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December 10, 2018

People : Objects


On my first day of medical residency, while other trainees across the country started long and nerve-wracking days in the hospital, the eight people in our primary care program sat down with our two program directors and shared our life stories.  I remember feeling so lucky that this was the philosophy underlying my medical education: that everything springs from our background, that what we value shapes our paths, that our foremost priority in becoming a caretaker is learning each person's narrative.  Similarly, last week I attended a retreat for health providers in safety net clinics in the East Bay, and we started the day by sharing an object that said something about us.  I offhandedly thought it would be interesting but had no idea how moving it would be, how much it will always stay with me.  It was an unexpected gift to share and learn such vulnerability, and to remember that this work and this community is founded on people who value this kind of raw storytelling.

There were themes in what people brought, and I loved these patterns alongside the individual stories.

The Legacy of Women
Three women shared objects that represented their grandmothers:
  • A knit baby cap made by her grandmother who knits them for babies born in the hospital where she volunteers, even after a stroke impaired her fine motor skills
  • A beaded flower, each petal made from a hundred beads.  The woman who made them lived to be 104 years old.
  • Weight bands, in memory of her grandmother who lifted weights daily up until the week she died.  This woman also lived to 104 (!).
The Perspective Lent by Nature
  • A teeny tiny sand dollar
  • A jar of pebbles, one of many that line a kitchen shelf as a reminder to stay present.
  • A photo of herself climbing in the French Alps, a place that has receded in sad ways over the years she has visited. 
  • A menorah his son made from wood collected in the wilderness.
Trying Over & Over
  • A magnolia tree that would not grow until being planted in a number of different environments
  • A spoon, used by her toddler son who is learning what can spoon (soup) and what can't (cardboard)
  • A Swiss army tool kit, with numerous ways to try and fix things
Origins
  • The only childhood photo she had of herself in Vietnam, before fleeing to refugee camps: a vision of what was and what could have been instead
  • A childhood photo of himself with a stethoscope, a 4th generation Chinese immigrant whose family was persecuted and driven to Mexico, bestowing upon him a Hispanic name
  • A book she can't read because it's written in German and connects her to her family's past as Holocaust survivors
Movement
  • A bike
  • Dance shoes
  • Running shoes (the women who brought shoes were sitting right next to each other)
Mentorship
  • A pen given to him after graduating medical school from the doctor who had cared for him since childhood in Nigeria
  • A crystal given to her from a mentor whose friendship perservered through a drastic change in career
  • A pawn from a chess set. She was taught by her grandfather, who once beat her in a chess game by playing against her with only pawns, that this is the most important piece.
Self-Expression
  • A knit square, as part of the Welcome Blanket, a re-imagining of the wall, where 2000 miles (the length of the proposed wall) of yarn are knit into welcome blankets for refugees
  • A manuscript of poetry
  • An iPod, in which he plays a song for every occasion 
Family
  • A wedding ring, the base of which forms the symbol of the trinity, and a wife who supports his commitment to care for the underserved 
  • A photograph of her growing family, and the need to protect our natural community 
  • A photograph of her clinic at the holiday party, and the community we create

My favorite, in its own category:
A painting of Nelson Mandela. He keeps a picture of Mandela in his office, as many reminders--of social justice, stamina and perspective (on a day he thinks is bad, he can feel Mandela looking at him: "Really? This is bad?"). But the painting he shared isn't the one he has in his office; it's a painting of that photo. A patient noted the photo in his office, saw its importance to him, and gifted it in a new form to him.

As for my object, I was dog-sitting in another person's home at the time so didn't have access to my personal items. As a last minute thought, I shared the book I was reading at the time, because I always have a book on hand. I explained that I had studied English in college, with the intention to make my living from stories, and how this eventually (unexpectedly) took me to medicine. As much as I love language, I can't imagine loving anything more than the narratives we get to hear, live and impact in small ways every day.  One of the best parts is working with and learning from a community of people whose values are so generous.  I can still remember in vivid detail each person's object, and by extension their story. During a time when I'm feeling like I can't hold much more, it's expansive to experience that stretching of emotional space.

November 19, 2018

World : A Pilgrimage to the Rural South



On our travels home from the Red River Gorge in Kentucky, my friend says to me: "This feels like a pilgrimage."  And I say, and feel: "Yes."  It isn't a word I would have been able to conjure on my own, and is more perfectly fitting than anything concrete I've formed in my head or have yet to form.  Obviously flying to the South and lounging luxuriously in a cabin isn't quite the sacrifice and effort of the Haj or El Camino de Santiago. But leaving our urban coastal work life for climbing in rural Kentucky makes me consider in slices what a pilgrimage might look like for me: what it takes, what it gives, what it seems like and what it could really be.

The underlying principle of pilgrimage is one of a simpler life, dedicated to and centered around one core value.  I'm fully aware of how sacrilegious it might seem to call climbing this one thing.  But I believe really strongly that as long as people devote and derive the same level of generosity and growth from whatever that one thing is, that thing holds true and equal weight.




I'm lucky to love the fullness of my day to day life, and often that love of fullness means that I'm constantly filling up my time and space. Because the content is good, I can forget the importance of pausing, the damage of continued force.  In Kentucky, with so much undeveloped land and trees tall in their natural existence, I remember how much life widens when I stop cramming my own boundaries. Focusing on the one goal to climb, there's a calming sense of purpose that infuses all moments, and I'm filled throughout even when not climbing.  This is what it feels like to possess presence.

This singularity sharpens everything else, like every object in my mind's photograph is shot in macro.  It's immensely useful to me to erase the demands of my daily routine and let everything else come to the forefront.  I find myself confronting a lot, admitting to myself weaknesses even as I feel the strongest I have in a long time. I remember that even as hardships reveal and cultivate strength, they are hard and wear you at certain soft spots.  I see where I can be unkind to myself and others, and I take this for parts of the whole (of myself, of our interconnectedness).  The emptiness of rural Kentucky paves this awareness with ease, and I'm grateful for how filling this space can be, how connecting this isolation can be.




Then there is the sense of time, both its stillness and its progression.  We came to Kentucky exactly one year ago, in the same week in October.  I love birthdays and anniversaries for their marching of time and event, and pilgrimages do the same.  Exactly six months post injury and exactly three years since climbing outside, I can't think of a better way to celebrate the steps since then than a repeat trip to the Red River Gorge with the two girlfriends who made climbing my life.  I connect with one of my very best friends, unique in my life in many ways, one being that I knew and loved her before climbing.  She introduced me to climbing, but that's the least of what she's given me so you can get a sense of how generous she is.  I've known her for over a decade and see her once a year if I'm lucky, so this week is special for bringing close what can sometimes feel far.  I connect with one of my very best friends in my daily life, who spearheaded my ventures outside.  She pushes me to grow in the confines of our immediate day to day, and to regularly leave those confines.  And I coincidentally connect with a friend I met climbing in Mexico this past winter, because this pilgrimage calls to people from all over the world. I accidentally took his gear and though we live in different countries we know I'll return it to him, climbing somewhere in the future.




Fall here feels fuzzily familiar from my years on the East Coast, a melting kind of warmth that at first seems solid then surprises you in its change in form. There's still the flutter of novelty that hasn't dissolved for me, and there's the wonder at how the leaves color first slowly, then quickly, over the course of the week we spend there. I feel that pace in our climbing, as we return to routes we tried the year before, and climb them a little better, and try harder routes and routes with different styles.




And because pilgrimages take you far from home, there is a sense of just how different this place is from where I live.  We travel abroad often for the exposure to other cultures.  We rarely consider the need to expose ourselves to the different cultures within our own country, especially those threaten our security and world views, and I'm grateful to climbing for giving us this chance.

Dogs are kept outside without fences and race into the streets, in front of cars and onto you as you stupidly run on the road, with a sense that this place is theirs and anything entering it is subject to their touch.  We want to respect this truth, as we feel an enormous sense of privilege, coming to this place by choice and for luxury.  In this county rich in rock, a quarter of residents live under the federal poverty line.  Fifteen miles away from the Red River Gorge lies America's poorest white town (Beattyville).  Climbers boost the economy in a way that's appreciated and resented.  On the highway I see a sign: "God and guns are the enemy of Democrats."  While I don't encounter any of the guns that everyone is reported to own, I'm accosted with clear hostility by a homeowner while running and have a small glimpse of what it means to feel unbelonging, unsafe.  Alongside gratitude for what I have at home, this makes me feel deeply unhappy about how little I know of others and they of me. We talk about what this means, and there's no easy response other than to remember the importance of bearing witness.  Different from the America I know, this is America also.

Upon returning home, there's a drive to reach out to people in places outside our spheres, for the midterm elections and shared goals across different communities.  I love most this sense of connecting to people in other states (physical states, states of mind).  Because of our pilgrimage, we call voters in Lexington, Kentucky to encourage them to cast their vote for Amy McGrath, the first woman to fly a combat mission in the Marines. I'm told by an 84 year old man that he'll be driving his grand-kids to the polls, asked by another to tell Amy McGrath that "everything will be okay," and assured by a couple with disabilities that "this disability won't keep us from voting."

Even though Mcgrath lost, these conversations, and the mass mobilization and voter turnout from this election, make me immensely grateful. There's a concrete outcome for our shared values and vision across this massive country with so many different types of people. At the same time, I'm sad about this deep divide that exists not just between political parties but among entire communities living side by side, living in the same country.  We see so little of each other.

This realization morphs my perception of this pilgrimage.  As first I experience Kentucky as a journey for myself, a way to disconnect from my daily needs and to cocoon my caterpillar self, this idea that holing myself up will ultimately open me up.  Later, I see that exploring my walls is a way of peering over and through into what lies on the other side.  Having had the luxury to climb so many walls, it seems like ready time to examine more carefully what I'm climbing towards.  Other people, other perspectives, and the webbing that thinly threads between.

And so I think that while pilgrimages take many forms, that versatile core value ultimately sheds its layers and underneath is the same thing: the long, hard travels we take to connect to each other.  Because as much as rock offers an escape, nothing can ever really exist for me in isolation and that pilgrimage has a purpose outside of the distance from home.  We take it back with us, and use it to continually reach across.


October 1, 2018

People : 1000 Piece Puzzle



A text conversation circa summer of this year:

Me: Working on a 1000 piece puzzle while listening to this book is my dream as an introvert and I'm up until midnight as a result.
Friend: Probably the nerdiest text message I have ever received.

If we were counting in terms of number of concrete unpleasant events, I'd have to say this year has been my rockiest.  Now that the events are past, it's much easier to share.  But what I take away most from them is gratitude for the incredible support and care I received as they were happening, and every day from the people in my life.  Sharing now is less about relieving burden, because honestly with that kind of love it never felt like I was carrying too much.  Sharing now is about the process of putting together this puzzle.

During the thickest part of it, I was spending a week at my childhood home to be with my mom while she recovered from a surgery to remove part of her lung (she continues to recover well).  For us this was the least hard part of her being sick--we were all relieved to get past the uncertainties of diagnosis and treatment, and to see the surgery go well.  For her it was harder, to actually feel the physical reality of being sick, to cough and breathe and move differently.

I'd just been told some not-horrible but not-great news about my own health (unrelated to my ankle, which at the time felt both trivial and heavy), part of which meant getting minor surgery now and major surgery sometime in the future. Having never been put to sleep or incised, this freaked me out a little (a lot).  I tried to maintain relativity, as it wasn't even close to the realm of what my mom has faced.  My mom, who is 4'11" tall and less than 100 pounds light, has given birth five times (one C-section--me), underwent open heart surgery, had a quarter of her lung taken out, and still manages to look sixty at near eighty, so I figured I could channel some of her bravery.

During this week I spent time with my mom and dad, but they are pretty low maintenance and most of the day they didn't need much from me other than being around.  I was feeling really down, and I couldn't climb (no partners in Fremont) and I couldn't run (my broken ankle was un-casted but recovering at 1 percent pace I wanted).  So I started this puzzle.

I got this puzzle for my dad for Christmas.  You can choose a photo and have it cut into any number of pieces.  I love how happy everyone looks in this photograph my brother Stephen took of my parents and my niece and nephews.  My dad likes games like Sudoku and has excellent spatial skills, so I figured I would make the puzzle super challenging at 1000 pieces.  It turns out this was a little too much.  Dad: "I opened up the box and my vision went blurry.  I closed the box."

So I decided to give it a shot.  Anyone who knows me knows that unlike my dad I have very poor spatial skills, but I do have lasik-rendered perfect vision so I figured I had that one thing on him.  The border was easy, and then suddenly a flood of obstacle after obstacle: the huge swaths of monochrome without any outline, the five flesh-colored faces, the varying shades of red, that neon orange-and-green cake with loopy cursive.

But as I sat for hours with the puzzle, shapes and strategies formed both naturally and with effort.  As I searched for my family's eyes and teeth and hair and lines in these pieces, the thousand pieces soothed ragged parts of me.  There's this indiscernible mess, but I know for certain there was once a whole and there is another whole to be made, and I know I can make that happen with patience.  Which was like water to me while all these not-ideal things seemed to be happening to me.  My brothers and I had been fighting a lot in the past few months, and I could see that we were fighting for control over what was happening to our mom, for whom we could only do so much.  My body, which I so value for its capacity to move, which I've relied on when all else seems out of my hands, had been broken and was about to be placed in the hands of a seemingly random surgeon. Here, I finally had control.

While I worked for hours on end on the puzzle, I listened to The Nix by Nathan Hill. I couldn't have designed a better fit for the activity of my hands, the frenzy in my mind and the flurry of feelings.  It's loosely about a man whose mother left him as a young boy, and his quest to piece together the story of her life from very little: a photograph, stray details from his dad, a couple facts.  There are a lot of characters, but in the versatile voice of the narrator and the crafted language of Nathan Hill, each person stood out sharply and strongly.

I felt the same about my family the longer I looked at the pieces and saw more clearly the differences between the shades of Asian.  In some ways I've never looked so hard at these cheeks I've snuggled and kissed.  I'd barely given their teeth a glance.  Immersing myself in this single picture of them created a new kind of intimacy--not better than real life, but just not existent in real life.

I left that swath of black sweater for last.  There were literally a hundred pieces that were just black, nothing else on them to guide which ones might be in proximity.  I separated them into piles based on how many edges were a "lock" into which other pieces fit, and how many edges were a "key" to insert into other pieces.  And stared at them, until I started picking up on minute differences in size of the lock and key, and I can put these solid blocks of color together as they are unique enough to have their own place, their own neighbors.  I like using this dusty, wilted part of my brain.  There's still a lot of random testing; I take one piece and align it down a column of other pieces until something fits.  I like this mindlessness.

At the end of the week, the parallel narratives in the book tumble into each other and the puzzle is done with not one piece missing, and the beauty of these alongside each other just about kills me.  I'm not kidding when I say that this experience is special to me. Yes part of that is pure nerdiness and the love of sitting alone in that nerdiness.  Most of it is the sifting and putting together of something complicated and close, the comfort and the struggle of that.  When I'm puzzling, the difficulty is still deep and in some ways the intermittent frustrations of the puzzle (my vision does go blurry many times) helps me see just how upset I am.  But confronting it in this solid way unwinds, softens my feelings.

In the months that follow, life starts to heal too.  By the time my dad tires of assuming my mom's domestic role she's recovered enough to take the position back, I'm climbing stronger than pre-fracture, I'm grateful for what a small surgery teaches me about the patient experience.  All the while, the puzzle remains on our dining room table as my dad looks for a frame to fit its unusual dimensions.

Then one weekend I'm home visiting my parents, I find that it's not there.  Where is it?  Is it framed?

It is not.

My mom, who in the haze of her first week post-operation didn't notice me crouched like a madwoman over this puzzle for days, had taken it apart.

Up until that point, I hadn't cried very much.  Mostly on two days.  The day when I read the report of my mom's lung scan, translating the medical language I wished in that moment I didn't understand.  And the day when my doctor told me I'd need a minor surgery now, and a major surgery sometime in the future.  But both of those days quickly dissolved into days of organizing, rationalizing, and accepting.  Each one easier than the last, as we dealt with the practical and came to terms with the conceptual.

Then the puzzle came apart, and I came apart too.  I was so irrationally angry at my mom, my mom who never cries for herself, who never once cried that I could see during the months of appointments and procedures.  I cried over the puzzle, because all of the sudden I could touch the fragility of this picture, of all the pictures I have in my life.  I can climb and sort-of run again, and every step feels off and it may be that my ankle never returns to what it was.  My mom is steadily re-gaining her strength, and we live with the uncertainty of whether her cancer will return.  I can see my surgery as a kind of gift in the path to empathy, and I'd give a lot to not have to undergo the other one.  This knowledge lay dormant in me and it erupted with the loss of the puzzle.  You'd think that your thirties would loosen your hold on togetherness, but a physical puzzle can really make you feel that you alone can put things back together, and when that concrete framework is gone, so goes my image of structure.

My kind and generous friend who let my senseless self talk to him for two hours in the immediate aftermath of this sentinel event  (thank you) about the puzzle (the concrete one, and the metaphorical one) said to me: all the pieces are still there.

But they might not be.  Some could get lost or torn by the time I try the puzzle again.  And even if they are all there, the experience will be different, and so the end will be too.

Soon after the puzzle fell apart, so did my relationship and while that felt like the hard right thing, the parallel again felt obvious.  There's the heavy idea of starting over: it takes so much energy, and how do you refuel after a break?  After so many breaks--in bone, in health, in a relationship, in the idea of having your family forever--how do you have the faith to rebuild?

The thing about crying over a silly thing like the puzzle is that I haven't cried since and I don't feel like I'll cry for a long time after it.  I've all out mourned the loss of constancy and control.  While I'm sure that it will return in spurts because we're built to strive for stability, this full implosion freed me to love these breaks.  For what they are on their own: the serendipity of misfortune and the randomness of our narrative, which remind me how much bigger everything is than me.  And for the rearrangement that follows, for the renewed attention to different parts of ourselves and the challenge to heal differently each time.

Because it's kind of amazing that with the same set of pieces, there's so much new to be experienced.  It's never exactly the same, and that broader possibility is more expansive than our lack of control is limiting.  It reminds me of being in Japan and learning that they periodically intentionally tear down temples in order to rebuild them, because they value this mirroring of what happens in actual life.

I didn't share a lot of these things as they were happening, because after the visible ankle fracture that couldn't be hidden, I experienced somewhat of a sympathy overload.  Which is just about the best thing you could ever complain about.  Everyone has been so kind and loving, and I really felt it could last me through anything, that it wasn't necessary to ask for more.  I share it now not for sympathy, because there isn't actually anything to mourn. These breaks and losses are a reshuffling for newness and more range of perspective. I share it now for gratitude, that life can be this delicate and this worth breaking down and building back up.

September 26, 2018

Reading : Five Amazing Audiobooks



I've been asked by a bunch of people recently for audiobook recommendations, and I love that so many people are listening to books.  I love talking about audiobooks and why I love them so much.  I've talked a lot about it generally--the layers of tone and character that oral narration adds, the ability to integrate language and narratives during other parts of your day, the slowing down of story when you read it aloud.  But it's hard to describe exactly why they are so great without some examples.  Also, it really takes the right book to get you into listening. Sometimes people are worried about being able to pay attention, and I agree it takes some getting used to, and if you start with the wrong book it can be off-putting (the first I tried was, randomly, Faulker's Light in August and it took me years before I tried again).  There are some books that I really feel are better experienced on audio, and here are five of my very favorites.

*

The Art of Fielding by Chad Harbach
This holds a special place for me as the first audiobook I ever really loved, and one of the few I've listened to more than once.  It's about a college baseball team: the dynamics of the team as a whole, but more so about three individuals and some of the people with whom they connect.  Henry Skrimshander, whose small size masks his immense talent until he's recruited by Mike Schwartz; Mike Schwartz, the team's captain whose pursuit of success in sport and school wears away his body and mind; Owen Dunne, whose affair with the college president is deep and difficult.  I don't know anything about baseball and never watch sports, but I was blown away by how naturally Harbach creates emotional depth alongside, and within, technical descriptions of the game. Also, it's super funny. If I had to choose one thing I value most in audiobooks it would be the ability of one narrator to adopt the voice, tone and personality of different characters, and it is so good in this book.


The Nix by Nathan Hill 
Another really funny book with an amazingly talented narrator, who can embody both the ennui of an English professor trying to instill the love of literature in bored college students while he himself doubts the value of old stories, and the ennui of one of those bored college students.  The loose framework of the plot is about the English professor trying to unearth the story of his mother who left him in childhood.  But it's one of those books that has very little to do with actual plot and much more about the character and context in which it's written.  So that it becomes a book about American life through various historical eras (post-World War II, 1960s radicalism, post-9/11, the current age of tech), geographical areas (cities and suburbia), and through the lens of so many different types of people who find themselves limited and traumatized by our world.  If you're concerned about a book that's not plot based being boring, don't be--this is the funniest and most entertaining book I've listened to in a long time.  (Though if you don't have a lot of time or patience I wouldn't recommend it as your first audiobook because it is almost 22 hours long. But it's really the audio-equivalent of a page turner and I blew through it in a week).


Ready Player One by Ernest Cline
I know this book-turned-movie is old news, but even if you're read it or seen it, I would recommend listening to this because it is so, so funny and well-done.  (Yes, I do see all these recommendations are funny books.  While I don't consciously seek out humor in fiction, when it's there it's really special, and it's especially appreciated on audio).  I looked forward to my commute just so I could listen to this book, and was always bummed when the drive was over.  The story about living in virtual reality is innocently sweet and moving, at the same time it's honest about how dark life can get in the hands of humans.  Among the recommendations I give, people often choose this one, and it's definitely a good first audiobook.


Exit West by Mohsin Hamid
This book is not funny, but it is beautiful.  Even though one of the things I appreciate about audiobooks is the ability to listen while doing something else, I fell so hard for Hamid's voice that I would sit on the couch and just listen to him read his book.  Besides having the perfect voice to match the story's depth, it's always an added layer to hear the story told by the source.  It tells the story of a young couple, Saeed and Nadia, living in an unnamed country where a civil war between the government and religious rebels forces people to flee their homes for fear of their safety.   The dangers and violence are concrete, which contrast with the unreal way Saeed and Nadia escape their country and enter others: through magic doors that transport them to Greece, England, then America.  This seeming ease of migration is undercut by the obstacles of assimilation that Saeed and Nadia face in each place.  As their environment changes, they change as individuals and as a couple.  I love how intimate their story feels, even as they traverse large spans of time and geography.  

Hamid is an amazing writer, and this book has the perfect combination of powerful story with powerful words.  He has this unbelievable skill of packing abstractions into sentences that feel close, real, and beautiful even when they are hard because they're so true.  The sentences are long, carrying along until you start to feel breathless too.  I have a habit of listening to audiobooks on increased speed, but the language in Exit West was so loving that I listened to it at normal speed.  It's also short, which makes for a good first venture if you're in the mood for a more somber book. 


Echo by Pam Munoz
Because music is central to this book, listening feels the most experiential way of reading it.  It tells three distinct stories of children growing up in different places at different times, who are connected by their possession of a special harmonica and their gift of playing it.

Friedrich is a twelve-year-old boy growing up in the throes of Nazi Germany. The birthmark on his face and his family's anti-Nazi politics make him a literal and conceptual target of Hitler's regime. His only source of power comes from his unique ability to play a harmonica, an instrument small enough to keep close at all times and with sound loud enough to give him voice in a world that otherwise wants to shut him out.

The harmonica makes its way to a young orphan named Mike living in Pennsylvania during the Great Depression.  His main mission in life is to find a family and home that will keep him together with his younger brother Frankie.  Again it's music, and the harmonica, that play a literally instrumental role in trying to achieve this. 

Later, the harmonica is in the hands of Ivy, the American-born daughter of migrant farm workers from Mexico. As her father takes over the farm of a Japanese-American family that has been sent to an internment camp, she witnesses the fear-driven racism resulting from Pearl Harbor.  And as she is segregated into an inferior school as part of an "Americanization," program, she experiences the racism personally.  Like the children before her, she finds space for herself with her harmonica.

I love how each child's story is narrated by a different voice, and how the sound of the harmonica throughout wordlessly connects all three stories.  Each person is vibrant and full in character, and each has a uniquely touching relationship with music.  Sometimes the music plays like a soundtrack and sometimes it takes center, and it all feels very organic in the way that noise and melodies shift in and out of view in real life.  Because you get so immersed in each person's individual story, you don't realize until the end how expansive the book is--covering so many World War II themes of persecution and capturing so many different arenas of suffering.  At the end, the stories come together with ease and heart, in a way that only a children's book can.

*

These are all fiction because besides that being what I love most, I think audiobooks lend more nuance to fiction than nonfiction.  But I do listen to and love non-fiction audio too, and books I've really enjoyed include Missoula by Jon Krakauer about rape culture in college towns, Nothing to Envy by Barbara Demick about North Korean defectors, and We Should All Be Feminists by Chimamanda Ngozi Adichie (narrated by the author whose voice is at once unique and speaks for all of us, and the short 40 minute running time makes for a good introduction to listening).

And if you don't already have this, get Libby!  Don't pay $30 for an audiobook when you can borrow it from your library.  It's true that you often have to wait for the popular ones--every week, I just put a few on hold (don't place too many at once because then they'll all come at once and you won't have time to listen to them all before they're due in 21 days).

Happy listening, and please give me recommendations too!

August 2, 2018

Health : Identity Through Injury & Illness



The last few months have been a succession of physical changes and abnormalities, each one progressively a little more difficult.  For me and for a number of people very close to me, injury and illness have shown up with sudden briskness (we are all relatively and fortunately fine).  Each one has challenged me to embrace the value of having the full spectrum of experience, which includes the stuff that sucks.  I started out pretty positive, have tried hard to sustain a reserve of patience and insight, and recently realized that getting worn out is a real, honest part of what people are. In that fatigue is the opportunity to confront things as they are, to unravel how to remain who we are in our daily routines when these routines are disrupted.  And how to be better.

Up until now, my life challenges have been primarily emotional and abstract.  This year, faced with changes in physical health, I'm learning a lot.  Despite spending the last decade in hospitals and clinics seeing people with acute and chronic illness, it's been shocking to me to confront more personally the fact that our bodies often operate independently of what we want, what we imagine.  I'm grateful for this very humbling reminder that for all our good intentions and wide exposure we never really understand what it is like: what it's like to be given bad news, what it's like to sustain and heal, what it's like to have a surgery, what it's like to live with risk and uncertainty. 

Physicality is something I've relied on as a constant source of strength through emotional difficulty--in my personal life and in work.  So when I stopped being able to push myself in that way, to maintain the movement that's been so crucial to getting unstuck, I didn't want to admit this loss.  I did everything (physical therapy, yoga, acupuncture, sauna, sports massages) so I could will healing into being.  I'm sure all of this is helping to some degree, but the majority of it is really up to my body, not me.  I think that part of why doctors make the worst patients is that we're trained to consider ourselves forces of change.  We acquire these tools and knowledge to make people better, and even though practice has proven to me the smallness of our scale of agency, underneath it all we hope that we have power.

During this whole tug of war with my body, I've thought a lot about what is defining for myself.  While climbing in a cast and then with a stiff foot, I developed a stronger appreciation of what I love about climbing that's independent of the level I'm climbing.  But I realized that even those things could disappear if someday I can't climb at all.  And until recently I couldn't run at all, which is something I've never been great at but has been an integral part of my identity and life.  I do it for pure pleasure and for coping with difficulties.  Without the things that you concretely do, you start to re-consider your conceptual self , and you question if there is anything about you that can remain constant.

This became even more prominent when faced with more permanent, life-altering physical changes in people close to me and in myself. Knowing that the broken ankle was temporary obviously made it much easier.  It was also the outcome (a fall) to an activity I chose to do (climbing). In contrast, when things happen to your body as a result of its own course and not from your direct action, this is another level of our lack of control.

What I've held most close through all this is that there's only so much I can do for myself.  We can want and will, and sometimes our bodies and our environments just say no.  So what is it that can stay true through all the things we might lose, all the aspects of ourselves and our surroundings that might change?

What I've found is that although there are limits on what we can acquire for ourselves, there is always something we can give others.  The degree and depth of gift fluctuate, but the presence is constant.  I love the malleability of this, our ability to adapt what we can offer depending on what we acquire and lose. The most important thing to me before injury and illness remains the most important thing to me now, which is the capacity to share. This isn't to say that I don't frequently forget and fail at that, only to say that it's the primary goal. 

I think that so far in life it's been easy to declare that a goal because I've been so extremely lucky in so many ways.  When things are good, it's easy to see the huge discrepancy between what I have and what others don't, and to strive toward more balance.  But on one particularly rough day, I found myself unable to provide and I was shocked at how quickly I could stop caring.  It's much harder to be giving when you're struggling too, when in moments of shock you feel not just like you're losing something but also that something has been taken from you.  I generally avoid framing things like the latter, because externalizing makes happiness hard.  But I recognize our natural tendency to do this, to feel why is this happening to me.  It's important to me to recognize without judgment our inherent inclinations, to better connect with each other and encourage each other to resist unproductive thought processes even as we know it's human to have them.

It was also hard that a certain number of events happened one after another, making me ask the contrived and real question of why this was happening.  We often talk about whether our lives really have an inherent narrative, or whether we piece the parts together to make sense.  As with many things I think the truth lies somewhere in between. If the former isn't naturally clear, I feel a certain responsibility to do the latter.  Given a set of circumstances, we're bound to move through them with some purpose.

And while at first this all seemed to be bad timing, some re-framing of perspective made me consider how things have aligned for the best.  That these things happen not to cause suffering, but to learn better how to ease it.  In the midst of all this, I received parallel gifts from an old friend and a new friend.  Neither of them knew about all these thoughts I'm just now putting down, couldn't have known that their sentiments came to me at a time I'm most able to absorb them, in most need of thoughts that take me outside my own needs.

I had just written most of the above when an old friend sent me this quote from Lincoln in the Bardo by George Saunders: "His mind was freshly inclined toward sorrow; toward the fact that the world was full of sorrow, that everyone labored under some burden of sorrow; that all were suffering; that whatever way one took in this world, one must try to remember that all were suffering (none content; all wronged, neglected, overlooked, misunderstood), and therefore one must do what one could to lighten the load of those with whom one came into contact; that his current state of sorrow was not uniquely his, not at all, but, rather, its like had been felt, would yet be felt, by scores of others, in all times, in every time, and must not be prolonged or exaggerated, because, in this state, he could be of no help to anyone, and given that his position in the world situated him to be either of great help or great harm, it would not do to stay low, if he could help it."

A new friend took me to the East Bay Meditation Center, where they spoke about the concept of a gift economy, where we give based on the fact that we all have something to share, not for trade or for acquisition. I read a little about it afterwards, and it turns out to be a complex topic of debate in economics and anthropology, but practicing the idea of giving without expectation of return resonated with me.

These fresh gifts recall the ever-giving value of the incredibly supportive and loving people in my life, and remind me that it's this sense of giving that I want at the core of my life, through changes in my emotional and physical identity.  So at these times, maybe the best way to maintain my sense of self when experiencing loss is to: bring to the surface what I've been given in the past; stay mindful of how much I have now; search for what even these challenges give me--for the purpose of giving all the above back and around always.


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