in a car accident and the lower part of her face got all mangled, but then Armand Assante, who plays a plastic surgeon, said he could fix her. Leola had to endure hours of painful reconstructive surgery, during which her husband left her because she didn't have any lips (which I guess is why the movie is called Why Me?). Armand Assante said he would make her a new pair of lips, only the other air force doctors didn't like the fact that he wanted to make them out of skin from Leola's vagina. But he did it anyway, and then he and Leola got married and worked together to help give other accident victims vagina lips. And the whole thing turned out to have been based on a true story.

I TEND TO believe in government because it was the U.S. government that paid for my brain surgery when I was five months old and provided USDA food so I wouldn’t starve during my poverty-crushed reservation childhood and built the HUD house that kept us warm and gave me scholarship money for the college education that freed me. Of course, the government only gave me all of that good shit because they completely fucked over my great-grandparents and grandparents but, you know, at least some official white folks keep some of their promises.

I tell them: don’t depend on a woodsman in the third act. I tell them: look for sets of three, or seven. I tell them: there’s always a way to survive. I tell them: you can’t force fidelity. I tell them: don’t make bargains that involve major surgery. I tell them: you don’t have to lie still and wait for someone to tell you how to live. I tell them: it’s all right to push her into the oven. She was going to hurt you. I tell them: she couldn’t help it. She just loved her own children more. I tell them: everyone starts out young and brave. It’s what you do with it that matters. I tell them: you can share that bear with your sister. I tell them: no-one can stay silent forever. I tell them: it’s not your fault. I tell them: mirrors lie. I tell them: you can wear those boots, if you want them. You can lift that sword. It was always your sword. I tell them: the apple has two sides. I tell them: just because he woke you up doesn’t mean you owe him anything. I tell them: his name is Rumplestiltskin.

I never worried about money. I grew up in a middle-class family, so I never thought I would starve. And I learned at Atari that I could be an okay engineer, so I always knew I could get by. I was voluntarily poor when I was in college and India, and I lived a pretty simple life even when I was working. So I went from fairly poor, which was wonderful, because I didn’t have to worry about money, to being incredibly rich, when I also didn’t “have to worry about money. I watched people at Apple who made a lot of money and felt they had to live differently. Some of them bought a Rolls-Royce and various houses, each with a house manager and then someone to manage the house managers. Their wives got plastic surgery and turned into these bizarre people. This was not how I wanted to live. It’s crazy. I made a promise to myself that I’m not going to let this money ruin my life.

Few people outside medicine realize that what tortures doctors most is uncertainty, rather than the fact they often deal with people who are suffering or who are about to die. It is easy enough to let somebody die if one knows beyond doubt that they cannot be saved - if one is a decent doctor one will be sympathetic, but the situation is clear. This is life, and we all have to die sooner or later. It is when I do not know for certain whether I can help or not, or should help or not, that things become so difficult.

Crest, that was his name, was meanwhile droning on, while Kate seemed to be only half listening. I could not hear him clearly, but I could guess at the gist of it. “Blah blah blah, I am handsome, I make a lot of money, this suit is expensive, and my shoes are made of the finest Corinthian leather hand-stitched by virgins under the moonlight. Of course, I could have gone into pediatrics, but for one of my amazing skill, really, plastic surgery was the only option. Beauty is so important, don’t you think? Oh, Kate, you are nearly as attractive as I. Why then should we not be beautiful together?”

She had doll-like, almost delicate limbs, small hands, and hardly any hips. But she now had breasts. All her life she had been flat-chested, as if she had never reached puberty. She thought it had looked ridiculous, and she was always uncomfortable showing herself naked. Now, all of a sudden, she had breasts. They were by no means gigantic - that was not what she had wanted, and they would have looked ridiculous on her otherwise skinny body - but they were two solid, round breasts of medium size. The enlargements had been well done, and the proportions were reasonable. But the difference was dramatic.

The truth is, I still believe that above all things physical, it is more important to be beautiful on the inside—to have a big heart and an open mind and a spectacular spleen. (Actually, most people’s insides are disgusting. Even pretty people have very unattractive insides. Have you ever seen those surgery shows on Discovery? Not pretty.)

Listen to me and listen to me good,” she ground out. “You are an asshole. You don’t tell me what to do, ever. The day you control my life, well, that day is when hell freezes over. I’m not some weak little wife type, asshole, and I don’t need a man to control me or tell me what to do. If you ever try to pull this shit again I’ll show you weak when they have to surgically remove my shoe from your ass. When you walk in the door of my house after you find a way back there, you have five minutes to pack up your things and get the hell out or you’ll need that surgery. I want you to get on a plane, take your miserable, bitchy little bald ass out of my life, and don’t ever come near me again. Do you hear me?

I would rather have bowel surgery in the woods with a stick. If you are not stung or pronged to death in some unexpected manner, you may be fatally chomped by sharks or crocodiles, or carried helplessly out to sea by irresistible currents, or left to stagger to an unhappy death in the baking outback.

The funny thing about time in the OR, whether you race frenetically or proceed steadily, is that you have no sense of it passing. If boredom is, as Heidegger argued, the awareness of time passing, then surgery felt like the opposite: the intense focus made the arms of the clock seem arbitrarily placed. Two hours could feel like a minute.

honour pricks me on. Yea, but how if honour prick me off when I come on? How then? Can honour set a leg? No: or a arm? No: or take away the grief of a wound? No. Honour hath no skill in surgery then? No. What is honour? A word. What is that then? Air. A trim reckoning! - Who hath it? He that died o‘ Wednesday? Doth he feel it? No. Doth he hear it? No. ‘Tis insensible, then? Yea, to the dead. But will it not live with the living? No. Why? Detraction will not suffer it. Therefore I‘ll have none of it: honour is a mere scutcheon: - and so ends my catechism.

We have been most successful, however, when our patients return to their homes and get on with their lives and never need to see us again. They are grateful, no doubt, but happy to put us and the horror of their illness behind them. Perhaps they never quite realized just how dangerous the operation had been and how lucky they were to have recovered so well. Whereas the surgeon, for a while, has known heaven, having come very close to hell.

I didn’t regret the decision to take hormones. I wouldn’t have survived much longer without passing. And the surgery was a gift to myself, a coming home to my body. But I wanted more than to just barely exist, a stranger always trying not to get involved. I wanted to find out who I was, to define myself. Whoever I was, I wanted to deal with it, I wanted to live it again. I wanted to be able to explain my life, how the world looked from behind my eyes.

There is something fascinating about what moral suffering can do to someone who is in no obvious way a weak or feeble person. It’s more insidious even than what physical illness can do, because there is no morphine drip or spinal block or radical surgery to alleviate it. Once you’re in its grip, it’s as though it will have to kill you for you to be free of it. Its raw realism is like nothing else.

My sister was wonderful to watch, kindly and gently discussing and explaining everything as she carried out the simple, necessary nursing. We have both seen many people die, after all, and I had worked as a geriatric nurse many years ago too. It felt quite easy and natural for us both, I think, despite our intense emotions. It’s not that we felt anxious – the three of us knew she was dying – I suppose what we felt was simply intense love, a love quite without ulterior motive, quite without the vanity and self-interest of which love is so often the expression.

Modern cosmetic surgeons have a direct financial interest in a social role for women that requires them to feel ugly. They do not simply advertise for a share of a market that already exists: Their advertisements create new markets. It is a boom industry because it is influentially placed to create its own demand through the pairing of text with ads in women's magazines. The industry takes out ads and gets coverage; women get cut open. They pay their money and they takes their chances. As surgeons grow richer, they are able to command larger and brighter ad spaces.

Never," enjoins a women's magazine, "mention the size of his [penis] in public...and never, ever let him know that anyone else knows or you may find it shrivels up and disappears, serving you right." That quotation acknowledges that critical sexual comparison is a direct anaphrodisiac when applied to men; either we do not yet recognize that it has exactly the same effect on women, or we do not care, or we understand on some level that right now that effect is desirable and appropriate. A man is unlikely to be brought within earshot of women as they judge men's appearance, height, muscle tone, sexual technique, penis size, personal grooming, or taste in clothes--all of which we do. The fact is that women are able to view men just as men view women, as objects for sexual and aesthetic evaluation; we too are effortlessly able to choose the male "ideal" from a lineup and if we could have male beauty as well as everything else, most of us would not say no. But so what? Given all that, women make the choice, by and large, to take men as human beings first.

In these days of physical fitness, hair dye, and plastic surgery, you can live much of your life without feeling or even looking old. But then one day, your knee goes, or your shoulder, or your back, or your hip. Your hot flashes come to an end; things droop. Spots appear. Your cleavage looks like a peach pit. If your elbows faced forward, you would kill yourself. You’re two inches shorter than you used to be. You’re ten pounds fatter and you cannot lose a pound of it to save your soul. Your hands don’t work as well as they once did and you can’t open bottles, jars, wrappers, and especially those gadgets that are encased tightly in what seems to be molded Mylar. If you were stranded on a desert island and your food were sealed in plastic packaging, you would starve to death. You take so many pills in the morning you don’t have room for breakfast. You lose close friends and discover one of the worst truths of old age: they’re irreplaceable. People who run four miles a day and eat only nuts and berries drop dead. People who drink a quart of whiskey and smoke two packs of cigarettes a day drop dead. You are suddenly in a lottery, the ultimate game of chance, and someday your luck will run out. Everybody dies. There’s nothing you can do about it. Whether or not you eat six almonds a day. Whether or not you believe in God.

But as the sun rose I crested the mountain of my self-pity and remembered I was always going to die at the end of this life anyway. What did it really matter if I spent it like this—caring for this boy—as opposed to some other way? I would always be earthbound; he hadn’t robbed me of my ability to fly or to live forever. I appreciated nuns now, not the conscripted kind, but modern women who chose it. If you were wise enough to know that this life would consist mostly of letting go of things you wanted, then why not get good at the letting go, rather than the trying to have? These exotic revelations bubbled up involuntarily and I began to understand that the sleeplessness and vigilance and constant feedings were a form of brainwashing, a process by which my old self was being molded, slowly but with a steady force, into a new shape: a mother. It hurt. I tried to be conscious while it happened, like watching my own surgery. I hoped to retain a tiny corner of the old me, just enough to warn other women with. But I knew this was unlikely; when the process was complete I wouldn’t have anything left to complain with, it wouldn’t hurt anymore, I wouldn’t remember.

Sometimes I think illness sits inside every woman, waiting for the right moment to bloom. I have known so many sick women all my life. Women with chronic pain, with ever-gestating diseases. Women with conditions. Men, sure, they have bone snaps, they have backaches, they have a surgery or two, yank out a tonsil, insert a shiny plastic hip. Women get consumed. Not surprising, considering the sheer amount of traffic a woman’s body experiences. Tampons and speculums. Cocks, fingers, vibrators and more, between the legs, from behind, in the mouth. Men love to put things inside women, don’t they?

When a worker is injured at an IBP plant in Texas, he or she is immediately presented with a waiver. Signing the waiver means forever surrendering the right to sue IBP on any grounds. Workers who sign the waiver may receive medical care under IBP's Workplace Injury Settlement Program. Or they may not. Once workers sign, IBP and its company-approved doctors have control over the job-related medical treatment - for life. Under the program's terms, seeking treatment from an independent physician can be grounds for losing all medical benefits. Workers who refuse to sign the IBP waiver not only risk getting no medical care from the company, but also risk being fired on the spot...Injured workers almost always sign the waiver. The pressure to do so is immense. An IBP medical case manager will literally bring the waiver to a hospital emergency room in order to obtain an injured worker's signature. When Lonita Leal's right hand was mangled by a hamburger grinder at the IBP plant in Amarillo, a case manager talked her into signing the waiver with her left hand as she waited in the hospital for surgery. When Duane Mullin had both hands crushed in a hammer mill at the same plant, an IBP representative persuaded him to sign the waiver with a pen held in his mouth.

Bear in mind that since medications do not fix anything, they allow the underlying problem to continue uncorrected and actually accelerate. Meanwhile, new symptoms and new seemingly unrelated diseases are the inevitable consequence of this biochemical faux pas. Furthermore, drug side effects are the leading cause of death. NSAIDs as an example of only one group of medications, are fatally toxic to thousands of people each year by damaging joints, lungs, kidneys, eyes, hearts, and intestines. And they are covered by insurance. You and your doctor have been screwed into believing every symptom is a deficiency of some drug or surgery. You've been led to believe you have no control, when in truth you're the one who must take control. Unfortunately, the modus operandi in medicine is to find a drug to turn off the damaged part that is producing symptoms.

We need an engineering friend.” She points a finger at Carin. “Go back to Briar and hook up with an engineering student.” “Okay, but I’ll need to actually have sex with him beforehand, so I won’t be back until,” she pretends to check the time, “ten or so.” “We’re all college graduates,” I proclaim. “We can put this together ourselves.” Clapping my hands, I motion for everyone to get on the floor with me. After three tries of trying to lower myself to the ground and making Hope and Carin nearly pee their pants laughing in the process, D’Andre takes pity on all of us and helps me onto my knees. Which is where Tucker finds us. “Is this some new fertility ritual?” he drawls from the doorway, one shoulder propped against the frame. “Because she’s already pregnant, you know.” “Get yo ass in here, white boy, and put this thing together,” D’Andre snaps. “This is ridiculous.” “What’s ridiculous?” Tucker stops next to me, and I take the opportunity to lean against his legs. Even kneeling is hard when you’re toting around an extra thirty pounds. “We took it apart. How can you not know how to put it back together?” D’Andre repeats his earlier excuse. “I’m an accounting major.” Tucker rolls his eyes. “You got an Allen wrench?” “Are you mocking us right now?” I grumble. “I don’t have any wrenches, let alone ones with names.” He grins. “Leave this to me, darlin’. I’ll get it fixed up.” “I want to help,” Hope volunteers. “This is like surgery, except with wood and not people.” “Lord help us,” D’Andre mutters.

In their 2001 study 'The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain,' Diane E Hoffmann and Anita J. Tarzian pointed out that women are 'more likely to have their pain reports discounted as 'emotional' or 'psychogenic' and, therefore, 'not real.' This invalidation parallels the invalidation of women's anger, which is similarly often reduced to proof of women's mental weakness. One study of postoperative pain relief for patients who had undergone coronary artery bypass surgery revealed that men in pain were given pain relief medication, but women were given sedatives. Sedatives aren't pain relievers, or analgesics. They're calming and dulling agents that 'take the edge off.' But for whom, exactly?

Marriage is like grafting a limb onto a tree trunk. You have the limb, freshly sliced, dripping sap, and smelling of springtime, and then you have the mother tree stripped of her protective bark, gouged and ready to receive this new addition. Some years ago, my father performed this surgery on a dogwood tree in the side yard. He tried a pink-blooming limb stolen from the woods to my mother's white-blooming tree from a nursery lot. It took yards of burlap and twine and two years for the plants to join. Even now, all these years later, there's something not quite natural about the tree, even in its amazing two-tone glory.

But that can't work, can it?" Said Richard. "If we do that, then this won't have happened. Don't we generate all sorts of paradoxes?" Reg stirred himself from thought. "No worse than many that exist already," he said. "If the universe came to an end every time there was some uncertainty about what had happened in it, it would never have got beyond the first picosecond. And many of course don't. It's like a human body, you see. A few cuts and bruises here and there don't hurt it. Not even major surgery if its done properly. Paradoxes are just the scar tissue. Time and space heal themselves up around them and people simply remember a version of events which makes as much sense as they require it to make. That isn't to say if you get involved in a paradox a few things won't strike you as being very odd, but if you've got through life without that already happening to you, then I don't know which universe you've been living in, but it isn't this one

The more legal and material hindrances women have broken through, the more strictly and heavily and cruelly images of female beauty have come to weigh upon us...During the past decade, women breached the power structure; meanwhile, eating disorders rose exponentially and cosmetic surgery became the fastest-growing specialty...pornography became the main media category, ahead of legitimate films and records combined, and thirty-three thousand American women told researchers that they would rather lose ten to fifteen pounds than achieve any other goal...More women have more money and power and scope and legal recognition than we have ever had before; but in terms of how we feel about ourselves physically, we may actually be worse off than our unliberated grandmothers.

By listening to the “unspoken voice” of my body and allowing it to do what it needed to do; by not stopping the shaking, by “tracking” my inner sensations, while also allowing the completion of the defensive and orienting responses; and by feeling the “survival emotions” of rage and terror without becoming overwhelmed, I came through mercifully unscathed, both physically and emotionally. I was not only thankful; I was humbled and grateful to find that I could use my method for my own salvation. While some people are able to recover from such trauma on their own, many individuals do not. Tens of thousands of soldiers are experiencing the extreme stress and horror of war. Then too, there are the devastating occurrences of rape, sexual abuse and assault. Many of us, however, have been overwhelmed by much more “ordinary” events such as surgeries or invasive medical procedures. Orthopedic patients in a recent study, for example, showed a 52% occurrence of being diagnosed with full-on PTSD following surgery. Other traumas include falls, serious illnesses, abandonment, receiving shocking or tragic news, witnessing violence and getting into an auto accident; all can lead to PTSD. These and many other fairly common experiences are all potentially traumatizing. The inability to rebound from such events, or to be helped adequately to recover by professionals, can subject us to PTSD—along with a myriad of physical and emotional symptoms.

To finally surrender ourselves to healing, we have to have three spaces opened up within us - and all at the same time: our opinionated head, our closed-down heart, and our defensive and defended body. That is the summary work of spirituality - and it is indeed work. Yes, it is also the work of “a Power greater than ourselves,” and it will lead to a great luminosity and depth of seeing. That is why true faith is one of the most holistic and free actions a human can perform. It leads to such broad and deep perception that most traditions would just call it “light.” Remember, Jesus said that we also are the light of the world (Matthew 5:14), as well as saying it about himself (John 8:12). Strange that we see light in him but do not imitate him in seeing the same light in ourselves. Such luminous seeing is quite the opposite of the closed-minded, dead-hearted, body-denying thing that much religion has been allowed to become. As you surely have heard before, “Religion is lived by people who are afraid of hell. Spirituality is lived by people who have been through hell and come out enlightened.” The innocuous mental belief systems of much religion are probably the major cause of atheism in the world today, because people see that religion has not generally created people who are that different, more caring, or less prejudiced than other people. In fact, they are often worse because they think they have God on their small side. I wish I did not have to say this, but religion either produces the very best people or the very worst. Jesus makes this point in many settings and stories. Mere mental belief systems split people apart, whereas actual faith puts all our parts (body, heart, and head) on notice and on call. Honestly, it takes major surgery and much of one’s life to get head, heart, and body to put down their defenses, their false programs for happiness, and their many forms of resistance to what is right in front of them. This is the meat and muscle of the whole conversion process.

Today, what's normal is being redefined: from vaginal birth to surgical birth; from 'My water broke,' to 'Let's break your water;' from 'It's time' to 'It's time for the induction.' As medical anthropologist Robbie Davis-Floyd writes, 'in the early twenty-first century, we do not know what normal birth is.' Most practicing obstetricians have never witnessed an unplugged birth that wasn't an accident. Women are even beginning to deny normal birth to themselves: if 'normal' means being induced, immobilized by wires and tubes, sped up with drugs, all the while knowing that there's a good chance of surgery, well, might as well just cut to the chase, so to speak. 'Just give me a cesarean,' some are saying. And who can blame them? They want to avoid what they think of as normal birth.

Patients in persistent vegetative state – or PVS as it is called for short – seem to be awake because their eyes are open, yet they show no awareness or responsiveness to the outside world. They are conscious, some would say, but there is no content to their consciousness. They have become an empty shell, there is nobody at home. Yet recent research with functional brain scans shows this is not always the case. Some of these patients, despite being mute and unresponsive, seem to have some kind of activity going on in their brains, and some kind of awareness of the outside world. It is not, however, at all clear what it means. Are they in some kind of perpetual dream state? Are they in heaven, or in hell? Or just dimly aware, with only a fragment of consciousness of which they themselves

The tractors came over the roads and into the fields, great crawlers moving like insects, having the incredible strength of insects … 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. That man sitting in the iron seat did not look like a man; gloved, goggled, rubber dust mask over nose and mouth, he was a part of the monster, a robot in the seat … 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 the tractor out, had somehow gotten 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 land as it smelled; his feet did not stamp the clods or feel the warmth and 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 not 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 blades – not plowing but surgery … 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, had no connection with the bread. The land bore under iron, and under iron gradually died; for it was not loved or hated, it had no prayers or curses.

Equally worrying, and far less recognized, medicine has been slow to confront the very changes that it has been responsible for—or to apply the knowledge we have about how to make old age better. Although the elderly population is growing rapidly, the number of certified geriatricians the medical profession has put in practice has actually fallen in the United States by 25 percent between 1996 and 2010. Applications to training programs in adult primary care medicine have plummeted, while fields like plastic surgery and radiology receive applications in record numbers. Partly, this has to do with money—incomes in geriatrics and adult primary care are among the lowest in medicine. And partly, whether we admit it or not, a lot of doctors don’t like taking care of the elderly.

Like no other particle on earth, the morphine molecule seemed to possess heaven and hell. It allowed for modern surgery, saving and improving too many lives to count. It stunted and ended too many lives to count with addiction and overdose. Discussing it, you could invoke some of humankind’s greatest cultural creations and deepest questions: Faust, Dr. Jekyll and Mr. Hyde, discussions on the fundamental nature of man and human behavior, of free will and slavery, of God and evolution. Studying the molecule you naturally wandered into questions like, Can mankind achieve happiness without pain? Would that happiness even be worth it? Can we have it all?

When I turned thirty, I briefly flirted with the notion of undergoing sexual reassignment surgery. Once again, I was ready for a big change in my life. Plus, I was having a really difficult time meeting gay guys who didn’t seem gay yet were still caustic. So I figured, as a woman I would have a whole new pool of men from which to fish. I decided that I would probably opt for the self-lubricating vagioplasty option. …the plus side of this vagina was that it was, like the name implies, self-lubricating. So I wouldn’t need to give myself away and reach for the K-Y. On the downside, it was always self-lubricating, so you had to wear a maxipad at all times, even at funerals.

There’s a reason they call childbirth labor. Making a healthy baby takes effort: It requires foresight and self-denial and courage. It’s expensive and demanding and tiring. You have to learn new things, change many habits, possibly deal with complicated medical situations, make difficult decisions, and undergo stressful ordeals. I had a wisdom tooth pulled without Novocaine while I was pregnant—it hurt a lot and seemed to go on forever. The kindness of the very young dental assistant, holding back my hair as I spat blood into a bowl, will stay with me for the rest of my life. Pregnant women do such things, and much harder things, all the time. For example, they give birth, which is somewhere on the scale between painful and excruciating. Or they have a cesarean, as I did, which is major surgery. None of this is without risk of death or damage or trauma, including psychological trauma. To force girls and women to undergo all this against their will is to annihilate their humanity. When they undertake it by choice, we should all be grateful.

The left and right sides of the brain also process the imprints of the past in dramatically different ways.2 The left brain remembers facts, statistics, and the vocabulary of events. We call on it to explain our experiences and put them in order. The right brain stores memories of sound, touch, smell, and the emotions they evoke. It reacts automatically to voices, facial features, and gestures and places experienced in the past. What it recalls feels like intuitive truth—the way things are. Even as we enumerate a loved one’s virtues to a friend, our feelings may be more deeply stirred by how her face recalls the aunt we loved at age four.3 Under ordinary circumstances the two sides of the brain work together more or less smoothly, even in people who might be said to favor one side over the other. However, having one side or the other shut down, even temporarily, or having one side cut off entirely (as sometimes happened in early brain surgery) is disabling. Deactivation of the left hemisphere has a direct impact on the capacity to organize experience into logical sequences and to translate our shifting feelings and perceptions into words. (Broca’s area, which blacks out during flashbacks, is on the left side.) Without sequencing we can’t identify cause and effect, grasp the long-term effects of our actions, or create coherent plans for the future. People who are very upset sometimes say they are “losing their minds.” In technical terms they are experiencing the loss of executive functioning. When something reminds traumatized people of the past, their right brain reacts as if the traumatic event were happening in the present. But because their left brain is not working very well, they may not be aware that they are reexperiencing and reenacting the past—they are just furious, terrified, enraged, ashamed, or frozen. After the emotional storm passes, they may look for something or somebody to blame for it. They behaved the way they did way because you were ten minutes late, or because you burned the potatoes, or because you “never listen to me.” Of course, most of us have done this from time to time, but when we cool down, we hopefully can admit our mistake. Trauma interferes with this kind of awareness, and, over time, our research demonstrated why.

Several years ago, researchers at the University of Minnesota identified 568 men and women over the age of seventy who were living independently but were at high risk of becoming disabled because of chronic health problems, recent illness, or cognitive changes. With their permission, the researchers randomly assigned half of them to see a team of geriatric nurses and doctors—a team dedicated to the art and science of managing old age. The others were asked to see their usual physician, who was notified of their high-risk status. Within eighteen months, 10 percent of the patients in both groups had died. But the patients who had seen a geriatrics team were a quarter less likely to become disabled and half as likely to develop depression. They were 40 percent less likely to require home health services. These were stunning results. If scientists came up with a device—call it an automatic defrailer—that wouldn’t extend your life but would slash the likelihood you’d end up in a nursing home or miserable with depression, we’d be clamoring for it. We wouldn’t care if doctors had to open up your chest and plug the thing into your heart. We’d have pink-ribbon campaigns to get one for every person over seventy-five. Congress would be holding hearings demanding to know why forty-year-olds couldn’t get them installed. Medical students would be jockeying to become defrailulation specialists, and Wall Street would be bidding up company stock prices. Instead, it was just geriatrics. The geriatric teams weren’t doing lung biopsies or back surgery or insertion of automatic defrailers. What they did was to simplify medications. They saw that arthritis was controlled. They made sure toenails were trimmed and meals were square. They looked for worrisome signs of isolation and had a social worker check that the patient’s home was safe. How do we reward this kind of work? Chad Boult, the geriatrician who was the lead investigator of the University of Minnesota study, can tell you. A few months after he published the results, demonstrating how much better people’s lives were with specialized geriatric care, the university closed the division of geriatrics.

The child's heart beat: but she was growing in the wrong place inside her extraordinary mother, south of safe...she and her mother were rushed to the hospital, where her mother was operated on by a brisk cheerful diminutive surgeon who told me after the surgery that my wife had been perhaps an hour from death from the pressure of the child growing outside the womb, the mother from the child growing, and the child from growing awry; and so my wife did not die, but our mysterious child did...Not uncommon, an ectopic pregnancy, said the surgeon...Sometimes, continued the surgeon, sometimes people who lose children before they are born continue to imagine the child who has died, and talk about her or him, it's such an utterly human thing to do, it helps deal with the pain, it's healthy within reason, and yes, people say to their other children that they actually do, in a sense, have a sister or brother, or did have a sister or brother, and she or he is elsewhere, has gone ahead, whatever the language of your belief or faith tradition. You could do that. People do that, yes. I have patients who do that, yes... One summer morning, as I wandered by a river, I remembered an Irish word I learned long ago, and now whenever I think of the daughter I have to wait to meet, I find that word in my mouth: dunnog, little dark one, the shyest and quietest and tiniest of sparrows, the one you never see but sometimes you sense, a flash in the corner of your eye, a sweet sharp note already fading by the time it catches your ear.

The world THE WORLD IS increasingly designed to depress us. Happiness isn’t very good for the economy. If we were happy with what we had, why would we need more? How do you sell an anti-ageing moisturiser? You make someone worry about ageing. How do you get people to vote for a political party? You make them worry about immigration. How do you get them to buy insurance? By making them worry about everything. How do you get them to have plastic surgery? By highlighting their physical flaws. How do you get them to watch a TV show? By making them worry about missing out. How do you get them to buy a new smartphone? By making them feel like they are being left behind. To be calm becomes a kind of revolutionary act. To be happy with your own non-upgraded existence. To be comfortable with our messy, human selves, would not be good for business. Yet we have no other world to live in. And actually, when we really look closely, the world of stuff and advertising is not really life. Life is the other stuff. Life is what is left when you take all that crap away, or at least ignore it for a while. Life is the people who love you. No one will ever choose to stay alive for an iPhone. It’s the people we reach via the iPhone that matter. And once we begin to recover, and to live again, we do so with new eyes. Things become clearer, and we are aware of things we weren’t aware of before.

Those clothes are Susie's,' my father said calmly when he reached him. Buckley looked down at my blackwatch dress that he held in his hand. My father stepped closer, took the dress from my brother, and then, without speaking, he gathered the rest of my clothes, which Buckley had piled on the lawn. As he turned in silence toward the house, hardly breathing, clutching my clothes to him, it sparked. I was the only one to see the colors. Just near Buckley's ears and on the tips of his cheeks and chin he was a little orange somehow, a little red. Why can't I use them?' he asked. It landed in my father's back like a fist. Why can't I use those clothes to stake my tomatoes?' My father turned around. He saw his son standing there, behind him the perfect plot of muddy, churned-up earth spotted with tiny seedlings. 'How can you ask me that question?' You have to choose. It's not fair,' my brother said. Buck?' My father held my clothes against his chest. I watched Buckley flare and light. Behind him was the sun of the goldenrod hedge, twice as tall as it had been at my death. I'm tired of it!' Buckley blared. 'Keesha's dad died and she's okay?' Is Keesha a girl at school?' Yes!' My father was frozen. He could feel the dew that had gathered on his bare ankles and feet, could feel the ground underneath him, cold and moist and stirring with possibility. I'm sorry. When did this happen?' That's not the point, Dad! You don't get it.' Buckley turned around on his heel and started stomping the tender tomato shoots with his foot. Buck, stop!' my father cried. My brother turned. You don't get it, Dad,' he said. I'm sorry,' my father said. These are Susie's clothes and I just... It may not make sense, but they're hers-something she wore.' ... You act like she was yours only!' Tell me what you want to say. What's this about your friend Keesha's dad?' Put the clothes down.' My father laid them gently on the ground. It isn't about Keesha's dad.' Tell me what it is about.' My father was now all immediacy. He went back to the place he had been after his knee surgery, coming up out of the druggie sleep of painkillers to see his then-five-year-old son sitting near him, waiting for his eyes to flicker open so he could say, 'Peek-a-boo, Daddy.' She's dead.' It never ceased to hurt. 'I know that.' But you don't act that way.' Keesha's dad died when she was six. Keesha said she barely even thinks of him.' She will,' my father said. But what about us?' Who?' Us, Dad. Me and Lindsey. Mom left becasue she couldn't take it.' Calm down, Buck,' my father said. He was being as generous as he could as the air from his lungs evaporated out into his chest. Then a little voice in him said, Let go, let go, let go. 'What?' my father said. I didn't say anything.' Let go. Let go. Let go. I'm sorry,' my father said. 'I'm not feeling very well.' His feet had grown unbelievably cold in the damp grass. His chest felt hollow, bugs flying around an excavated cavity. There was an echo in there, and it drummed up into his ears. Let go. My father dropped down to his knees. His arm began to tingle on and off as if it had fallen asleep. Pins and needles up and down. My brother rushed to him. Dad?' Son.' There was a quaver in his voice and a grasping outward toward my brother. I'll get Grandma.' And Buckley ran. My father whispered faintly as he lay on his side with his face twisted in the direction of my old clothes: 'You can never choose. I've loved all three of you.

No matter who you were in sixteenth-century Europe, you could be sure of two things: you would be lucky to reach fifty years of age, and you could expect a life of discomfort and pain. Old age tires the body by thirty-five, Erasmus lamented, but half the population did not live beyond the age of twenty. There were doctors and there was medicine, but there does not seem to have been a great deal of healing. Anyone who could afford to seek a doctor's aid did so eagerly, but the doctor was as likely to maim or kill as to cure. His potions were usually noxious and sometimes fatal—but they could not have been as terrible and traumatic as the contemporary surgical methods. The surgeon and the Inquisitor differed only in their motivation: otherwise, their batteries of knives, saws, and tongs for slicing, piercing, burning, and amputating were barely distinguishable. Without any anesthetic other than strong liquor, an operation was as bad as the torments of hell.

Note to self: Try to extend positive feelings associated with Scratch-Off win into all areas of life. Be bigger presence at work. Race up ladder (joyfully, w/smile on face), get raise. Get in best shape of life, start dressing nicer. Learn guitar? Make point of noticing beauty of world? Why not educate self re. birds, flowers, trees, constellations, become true citizen of natural world, walk around neighborhood w/kids, patiently teaching kids names of birds, flowers, etc. etc.? Why not take kids to Europe? Kids have never been. Have never, in Alps, had hot chocolate in mountain café, served by kindly white-haired innkeeper, who finds them so sophisticated/friendly relative to usual snotty/rich American kids (who always ignore his pretty but crippled daughter w/braids) that he shows them secret hiking path to incredible glade, kids frolic in glade, sit with crippled pretty girl on grass, later say it was most beautiful day of their lives, keep in touch with crippled girl via email, we arrange surgery here for her, surgeon so touched he agrees to do surgery for free, she is on front page of our paper, we are on front page of their paper in Alps? Ha ha. Just happy.

Because I live in south Florida I store cans of black beans and gallons of water in my closet in preparation for hurricane season. I throw a hurricane party in January. You’re my only guest. We play Marco Polo in bed. The sheets are wet like the roof caved in. There’s a million of me in you. You try to count me as I taste the sweat on the back of your neck. I call you Sexy Sexy, and we do everything twice. After, still sweating, we drink Crystal Light out of plastic water bottles. We discuss the pros and cons of vasectomies. It’s not invasive you say. I wrap the bedsheet around my waist. Minor surgery you say. You slur the word surgery, like it’s a garnish on a dish you just prepared. I eat your hair until you agree to no longer talk about vasectomies. We agree to have children someday, and that they will be beautiful even if they’re not. As I watch your eyes grow heavy like soggy clothes, I tell you When I grow up I’m going to be a famous writer. When I’m famous I’ll sign autographs on Etch-A-Sketches. I’ll write poems about writing other poems, so other poets will get me. You open your eyes long enough to tell me that when you grow up, you’re going to be a steamboat operator. Your pores can never be too clean you say. I say I like your pores just fine. I say Your pores are tops. I kiss you with my whole mouth, and you fall asleep next to my molars. In the morning, we eat french toast with powdered sugar. I wear the sugar like a mustache. You wear earmuffs and pretend we’re in a silent movie. I mouth Olive juice, but I really do love you. This is an awesome hurricane party you say, but it comes out as a yell because you can’t gauge your own volume with the earmuffs on. You yell I want to make something cute with you. I say Let me kiss the insides of your arms. You have no idea what I just said, but you like the way I smile.

New Rule: Now that liberals have taken back the word "liberal," they also have to take back the word "elite." By now you've heard the constant right-wing attacks on the "elite media," and the "liberal elite." Who may or may not be part of the "Washington elite." A subset of the "East Coast elite." Which is overly influenced by the "Hollywood elite." So basically, unless you're a shit-kicker from Kansas, you're with the terrorists. If you played a drinking game where you did a shot every time Rush Limbaugh attacked someone for being "elite," you'd be almost as wasted as Rush Limbaugh. I don't get it: In other fields--outside of government--elite is a good thing, like an elite fighting force. Tiger Woods is an elite golfer. If I need brain surgery, I'd like an elite doctor. But in politics, elite is bad--the elite aren't down-to-earth and accessible like you and me and President Shit-for-Brains. Which is fine, except that whenever there's a Bush administration scandal, it always traces back to some incompetent political hack appointment, and you think to yourself, "Where are they getting these screwups from?" Well, now we know: from Pat Robertson. I'm not kidding. Take Monica Goodling, who before she resigned last week because she's smack in the middle of the U.S. attorneys scandal, was the third-ranking official in the Justice Department of the United States. She's thirty-three, and though she never even worked as a prosecutor, was tasked with overseeing the job performance of all ninety-three U.S. attorneys. How do you get to the top that fast? Harvard? Princeton? No, Goodling did her undergraduate work at Messiah College--you know, home of the "Fighting Christies"--and then went on to attend Pat Robertson's law school. Yes, Pat Robertson, the man who said the presence of gay people at Disney World would cause "earthquakes, tornadoes, and possibly a meteor," has a law school. And what kid wouldn't want to attend? It's three years, and you have to read only one book. U.S. News & World Report, which does the definitive ranking of colleges, lists Regent as a tier-four school, which is the lowest score it gives. It's not a hard school to get into. You have to renounce Satan and draw a pirate on a matchbook. This is for the people who couldn't get into the University of Phoenix. Now, would you care to guess how many graduates of this televangelist diploma mill work in the Bush administration? On hundred fifty. And you wonder why things are so messed up? We're talking about a top Justice Department official who went to a college founded by a TV host. Would you send your daughter to Maury Povich U? And if you did, would you expect her to get a job at the White House? In two hundred years, we've gone from "we the people" to "up with people." From the best and brightest to dumb and dumber. And where better to find people dumb enough to believe in George Bush than Pat Robertson's law school? The problem here in America isn't that the country is being run by elites. It's that it's being run by a bunch of hayseeds. And by the way, the lawyer Monica Goodling hired to keep her ass out of jail went to a real law school.

What characterizes an addiction?” asks the spiritual teacher Eckhart Tolle. “Quite simply this: you no longer feel that you have the power to stop. It seems stronger than you. It also gives you a false sense of pleasure, pleasure that invariably turns into pain.” Addiction cuts large swaths across our culture. Many of us are burdened with compulsive behaviours that harm us and others, behaviours whose toxicity we fail to acknowledge or feel powerless to stop. Many people are addicted to accumulating wealth; for others the compulsive pull is power. Men and women become addicted to consumerism, status, shopping or fetishized relationships, not to mention the obvious and widespread addictions such as gambling, sex, junk food and the cult of the “young” body image. The following report from the Guardian Weekly speaks for itself: Americans now [2006] spend an alarming $15 billion a year on cosmetic surgery in a beautification frenzy that would be frowned upon if there was anyone left in the U.S. who could actually frown with their Botox-frozen faces. The sum is double Malawi’s gross domestic product and more than twice what America has contributed to AIDS programs in the past decade. Demand has exploded to produce a new generation of obsessives, or “beauty junkies.

When I learned my mom was going to die of cancer at the age of forty-five, I felt the same way. I didn’t even believe in God, but I still felt that he owed me something. I had the gall to think How dare he? I couldn’t help myself. I’m a selfish brute. I wanted what I wanted and I expected it to be given to me by a God in whom I had no faith. Because mercy had always more or less been granted me, I assumed it always would be. But it wasn’t. It wasn’t granted to my friend whose eighteen-year-old daughter was killed by a drunk driver either. Nor was it granted to my other friend who learned her baby is going to die of a genetic disorder in the not-distant future. Nor was it granted to my former student whose mother was murdered by her father before he killed himself. It was not granted to all those people who were in the wrong place at the wrong time when they came up against the wrong virus or military operation or famine or carcinogenic or genetic mutation or natural disaster or maniac. Countless people have been devastated for reasons that cannot be explained or justified in spiritual terms. To do as you are doing in asking If there were a God, why would he let my little girl have to have possibly life-threatening surgery?— understandable as that question is—creates a false hierarchy of the blessed and the damned. To use our individual good or bad luck as a litmus test to determine whether or not God exists constructs an illogical dichotomy that reduces our capacity for true compassion. It implies a pious quid pro quo that defies history, reality, ethics, and reason. It fails to acknowledge that the other half of rising—the very half that makes rising necessary— is having first been nailed to the cross. That

A rain of pebbles from overhead makes me glance up in time to see Ruthann step onto the lip of the cliff, another fifteen feet above me. Her body is wrapped tight in a pure white robe. "Ruthann!" I shout, my voice caroming off the rock walls, an obscenity. She looks down at me. Across the distance our eyes meet. "Ruthann, don't," I whisper, but she shakes her head. I'm sorry. In that half-second, I think about Wilma and Derek and me, all the people who do not want to beleft behind, who think we know what is best for her. I think about the doctors and the medicines Ruthann lied about taking. I think about how I could talk her down from that ledge like I have talked down a dozen potential suicide victims. Yet the right thing to do, here, is subjective. Ruthann's family, who wants her alive, will not be the one to lose hair from drugs, to have surgery to remove her breast, to die by degrees. It is easy to say that Ruthann should come down from that cliff, unless you are Ruthann. I know better than anyone what it feels like to have someone else make choices for you, when you deserve to be making them yourself. I look at Ruthann, and very slowly, I not. She smiles at me, and so I am her witness -- as she unwraps the wedding robe from her narrow shoulders and holds is across her back like the wide wings of a hawk. As she steps off the edge of the cliff and rises to the Spirit World. As the owls bear her body to the broken ground.

These days, there are so few pure country people left on the concession roads that we may be in need of a new category of membership, much as sons and daughters of veterans are now allowed to join the Legion. A few simple questions could be asked, a small fee paid and (assuming that the answers are correct) you could be granted the status of an "almost local." Here are some of the questions you might be asked: Do you have just one suit for weddings and funerals? Do you save plastic buckets? Do you leave your car doors unlocked at all times? Do you have an inside dog and an outside dog? Has your outside dog never been to town? When you pass a neighbour in the car, do you wave from the elbow or do you merely raise one finger from the steering wheel? Do you have trouble keeping the car or truck going in a straight line because you are looking at crops or livestock? Do you sometimes find yourself sitting in the car in the middle of a dirt road chatting with a neighbour out the window while other cars take the ditch to get around you? Can you tell whose tractor is going by without looking out the window? Can people recognize you from three hundred yards away by the way you walk or the tilt of your hat? If somebody honks their horn at you, do you automatically smile and wave? Do most of your conversations open with some observation about the weather? Is your most important news source the store in the village? Have you had surgery in the local hospital? If you hear about a death or a fire in the community, does the woman in your house immediately start making sandwiches or a cake? Do you sometimes find yourself referring to a farm in the neighbourhood by the name of someone who owned it more than twenty-five years ago? If you answered yes to all of the above questions, consider it official: you are a local.

EVERY WEDNESDAY, I teach an introductory fiction workshop at Harvard University, and on the first day of class I pass out a bullet-pointed list of things the students should try hard to avoid. Don’t start a story with an alarm clock going off. Don’t end a story with the whole shebang having been a suicide note. Don’t use flashy dialogue tags like intoned or queried or, God forbid, ejaculated. Twelve unbearably gifted students are sitting around the table, and they appreciate having such perimeters established. With each variable the list isolates, their imaginations soar higher. They smile and nod. The mood in the room is congenial, almost festive with learning. I feel like a very effective teacher; I can practically hear my course-evaluation scores hitting the roof. Then, when the students reach the last point on the list, the mood shifts. Some of them squint at the words as if their vision has gone blurry; others ask their neighbors for clarification. The neighbor will shake her head, looking pale and dejected, as if the last point confirms that she should have opted for that aseptic-surgery class where you operate on a fetal pig. The last point is: Don’t Write What You Know. The idea panics them for two reasons. First, like all writers, the students have been encouraged, explicitly or implicitly, for as long as they can remember, to write what they know, so the prospect of abandoning that approach now is disorienting. Second, they know an awful lot. In recent workshops, my students have included Iraq War veterans, professional athletes, a minister, a circus clown, a woman with a pet miniature elephant, and gobs of certified geniuses. They are endlessly interesting people, their lives brimming with uniquely compelling experiences, and too often they believe those experiences are what equip them to be writers. Encouraging them not to write what they know sounds as wrongheaded as a football coach telling a quarterback with a bazooka of a right arm to ride the bench. For them, the advice is confusing and heartbreaking, maybe even insulting. For me, it’s the difference between fiction that matters only to those who know the author and fiction that, well, matters.

One might go to the bakery, perhaps," he said. "But did you know the baker has tuberculosis? All the people here run around in a highly infectious state. The baker's daughter has tuberculosis too, it seems to have something to do with the runoff from the cellulose factory, with the steam that the locomotives have spewed out for decades, with the bad diet that people eat. Almost all of them have cankered lung lobes, pneumothorax and pneumoperitoneum are endemic. They have tuberculosis of the lungs, the head, the arms and legs. All of them have tubercular abscesses somewhere on their bodies. The valley is notorious for tuberculosis. You will find every form of it here: skin tuberculosis, brain tuberculosis, intestinal tuberculosis. Many cases of meningitis, which is deadly within hours. The workmen have tuberculosis from the dirt they dig around in, the farmers have it from their dogs and the infected milk. The majority of the people have galloping consumption. Moreover," he said, "the effect of the new drugs, of streptomycin for example, is nil. Did you know the knacker has tuberculosis? That the landlady has tuberculosis? That the landlady has tuberculosis? That her daughters have been to sanatoria on three occasions? Tuberculosis is by no means on the way out. People claim it is curable. but that's what the pharmaceutical industry says. In fact, tuberculosis is as incurable as it always was. Even people who have been inoculated against it come down with it. Often those who have it the worst are the ones who look so healthy that you wouldn't suspect they were ill at all. Their rosy faces are utterly at variance with their ravaged lungs. You keep running into people who've had to endure a cautery or, at the very least, a transverse lesion. Most of them have had their lives ruined by failed reconstructive surgery." We didn't go to the bakery. Straight home instead.