The things time doesn't heal

It's been a year today since my friend's mom died. The family has been in my thoughts all day. As has Patti, as you can imagine. I thought about her a lot this past weekend, as her son and daughter-in-law now live in the house she used to have. I miss her.

It's incredible to me that it's been a year. It's still a shame, you know? And it got me thinking about how these losses never get easy. It gets better over time, I really think it does, but it never goes away. There's always a gap there, a line that has ended, and no matter how hard you try, there's no filling that void. No amount of office work, of alcohol, food, drugs, sex, video games, any of the distractions we use can make us whole again, regardless of the mass quantities we might apply. Eventually, it gets integrated, it becomes part of who you are. There's a resignation and a familiarity about it. With work, with therapy, with time, it becomes less of a burden and more of a companion. You move on, but you carry it with you.

I think that's the best outcome we can hope for.

Grief is the risk you take by loving someone. It's not a new idea. And the fact is, you can't know one without the other. If you never grieve the people who leave you, it's because you don't invest yourself in them. And if you don't invest yourself, you never know the incredible power and goodness that comes from love and intimacy. In some ways, the grief replaces the person you lose, it stands next to you instead. But what it brings is not purely the pain of the loss; it anchors you to the memories. It remembers when you're afraid you won't. It brings to you a moment of wit, or insight, or comfort that the person might have offered. It hurts, but in the pain it reminds you how strong your love was.

I was driving home from picking up Maggie tonight, and my mom texted me that she loved me - a usual bedtime ritual. And for a small moment it made me sad, thinking that someday I'm going to miss that so much. And I started thinking about my grandmother - a kind, giving woman who helped raise me, and who died after a short illness when I was in junior high. And I started wondering what she would've done with a phone that could text. Would she have used it? Would she have had fun with it? I delved briefly into the fantasy that, wouldn't it be great if she could text me from wherever she is now? Oh, how I would love the chance to talk to her again. And I realized suddenly that I was crying pretty hard. It's been, what, twenty years? (Holy shit, is that right??! I'm pretty sure she died in August of 1991...holy cow....) And I started thinking about the memories I held so dear. I started thinking about her sister, who died not long ago, whom I also adored. And I cried harder. I loved them both so much.

It never lets you go.

And I think that's a good thing. I don't ever want to let go of people that mean so much to me.

It's my blog, and I'll whine if I want to

So this particular blog entry comes with a disclaimer. Believe it or not, I keep a lot of personal shit off the blog. But I'm having one of those days weeks months moments when I just...don't care. To the best of my knowledge, no one who's about to be mentioned reads my blog, so it's probably not you (although you may know the players involved, keep it to yourself). No, I don't know that I want to talk about it. I just want to bitch.

I'm not doing so well. I'm going to be honest. I'm in a pretty dark place right now. I generally hold up the facade remarkably well, and even that is starting to falter. I'm finding myself much more negative these days than I want to be.

Friday was a horrible day. I got chewed out at work by my boss. I cried in her office for 45 minutes, after which I ran into the person I least wanted to see right then and had to walk straight into a family meeting. What almost makes it worse for me is that she thinks she's helping. I'm not going to perseverate any longer on whether she's right or wrong or just looking at part of the picture, because it's irrelevant. Yes, I'm off my game at work, because my entire life seems to be busy imploding. I'm not saying it's okay. I'm saying please give me some consideration for the fact that many people would not look okay from day to day. Please hear me when I say I don't understand what I'm doing wrong in any sort of prospective way. Please understand that I'm a little bit fragile right now and treat me accordingly. And know that my professional identity is such a part of the core of who I am, that right now I'm going to internalize every moment of potential criticism.

Friday after work, I spent an hour sitting outside the hospital in my car waiting for them to discharge my dad. And mostly crying. They finally let him loose, and I took him home, and promptly got into an argument with my parents about what essentially boils down to a tension between their needs and mine. I'm trying to keep my head above water, and I'm feeling like no one is acknowledging what I need. I don't care if that need doesn't get met, truly; I just want someone to recognize the kind of pain I'm in from the fact that my life currently sucks in multiple ways and both my parents are actively dying.

Meanwhile, I have this friend who is being remarkably ambivalent about what kind of friends we are. No, that's not true. I'm interpreting this friend's actions as ambivalence; in truth, they may be clear in a way I can't currently see, there's no way to know. But I feel it very acutely right now. I'm as needy as I get, which frankly isn't usually asking too much. I just want some consistency. I just want to know where I stand. And I just want, mostly, to feel like I have consistent support. I don't want anything to be this complicated right now.

And then, of course, there's this particular circle of friends that I have. And there's a developing schism in that group. I, truly, have no idea what to do about this. I feel like I'm going to need to choose a side in the near future, and I don't want to. It's not fair. I don't want to feel like my friends are choosing a side of this division over me, and I don't want to feel like I'll have to relinquish those friendships to stay neutral. Because then I might as well have chosen a side, which  feels like a lose/lose for me. I really value people on both sides. And I don't like being strewn akimbo in this process.

I'm feeling so unbelievably incompetent in pretty much every corner of my life these days. Personal, filial, romantic, professional, familial. I feel like a failure as a grown up. I pretty much hate my life right now. And in the middle of all of this chaos, on goes my personal work in therapy - dealing with my issues, figuring out who I am, what I want, and what's authentically me, trying to understand the things that repeatedly get in my way.

I want my life back. I want myself back. And I don't know how to get there.

Friday whining

Today sucked.

I hate my life.

That is all. 

Intern, turn, turn

So I'm playing intern again today.

We sent our actual interns to the beach this weekend. Unfortunately, it's pretty cold here in NC. But I bet they're having fun anyway.

I, on the other hand, am not at the beach. I'm sitting in the Neurology call room waiting for the 8pm shift change. Which isn't so bad.

I mean, except for this, in the shower...

And the mousetraps in the call room itself.

What is it about me and roaches and vermin?

Although....look at the publisher of the bottom book. That, at least, cracks me up.

It's been interesting. I haven't actually been on a non-psychiatric service in, what, over two years? And I think my neuro month was about three years ago. I was really anxious about this morning. Turns out, of course, I needn't have been worried. It's like falling off a bike.

I forget sometimes, too, what a difference it makes to be a senior resident. I was thinking earlier about my first day on Neurology as an intern. As luck would have it, it was also my first day at Baby Blue. Ever. There was supposed to be someone replacing the anesthesia intern, so they told me, hey, don't worry about it. But of course, that person didn't show up until Tuesday. Suddenly? Oh. Hey. Could you cover his patients? Just go see them and write notes. Don't worry too much about it.

Yeah. Right. Not to mention, I had no idea how to use the computers here. I couldn't remember how to write orders. I'd totally forgotten my log in for the electronic medical record.

I sat in the workroom, right off the nurses station, trying not to cry. I was absolutely determined to figure this out. I called the help desk. I dove in. And, of course, I figured out enough to get by. They were happy.

Of course, that didn't actually address that I knew practically NOTHING about neurology. Recovering gynecologist, remember?

But it turned out to be a pretty good month. I had good attendings and reasonable residents and my co-intern was AWESOME. I had a nice white cloud for call. I caught some really interesting cases. And generally, I had a good time. Notably, I was the only one in my class who actually liked their neuro month...

So, today? Not so bad. And I get two days off in compensation for this, one of which I'm taking tomorrow.

Which is useful, because I could really use some sleep. Yesterday was loooong. I went for coffee, then did the headless chicken thing preparing for Cleo's not-a-baby-shower (nothing like doing it all in the last few hours before the party, you know?). Then, of course, was the actual not-a-shower. Which was a lot of fun. Fewer people actually showed up than had RSVP'd, but we had lots of fun, even if there was too much cake (is there such a thing?).

I ran home, showered, ran and picked Maggie from my folks', ran to drop her off at home, and then ran to Jen and Bill's. A bunch of us went to a not-so-local haunted house last night.

I'll be honest. I had significant reservations about this. We didn't leave until 7:30 pm, which I knew was not going to get me home at any reasonable hour. I was crabby and wanted to hide from the world before I even got to Jen and Bill's. And, let's be frank - PTSD girl in a Haunted House? Not necessarily the best idea. But I like my friends. And it's fall. And really, why be responsible?

It was okay. I enjoyed the time with my people. The Haunted House itself was pretty good. The headless horseman rode up on a real horse! I, however, spent too much time figuring out what was going to jump out at me from where, which figures were props and which ones were people. I don't really relish that feeling. I don't really like being scared - it brings up too much. I don't like people getting up in my face. It was reassuring knowing that they weren't allowed to touch me, but they came closer than a bratty younger brother in the backseat who's "not touching you! Not touching you!". On the whole, thought, it was fine. And I enjoyed the drive there and back and the silliness waiting in line (for-ev-er). And my friends were pretty amusing to watch going through the haunted house.

I did get insulted by a redneck zombie, though. He came up to me and said, "Looks like we could feed on this one for a couple of months." I was pretty pissed about that. In fact, I'm still kind of pissed about it. But, then again, he did invite me to stay for dinner....

Today...

...not so good.

I'm not really sure why, to be honest. It was just...difficult.

I think it's still part of my Crisis of Something. But wow am I in one of those awash in your emotions, stuck all up in your head, mulling over life kind of funks.

And I have a 7am patient tomorrow. So I'm going to bed on old lady time.

Crisis of...something

So, I apologize for the fact that the blog, of late, has sucked. No, no, it really has lacked my typical enthusiasm and investment. And I can pinpoint where this fell off, because I stopped blogging every day. And I recognize that as a symptom, not a causative factor. But even when I go back and read what I have written, it's not my usual level of attention to detail. For example, I've been misusing May and June's names for a month - May is a year ahead of me and older than June, which is why she's May. June is my classmate that just got married. You'll notice that I just married off May, which I'm suspecting neither May's wife nor June's husband would support. And Olga has had like seven different names.

The truth of it is, there's something not right with me. And to be perfectly frank, I'm not sure what it is.

Jen suggested this morning that I'm burned out. Which, yes, definitely a part of it. I don't know how I could be running a family care home and being a chief-ish resident and functioning as a very busy first year child fellow and trying to maintain some sort of social connections and working twice a week on a very difficult insight-oriented journey without burning the candle at both ends. I'm very overwhelmed by my life right now, which makes sense, because any single component could easily by itself be overwhelming. The family care home is sucking up a lot of my time and energy, but it ways that are sometimes reasonable. I don't know how to say "here's how you can help me" without it coming out as "stop sucking the life out of me." And sometimes it just has to be what it is, like Thursday, when I was cranky and restless and all I wanted to do was go home and sit in the quiet and make frozen pizza and watch NCIS and then go to bed at 8:00. But I got to my parents' and my dad was bleeding internally. Very reasonably, we changed direction and went to the ER. All the while, though, I felt like I was sitting there looking at the end of my rope.

But I used to be able to handle that a lot better. It would not have bothered me three months ago to anywhere near the extent that it did that my minimal plans for the evening were voided. So, yes, while I feel like there's a very significant chunk of caregiver fatigue in the mix here...that ain't all it is.

There's also probably a seasonal component - I'm VERY light responsive (some would say seasonal affective), and you might have noticed, the light is dying. I have a hard time getting up in the morning. I have a hard time staying up at night. I always, always get a little more depressed when the season changes, but it's much earlier this year. Typically that doesn't kick in until November or December. So something is sensitizing me this year.

I know there's some biological stuff going on as well. My thyroid hormone replacement is still clearly inadequate. My new - if tiny - medicine to address the stress-related borderline high blood pressure I've been having might be contributing. And there may be something more systemic going on, if my stiff, sore joints are any indication. Plus, I still haven't had that sleep study I need. Maybe I have sleep apnea, who knows, but more likely I think I have some sort of REM sleep disorder. I have these ridiculously detailed, highly affectively charged, absolutely EPIC dreams that go on and on and on and on, for literally hours. I have massive sleep inertia when I wake up in the middle of one of those epic voyages (seriously, Homer had nothing on me, and it definitely interferes with my quality of sleep. So I probably need to get that looked at.

In a psychoanalytic sense, it also occurs to me that I've doubly lost my holding environment. I had one here, in NC, away from my childhood and my old life and the painful things about that, a place where I could grow and individuate that authentic self, a distance at which I could appreciate the things I loved about my family and my life back home. But at the same time, I had a safe place to go back to if there was too much trouble here. Like, when the bottom fell out of my life at the Emerald Palace, what did I do? I ran home. Now, I have neither of those places.

But then there's this deeply existential piece. I feel like I've lost my sense of my identity over the last few months. Who am I? What am I doing? What am I becoming? All of those questions suddenly have tenuous and very nebulous answers all of a sudden. My self-concept has always been ruled by outside influences, and I think in becoming more aware of that, of trying to locate that which is more authentic, I've become aware of just how diaphanous is that by which I've defined myself. Winnicott talked about the false self, the ideal persona created which we present to the outside world. Trouble is, the harder I look, the less I feel confident that I can locate an authentic self-object in my internal world. It's somewhere in my shadow, which I cannot access readily, if at all right now. That's the point of therapy, indeed, but that doesn't make me feel any more whole right now. And I think the bigger issue is, there's a lot of affect that's been split off for a long time which is now trying to reintegrate itself as my self-awareness journey proceeds. And there are reasons it left - namely, like any split off affect, it was too painful to tolerate at the time. Now, though, I'm suddenly wading in it until my fingers are pruney. Which sucks.

(Psychobabble, psychobabble, psychobabble. Sorry, it's what I do.)

The point of all of this, I think, is that it just is. There's no quick fix, no magic pill, no right answer. So I just keep going along, keep my head in the game, keep telling the story as it needs to be told (I've been reading a lot about narrative psychiatry lately). I have to identify what my needs really are before I can meet them. And I can hope that my friends' patience with me is a model and reminder of how I need to be patient and kind with myself.

Uncomfortable though it may be, this too will pass. But the only way out is through.

Suckage

My cousin died last night.

It wasn't totally unexpected. She lost a hard-fought battle with ovarian cancer. But she just went into hospice Friday. We weren't expecting it to happen quite this fast (although, my family does this. My grandfather did the same thing. Had dialysis one day, decided the next to stop dialysis and enter hospice, died the next night).

This. Sucks.

She was only 56. She has two kids, 20 and 24.

And here's the other thing. She and my mom - my mom, who also has cancer. Don't think that's escaped me - haven't spoken in years. It's a long and complicated story, as these things always are. She wasn't perfect, but, who of us is? They both played a part in the estrangement, obviously. But, now, there's no fixing it. There's no changing things. There's no closure.

It just sucks. The whole thing is awful, and unfortunate. It just serves as a reminder that one can never take things for granted. That this life is ephemeral, and we can all be snatched away at any moment.

And it hit home really hard that my mom has late stage cancer. I can't handle thinking about that for too long right now.

Honestly, I'm having a really hard time with a lot of this. I've been scattered and irritable all day. I spent some time with my folks, and actually got a few things from my every day life taken care of. I've talked electronically to a bunch of family members. I stressed out over weird things and laughed at things that weren't especially funny.

I also snarked pretty hard at a friend of mine, which ended in one of us picking a fight with the other (although I'm not entirely sure who started it). He had enough sense to press pause on the argument, came back at me several hours later and was like, what can I do? I told him I was displacing, apologized.

I hate it when people get to see the crazy. I try so hard to keep it under wraps.

Happy 4th and whatnot

Back from Rene's wedding at the Biltmore in Asheville.

The wedding itself was a-ma-zing.

 The Estate is phenomenal.

She looked incredible, the scenery was breathtaking...

A good time was had by all. In fact, um, a few had a little too good of a time. Which led to some significant badness after the wedding.

But, in the end, I think all will be well. And fortunately, I have an appointment with my shrink tomorrow...what a night.

Barred

So I have this friend.

No, no, an actual friend. A friend who started as a friend of a friend but now I consider him a friend in his own right (I think that if they broke up, his girlfriend - my original friend - would ultimately get custody of me, but we could still be friendly). This friend has had some really awful shit happen to him, not the least of which (ahem) was getting sentenced to life in prison at the tender, formative age of 15 while taking the fall for a crime he was only involved in as an accessory.

That's the short version of the story. The long version, actually, is the subject of an indie documentary.

It's a good story, ultimately, because even if it was nearly three decades later, this was rectified. Tomorrow there's a celebration to commemorate his one year anniversary of his release. And I have to say, it's been a pretty remarkable year. He's done an amazing job of reintegrating, keeping his nose clean, and being a functioning member of my social circle.

There are times, of course, this gets downright comical, like when he got a ticket because he'd never seen a parking meter before and didn't know you had to feed it ("There was a bike chained to it. I thought it was a pay-per-use bike rack."). And there's times when it just completely sucks that his previously rough life led up to that at such an important time in his life and development.

We were having coffee this morning (it's what we do, since he's part of the coffee-related circle of friends), and he was like, "You know, I think about all of my experiences, and realize now, I generally don't have troubles." We, of course, were all like, what? And he went on to explain that, although he does sometimes get worked up about things, when he really takes a moment to stop and look at what's happening, it never really seems to be that bad. What's the worst that could happen?

Remarkable, really. I think there aren't many people who could walk away from this experience or even the things that preceded it and not think the world was a heinous, awful, dangerous place.

I told him this morning, it's absolutely amazing, that he got a second chance. A whole new life. Full of new discoveries and good people and humor ("This is my friend from school. We went to Penn State. No, wait, that was the State Pen") and the little everyday triumphs and tragedies that make life what it is.

I'm a little bit jealous, actually. He got to leave his prison. So many of us - myself included - can't ever seem to get out of our metaphoric ones, to free ourselves from the past. His imprisonment meant something much more literal, of course, his liberties curtailed in a way mine have never been. But what I'd give to not be shackled to those years of abuse and pain and terror. I recognize it as a hell of my own creation (well, maybe not exclusively mine), but apparently, like Persephone, I can't ever really leave.

So, in short, Bill, if you're reading this (or if Jen is telling you about it. Hi, Jen!), good work. Keep it up. We're all really proud of who you're becoming and the transition you've made. And don't ever let the rest of us forget how lucky we are to take our freedom for granted.

Wiiiiiii!

(You have to say that out loud. The double entendre is in the onomatopoeia. Gesundheit.)

I think that somehow today I recommitted to my "change your mind and change the world" plan, that I again decided optimism for its own sake was warranted. The last week has tried very hard to suck the life out of me, and rather than fight it, I've decided instead to simply refuse to let it.

Today wound up being another good day. In truth? Yesterday was pretty hard, but when I focused on the good in it, I found that there actually was quite a lot. Today had it's rough edges as well, but, you know...

I overslept a little, but managed to pick my cousin up in time for her to carpool with me to CH. I dropped her off at work, ran some errands, went to Starbucks and mostly played on Facebook worked (I'm still buried beneath a pile of unwritten and overdue notes. But I got two discharge summaries done this morning. There's hope). I met my completely awesome shrink (have I mentioned how much she rocks, offering me a Saturday slot and whatnot?) and we actually had a really good and productive session. I bummed around at Border's for a while, picked up a book for me, one for my dad, one for my aunt, and then swung by and picked up my cousin, who it turns out had a very interesting morning (and has also caught the plague, which is sad. Damn patients, can't keep their germs to themselves). I dropped her off, got lunch, hung out with my folks.

And? I finally broke down and bought a Wii. I? So totally heart that thing (don't worry, Claud, I don't have the cow game yet). It was a bit beyond my means, but my folks helped out and there were gift cards involved. I bought a second controller used at GameStop.

I have to say... it was completely and totally worth every penny, merely to play Wii Bowling with my dad.

I also sucked it up and bought Super Mario Brothers for Wii, which is not actually that good a Wii game, but totally makes up for it in nostalgia. If, of course, you're from the generation that spent countless hours of their childhood playing low-resolution but high-awesomeness games on the NES. It was remarkable, how I even remembered where the little one-ups and bonus boxes and whatnot were in the original game, like it was somehow stored in my body memory. And after my parents went to bed, I sat there remembering sleepovers and Skittles and Cool Ranch Doritos, summer afternoons with my cousin D (who saved the princess way before I did), big hair, "boy-crazy" friends, jelly shoes and Hypercolor t-shirts.

It made me smile way more than any of those things ever did at the time.

And in the midst of today I made plans for tomorrow. Family time in the AM, folks have to be at the airport by 3ish, and then they get on the big silver bird back to the Chi. After I drop them off, though, Cleo and I are celebrating our collective survival of the past two months or so in typical girly fashion (what isn't made better by a mani-pedi?). And then I have dinner plans later, although so far the plan is exactly as cohesive has, "Let's have dinner tomorrow. What, 7? Yeah, that'll work."

Plus, Maggie and I found the first evidence of daffodils poking through the ground today. Spring is coming!!

Even as completely stressful as this week has been, it's been good to have my family here. And the stress I know about (much less what's lurking in the shadows) doesn't show too many signs of letting up anytime soon. So, I guess there's a choice to be made. I have strong family ties, good friends around me, I have the best dog ever. And every day people let me intimately into their lives and get a fleeting glimpse of the boundless expanse of wonder that is the human psyche.

How can I pass that up?

Calm

There's a storm brewing this week. It's a metaphoric one, but nonetheless. This week is going to be particularly psychologically challenging for me. Well, it could be.

Not to be cryptic or anything. Mostly what I'm saying here is, I'm a little stressed. I don't do anticipation particularly well, but I'm always well-prepared. Details will follow when I feel it's okay to tell them.

(I'm fine, btw. So are my parents. So don't waste time worrying.)

But here's what it makes me think of.

There was this guy, a few years ago, with whom I was involved. It was probably the single most vulnerable point in my adult life, and in as many ways as he was toxic, he was also one of the most helpful and supportive people in my life for a time. Peter (I'm sure I've mentioned him on here before) had a lot (LOT) of his own issues, and I still occasionally hope to hear from him some day down the road when he's had a lot of therapy or is on his Eighth Step or something. But nonetheless, Peter and I had this really interesting way of interacting, wherein, when he was most revealing of himself, he always spoke in these big metaphors. I really don't think he actually knew he was doing it, but it was still somehow always my job to listen to the story about remodeling his home or rounds at the hospital and at the end, say, "So what you're really trying to say is..." He spoke of his home as a metaphor for himself, frequently, often talked about our ways of relating in stories about how he related to his patients. He'd tell me a story about a woman in his office enduring a procedure without anesthetic, how he felt really worried about how much pain his ministrations were causing, but she told him to keep going. I said, "So, what I think you're really saying is, you're afraid that you're hurting me by trying to help, and worried I won't tell you when the pain is too much."

His answer was always the same: "What? No. I mean, I'm saying, I mean, no, I mean....yeah, okay."

At his core he was a good man (possibly several); I still believe this. But there was just so much that got in the way. Not to mention, I was not at my most stable right at that juncture, and my shrink at the time was encouraging me to be a lot more engaged with Peter than I ever should, for reasons that were probably not all that altruistic on the shrink's part. Ah, it was a mess.

So, at one point, he and I are fighting (because we did that about 60% of the time), and there had been a blowup, and we weren't speaking (because he knew that I HATED it when he stopped talking to me). And I was in northern Florida for some other reason, and he was refusing to acknowledge me being in the same state.

And then, there was this little storm that blew through.

I remember being caught in the outer bands of Katrina; I have never seen it rain that hard in my life. I was soaked straight through to the bone from running from my car to my hotel. They had to give me towels in the lobby because I was just so drenched I was leaving puddles on the floor. I knew the eye was passing over southern Florida, where he was, but well, it was only a Category 1 storm at the time. And I'd gotten quite an education from him already about Cane-Proof windows and storm readiness and blah, blah, blah.

But I got up the next morning, and opened my browser, and the first thing that popped on to my screen was "KATRINA BALLOONS INTO CATEGORY 5 HURRICANE." I looked out my window at the glorious sunny day that had appeared, and tried to figure out what to do with the ball of lead in my stomach. And after much internet reading, caffeine, and contemplation, the answer seemed irrefutable to me: I was headed south.

An hour or so down I-95 (far enough that I wasn't likely to change my mind but not so far that it would cost me much time if he was like, fuck you, stay the hell away from me), I decided I should probably warn him that I was in town (my friends in north Florida had all been like, just show up in the south. Call and be like, hey, I'm at the Starbucks down the block, come meet me for coffee). But that felt a little too stalker-ish to me, and I wanted to give him the chance to tell me not to come. So I called.

He answered, of course, because no matter how mad he was at me, he never seemed to figure out how to screen my calls. I could hear people talking in the background, recognized a couple of the voices as those of his family members. And I was like, hey, I'm heading your way. He balked a little - never told me not to come, said he wasn't sure he'd have time to see me, wasn't sure what kind of disaster their clinic schedule was going to be the next day, wasn't sure of much of anything. How long was I going to be down there? Because maybe he could see me the day after. I was like, look, I'm coming down because I'm so much closer than I usually am, and because there was just this big natural disaster, and that tells me it's time for you and me to work this the hell out. Once and for all (although it wasn't).

And somewhere in all the discussion of semantics and scheduling, I finally realized the one thing I hadn't asked that I really needed to: "You guys are okay, right?"

He says, "What? Oh, yeah, fine, of course."

I guess I'd known from the tone of his voice, the stories (metaphors) he'd told me about the day's activities, the laughter in the background. But I still needed to hear it stated.

As it turned out, I drove down, we had a very long phone conversation while I was stuck in traffic on 95 and he was sitting in the hospital parking lot. We never did get into the same space, but we parted on much more amicable terms (that time). I was able to drive for a while around sunny south Florida, in a town I absolutely adore (with or without him in it), and see for myself that Katrina, there, had been little more than a thunderstorm in their view - a far, far cry from the devastation it was unleashing on the Gulf coast.

Somehow, Katrina, from my vantage point, seemed as equally metaphoric as any story that had passed between us, any words spoken or unspoken, in so many ways. It was, indeed, a harbinger of things to come with us; it was also a perspective on how each person individually perceives and experiences a storm, how that storm may vary in lethality and intensity from moment to moment, and how none of these things have any bearing on what has been forecast.

It's better that we've parted ways. But I still worry about him. I have moments where I still miss him (or, at least, parts of who he was). I know how different I am from then; I wonder what he'd think about that, what he'd say, how he's changed. And I can't get through one of our southern squalls without thinking of him, of Katrina and what she meant, and smiling a little at those few fond memories I still hold.

Holy cow, it's 2010.

So, it's a whole new year.

I had a wonderful time last night. Hung out with the old crew (it was, after all No Pants New Year, season 8), stayed up until 5am, laughed, talked, remembered why I adore these people so much.

I thought a lot yesterday about the changing year. It's sort of arbitrary, like a birthday - nothing is really different about the day to day, but in a way, that's also not true. Because for whatever reasons, we associate these things culturally with new beginnings, taking stock, and moving forward.

2009? Wasn't all bad. It wasn't generally all that good, mind you. The last few weeks in particular were amazingly stressful. But some very wonderful things happened in 2009. Life keeps going; it's blissful, horrible, awesome and terrifying all at the same time. You can resist the flow if you like, but in the end you have no real choice but to keep moving with it.

I frequently can't believe I'm a third year resident. Partly in the sense of, whoa, where the hell did the last two and a half years go? But also, you'll remember that my entire first year I couldn't convince myself that they weren't going to turn around one day and fire me. I couldn't conceive of the possibility of being promoted to second year. And yet, time goes forward. I'm still employed. I'm halfway through my tenure at Baby Blue, exactly, and somehow two and a half years seems both like a heartbeat and an eternity. I love my job. I know psychiatry. I know what psychiatrists *do*. Three years ago, I couldn't have said any of these things.

And I'm continually amazed at the caliber of the people around me. I'm perpetually marveling at all the good people in my life, frankly, local or otherwise. I have wonderful people close to me - the family I've created in my life and the family created for me. I have amazing friends, colleagues, and people that touch my life everyday. I also have somehow acquired better skills for dealing with the toxic people or interactions that sometimes lurk in my life like depth charges (although, let's be honest, I still have a good deal of skill to obtain in that arena).

We were waxing nostalgic last night on how it's been a decade since the Y2K scare. None of us could believe it'd been 10 years. I was thinking, later, as I lay on my friends' couch in the dark, about what a decade it's been. Thinking about where we all were ten years ago, how much has changed in these years that have just flown the hell by...it makes me think I can't even imagine what we'll be talking about on the eve of 2020.

I've been thinking this week how my life at times feels almost unrecognizable from what it was 10, 15 years ago. One of my relatives posted an old picture of me on Facebook a while back; one of my friends came into my office the next day and was like, wow, I almost didn't recognize you. And I said, yeah, well, those were different times. He asked if I had the same personality then that I have now, and I honestly wasn't sure of the answer. Similarly, I had coffee this week with a very dear friend whom I haven't seen since we graduated from medical school, and she commented that I seemed very different from then. I asked her to elaborate, and she said she noticed how "anxious and tired" I seemed.

I can't argue with that.

She reminded me that the girl she knew in medical school was confident, put together, always on top of things. What she didn't know about that was two things: A, it was a ruse. I'm still the woman who keeps her shit together in a crisis, still the one who puts out fires, still the girl who gets it done. Those things are true about me, and they're part of who I am. But I've been able to get much more in touch, for better or worse, with the side of me that is, frankly, a mess. Who isn't so good at being a grown-up some days. Who drops the ball occasionally, can't find the floor of her closet, and has learned how to live with (shudder) a low census of roaches in her apartment. Who sometimes is too passive, who often gets her feelings hurt, who internalizes everything that goes on around her. Who's funny and neurotic and is sometimes a spaz. Who is uncoordinated and imperfect. Who tries not to throw stones in her glass houses and who sometimes finds the storms of her own emotions to be completely overwhelming. Who attaches fiercely and faithfully to people, even though she thinks she rarely lets them see that. Who finally believes that happiness is an attainable reality.

The other thing my friend doesn't know about this, this has been a very significant source of angst for the past year or so, feeling like I don't maintain that facade of Ms. "Everything's under control, here." I feel like it makes me seem weak. In truth, I feel like it makes me weak. But the reality of it is, it's only because I've started allowing that shell to weaken that I've started to understand the many layers of who I am. And, that those components of myself are from where I draw my strength.

And so, we move on into 2010. A new year, a new chapter, and (arguably) a new decade. I have great things in mind for it.

The morning after

First of all, watch this (for some reason, I can't seem to embed it, so you'll have to settle for a link).

It's a parody. We sang that one year (in four-part harmony, of course) in Madrigals. It still cracks me up.

Today was a very delightful day of doing pretty much nothing. My mom made bread, I ate some of it. We had a crackling, lovely fire. I read some Hawaiian ghost stories in a book I bought while we were there in October, that I finally cracked at the airport. All three of us did some napping. I did leave the house, once, when my mom and I went to Starbucks for breakfast.

Yesterday was....I dunno. Not what I remember holidays being when I was a kid. Which isn't new, really. Things haven't really been "right," I guess, since my yiayia (grandmother) died, but that was almost 20 years ago, now. There was a lot of contention in the family after that, for a while. Then my grandfather died, then my aunt's mom, then her dad. Now it's just us, my aunt and uncle, my cousins, and my aunt's sister, sitting around a table, making too much food for eight people and sniping at each other. It's a far cry from the jubilant, boisterous holidays of my kidhood, when D an I used to complain about sitting at the kiddie table, my grandmother made too much food for the 12 of us and whatever distantly-related (or not) koumbari happened to be joining us for the holiday, and we all clustered around the tables and argued loudly. Now it's like we're white people or something. But with more food.

My cousin brought his girlfriend to Thanksgiving. That was sort of monumental - none of the three of us cousins has ever brought anyone to a holiday dinner. Apparently she was lovely (I say "apparently" only because I was in NC). I was hoping she'd come for Christmas...I've suspected for a long while that they were involved but have never met her in person. Alas, though, she was off visiting her own family in a whole other state.

Lucky her.

I can't figure out why I'm so irked after this particular Christmas dinner. It's not like anything has really changed with our little family. My aunt makes me feel inadequate and worthless. My uncle doesn't say much. My one cousin is sullen, the other is beige and answers any direct questions in monosyllable responses. My aunt-in-law (my aunt's sister) is kind of funny but spends a lot of the time sniping with her sister. My mom gets anxious about the food. My dad tells stories. I? Wish I drank more.

So I don't know why it was so painful this time. Maybe I'm paying more attention to what I want it to be. Maybe I'm more sensitive to my own internal responses (damn my shrink and my progress in therapy)(no, not really). Maybe NC is really starting to feel more like home than home. Maybe I'm different with them than I am with other people.

I just wish I felt like my family liked me more (and by "family," here, I'm referring to my extended genetic family. My parents, and my non-genetic relations, seem to like me just fine. Weirdly). It's amazing to me how no matter how old I get, no matter what I manage to accomplish or that at which I manage to fail (because sometimes it seems like the accomplishments are more problematic), I never feel like I'm even close to good enough. And I can't ever seem to figure out what it is that would make me so.

I could keep whining, but I'm not sure it's useful to anyone outside my head.

It also finally caught up with me that I don't think I really have a whole lot planned for the week, unlike my typical whirlwind home visits. I think a lot of my non-core friends are out of town. So maybe I'll get to spend some actual quality time with some of the core group this time? That'd be cool.

One day closer to Friday

I'm so freakin' tired...

The consult service, at least, had a reasonable day. I'm sure we'll get slammed tomorrow. I spent a lot of time fighting with a particular medicine service about why high sodium, dehydration, and a white count could still be making my patient delirious, even though she'd already had antibiotics...so, uh, maybe you should give her some fluids. Even if it means tying her down a little. I mean, soft restraints, not ideal, but dying? Less ideal. Seriously, people, why am I doing your job for you? Remember, I'm "just" a psychiatrist.

In better news, my dad is home from the hospital. Which is making *me* very anxious, because this afternoon they were like, "we need to do surgery!!" and then like an minute later were all, "Never mind. We're discharging you. Go see your real doctor." I'd been trying really hard not to "interfere" to that point (SO difficult...I know enough to get freaked out by everything). But at that point I was like, "GO CALL YOUR CARDIOLOGIST. RIGHT. NOW." Which he did. And said Cardiologist - whom I learned Cardiology from - was okay with them discharging my dad. Him I trust. So, okay.

Still. Bleh.

One nice thing, though, about all of this - when I heard the whole surgery thing, I went and told the people I needed to tell that I might have to bolt in a hurry. Everyone was like, no problem. Do what you need to do. We'll get it taken care of. Don't even worry about it. I also brought up with most of them that I might need to have my knee scoped in the near future, and got the same response.

Back at the Emerald Palace, I neglected my abscessed tooth for about six weeks. By the time I actually went to a dentist, he was like, "Oh, holy crap!", started me on a course of antibiotics before he'd even really look at it, and sent me to an endodontist for the root canal because it was too complicated for him. I think I went to the dentist post-call, but when I tried to take an afternoon off (on Anesthesia, who, of course, were like, yeah, get out of here, hope they give you the good drugs) to have my root canal done? I was "abusing the system."

So much better here. I really like the people I work with, and it's nice to know they've got my back. And not because they're sticking a knife in it.

Oh yeah....

So, once upon a time, this was an anonymous blog. The first post or two I ever wrote, way, way, way long ago, were very frank accounts of what I was thinking. I didn't especially feel the need to censor myself, since I was quite sure no one I knew would be wandering by, and if they did, by chance, they wouldn't actually know it was me. That's why my handle is dk, and not just outright Kate.

When I was getting ready to leave for NC, my friends convinced me that I needed a public blog, so they could follow my adventures (and mundanity) when I was so far away. I could easily have just started a different blog, but there was something about the one I already had to which I felt attached. And to be honest, I'm a really well defended person (note the difference from "defensive"), so even in anonymity, that kind of extreme openness was really difficult. Plus, that was a point in my life when my defenses needed to be particularly strong and well-structured, so it wasn't the time to push that. Thus, I deleted my initial efforts, and started again. In retrospect, it was a reenactment of my real world - I was starting over, trying to be open about things I didn't need to be ashamed of, to be accepting of myself. Less about what others wanted me to be. More about what I think, feel, and know, but in that truth, of course, still guarded - particularly acutely - still measured, but more authentic than the previous few years of my life had been.

As the years have passed, I have a more regular readership; more of my family, more of my co-workers (hopefully none of my patients), more people I really do know, either through actual real life or from the blogosphere. This makes me sanction myself differently, I think, but regardless, I don't mind; it's something I find strangely reassuring about my relationship with the people who are real and important in my life. Yes, it means my thoughts are more filtered - i.e., I don't talk much about the dysfunction of my various families, I lose the ability to complain about my coworkers, and I sometimes have to think pretty hard about what I want people to know who can look me in the face the next morning and have an opinion on it.

It's funny how, despite the exhibitionist, narcissistic, self-important nature inherent in blog writing, so much of what I do here is centered around other people, even before I type a single character. And I'm cool with that. I always have been a fan of irony.

But every now and then, I have these moments where I remember that, in fact, this is my blog. It's a window into who I am, regardless of how tightly I pull the curtains from time to time. I have no particular reason to be ashamed of who I am, or why I am this. And I forget, sometimes, that this is an acceptable forum for being who I am.

Curious, though, that this is the incident which led me to this musing.

I had barely a confrontation this morning with someone I considered a friend. Not necessarily a "good" friend, but someone to whom I felt connected in a couple of different ways. Someone I know to be resistant, but, being who I am, I tend to tolerate resistance fairly well, and to be frank, thought there was progress. And after a little too much ambiguity for a little too long, I finally took the "What exactly is going on, here?" road (in much more subtle language). And...I can't say that didn't work out, because I'm always a fan of knowing over not knowing. And I think drawing a boundary in this case was actually an important communication in itself. But the answer was sort of painful, for a variety of reasons for which this particular friend is and is not responsible.

I responded, on the surface, reasonably, I think. Internally? I felt for a moment like my little boat had been capsized.

Not that this friend has all that much power, but the issues activated were much greater. So I did my best to let those pass, tried not to fight them, to figure out what was at the real heart of the situation.

I gave up on what I'd been doing (because, well, distracted...), and I picked Mags up and we went over to State Hospital. Which may seem like a weird place to walk your dog and think, but trust me, that's just the place. The grounds are beautiful, there's a lot of open space to run (if you're Maggie) and a lot of trees and sunshine and scenery (if you're me). The place has a mojo, you know? Lots of stories of hauntings abound, but whatever, the place has a very old energy. So we went, and we walked a little. Maggie played with some other dogs, I played with some other owners, and both Mags and I made new friends. It was a great choice.

And what I came to, eventually, was that under the anger and defensiveness and fear of what had been stirred, was mostly disappointment. At that, mostly in my friend's lack of insight. There was some sadness and a little bit of sorrow about the things here that I can't fix (because that's what I do, I fix things). And ultimately - really, the part that was and still is painful several hours later - a good deal of recognition of the things I can fix; that is to say, the things that are mine. Unfortunately, none of those will particularly help this individual situation, but they will help my own journey.

Here's another thing I notice: when people are coming from a defensive place, they tend to say the exact opposite of what they really mean. Not always knowingly, and in fact, they probably consciously hold that what they really feel in that moment is what they're saying. But in the light of authenticity, this is rarely what they actually feel.

Today? That I know this, and my friend seems not to, makes me really, really sad.

How is it Monday again?

Seriously. And what a Monday it was.

People are so irritating. I spent a while in Mikaela's office today ranting about this. Particularly about how freaking annoying I find men who can't quite get the idea that sometimes, other people know better than they do, or see things differently than they do, or whatever, and just because that person's a woman doesn't mean you're any less awesome and manly and virile.

I hate that politicking nonsense. Go stroke your own ego. I have patients to take care of.

Get a therapist. Hell, get a hooker. Whatever works. I don't care, just get out of my way.

But in better news, I got some quality girl time with my aunt tonight since my uncle was out of town. We ate breakfast pizza for dinner (crescent roll crust, with scrambled eggs, potatoes, cheese, etc on top, made like a pizza) and looked at pictures online of Saturday's soiree and it was very very nice.

Meanwhile...I'm going to bed...maybe when I wake up, people will stop being stupid.

(It could happen. Don't crush my delusions. It's just mean.)

Not at all painless

I still just don't even know what to say.

Tuesday night, someone I care about very much tried very hard to take her own life.

Except, here's the thing - "she" didn't...my cousin, whom I love so very much, struggles with something called Dissociative Identity Disorder, or DID. It used to be called Multiple Personality Disorder. Very, very bad things happened to her when she was in her most formative early years. When significantly traumatic things happen during the development of one's personality, if the predisposition is there (and we're not really sure what that is), the personality structure can fracture. It's a complicated and confusing situation, and more than it's worth getting into here. But the thing is, while a few decades ago this was the diagnosis du jour, it's now one of the most hotly contested diagnoses in psychiatry.

I feel like people often try to diminish things they don't understand. Even the people who have this don't understand it. But bigotry and bias, as always, will not make it better.

I'm not going to argue the validity of the diagnosis. I think it's ridiculous that we even have controversy like this in a scientific pursuit. The "because it's weird and I don't get it" defense doesn't hold up, folks. And anyone who doubts the existence of this disorder needs to spend a couple of days with my cousin, or my ex, or my good friend in Florida. Herschel Walker, football great and Heisman Trophy winner, recently wrote a book about his struggle with DID. It's out there, folks. And no, it's not a "convenient excuse" that allows you to disavow responsibility for your actions ("It's not my fault, my alter did it"). Yes, it can be malingered for some sort of secondary gain, but so can every other psychiatric illness, or for that matter, most medical ones (factitious disorder, anyone?).

Imagine for a moment that you wake up tomorrow morning, and walk into the kitchen, and pour your coffee as usual. And on the counter you find a bag full of things you don't remember buying. Maybe they're clothes that are so totally not your style, or expensive electronic gizmos you really can't afford. You wonder who bought them, and look at the receipt, and the name on the credit card is yours. Except the signature doesn't look quite right. Imagine how confusing that would be. Did someone steal your card, break in, and leave the stuff there? Maybe one of your family members bought it with your card? You look at the time on the receipt and try to remember where you were at that time yesterday, and...strangely...for the life of you, you can't. And you wonder why this keeps happening...

Now imagine what you find is cocaine. Or cuts and bruises all over your body. Or you wake up in jail. Or in the ICU.

Imagine you wake up safe in your own bed with overwhelming feelings of guilt, shame, depression, worthlessness, and have no idea what you've done. Imagine people coming up to you on the street and seeming to know you, including details of your life, except you have no idea who they are and they're calling you by a different name. Imagine losing big chunks of time, finding yourself in places you don't remember getting to, or hearing voices running commentary on your life while you're trying to live it. Imagine feeling like the only way to end the chaos was suicide. Imagine not thinking that and waking up in a puddle of blood or with a tube down your throat.

Not every case is this extreme, or dramatic, of course; these disorders all exist on a continuum, like depression, or schizophrenia, or anything else. People with DID (or any disorder on the dissociative spectrum) can be very ill and still remarkably high-functioning. Remember that the whole point of the disorder is survival. It's a very primitive but powerful form of adaptation.

I gave a lecture on DID last year to the interns, and the take-home point I tried to make to them was this: the real myth is that we have one cohesive, integrated personality. Think about it; you're constantly altering what parts of yourself are most prominent. I think of myself as generally consistent within the circles of people who know me, but at work, I'm more reserved and professional. I don't drink at work, of course. I don't wear my pajamas. Even the difference in closing our office door reveals a much more sarcastic, silly, sassy version of me than my patients will ever see, but if you ask those same patients about my personality, many of them would cite sarcastic and sassy. Some of them wouldn't - some of them see the more overtly maternal traits that I have, and think of me as soft and supportive and positive. Some of them would call me a hard-ass bitch. None of the above things are not who I am, all the time. They're just not always who I am in the moment.

DID is an extension of this process, as I conceptualize it. Most personality-related pathology is just an exaggeration of normal traits, right? We all have our moments when we're particularly narcissistic, or borderline, or avoidant, especially in times of crisis when our defenses are strained. When it becomes the defining aspect of our interactions, when it severely impacts our ability to function in a healthy way, psychiatry calls this a personality disorder. DID is no different - it's an exaggerated expression of a normal structural phenomena, in response to an event or series of events that exceed the capacity of the existing defenses to protect the psyche from painful or destructive emotions.

And, in case you were curious, the above is a lovely example of the defense mechanism of "intellectualization."

My own painful and destructive emotions? Too numerous to count in this instance. The dominant one is, I'm so terrified for her.

The other point of this post? Again, I hearken back to suicide. It's never just you that you're trying to kill. Even though my cousin survived, and is expected to be medically fine, and is finally in a safe place (finally....well, that's another story for another day), a little bit of all of us who love her died on Wednesday. It sounds overdramatic, but it really isn't; any sensitive person who's been in this situation can tell you.

But, we all do what we can, you know? We try to help, we mobilize the resources we have, both internal and external. We hope that someday we can look down at the well-healed scar and appreciate it as a memory of damage overcome. We try to learn what we can and move forward. I deal with suicide every day at work, and know this provides me an invaluable perspective. I know it strengthens my own resolve not to ever go down that path, regardless of how bad my own internal chaos might get. I know it makes me all the more grateful for the time and interactions and moments I have with people interspersed within the minutia of my life. It fuels my academic interest and professional development. And it makes me hope that I never, ever, ever have to deal with a similar experience again.

Defenses.

Yeah, there's something going on. I'm fine, my folks are fine, Maggie's fine. I spent a long time tonight trying to compose a post, but I'm just so confused about the whole thing that I can't quite put it into words.

It's one of those occasions in which something is so unreal that I don't really know what to do with it. I keep saying, yeah, yeah, I'm fine, because, well, I am, but mostly because, there just aren't words. I keep trying not to tell people, because that's what I do, I just go on quietly when my life is falling apart. Actually, a number of bad things have happened to the people around me lately, and it's definitely taken its toll on me, but only a few close people know anything about it. I'm always "fine."

Truth is, I'm not sure I know how to let myself be not fine.

I got into a little tiff with Scott this morning. I walked in, ridiculously early, as always, and was bantering with him and Sonia for a while (they were the overnight call team). And we were talking about this patient we all know a little better than we'd like to, and he makes this sarcastic comment about a subject which is sort of a running thing between us. It was standard fare; we've debated this rather jocularly on multiple occasions. Unfortunately, this just happens to be the topic related to the recent badness in my life.

So today there was no joking or debating. Today there was me, sniping, which wasn't fair. He didn't know that today was not the day to confront that. But instead of "Not now, man," what came out was, "Oh, you can fucking bite me."

He dropped it, we moved on, things lightened. And I felt bad about this all day. So I texted him before I left work and was like, I'm sorry. Here's why I snapped at you this morning. In truth, it was maybe 10% of the reason I actually snapped at him, but that was the best explanation I could give. He was like, I didn't even think of it as a snap. Figured you were tired. Really sorry I went there, and about what happened.

My first thought about that was, great, I love that I'm even blowing this out of proportion, that I (as always) made the assumption it was as bad outside my head as it was inside, but apparently I can't even let that kind of stuff show very much. My second thought was, God, I so incredibly HATE that I told him. That I let him see even that tiny crack of vulnerable and crazy. Hate hate hate.

But, it is what it is. And what it is, is that I'm way too defended.

I know this about myself. I know why it's there, and I'm not sure how to make it not so.

So tomorrow, when I don't have to be up at 5am after another night of tossing and turning, I'll have more to say about this. Meanwhile, I have some unsettling dreams waiting for me...but that's pretty much the same as every night.

Sunday Secrets

So, every Sunday morning at midnight, the new crop of secret postcards go up at PostSecret. They're often poignant, typically interesting, and frequently amusing. And feed that voyeuristic thing we all have but don't like to admit to. I look forward to them all week.

I love, love, love this one, from this week's secrets:

Love.

(And no, really, I'm going to bed now.)

Where's my day of rest?

It was a busy day. It's gonna be a busy day tomorrow. Oy.

The dogs woke me up at 6:30 (on a Saturday!! Need to get those girls a calendar) by dive-bombing me. So I finally agreed and got up, Mags and I went to Starbucks (Maxine got to stay home in Maggie's crate, which she just loved. It was adorable. She thought she was queen of the world), and then I came home and worked on a knitting project that's due next Saturday. I spent two hours at the gym. I picked up my bridesmaid's dress - which, blissfully, is the right length and doesn't need to be altered - and my shoes, and a new skin for my phone (the old one fell apart today). I went to work for three or four hours and moved most of my stuff to my new desk in our new office (the Pink Office is going prime time, folks. We're a little worried, given the nature of the conversations that go on in there on a daily basis). I also cleared out all my files and my big stack of papers and my drawer of, as Ruthie calls it, Nuclear Holocaust food (I had a lot of microwave-in-the-pouch rice stuff in there). The dogs are fed and walked...and I'm really, really tired.

I met my new trainer at 9. She's nice. She's a she. That's a little weird. Gomer she ain't, but, maybe the change is good. We're going to call her Kelly. She's blonde and thin (she has a very athletic build, though, she's not a twig) and younger than me, but easy to talk to and, as she says, "probably a little more gentle and sensitive that your last trainer." So far I like her, which is more than I could say for Gomer after our first session. He grew on me, though, obviously.

But one thing she definitely has on him was that she seemed to take me seriously today. We did our little assessment, which was way more involved than the one Gomer and I did (his was all weights and measures. She tested my balance, my heart rate recovery, my lifting endurance), and she was consistently just like, alright, here it is. And she seemed reasonably impressed (I maxed out on the 40lb chest press at 40 reps. Our new goal is 50 reps of 55 lbs in the next 8 months. I don't know why 8 months, but, okay). Now, she also has the benefit of getting me after six months of Gomer, which Gomer obviously did not. But he was sort of like, "Yeah, whatever" in the beginning, until I actually did what he told me to between sessions and didn't drop out and was like, "bring it on." She also did a really good job of being like, "Okay, you're a doctor, I don't need to explain things like BMI to you or why it's useless." She also was like, "great," when I said I didn't want weight to be a goal. Gomer, our first day, was like, "Let's try to get you to lose 10 lbs this month." I said, "Well, let's just do what we do and see where I end up." He didn't seem to know what to do with that answer. He got over it. Gomer really did do an awesome job of "getting over it," in a lot of different ways.

I had to pick a goal for our training work, either "lean," "healthy," or "strong." Now, as she pointed out, you head for one, the others will follow, but, they have different schemas depending on what you pick. I thought about it for a minute, and picked lean.

This was kind of huge for me (no pun intended). Because I'm never going to be skinny. Ever. My calculated lean body mass alone (so, none of the fat, just muscle and bone and organs and whatnot) rests right at the lower cusp of "obese" on the BMI range (because BMI is USELESS. Ahem). And I don't intend to stop building lean body mass just yet. But my frame is too big, and my genes too curvy, for me to ever be skinny. So I spend so much time trying to accept that fact that it feels a little like I might be setting myself up for failure by making this choice. But, the goal, really, isn't "skinny." It's "change my body" - not, primarily, my cardiovascular health or my endurance or my muscle strength - which is more reasonable, and more healthy, but also just a huge-huge-hugely-huge step out of the "safe" zone for me. "Fat" is an easy thing to blame when things go wrong. "Fat" is a useful device for internalizing my anger and self-deprecation and all those other things that go along with a history like mine. "Fat" is also protective against having to relive that history. It gives me a wall to put up when I need one ("He'd never be interested. I'm too fat. Good reason not to take the risk"). I don't know what I'd look like any other way, what I'd feel like, what it would be like to be me. This is frustrating and annoying (and, in a lot of ways - mostly influenced by my underactive thyroid and my polycystic ovaries - not as within my control as I might like to think), but it's also....safe.

So it's really interesting, this (we're going to go with "interesting"). Most of that minute I was thinking about it, I was thinking, is this something I'm ready to do? To focus on? To say, I accept this, but I want something different? To let go of all that it means, symbolizes, and provides?

I think I am.

And, you know, my real goal is still to accept who I am, whatever size, whatever else it means, no matter what. To feel better in my body and in my skin, to live here and live fully. So it fits that I'm not really working towards a weight goal (although I have a safe body fat percentage as a target) and not really working in a rigid time frame. It just is what it is, it comes as it comes, it moves forward and backward as it needs to. And we'll see where it goes.

Look, y'all, no one said it was normal inside my head...