Christmas cats and lists

dsc_0272In light of recent events–from the President-elect’s questionable cabinet choices to his quite frankly terrifying policy agenda–I have seen many take to Facebook, sharing essays and thought pieces as a way of expressing their concerns, fears, and frustrations. I have to admit, I, too, have been deeply affected by this election. For some reason, I have had random episodes of tearfulness since mid-November (three things that have made me cry: hillary’s concession speech, any song from hamilton except ‘say no to this’, and that episode of bones where david boreanaz gets trapped on a cargo ship with–spoiler alert–the ghost of his dead army friend), and so, in turn, I would also like to express myself, and respond in the only way that I know how–the only way that feels right.

Through dance yarn.dsc_0280Here are my tiny cats (#catstrumphate), and they are about the cutest things I have ever made ever. This is one of the very rare times when I’ve seen something online, tried to copy it, and then have it turn out well! I was so surprised by how adorable they looked that I made six of them in the span of two days out of sheer excitement (what shelf exam?). For those two days, I was a knitting machine (machat) (<– i just want to take a moment to acknowledge the beauty of this english-to-french portmanteau).

And then I made two owls. Because why not.dsc_0294I started off with just a simple tube using up some scraps of grey yarn I had left over, and then once I realized what was happening, I sort of just ran with it. I added batting, pink collars, tails (long ones for cats, stubs for owls), and even a loop so they can be hung from practically anywhere! From fences to air vents, there is quite literally no such thing as an inappropriate place for cats (and two owls).dsc_0246Except for tree branches. While I wandered Hyde Park taking pictures of my cats (and two owls) in various settings, I learned that if you hang them from tree branches, the whole thing looks a little effigy-ish, or like someone decided to strangle (stringle?) an entire litter of cats (and two owls).

These six cats (and two owls) comprise what I hope to be just the beginning of my new knitting series, in which I knit a variety of tiny animals that can be used as both holiday ornaments (yarnaments) as well as everyday buddies that hang around your house and keep you company! Foxes, puppies, and maybe penguins to come!

Of course, discussion of my knitting successes would not be complete without a picture of my very first stuffed animal, which I misguidedly filled with rice. May rice-bunny keep me humble and always remind me where I came from (i can make that joke because i’m asian).dsc_0256As it nears Christmas, it invariably also nears my mother’s birthday. In contrast to my father, who would be happy with a glass doorknob to round out his collection, my mother has always been harder to shop for, which is why I usually don’t do it at all, and instead leave the task up to my sisters, and then pay them back (maybe) afterwards. However, I am twenty-six now, taking my first steps into adulthood, and I feel like it’s time for me to take a bit more responsibility. And since I know myself to be an absolute horrible shopper (i’m a chronic faller), I’ve decided to make her a gift using something I’m actually decent at, expressing my affection the only way I know how:dsc_0298Cats!

lol, jk. I’ve actually written something for her. I can’t say that I’ve written something about her, because I still don’t know how to write about anyone other than myself. But it’s safe to say that these words, however egocentric, were written with her in mind.

Also, if I don’t see you all before next year, have a meow-y Christmas and a happy owlidays (i’ve been holding those in for so long).

***The ice cream sundae was invented in Evanston, IL.

Oh yeah. Also, in case there’s any doubt: as irreverent as I am towards the personal space and privacy of others (i have eavesdropped on multiple first dates from start to finish), there are some things, like HIPAA (and women who go through labor without an epidural), that you just don’t mess with.


Lists

There’s a folder that sits in the upper left hand corner of my computer screen whenever I log into Epic, and it contains a list of every patient I’ve taken care of since starting my third year of medical school. It’s a barebones list. A last name, first initial, and an age. Every now and then I’ll scroll through it and see how many I can remember, which recently has become a rather disappointing exercise, since after only five months there are already names that I don’t recognize anymore. Complete strangers again. Perhaps worse, there are names on my list that I can only associate with a particular diagnosis. A couple sickle cells, some DKAs, that one bad case of osteo. We were discouraged from abbreviating patients like that—equating them with the diseases they possessed—but I’ve been overconfident and careless, and now, for many, a disease is all I have left. But for a few, such as Mr. Guerrero, who is eighth on my list, I seem to have so much more.

It took me a while to find him in the emergency room, I remember, snaking between idle gurneys and peeking through curtains. The place was alive with movement, and the collision of conversations was dizzying. I smelled maple syrup. Sickly sweet, but a pleasant non sequitur from the mob of ringing phones and anxiously blinking displays around me. I followed my nose to the very back, next to the staff restroom and clean linens, and, pulling back the curtain, he was the very picture of contentment—reclined in bed, beaming, drowning a plastic take-away container of waffles with tiny packets of syrup.

Mr. Guerrero was seventy-four years old and as pale as a sheet. He spoke mostly Spanish, so much of our conversation was either gestured or interpreted through his son, Victor. Mr. Guerrero had leukemia, and every cell in his body was paying the price. Platelets, red blood cells, white blood cells. Cancer had replaced almost all of them. This morning his stool was black, Victor told me, and they were afraid he was bleeding into his stomach. Neither of them seemed very concerned, and Victor spoke with the kind of proficiency that told me this was not the first time bringing his father to the hospital. He scrolled through Facebook on his phone while I examined Mr. Guerrero, which was difficult given the cramped enclosure the three of us were sharing, but he was kind and accommodating, agreeing to set aside his waffles, at least momentarily. And between breath sounds and heartbeats, I admired them, their ability despite the surrounding chaos to transform their square foot of privacy into something else entirely. Something ordinary. I thanked them when I was finished and I left feeling lighter somehow, reassured by their optimism, and thinking of breakfast.

They stayed for three days, and I don’t remember them having a single visitor. It was just them: Mr. Guerrero and his son. I walked by their room once and saw Mr. Guerrero sitting calmly in the bedside chair, looking out the window over Washington Park in silence, and Victor lounging on the windowsill in sweatpants, working on his laptop. It was late afternoon, and warm light streamed into their room. Such a mundane tableau, and yet I was intrigued. Like they’d been in that room for years. I couldn’t help but stare.

Hours before their discharge, I saw them on the hospital floor, walking laps around the nursing station. Mr. Guerrero took slow, meted steps in his hospital gown, not bothering to tie the back, and Victor followed alongside, rolling the IV pole between them. They spoke quietly to each other in familiar Spanish. Side by side you could see the resemblance. I waved as I passed them, and Mr. Guerrero gave me the same smile from when we first met, exuding a waffles and maple syrup kind of satisfaction. Just a small gesture, an interaction by the most generous of terms, but it struck me, the two of them simultaneously together and alone, their language their form of privacy, a world all to their own. Two people whose silence was never empty, never wanting. They left later that afternoon, and custodial staff was quick to strip the bed and mop the floors, but I swear even afterwards there was something in that vacant room, the warmth of home having soaked straight through the sheets, the inimitable ease that belongs so naturally between fathers and their sons enduring as an afterthought, hanging thick in the air.

Twelve names below Mr. Guerrero is Avery. I know considerably less about Avery than I do Mr. Guerrero. I don’t even know what Avery looks like. I was with him for only fifteen minutes, and the entire time he wore a large, black helmet with a grid of plastic wire across his face. He sat on the couch, tucked in the corner of the room, and took huge, whooping breaths. Like someone turning a vacuum cleaner on and off.

Avery was ten and had autism. He was brought to clinic by his mother, who sat on the other end of the couch. His sister, Nadia, was there, too, sandwiched between them. Nadia looked to be around twelve and bored, dragged along since they came directly from school, I assumed. She wore dark eyeliner and a decoratively bedazzled t-shirt. She held her phone lazily in her hand. Avery’s mother was overjoyed. He’s improved so much, she told me. He’s not even anxious to be at the doctor’s office anymore. I looked over at Avery, who was still hyperventilating in his football helmet, and I imagined what his last visit must have been like. I approached him cautiously, but he recoiled further into the wall behind him, breathing louder and heavier. He started batting the sides of his helmet with his fists.

“Go calm your brother down,” Avery’s mother said to Nadia, as casually as if she were asking her to set the table for dinner. Nadia got up from the couch and called to him, gently slapping her thigh and cooing his name in a singsong voice. You would think that would seem inappropriate, demeaning almost, beckoning him that way, but it didn’t. For some reason it felt entirely natural, and I wondered how often she had to calm him down at home, or at school, and how much of their relationship consisted of this routine. Almost immediately, Avery dropped his hands and quieted his breathing. The sudden silence was jarring. He stood and walked over to his sister, standing just inches away without touching her, without looking at her, his head bowed from the weight of his helmet. His thoughts were inaccessible, secured by thick plastic, but he appeared calm, his shoulders giving a gentle rise and fall and his arms limp by his side. I looked at Nadia, who was unfazed. She glanced at her phone and sent a quick text. She was used to all this. I didn’t speak to her, but I was dying to ask. What has to happen before someone gets used to all this?

I don’t think I’m unique in keeping track of my patients. I’ve been told that it’s a good habit for doctors, a way to monitor the accuracy of our diagnoses and the ripples of our clinical decisions. But that begs the question, who’s list am I on? I imagine my last name somewhere between Ladner and Lau, and I wonder what my one-liner could be. The 2AM asthmatic, or the subdural hematoma who cracked his skull doing something called a ‘totem pole’. It becomes a philosophical question at some point, but it seems to me that we are all on somebody’s list. My father, for one, suffered a heart attack at fifty, so the list he belongs to is quite extensive, I imagine, divided into volumes, filling the shelves that line the walls of his cardiologist’s office. My mother is also on a list, albeit a much more exclusive one. A one in a million kind of list. Like my father, it happened several years ago, but different wounds heal in different ways, and there are still times that I think about it—the butterfly that had to beat it wings just so—considering the alternate reality it displaced, and how things could have been different had that list been just one name shorter.

I was a freshman at UC Berkeley when she received her diagnosis. My parents had called earlier that day asking if I was free for dinner, which, in retrospect, was suspicious, given their preference for surprise visits and ‘coincidental’ run-ins at various establishments around campus. They drove up from San Francisco, and we ate at Smart Alec’s on Telegraph Avenue. And over burgers and a slab of cornbread, my mother explained to me how her appendicitis half a year ago was not as benign as the doctors had thought, and that something had leaked from that pinky sized organ and seeded into her abdomen. Pseudomyxoma peritonei. It’s a mouthful, but she said it masterfully. I asked her if it was cancer and she said it was but it wasn’t, which was ridiculous, because the world was falling apart and how could it be that I wasn’t allowed even this modicum of certainty.

She described the surgery, which would require debulking and a deep scrubbing cleanse of her abdominal cavity. She talked about being grateful and hopeful, which I questioned if she really believed or was saying more for my benefit, or my father’s. I forgot at which point I stopped listening. For a long period of time I nodded absentmindedly, distracted by gloomy hypotheticals. And then out of nowhere, she spoke, cutting clean through the fog and the bad taste of plastic in my mouth.

‘If I could, I would have it all. I would see you grow up, see you grow old. I’d meet your children and their children. I’d be healthy and strong forever. But I can’t have it all. No one can, and I know that now.’

My parents drove home later that evening and I walked back to my dorm room in a daze. It was hardly eight o’ clock, but I went straight to bed, which is what I tend to do in overwhelming situations. It’s my way of escaping time, of exacting some semblance of control. But it’s all illusory. I knew that when I woke up nothing would be different, that life would still be tenuous and the truth would persist. But in a dream, you never know you’re in a dream, and in those moments, that kind of ignorance becomes undeniable.

It’s been seven years, and for some reason, that night remains as clear as ever. I know that it was a Wednesday, and I remember where they parked their car along Durant Avenue. I remember the seats we sat in, the food we ordered, the awkward preamble of small talk and silence. The deep breath before the plunge. It’s frightening how time becomes immortalized like that, bits and pieces frozen in amber that we can hold and turn over in our hands. We have no say in the what or when of them, who gives them to us, whether they haunt or inspire, but they form and we collect them all the same.

I have yet to meet anybody else with pseudomyxoma peritonei (I haven’t even seen a case of appendicitis), but in the past five months, I’ve been reminded of that night time and time again. It’s a subtle sense of familiarity, like a shadow or an echo. Some days I miss it, sold by the almost perfect, almost seamless adjustments, and then some days I see it, and it’s everywhere. Like a creeping sensation of being tugged, pulled from normalcy and hurled into uncertainty. It’s the whiplash of a diagnosis, and then the long journey back.

I always think that my list is longer than it actually is. There can’t be more than fifty people on it, but in my mind, I could fill cities. And perhaps that’s because, despite the charge we have for our patients, there is something deeply preoccupying about those who accompany them. Plainclothes visitors who we cannot look up in our electronic medical record, off limits to our probing curiosity. Family and friends who are unknown, yet remain unforgettable and uncomfortably close. They are ubiquitous, and their number grants them a certain degree of anonymity. So on first glance, we don’t recognize them—all those who share in a diagnosis but bear none of its marks, even the ones who are sleeping, trying to make the world quiet for a night—but then we look again, and we see it. We see them, all of them, and they’re everywhere.

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