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Sarah'n Dipity

Sarah'n Dipity This is the part before... the other part... where I had kids... this is before that. And sometimes after. But it's not that part.


Where is Home?

I'm feeling a little lost.

This month marks the 20th anniversary of when I moved to the U.S. from Canada. Twenty years ago, I packed what I could in to my car, tossed my 54 yr old mom in to the front seat, and I drove from Vancouver to Houston. Mom came along because even though I was 26, she was worried about me making the trip alone - apparently she has some secret ninja skills I never knew about growing-up.

I moved to go to Grad school.

And I've been here ever since.


A little history: I was born in the U.S., in Houston, but my parents were Canadian - my father was working on his PhD at Baylor and I was born while they were there. I have an older sister who was born in Canada before they moved to Texas. When I was 3, the family moved back to Canada. Vancouver. My little brother was born there 2 years later.

So I am an American by birth, the only one in my family. But I was raised in Canada, naturalized as a Canadian citizen by my parents after they moved back. As a typical middle child, I always felt that this was just one more thing that made me the odd-one out.

But despite not having been born in the Great White North, I have always considered it home. I have always referred to myself as a Canadian, even now, even after 20 years of being back in the country of my birth.

I grew up there. I went to school there. I learned to drive, bought my first car, got my first job, trick-or-treated, had birthdays, hunted for Big Foot, broke bones, became a nurse, and so much more... there.

More specifically, Vancouver. The North Shore. Where we lived, where my mom still lives, where my brother was born and has lived his entire life with the exception of a year away in London. This is my base. This is my home. It's where I've always come back to. Breaks during college, to live for 2 years so I could save and get ready for grad school, bringing the boys to visit my home, my family.

There is a feeling I get, every time I go up there, as I come through Stanley Park and to the beginning of the Lion's Gate bridge and see Grouse mountain on the other side. The mountain I spent every weekend on when I was little, skiing with my dad and sister. Sitting there, as always, waiting for me, wondering where I've been, but welcoming me nonetheless. It doesn't matter how tired, stressed, pre-occupied, or whatever else I might be, this sight fills me with reassurance, peace. And there is nothing better than opening the car door when I get there, taking in a deep breath, and letting the sea, forest and mountain air fill every part of me.... there is a quality to it, partly smell, partly, feel, I'm not sure how else to describe it, but it's unique to that area and it's home.

To this day, that is home to me. Doesn't matter that I've been in the U.S. for 20 years, that I've lived here in the same area of South King County now for 11 years - which is the longest I have lived anywhere since I was 18. Doesn't matter that I had my kids in Philly, and have essentially raised them here. Home, is still Vancouver. My kids, for their part, love it there. I believe that has as much to do with how I feel when we go, as it does with the fact that the place is just fantastic. I am sure that they can sense my comfort, and contentedness when we visit.

And I do feel comfortable there, like I belong. Despite my Washington plates, I never feel like a tourist when I drive there. The streets are all familiar, I know my way around as well as most locals. Even though the city has changed pretty dramatically over the years, much is still the same. And we stay with my mom, or my brother, in their homes, not some hotel. My mom has not lived in the house I grew up in since 1984 but that doesn't matter. She still lives in the same part of Vancouver and it's still, her.

And I think that's why I'm lost now.

In less than a week, my brother is moving. Not just to another house, to another province entirely. About 3 weeks shy of 41 years in Vancouver and he's leaving. It's a good move for him and his family, but definitely a big transition for the rest of us. My mom especially. And because of that, she now tells me that she is also wanting to move. Not to follow my brother, but to Salt Spring Island, off the coast of Vancouver Island.

Her reasons are logical, and financially it makes an enormous amount of sense.

But suddenly, I'm feeling... homeless.

I want my mom to do what's best for her, and I know that Salt Spring is beautiful, and it's still B.C., and I'll still love going there when we visit.

But it's not home.

Which made me realize, home for me isn't just a place and it's not just people. It's the combination of the two. I've always had my anchors in Vancouver in my mom and brother, the ones who stayed even though my dad, sister, and I all left. But soon I may no longer have anyone there. And even though it doesn't change the place, it does change how it feels, to some degree. My sense of belonging, that it's still MY home, because these people that I love are still there, in the place that I love so much. That will be lost. I don't want to stop going there, but must I become a ... visitor, a tourist, with my foreign plates, staying at a hotel, when I have always been a daughter or sister coming home where I belong?

I suppose I'll have to.

Which is making me a bit sad.

Because it won't really be home. It will still be awesome, and still have all my memories and feelings and places, but it won't be, home. Because there won't be anyone left there to make it so. By the same token, if mom is on Salt Spring, we can go visit, and still enjoy it and still love being with her, but it won't be going home to visit her. It will simply be going to visit.

Which may all just seem like semantics to some.

Not to me. It's just been a part of my life, that intangible, intertwined people with place... feeling... for so long, the fact that I might be losing that is hitting me unexpectedly hard.


For 43 years, since I was 3 years old, it's always been home.

I wish I knew how to keep it that way.


Grouse Mountain, from the Lion's Gate Bridge, my last trip home.


Where's the Funny at? 1973, Apparently.

Someone dear to me needs to read something funny right now. Unfortunately, my funny seems to have fizzled over the last little while. Life can be distinctly un-funny sometimes and unfortunately, there's been a lot of that going around here lately.

But it can't be all gone, can it? It's in there somewhere, it's just being detained by some ugly-ass brain-clutter. Think of it as the TSA of my humor impulses.

So what to do? Fortunately for all of us, sitting near my desk, is a box. This is no ordinary box. It is me, or rather, it is a collection of me at various ages through my childhood. And as a kid, I was lucky. No ugly-ass brain clutter getting in the way of my comedic talents (aka my insanity in its natural, uninhibited state).

There are things in this box that have had my 14 year old son laughing so hard he was in tears.

I think, this particular situation calls for some drastic measures. So I won't waste your time quoting what all my friends wrote on the cast I had on my arm when I broke my wrist when I was 10 (yes, I have the cast... ).

I'm going to bring out the heavy artillery. The Fat Man AND Little Boy of my funny arsenal, I give you me, when I was 8, trying desperately to emulate my 13 yr old big sister by keeping a journal on a trip my family took to Europe during the summer of 1973.

Why is this funny? It will be painfully obvious when you read it. I will, however, follow it with an explanation because to the uninformed, it will appear as though I was either high, or functionally illiterate. I was neither. I think.

This is copied exactly as it is written in the journal. You're going to think I'm making this up to be funny. I assure you, what you are about to read are the unadulterated musings of my 8 yr old self. Translation in to actual English by request only.

" Tuesday August 7

on Tues day we went on a Train To London we Took The Train have way a got on a sub-way The rest of The way. When we got of The Subway we went To Trafalgor sqare Then went To buckingham palace and when we wer goeing down The street we saw a coach whith qeen mother in iT. Then we went To s.T. Jamse park and I fed The pigon'se. Then we went To wesTMiNster abby wich is a church. and Then we whent To big ben and herd it strike 4:: Then we Took The subway To The Train and went To The hoTel and in The niTe we saw a gard wiTh a busbe and we saw The park wher The qeen's children play."

"What we did onThursday.

on Thuersday we went to stone henj. sTone henj is a bunch of sTon's That was made by cavemen."

"what we did on Monday. on Monday We Whent To The mendip HoTel and watide For a bus ThaT Took us To a saFary wher you have To STay in your car and role up your windose. animils: we saw geiraf's and a water buflo and MoKyes and osTereg and eleFanTas and rinoes and camel's and Loion's and cheeTas. Then we had Lunch. Then we whent To logleit hous and in it we saw old dresses and old baTh Tub's."

"what we did on wensday    on wenday we whenT To The Towr of London and saw wher ann bollyn got her hed chopet oFF and saw suit's oF armer and most in portent  of all we saw The crown Jeul's They wher lockt up in a volt down STair's They wer beuTeFull aspeshLy The qeen's Speshel crown. Then we atemTed To shop but we dident. Then we Took a Decer bus To hide park and whent home."


So. Much. Awesome.

Oh, and there's more. But I'll save the rest for the scientists who want to study me after reading that.

I can offer an explanation for some of it. You see, I grew up in the '70's. The Viet Nam war was still going on, Nixon was still "in charge" and peace, love and hippies were all the rage. We wore granny dresses with Addidas to school. In the choir we were singing songs like, "One Tin Soldier" and "I'd like to teach the world to sing". In arts and crafts? We made God's eyes. Seriously. Look, there's some now....


My second grade, which immediately preceeded the trip, began with a nice lady teacher, Mrs Dean, who was pregnant and pretty much just read us stories until she went on maternity leave at Christmas. Her replacement for the rest of our year was the ultimate hippie. Mr Dion. He had long, crazy hair on his head and his face, he wore sandals every day, he taught us how to make our own marbles out of clay and mud, and he didn't really teach us anything academically. But he was sure nice. And made a mean God's eye. So 2nd grade was pretty much a write-off for me. They had used a strange system to teach us to read the year before, ITA (Initial Teaching Alphabet) which completely messed me up and no one had fixed it yet. Hence my bastardization of the language. I have no explanation for the insane use of apostrophes, nor the apparent compulsion to capitalize all my "t's".

So there you go. England through the eyes of an 8 yr old me, for your amusement and disbelief.


ps. the Stonehenge (see? I can spell it NOW... ) comment has been a family joke basically since I wrote it. And the listing of all the "animils" we saw that the safari park is what kills my teenager every time. He's particularly fond of the "elefantas".



Christmas Past

This is usually my favorite time of the year - Christmas time.  This year, not so much for various reasons, so, in an effort to find a little more spirit, I'm remembering why I've always loved it in the past.

And you're so lucky, I'm going to share it all with you!


My family was not religious.  The only times we ever went to church were for weddings or site-seeing (in Europe).  But we did celebrate Christian holidays and I did understand the history behind all of them.  So we had Christmas.  And Christmas for me was magic.  I loved singing carols in the school choir, dressing up to go sing with the choir at the local mall,  and going from house to house on our street with all the neighborhood kids singing carols the whole way.  Watching my mom take out all the special Christmas knick-knacks and set them up around the house, they were the same ones every year: a red, wooden sleigh that had little presents piled in it and funny elves made of shiny foil-like material that would sit in the back - this was the center piece on the dining room table.  Two, very tall green candles that were never, ever lit, that stood on either side of a lovely angel, gold, with blue robes, a very artistic piece, I can't tell you what she was made of - their place was on top of the tv cabinet in the living room.  We had a wreath, all gold and blue and burgundy bits of I don't know what, that went up on the front door every year.  They were always the same.  They are embedded in my memory and my feelings about Christmas to this day. One Christmas a few years ago when my mom came to stay with us, I asked her to bring the sleigh.  I missed it, hadn't seen it in years as it had been so long since I'd spent a Christmas at my mom's place.  She brought it.  It was as awesome as I'd always remembered it.  :)

Something else that "is" Christmas for me, is a recording of the Mormon Tabernacle Choir singing Christmas carols.  My father grew up as a Mormon.  My mother converted when she married him.  They left the church a couple of years after I was born, but, some things stayed with us, and the Tabernacle Choir's Christmas carols were one of those things.  For me it IS Christmas.  My mom would play the album all the time leading up to Christmas day, especially when she was making shortbread cookies, another essential Christmas element for me.  It's also all we ever listened to on Christmas morning.  When I was no longer living at home and at a point where I wasn't always going to be home for Christmas, I found the recording and bought it for myself, first on a cassette tape and later on a CD.  I still have it and it's still the only music I'll listen to on Christmas morning.

My mom's shortbread cookies are actually my great-grandmother's shortbread cookies.  Mom made them every year at Christmas.  They are light, not heavy like most shortbread and they are my favorite cookies.  Easier than easy to make, only 3 ingredients.  They are now my oldest's favorite cookies too.  I have changed the recipe a tiny bit, but not enough to lose what makes them so .... them. When I was in college I would make them and give them out to friends before heading home for Christmas break - if I couldn't be home while my mom was making them, I would make them instead... listening to the MTC on cassette of course!

When I was growing up, my dad had a meeting he went to in New York City every year just before Christmas.  He would often do much of his Christmas shopping while he was there.  Now, my father is a fantastic gifter.  Seriously.  The man knows how to shop.  He would go to FAO Schwartz and find the most amazing things for us... one year, he got me a set of gold plated jacks that came in a beautiful red velvet bag with a gold tassel tie.  Yes, I'm serious.  I still have them in one of my keepsake boxes, I think.  He would also give me calendars.  Every year starting in 1975, he would bring me home a calender from FAO Schwartz to use over the next year.  These calendars were the coolest things ever.  They had stickers all on pages in the back for everything you could think of that might be going on, so you could stick them on days when that thing happened.  I was also quite a fanatic when it came to learning unusual things - I would sit for hours on end in my dad's study surrounded by every Time Life book on every subject imaginable just reading them... all of them - so these calendars were just filled with all sorts of "did you know?" type facts.  Hmmm.  I have one sitting in a box that is easy to get to right now, I should scan it in here so you can see what I'm talking about...



Yes, these are really scanned from the actual calendar.  I still have it.  I have almost if not all of my calendars from that year on.   I loved these calendars!  To this day, my mom still gives me a calendar every Christmas.  I wish they still made these ones, though...

Helping dad decorate our tree, and by "helping" I mean we (the kids) got to put the fake birds on the tree, was also a must.  Lol, we had about 8 of these, birds, not sure what type they were supposed to be, they were white, with really long tails, and we got to pick where to put them.  My dad did everything else.  Mind you the tree was always about 10 -12 feet high so, that was probably a good thing.  Also, these were the days when the lights would get REALLY hot when they'd been on for a while.  I'd burn myself at least once every Christmas touching some - I was one of those kids who even though I knew they were hot, had to touch them to see just how hot they were...

When we were a little older, my sister, mom and I would make a gingerbread log cabin every year.  We got the recipe and pattern out of Sunset magazine and did this for years.  I continued to do it once I was living on my own, but in my many moves over the years, managed to lose the pattern and recipe some time ago.  So sadly I haven't made one for quite a while.  One of these years I'll find a good recipe and make my own pattern.

On Christmas Eve, we would put out some of mom's shortbread cookies, a mandarin orange, and a Coke for Santa.  Yes, our Santa was quite a Coke fan, as it turned out.  This never struck me as odd, it's just what we always did!   My sister, brother and I would take all the presents from family and friends that were stacked on a table in the hall and put them around the tree.  We would also put all of our own presents out.  Stockings went on the coffee table in front of the fireplace (we couldn't hang them).   My mom made our stockings when we were babies.  She used the same pattern, so the three of us had the same stocking, with just tiny little differences here and there.  Like the star on the Christmas tree of mine is different than the one on my sister's.  I love my stocking.  Each of us is still using them which is the coolest part.  We're talking 40 - 50 year old stockings here!

For me, the very best part of Christmas was never so much what was waiting under the tree in the morning, but more about the fact that there were things there that hadn't been the night before.  It was the magic, the surprise, how pretty everything was, how good it smelled, all of it.  Seeing how the scene around the tree had changed from the night before was my favorite part, always.  My dad loved taking pictures but also movies, and in those days, making movies involved more than just grabbing a video camera.  The camera needed lights.  Huge, blinding, hot, insane, lights, that had to perch on the top of the movie camera.  These lights took a while to get warmed up and bright enough, so, on Christmas morning, the three of us kids had to wait at the top of the stairs, while dad got the lights and camera ready to go.  When he was ready, we had to parade down the stairs, never minding the nuclear-blast brightness of the spotlights aimed directly at our bleary, sleepy eyes.  It's hilarious to watch those movies now...

But when we would get downstairs, and make our way toward the living room, that, that moment when we would see what Santa had done, THAT was my Christmas.

And always has been.  Even when I got to the point of knowing the reality of Santa, it didn't matter.  Even when I was 24, working as a nurse, and at home with my mom one Christmas, I made her wait until I had gone to sleep before she could put out her presents....

This has made Christmases as a grown-up a bit tough though, my insistence on wanting there to always be that magic.  Probably one of the saddest moments of my life was Christmas 1994.  I was in Philadelphia, had moved there about 6 months before from Houston after finishing grad school.  The only family in the area was a second cousin of my mother's.  I had friends that I'd made since moving there, but, they all had their own families to have Christmas with.  I got a very small, live tree, an Alberta spruce I think, and put a small string of lights on it and a few strands of beads.  I had a couple of presents that my mom and sister had sent to me, but that was it.  I remember staring at my lonely, tiny tree with my 2 presents under it on Christmas Eve and just praying that some sort of magic would happen and things would look different in the morning.  It wasn't that I wanted more, I just needed that magic to happen.  But it didn't and I was very, very sad.  I was all alone that Christmas, only one I ever have been and I hope I never will be again.

These days I get to make the magic for my boys.  And that works for me.  Because I get to see it in their eyes and that's just as good. :)  My oldest knows about Santa, but much like me, he still needs that magic.  So I am more than happy to make it happen for him as long as he needs it because I know how he feels.

Hmm.  What do you know, I'm feeling better already.  Now where's that Mormon Tabernacle Christmas CD???  No seriously, where is it, I have no idea...



Four words that my neurons actually signaled my language center to say.  This is a sentence that left my mouth, audibly, and on purpose, so as to reach the ears of another human being.

I'm not sure I need to write anything further, it's a stand-alone statement, really.

But I will.  Because I'm a giving person.

Also, this wouldn't be much of a post otherwise.

I recently had the pleasure of spending time with some old friends.  These are people I haven't seen a very long time but we were close in college.  It was pretty special really, seeing each other after such a long time and discovering that we still get along as well as we did 25 years ago.  Better, in fact.  Some might have worried that we wouldn't have anything to talk about, that it would be awkward, that we'd get all of our up-dates out of the way and have nothing left.  Not the case at all.  It was like the things that had kept us close in college were still there, but there was more now - it's hard to explain, but suffice to say, this was an amazing reunion that I am so glad we made happen.

Over the course of our visit, the topics up for discussion ranged from the serious to the silly.  At one point, we somehow managed to have a discussion about toilets that we have all encountered in our various travels throughout the world.  I had some interesting experiences with "toilets", and I use that term loosely, in France from about 30 some years ago and the most sinister toilet paper (again, the term is used only for lack of a better one... ) EVER in London.  I'll save the details for future Dad/Canoe posts.  One of my friends regaled us with stories of toilets in Eastern Europe.  Specifically, the fact that they have.... a shelf..... that sticks out..... in the center..... instead of just a bowl.  Ummmmm, ok.  A shelf. Yep, shelf.  A SHELF.  Yes, a shelf.  Sticks out, under where you ... go.  So, you go, and everything just lands...... on. the. SHELF.  Yes.  Seriously?  YES.  WTF?!  So, but, what? WHY?  Apparently, so you can "examine" your poo.  Wow.  Just, wow.  Also, EW.  I mean, I used to be a nurse and trust me, I've seen my share of poo.  My youngest who is autistic isn't potty trained yet so I deal with a lot of it.  But there's a reason for that.  I am not that interested in becoming that well acquainted with my own on a regular basis, thank you very much.

SO, these toilets with the shelves became the joke for the remainder of our visit.  At one point, I referred to it as the "poo-shelf", which had us in hysterics (yeah, we're very mature... ) and that was it.  From then on, any time any one of us said "poo-shelf", hysterical giggling would ensue, mostly from me, because I'm just that classy.  I'd like to take credit for coining the term "poo-shelf",  but alas if you Google "European toilets shelf" you will discover that the poo-shelf is quite well documented. One of my friends mentioned that it was good to know that no matter what was going on, they knew that all they had to say was poo-shelf and I'd be laughing.

Foreshadowing.  I'm so clever.  Welcome to highschool creative writing.

Shut up.

Anyway, on our last day together the discussions leaned toward more serious subjects and on a few occasions when I wasn't feeling very happy someone would say "poo-shelf" and I'd start giggling.  I'm not very complicated.  It's a gift, everyone should be so easy.  That's what I keep telling myself, anyway.  So when we were discussing something that actually had me quite distressed at one point, I could see what was about to happen and I just blurted out, "DON'T POO-SHELF ME!"  Which was followed by a moment of stunned silence, then giggling.  From all of us.  Then all out doubled-over laughing.  "You just used that as a sentence... wtf?!"

So poo-shelf is now also a verb.

You're welcome.


My Father, My Canoe

Yes, I realize the title is a little odd.  It will make sense in a minute, though.

First I apologize for sadly neglecting this blog, not that I have more than 1 reader, but still!  Seemed like a good idea, I do have many ideas for stories running around in my head at any given moment, but silly things like the rest of my life always seem to get in the way.  Anyway, if you're patient, there will always be new posts here, just not as often as the other blog.

SO.  I read a wonderful article recently, it was a travel article, but the majority of it was a lesson in New Zealand's Maori culture/history: http://theadventurecorner.explorerscorner.com/2010/09/whats-your-canoe/ Go read it now, so the rest of my post will make sense :)

And I got to thinking - what IS my canoe???  I have a good friend who is fortunate to actually HAVE his own canoe, an actual canoe, that has been used extensively as the conduit to many adventures over the years.  I don't have a canoe.  A real canoe.  But at least growing up, I certainly had my share of adventures.  Thinking about it, I realized that most of our travel adventures came about because of my father.  We were very fortunate in that mom and dad took us pretty much everywhere.  Sure, they went on some trips without us, but the vast majority were the whole family, all 5 of us.  Several of the more exotic of these were a direct result of my father's involvement with a world organization relating to the work he did a a physician. What could simply have been business trips for him, turned in to fantastic family adventures for us.

Not every adventure I had came from those trips.  Many were derived from the imaginations of me and my friends using the forest around our house and that surrounded our school, so the woods where I grew up certainly get to share "canoe" status with my dad.

But the ones I'll be writing about came about because of Dad.

Of course the problem is, where to start!?!  I suppose chronologically makes sense, but I'm guessing that will go out the window as I remember things.

I think the first adventure I can attribute to my dad that I remember completely was the winter I was 3.  We had moved to Vancouver, BC, from Houston, TX and this was our first winter in Vancouver (my parents and big sister were Canadian, but they had been in TX while Dad was working on his PhD.  I was born while they were in TX, so I'm the lone American of our crew).  For any of you familiar with the Pacific Northwest, it's not like the rest of Canada in the winter.  It's like Seattle - more rain than anything else, snow happens but not always and when it does, it isn't usually a lot.  Every now and then of course, there are exceptions. That winter of 1968 was one of them.  We got snow and lots of it.  Feet of it.  And it stuck around for a bit.  For me, this was exciting, coming from TX and never having seen snow before.

My mom got me a snow suit.  It was orange.  Remember the time period and that will make more sense!  Also, if you think about it, small child, big snow... orange is certainly a nice, easy color to see, so, less chance I'm going to disappear.  One afternoon, my dad took my sister and I outside.  We had a carport, not a garage, and my dad had set a ladder up to the roof of the carport.  He had my sister and I climb up there - I'm 3, remember -  and we waited while he took all the snow he had moved from shoveling the driveway, and put it in to a huge pile right below the side of the carport roof.  Then he told us we could jump off the roof and in to the snow pile.  Yes, my father told his 8 yr old and 3 yr old daughters to JUMP OFF THE ROOF OF THE CARPORT and in to a snow pile.  He was so freaking awesome.  So, jump we did!  Much to my poor mother's horror, I'm sure.  But yes, still a bit of a toddler I lept off that roof, fully trusting that my dad wouldn't have told me to if it weren't a good idea. Totally plowed in to that snow pile.  It was ridiculous.  And seriously fun.  Of course I had/have an extraordinarily active imagination so the whole, "check me out I'm a flying superhero!" thing was evolving nicely.  Leading to some not so snowy landings off a neighbor's roof a year or so later ( I had an umbrella, ok?!) but that I can blame on my big sister, who was older and knew better, but didn't like me very much.

But back to the snowy day with dad.  We'd pretty much packed the snow pile down after a bit, so then my dad took out some skis he'd bought for us, and threw us in them, and sent us down the driveway.  Mine were red, with white bunnies on the tips, and wood.  Yes, this was back when a lot of skis were still being made out of WOOD.  I'm prehistoric, what can I tell you?  I'm 3, remember, never having even seen snow before this, and there I was, careening down our short but somewhat steep driveway on skis.  Fairly certain I fell all over the place.  But it was amazing fun anyway.  And this started a very long tradition of skiing with dad, as he joined the ski patrol not too many years later at our local mountain, and took my sister and I up with him almost every weekend.

I had not wanted to leave Houston when we moved - I was 3, don't judge me - but my dad's spirit of fun and adventure made me forget all about my old house with the green doors and fed my imagination with wonderful ideas that day.  As a kid, and even as a grown up, haven't you ever looked at a big pile of snow, and thought, man, that would be fun to just jump in to..... well, I've done it.  And it WAS fun.  And I have my dad to thank for that.

I have many, many "dad canoe" stories.  I'll post them every so often.

So, as the Maori would ask, what's your canoe? 


My September 11th Story

I'm sure everyone has their story - where they were and what they were doing 9 years ago today.  I don't like to talk about it much.  No, I didn't lose anyone close to me, nor was I living in NYC or Washington or Pennsylvania at the time.  But the events of that day and watching it all happen live, from shortly after the first plane hit the WTC, affected me profoundly and it's still very difficult to re-visit those feelings.

Had been in the Seattle area for about a year after moving from Philadelphia in 2000.  The boys were little - Zach was not quite 5 and Josh had just turned 3.  Josh was about to start in public school, as Early Intervention was handled by the school districts once kids turned 3.  We were supposed to go to his new school to see the class and meet the teacher that day.  I was up just before 6am with Josh.  The boys' dad called me from his cell phone on his way in to work to tell me that I should check the news - he'd heard on the radio that a plane had hit the WTC in NYC and didn't know much more about it.  Planes have hit buildings in the past.  Usually small ones, always accidental.  I turned on the tv to see what was happening and what I saw was more than what I had expected - tower 1 was burning, black smoke pouring out of those upper floors... this was no small plane.  My brain tried to process this quickly - big plane, what happened? oh my god how will they escape those top floors?  This is terrible.... then it happened.  The second plane hit tower 2.  The camera was not on the building at the time, but we heard it, then saw the horror of the result within seconds as the cameras focused back on the towers..... ummmm.... ok.... ok... what just happened?!? Another plane? Jesus, what the hell???  The realization that I had just heard hundreds of lives ending began to sink in, as well as fear.  What were the odds?? Both towers were now burning, flames and deadly, horrible black, jet fuel smoke just ravaging those upper floors.  God, how are they going to help those people up there?  And WHAT THE HELL IS GOING ON?  Zach was up now but I had him play in the playroom, I didn't want him seeing this.  I was riveted to that tv.  Reporters were talking, towers burning behind them, NYC fire and rescue on the job.  They are talking to another reporter in Washington D.C. live, I'm not the only one getting a bad feeling about this it seems.  While they were talking on live television we heard the plane crash in to the Pentagon.  Live.  The reporter was talking, then he started yelling about a plane, then it was silent.... for a minute or so.... at which point the blood in my body went ice cold and every hair stood on end.  The reporter was back, another plane had crashed, in to the pentagon.  You could see the panic on the faces of those reporting that morning.  It was now clear that something deliberate was happening.  It was terrifying.  How many planes were there?! I called my mom - I was beside myself, I didn't know if I should throw the boys in the car and get up to Canada or not.  I was trying to figure out if we were far enough away from Hanford (53 million gallons of high level radioactive waste... ) to be safe if it was a target.  Can you outrun a radioactive blast? What about the Trident sub base?  And all the air bases around here?  A million reasons why I should be very, very scared went through my head.  My mom told me to sit tight for a little.  I couldn't take my eyes off the tv.  It scared me to death, it was horrible, but at the time, it was all I had to keep me connected, to have some idea what might be going on, in my mind, the thing that was going to tell me when it was time to leave if I had to.  They were talking about another plane now... wait, ANOTHER plane?  Unconfirmed reports of a plane crashing in Pennsylvania somewhere, not a populated area.  Ok - was this even related? It didn't fit the pattern, but, what are the odds of a random plane crash happening in the middle of all this???  Confirmation that a plane did in fact crash has been made.  Then the stories start coming in - the cell phone calls, to and from the people on that plane in Pennsylvania.  It became rapidly apparent that it was most certainly related to the other events.

I cannot really tell you how scared I was at this time.  This was real. This was happening.  And it just seemed to keep happening, and no one knew what was going on.  All the while, behind the reporters I was watching on NBC that day, the towers were burning. I can't, even today, talk about the people that jumped because they knew they were going to die and chose to fall to their deaths instead of burning or suffocating.  I heard them land.  That's all I'm going to say.

Then,  as I was watching Katie Couric update us on what was known so far, tower 2 began to collapse.  Behind her.  Live.  She stopped talking.  I stopped breathing.  It was almost more than my brain could cope with.  I knew what I was seeing.  And I'm not talking about the collapse of one of the world's tallest and most iconic buildings, I'm talking about seeing death.  You knew there were still a lot of people in that building.  People trying to get out of that building.  There were firefighters and policemen and women and paramedics on the ground trying to get people out, and safe.  I knew I'd just seen many, many people die.  I also knew that friends and family of all those people likely just saw the same thing.  For the first time that morning Katie Couric had nothing to say.  No one could talk.  I looked at tower 1, now alone, still burning..... and started sobbing uncontrollably.  I knew it was going to come down.  Everyone still in tower 1 who was still alive and working to either get out or get people out knew it too as they'd just witnessed what happened to tower 2.  I called my mom again, I just didn't know what to do, this was beyond my ability to deal with, I'd never experienced ANYTHING this incomprehensibly horrible before.  I felt sick.  Standing in my living room, helpless, eyes glued to tower 1, praying it wouldn't suffer the fate of its sister, knowing that it would.

And it did.

And like that, they were gone.  The towers, thousands of people both in the buildings and on the ground, were gone. Right before our eyes.  It was hard to know what to do.  I was scared, I was sad, I was angry, and completely at a loss as to what I could or should be doing.

There hadn't been any more crashes for a while.  Air traffic was being suspended completely, planes were literally being told to land, PERIOD. The skies were quiet.  Which was a very, very strange thing.  You don't realize how much noise air traffic really creates in the background of your daily life until it's no longer there.  The silence was eerie and frightening because I knew WHY it was silent.

I managed to get Josh to his school Open House though everyone I saw that day was walking around a bit like I was, in a daze, not really sure what they should be doing, feeling horrible.

It truly was one of the worst days of my life even though very thankfully, I was not affected by loss directly.  Of course it was played out over and over and over again on the news for quite some time.  Then the videos of the planes actually hitting the towers came out.  The full story of Flight 93.  The magnitude of it all continued to unfold for quite some time.  People desperately looking for those missing.  The stories were amazing and unfathomably sad.

I cannot look at video or pictures of the towers from that day any more.  The feelings I get are too terrible, that day was so overwhelming.

Most eerie of all was the name of a flight attendant on American Flt 11: Sara Elisabeth Low.  My maiden name is Sarah Elizabeth Low.  My dad called me to tell me.  It was upsetting for him even though he obviously knew it wasn't me.

And ever since Sept 11th, 2001, I cannot hear a plane fly over head without instinctively looking up for it, and watching it until I can no longer see it.  I'm not sure why I do this.  Like watching it will keep something terrible from happening? I don't know.  But it started as soon as air traffic was back up after the attack and has never stopped.

While I'm exceedingly grateful that no one I know or was close to was involved in the events of that day first hand, it has left a scar on my psyche that will not soon go away.  I can't imagine what it must be like for those who were involved or affected directly.

Hard to believe it's been 9 years.


Depression. Turns out, it's Not Just for Sad People

True story.

Ok, so, maybe I'm a little late in figuring this out.  And it wasn't until I was diagnosed myself last year that I really understood this.

It was a surprise really.  Not so much then, as things were pretty terrible and I was almost incapable of functioning, I knew it then.  It was the realization that I had been for years without knowing it and it took the equivalent of a nervous breakdown to finally bring me to getting help.  That was the surprising part.

My whole life I've been told I was a "strong" person.  And I think I am to a certain extent.  Unfortunately this also led me to disregard any notion that I might not be Super Woman.  My adult life has been somewhat tumultuous and difficult on a personal level, and as the mother of a profoundly autistic son, there is an enormous amount to deal with there too. Most of it pretty tough.  But I carried on.  Really not dwelling on things and just doing what I needed to do every day.  I was acutely aware that whenever I did allow myself to think about things too much,  it was more than I could deal with.  So I just... didn't.  It all got stuffed in a brain-closet, not ever to be opened.  And I went about my life.

Every now and then, someone, a friend, or my mom, would ask if I thought I was depressed.  "No, I'm not. I'm fine."  Was always my answer.  "I'm not sad. I am not an unhappy person. "  Apparently, I was under the impression that clinical depression meant that you had to be sad all the time. Obviously sad.  And I wasn't.  Well, not on the surface anyway.  There was that brain-closet.  But I never went there.  So I was cool.

My assumption was rather erroneous.  And somewhat dangerous.  I had spent so long ignoring it that when circumstances in my life changed last summer, what should have been a good thing, moving forward, turned in to a complete break-down.  Not because of what was happening, but more because it had opened that closet - and everything I had stuffed in there over the years fell out in huge pile on top of me.  That's the best way I can describe it, anyway.

I was completely lost, no matter how hard I tried I could not push it all back in there and get the door shut.  I couldn't go for more than about 30 minutes without breaking down in to tears. Daily.  I didn't care how l looked any more. This from the girl who would do her hair and wear lipstick to karate and kickboxing.  I didn't want to leave the house.  I didn't want to do much of anything except curl up on the couch.  And eat.  I'd do what needed to be done for the boys each day, but that was it, there was nothing else. I felt like I had given everything I had for years and now it was just all gone.  I gained weight.  I didn't feel like talking to people.  And of course, it's a nasty cycle - the worse I looked, the worse I felt about myself, and the less I wanted any contact with anyone.

My family was understandably concerned.  They wanted me to get some help.  "What? I don't need help, I'm a 'strong' person. I can figure this out myself."  I had a hard time reconciling myself to the notion that even Super Woman needed help sometimes.  I was also afraid.  Afraid of being thought of as "weak" or worse, labeled as "depressed" and having people stereotype me.  Like I had unconsciously been doing all those years.  I was also worried about the stigma of seeing a therapist or taking medication, as if people would think there was something "wrong" with me.  Well, there was something wrong.  I was really just battling my own insecurities.

Eventually, the family prevailed and I sought help.  Found a counselor and my doctor worked on finding a medication regimen that was right for me.  I was really nervous about the meds, so afraid that they would "change" me somehow, I didn't want to not feel like myself, I didn't want my personality to be chemically altered.  Turns out, none of that happened at all.  They have certainly made a difference as I no longer fall apart at the slightest hint of all not being right with the world, which is good.  It has taken a while to really "come back".  But I feel like I have.  My motivation has returned, I'm taking care of myself again physically, and I'm not stuffing things in that brain-closet any more.  I know how dangerous that was and I don't want to go there again.

I don't know how long I'll need to be treated, but it doesn't matter.  As long as it's necessary.  I have learned a lot over the last year, mostly about myself but about this disease as well.  It's insidious, not always overt as I'd believed.  Being a "strong" person does not make you immune and being depressed doesn't make you any less strong, or less of a person. It attacks your belief in yourself, it erodes your confidence to such a degree that even the simplest thing can seem impossible.  Worst of all, it destroys your ability to hope, your ability to see things as ever being better, yourself as ever feeling better. Depression is nasty and its frightening, I don't think I've ever felt so lost and out of control.  My family has been invaluable in the process of my recovery.  I haven't talked to too many people aside from them, my doctor, my counselor (of course, now this is out there for everyone and their dog to read.... you, know, those dogs that read stuff on the internet... shut up) and a special friend or two.  But I decided to write about it because I know that while there are a lot of people getting the help they need there are also many who like I did, are ignoring things that they shouldn't, or who are too afraid to ask for help.

Don't be.

I suspect that I'll be able to write about this with much more humor before too long, I'm just not quite there yet.

Soon though.  :)


What's My Age Again?

So I turned 45 in May of this year.

Age is a funny thing.  Have you noticed that it's not the same for everyone?  Why do some people seem so much older or younger than they actually are?  Why do some people seem to age faster than others either physically or emotionally?  I've decided that generalizing people based on their age is useless, it can't be done, we are all too different in that respect.

Strange fact about me: I pretty much always assume that most adults that I meet are older than I am.  Unless it's really REALLY obvious that they are not.  It's just the default for me.  These days I have to catch myself - at 45, I tend to be the one near the top of the age scale of the people I interact with.  But I never think that way.  For a long time I wondered why.  I suspect it's because growing up, all adults were older than me, so that's just how my brain was conditioned to see them. And for whatever reason, I never grew out of that mind-set.

Or maybe it's because I'm just really immature.

I am.  I admit it.  But not in the way you think of when people are using that term in a derogatory sense.  Most of the things that interest me, the things I like to do, watch, listen to, play, read about, the clothes I like, the way I talk,  everything, is more closely associated with younger people than with those my age or older.  Ask my mom - she is always trying to get me to shop at Talbot's, she's even bought me clothes from there.  Which I don't wear.  Because it's just not me.  I'm still wearing PF Flyers, Lucky Jeans and have actually darkened the door of Abercrombie and Fitch a few times in the last 5 years.  None of it is any sort of conscious effort on my part, it's just where my tastes run. I play video games.  One of them is an MMORPG so I play with other people - the vast majority of whom are about half my age or younger.  Most of the time it doesn't matter, I get along pretty well with the people I play with and more often than not, many of them have no idea how old I am.  Until I start talking about obscure '80's alternative music or John Hughes movies, that is.

Which is kind of the irony of our "ideas" about the things people like or dislike as they get older.  I had the notion that because my mom listens to nothing but classical music and opera, that that was what was supposed to happen to my musical tastes as I aged.  Somehow, maturing meant less The Cure and more La Boheme.  But that's not it at all. My mom listens to what she listens to because that's the kind of music she's always liked, even when she was younger than I am now.  And don't get me wrong, I like some classical music and even some opera - you're just not going to find any on my i-Pod or hear it in my car.  In fact, my strong bond to '80's era music is often what ages me in the eyes of others - many of those I associate with these days were barely infants or not even born yet when I was in college listening to it all.

All this to say, I just don't really pay that much attention to my age.  It's not something that has much bearing on the rest of my life.  Of course, the fact that I am now wearing bi-focal contact lenses and tri-focal glasses throws it in my face a little every day.  But it's better than having to hold things half way across the freaking room to see the small print... on a side note, how the hell do bi-focal contacts work anyway???  I mean, there's no line or division between the distance and up close corrections, there's no difference in the way you put them in, meaning, you could spin it around and you'd still see perfectly well.  HOW DO THEY DO THIS? I don't get it.

Anyway.  I noticed over the last few years that it did matter to me what other people's perceptions were, so I found myself more reluctant to be upfront about how old I am.  I don't want a number getting in the way of anything.  We do tend to stereotype when it comes to age, I am just as guilty of this as anyone.  As I neared the completion of my 45th year however, my attitude changed somewhat.  Why hide what I can't do anything about?  There's nothing wrong with how old I am, if people have a problem with it then they need to get to know me better.  So my fantastic DKNY frames are now holding multi-focal lenses (which you wouldn't have known if I hadn't told you...), I am no longer hiding the white patch  of hair up at the front of my head, and if you ask me how old I am I'll tell you without hesitation. I'll still play World of Warcraft when I want to, listen to The Psychedelic Furs and Peter Gabriel loudly in my car and shop at A&F when I feel like it (sorry, mom).

Still, accepting my own age is one thing.  Accepting everyone else's is another.  My parents are now in to their 70's, my dad is 75, mom is 73 this year.  When I type that, see it, or even say it, it sounds old.  When I hear of someone in the news who has passed away and they are in that age range, I think, well, yeah, that's pretty old - then I'm like, wait, that's not right, my mom and dad are that age and they ARE NOT OLD!  My sister just turned 50.  FIFTY.  Which is just wrong.  I mean, that's kind of... old.  But my sister isn't old.  You see how this gets confusing.  Also, if you happen to be reading, Happy Belated Birthday Cecilia!  I have an awesome card, which I've actually had since May but I didn't get mailed because I fail at using the post-office, so I'll just bring it to you when we are up on the Island in August.

I digress again.

I do that. You'll get used to it.

I just think the whole thing is weird.  Am I the only one that feels like all the people I love are just sort of frozen in time?  I know there are some physical changes that have occurred over the years, but they are still the people I grew up with, my family, essentially ageless because I always see them through the eyes of my younger self.

Yeah, her.


Alright, now someone bring me 10 cats and tell those kids to GET OFF MY LAWN...



That Time I got Fonzie's Autograph and Drove a Golf Cart In To a Lake

Ok, so the two events didn't quite happen at exactly the same time but they did happen on the same trip. Sort of. 

My family took a lot of vacations when I was a kid and I can pretty much guarantee that you will see many posts here taken directly from those trips. While my father is/was waaaaaay smarter than Clark Griswold, we still managed to have story-worthy adventures on most of them, and frankly, we did some pretty kick-ass things for a family of 5.

This particular trip was to the Hawaiian island of Molokai, in March of 1975. I was just about 10, my sister was 14 and my brother was 4. When everyone else was on Maui or the Big Island, my parents chose to take us to one of the least known of the islands - at the time there was only 1 hotel and the only thing most people associated with it was the Leper Colony, which by the way, had only stopped "admitting" new "patients" 6 years prior to that. So, there we were, the 5 of us, staying at the Sheraton Molokai for almost 2 weeks. Us, the hotel staff and a very small number of other guests were the only people around. It was pretty surreal, really, the place was essentially empty. We had the pool and beaches to ourselves. Which was great, just strange. Molokai is home to one of the longest sand beaches in all of the islands - Papohaku or 3 Mile Beach, and we had it all to ourselves. Don't believe me? Taken with my Kodak Instamatic, thank you very much! No people on that beach, it was amazing. So, we had the place to ourselves. Now my parents were pretty happy to let us be "free-range" kids, but the surf was way to strong for us to swim so we kept to the beach most of the trip. We each collected enough puka shells to make our own bracelets/necklaces. The locals found us funny - 3 kids crouched on the sand, butts in the air, sifting for shells.

I am the middle child in my family, living up to the stereotype proudly, too. If there was a predicament to get into, danger to be found, something to fall into/out-of/over, I was your girl. I was also fearless (wish I still were). One day on our way from the hotel to that beach, we stopped to look at some tidal pools. I saw what I assumed was a fish sticking its head out of a hole in the rocks, so I stuck my hand in to try to get it to come out... because fish are a lot like dogs that way... I was 10, shut up!   Couldn't get him to come out so I gave up.   My dad comes along, and I show him my shy fish-friend. My dad's eyes just about bugged out of his head. Turns out my "fish" was actually a Moray Eel. This kind of thing was pretty much par for the course with me.

The hotel had its own golf course. Full-sized course, complete with sand traps, lakes, and golf carts. Nobody in my family golfed really but my dad decided to play the course one afternoon. My sister played with him, my brother and I tagged along to watch and ride in the cart. The afternoon was getting a little long, watching my dad and sister had lost most of its entertainment value after the first couple of holes. My brother and I were hanging out in the cart to get some shade. My dad could tell we were getting tired of the whole thing so he tells me to go ahead and drive the cart to meet them at the next hole.  Me.  Um, k...  don't get me wrong, my brother and I were pretty psyched about this turn of events, but I was a lot like Gerald Ford when I was a kid - kind of oblivious and not always that co-ordinated.

Having never driven anything before in my life, I jumped in to the driver's seat, and we set off.  I was doing ok for a bit.  But the course had a lot of hills.  We ended up heading straight down one of them.  I kind of freaked out - we weren't going all that fast, but this was a regular sized golf cart and I was 10.  There was also a lake at the bottom of this hill.  I drove us straight in to it.  Neither of us were hurt and after we'd all laughed for about 10 minutes straight my dad was able to get the cart out of the water (it was only about 2 feet deep).  If you look closely, you can see the actual cart in this picture - no, not in the lake. :P

My dad was a doctor.  A neurophysiologist.  He also spent most weekends volunteering with the Ski Patrol at one of our local mountains, so, he was more than capable of triage when needed.  One night the hotel manager called our room to ask if dad could come and see one of the other guests who needed some medical attention, so off he went.  At dinner the next night, a man came over to our table to talk to dad.  It was the husband of the woman he had gone to take care of the night before.  He was very grateful and wanted to thank him for his help.  My dad introduced all of us.  The man started talking to my sister, brother and I, asking us quite a few questions, mostly about the tv we liked to watch.  He wanted to know what our favorite show was - we said "Happy Days" without missing a beat, all three of us.  He smiled.

He asked us if we would like an autographed picture of Fonzie aka Henry Winkler  -  we all freaked out a little and said yes, of course!  Turns out, this man was Fred Silverman http://en.wikipedia.org/wiki/Fred_Silverman If you click that you will see that he was a major television executive and producer and had just moved to ABC from CBS.  He told us he worked with "Fonzie", that he was a really great guy, and that he would have him send us autographs.  We were pretty excited.

I managed to survive the rest of that trip and we went home.  We forgot about the whole Fonzie picture thing, as a few months went by without hearing anything.  Then out of nowhere, they arrived.  Almost better since it was a real surprise at that point.  Even better still, instead of just autographs we each got a picture of Henry Winkler, signed with a different message from him to each of us - this was pretty much one of the coolest things ever.  He not only remembered and made good on his promise, but that we each got something unique was perfect, especially for 3 such different kids.  I still have mine, thank goodness, here it is: 
I wish I could remember what he wrote on my sister's and brother's.




Function: noun
Etymology: from its possession by the heroes of the Persian fairy tale The Three Princes of Serendip
Date: 1754
Definition: the faculty or phenomenon of finding valuable or agreeable things not sought for; also : an instance of this

If you’ve ever had occasion to ponder the course of your life, the decisions you’ve made, directions you’ve taken and wondered, how would things be different if I’d done this instead of that?  Gone here instead of there?  Chosen this person instead of that one?  You are not alone.  I think it’s something most of us contemplate at one time or another, if not regularly.  Sometimes you may even question the paths you’ve chosen.

When I do this, I try not to do it with any regrets.  I cannot change the past but I can be conscientious about how I look at it.  Could I have made better decisions?  Of course.  Should I have made different decisions?  Maybe.  But I am one of those people who chooses to believe that everything happens for a reason.  You may not always be fortunate enough to realize or discover these reasons, that doesn’t mean they don’t exist.  It’s the “It’s a Wonderful Life” theory - yes I made that up - and I am a firm believer.

I am also very fortunate in that I already know the reason why the paths I took in my life led me to where I was and what I was doing 16 years ago.

Her name, is Tina.

I was working as a Neonatal Nurse Practitioner in the NICU at the Children’s Hospital of Philadelphia (“CHOP” from here on).  I had completed my Master’s degree in January of 1994, then moved to Philly from Houston to take the job at CHOP in April.  So I was still fairly new to the job and the unit.  CHOP was the Mecca for Neonatal Intensive Care at the time, all of the top docs in the country in the field were there.  The people who wrote all the textbooks I’d used all through my graduate degree were there.  This is where the newest and most extreme envelope-pushing treatments were happening - including liquid ventilation (think “The Abyss”, only using a ventilator).  So I took the job there, wanting to learn from these people, wanting to be part of the forefront in the field, and I was scared out of my mind.  I knew it was the place to be, but wow, the stress and intensity of that job was mind-blowing.  Even having been a neonatal nurse for years before becoming a practitioner hadn’t prepared me for what it was like.  There’s a big difference between the stress of caring for the babies in the unit as a nurse vs being responsible for making the decisions about their treatment, particularly in urgent or extreme situations.

I had only been there for about 2 months when I met her.  On Monday June 6th, 1994, I arrived at work in the morning to be told I was being assigned as the primary practitioner for a new admission that had come in the day before.  Tina was barely 3 days old, the second of twins born at 26 weeks, she weighed 2 lbs 1.5 oz.  She and her twin brother were delivered early due to their mom developing severe pre-eclampsia (hypertension) and pulmonary edema (fluid in the lining of the lungs).  Her brother was a tiny bit heavier, and contrary to conventional wisdom in neonatology (premature baby boys tend to be sicker in general than premature baby girls), he was also the stronger and healthier of the two.  In fact, he never came to our unit, they were able to take care of him at the hospital where they were born.  Tina, on the other hand, was very, very sick.

As the crew that had been on over the week-end handed her care over to me, I stood staring at this baby.  I had been working in neonatal intensive care for years, really sick babies were not new to me.  There was something about Tina, though.  Her mom was there, in a wheelchair, still sick herself - she’d been allowed to come stay with Tina for a little but she herself had not even been discharged from the hospital yet.  I watched her, just sitting, watching Tina.  Her tiny baby girl had a high-frequency ventilator attached to a tube in her trachea, 3 chest tubes, and multiple IV’s and monitors.  If you have never been in an intensive care unit, I can tell you that contrary to what you might imagine, they are quite noisy.  High frequency ventilation (she was on a Jet, if any of you have any knowledge of the field) is even louder than regular ventilation.  I can’t really explain it, but, I just know that as I was listening to report on her and watching her mom, there was something, this inexplicable… thing… she was very calm, very grounded, but she was very focused on her daughter despite all the noise and intensity of the environment.  It was like no one else was there.  I introduced myself and explained that I was to be Tina’s primary practitioner, meaning, I would be the one managing her care day to day, with a Neonatologist over-seeing the plans/orders.  I felt an immediate connection to Kathy.  I don’t really know why, I just did.  I was single at the time, never had any children of my own, but I empathized with her.  I had no idea how she was managing - she had been so sick herself that they had to deliver her babies extremely early, that in and of itself had to have been the hardest part.  Knowing it had to be done, also knowing that her children would be at very high risk because of how premature they were going to be.  Knowing it was possible they might not survive.  No doubt feeling guilty, though her condition was something she couldn’t have prevented.  Now she was still recovering herself, had one baby in the hospital where she was, sick, but stable, and one in extremely critical condition in an entirely different hospital.  How do you DO that?  How do you not just fall apart?  I have no idea.  But she didn’t.  She was there, she was intent on her daughter.  She was my hero.  There was just something in the way that she talked to me, they way she listened to what we were telling her about Tina, that told me - Tina may have been extraordinarily sick, but she was going to get through it.  Her mom knew it.  Then I knew it.  She just would.

It wasn’t a matter of denial or not understanding, Kathy is a smart woman, listened carefully and asked good questions.  I wish there was some way to explain it.  Tina’s dad, Mark, was the same way.  Both very calm, very bright, very strong people who had a way of making me feel better when they were there.  I think I felt better because I knew that they were good for Tina.

Science, experience, and “just knowing” don’t always work well together.  I knew, as did my colleagues, that Tina’s condition did not bode well for her future, even if she were to survive.  Neonatology is one of those specialties where, no 2 babies are necessarily going to have the same course despite having the same issues, but with years of outcomes to look back on, you can make some reasonable predictions based on what you’ve seen before.  If I had been working strictly based on what I knew, I would have accepted the fact that she was not going to make it, or at best, would be severely handicapped needing years and years of significant medical care.  I, however, am very good at suspending my beliefs, working around what my brain thinks it knows, in order to reconcile “just knowing” with my responsibilities.  Sometimes this is a good thing, other times, not so much.  In this case, it turned out to be a good thing.

Miss Tina did her best to make that difficult, though.

Extremely premature babies are at risk for many, many things to go wrong.  There is a reason gestation is as long as it is - babies need that time for everything to mature and develop enough to function outside the womb, without a placenta doing all the work.  14 weeks early, means the lungs aren’t fully developed yet, the GI system isn’t fully developed yet, everything is immature and not ready to be functioning outside mom.  Yet, they have to.  Unfortunately, there is no going back once you’re out!  Their tiny blood vessels are fragile, their immune systems are not ready to go yet, just so much going against them.  Tina and her brother both had IVH’s (intra-ventricular hemorrhages - bleeding into the ventricles of the brain, the ventricles being the 4 spaces in the center that are filled with cerebral spinal fluid and are connected to the central canal of the spinal cord).  Depending on how significant the bleeding is, this can be a minor issue not requiring anything but periodic ultrasounds to keep an eye on things, or a major issue due to significant bleeding that can lead to swelling, sometimes seizures, and other problems.  In the latter situation, neurosurgery is often required to place a shunt in the ventricle, to drain the excess blood/fluid to the abdomen.  Tina needed a shunt after they discovered that a clot had developed and was blocking the connection between 2 of the ventricles.  So this tiny baby who needed the most high tech machinery we had just to keep her ventilated, went for neurosurgery.

Her lungs were a mess.  The terrible irony of neonatal intensive care is that, many of the things we have to do to keep these babies alive, can also cause life-threatening problems themselves as time goes on.  Mechanical ventilation is one of those things.  Necessary, because babies born that early cannot breathe on their own, their lungs are not even finished developing yet.  But the constant force and pressure of air/oxygen being pushed into them by the machine, causes damage.  The longer the baby is on a vent, and the higher the settings are (basically, how hard the vent has to work to keep the baby properly ventilated), the worse the long term prognosis will be because the damage from the vent will be significant.  So Tina needed a massive amount of ventilatory support for the first several weeks.  This did not help her already compromised lungs.

For those first couple of months through that summer, it seemed like every week, usually on Friday, something would go terribly wrong.  On several of these occasions, Tina tried to leave us.  It was kind of a nightmare, I started to dread going in on Fridays, I can’t even imagine what it was like for her parents.  Every week we’d have to intercept them when they came on to the unit to shepherd them in to the Meeting Room, so we could sit down and explain what dire straights Tina was in now.  It was horrible, so many times having to sit in that room and tell them what went wrong this time, to expect the worst, that we weren’t sure if she would make it though the night.  Again. And again.  One of the worst Fridays stands out in my memory as probably one of the most difficult days in my life.  She’d actually been doing ok for a couple of weeks, things seemed more stable, she was even being weaned off her IV nutrition and was being given tube feedings.  Lulled in to a false sense of security though.  We’d finished rounds, I was sitting at the desk putting orders in the computer when I head monitor alarms starting to go off, nurses running, then they were yelling for me and the Fellow that was on.  It was Tina.  My heart and stomach pretty much hit the floor.  When I got to her bedside, she was coding, her tiny belly swollen, discolored and tense - I knew immediately what was happening and as much as I had believed she would “be ok” even through everything before, this looked like it might be the big reality slap in the face.  She had NEC.  N.E.C. stands for necrotizing enterocolitis, which is basically an acute inflammatory response of the intestines to feedings, in severe cases leading to intestinal necrosis (death).  As with  everything, this can be mild to severe, Tina of course, went all out with a severe case.  Her onset was sudden, and almost killed her.  We had to resuscitate her most of the rest of the day, and I mean, many, many hours, just trying to keep her alive.  I had to hand the rest of my patients over to the other docs, the Fellow and I did not leave her bedside.  Her gut had essentially disintegrated and she needed emergency surgery to remove the dead intestines to try to save what might be left.  But surgery wouldn’t take her while she was still literally on the brink of dying any moment.  So we kept working on her.  I stayed in to the night, until we finally got her stable enough that surgery agreed to take her.  It took more than a little convincing on our end though, they knew her history, knew how bad her prognosis was even without this terrible complication, they were very much against taking her at all.  This is where the science and knowledge part gets in the way.  Luckily for Tina, the neonatologist we had on her team, Dr Polin, seemed to have the same sense about her that I did - he was a tremendous ally and had a lot more pull with the surgical powers that were than I did or even the Fellow.  So, at some point between 11pm and midnight, they took her to surgery.  I stayed with her parents.  I wasn’t leaving until she came back, I didn’t know if she would come back.  I had to stay.

They brought her back to the unit at about 2:30, 3am.  Now, I know from talking to Kathy  that what the surgeon told them, and what he told us, was very different.  I hesitate to write this now, because I know that what he said to them was important and it helped them get through a lot with her.  He told them “where there is life, there is hope”.  Which is certainly one of the only ways you can stay positive in cases like this.  I commend him for his sensitivity with them.  What he told us (“us” being the medical staff) was this: “We opened her up, looked around, saw that she had very little bowel that was not already necrotic, so we decided that there was no point in doing anything. She does not have enough viable bowel to survive.  We put a drain in, but there’s nothing anyone can do at this point, she just doesn’t have enough left. We’re not sure why you guys pushed so hard for us to do something, she is not going to make it.”  I’m sorry Kathy.  That is almost word for word what he said to me that morning.  I didn’t know what to do.  Kathy and Mark were there, still, with that calmness and strength they had, and I had years of experience and science running through my head that were no longer staying neatly tucked away behind my “just knowing” she would be ok.  I had to go home, at 4 am, I finally did.  I needed a couple hours of sleep before heading back in the morning and I had to get my head together again.  I was not ready to give up on her.  I knew her parents weren’t, and wouldn’t be.  I had no idea how to work around the not having enough viable bowel issue, that’s really pretty cut and dry.  So I just took it one day at a time from there on out.  I’d learned that you couldn’t ever get too comfortable with her, so it really was just day to day.

She had another terrible set back one day when she started seizing and we couldn’t stop it for several hours.  Seizures are not good for your brain.  On top of everything else she had going on, this just seemed like overkill on the “everything that can go wrong, will go wrong” scale.  Once again we got her through it though, once again dragging poor Kathy and Mark in to the dreaded room to explain yet one more thing that was likely to result in a very poor outcome for their daughter.  Seriously, how much can you take?  They took a lot.  I spent that summer feeling like I’d been run over by a truck several times, I can’t even begin to understand what it was like for them.

One day at a time though, we carried on.  Tina made it through each crisis, defying all odds and reason.  Dr Polin and I cautiously decided to work on getting her home once it seemed like there was truly nothing else that could set her back any further, she’d already been through it all.  We started weaning her ventilator settings, slowly, but wean them we did.  We started feeding her again.  Why? We had no idea, we knew it likely wouldn’t work given what surgery had told us, but we also knew we couldn’t leave her on IV nutrition for much longer, that can also lead to problems… you know, that’s just what she needed… more problems.  So, slowly but surely, we were making progress.  She was tolerating the lower vent settings, she was tolerating feedings - which pretty much blew everyone’s minds.  Surgery would come in to do their rounds in the mornings, stop by her bed, shrug their shoulders, shake their heads in disbelief and leave.  It was completely inexplicable.  Yet, it was happening, who were we to argue?

With all of our other patients, it was science, it was facts, it was evidence-based medicine.  With Tina, we were flying by the seat of our pants by that point.  Everything bad thing that could have happened, happened, yet she survived, and not only survived, but here we were actually making progress with her.  None of this made sense to anyone.  This also put me in opposition to most of the other medical staff on numerous occasions.  In big teaching hospitals like CHOP, medical residents and Fellows rotate through the different specialties each month.  Only the Neonatologists and the Nurse Practitioners were consistent.  Even the Neonatologists rotated every month though, so at the beginning of each month a new group of docs would come in.  Most of them would just look at me like I head 2 heads when I was giving report on Tina, not understanding why were bothering trying to get her to the point of going home.  None of them believed she would ever make enough progress to be discharged and most believed her chronic lung disease and/or her lack of functional intestines and tendency toward sudden, intractable seizures would kill her.

By the early Fall, I was more convinced than ever that we were going to get her home. Her mom, dad and I became friends.  This might be the point at which you think, well, now she’s letting her emotions get in the way of her actions.  And you’d be right.  However, this is where my part in the story becomes more significant.  This is also one of those times when my “just knowing” and my emotional commitment to something I believed with everything I had, was a good thing.

With every emergency we had with her that summer, there was always some convincing that needed to be done on several levels.  There was always someone around who questioned what we were doing, why we were putting this baby through so much, wouldn’t it just be best to let her go?  Other docs, specialists, nurses, you name it.  At those times I was lucky to have had a Fellow or Dr Polin around to back me up.  As things settled down, and her issues no longer constantly threatened her life, it was more and more just me.  Dr Polin wasn’t the attending physician for several months, and we had new fellows coming in.  Tina’s history, x-rays, ultrasounds, and prognosis were pretty terrible.  New docs came in and constantly questioned me on what we were doing.  I had to work hard in the face of what everyone knew, to convince them to let us continue our plans for trying to get her home.  Some eventually gave up and just let it alone.  Others, did not.  I would come in after a weekend off to discover her vent settings back up again. What happened?  Oh, well, the docs on over the weekend didn’t think we should be weaning her when her x-rays look so bad so they put her settings back up…. wtf?!  Are you kidding me?  She was doing FINE.  I don’t care what her x-rays looked like, I know what she looked like, I know that her blood gases have been good, I know that she’s tolerating the lower settings.  So I’d have to work her back down again and continue to fight with people over how I was managing her.  As I mentioned earlier, the longer a baby stays on a ventilator the worse the prognosis.  So when people would turn her settings back UP after we had worked so hard to get them DOWN, was just frustrating beyond belief.  These people were letting science get in the way of what was right before their eyes.

The turning point to all this constant pushing and pulling was one morning when we had a new attending and a new Fellow starting their month in the unit.  We got to Tina, I gave them the whole story, including where we were at then and what our plans were.  Once again, I started getting grilled on why on earth we would be even trying to get her off the vent, don’t you know she has chronic lung disease?  The Fellow, right in front of me, walked over to her vent, and cranked up the settings.  Oh. No. You. DIDN’T.  I was livid, I’d had enough of this BS, I was her primary practitioner, Dr Polin was backing me up on the plans, Tina was actually making progress and doing well why couldn’t everyone just back the f*#% off ?!  I let loose on both the Fellow and the Neonatologist right there in the unit.  Fellow started yelling back.  We were hauled in to the hallway.  I was told I was letting my emotions get in the way of her care.  I told them they were letting an x-ray get in the way of it.  They weren’t looking at Tina, if they were, they’d see that she was doing well with the weaning.  I threw my trump card at them - I went to Dr Polin, told him what was going on, and asked him to please tell the rest of the medical staff to not interfere with plans that he’d signed off on.  He did.  They finally left me alone to keep working on getting her home.  Every morning on rounds they’d just nod and roll their eyes at me.

Until the day we sent her home.

We got her off the ventilator.  We got her off all her IV’s and on feeds.  She wasn’t having any more seizures.  We sent her home.

Often when premature babies survive their initial ordeals in the NICU, they can end up with significant long-term issues, like, Cerebral Palsy, BPD (broncho pulmonary dysplasia, basically, chronic lung disease), feeding issues, learning issues, the list goes on.  We got Tina home but I had no idea what her life was going to be like.  I was glad she survived, that her parents and twin brother finally had her at home, but I also worried about her future.  We kept in touch, after she went home.  It was so great to see Tina somewhere other than the hospital and she seemed to be doing really well.

6 years later, in the summer of 2000, I left Philly and moved to Seattle.  The last time I saw Tina in person she was only 6.  But her mom and I have kept in touch over the years, to this day.

Tina is now 16.  She has had some difficulties, some physical, though not severe.  There have been some learning and social issues, too, most of which she is able to make progress with because of great parenting, great therapies, and support behind her.  It’s not always easy for Tina, and I know her parents and brother worry about her.  But I also know that with a family like hers, she will always have the love and  help that she might need.  Tina is special.  She survived when she simply should not have.  To this day, I cannot explain how it is she managed to not only survive, but eat, given how severe the situation was when she developed NEC.  It’s beyond anything that makes sense.  I mean, really, the only thing I can think of is that the necrotic bowel somehow didn’t die completely AND got better… which doesn’t happen, but otherwise I have no idea.  Why we were able to get her off the vent, why she didn’t end up with severe CP, why she didn’t continue having the horrifying seizures, why, despite the things that are difficult for her, is she essentially a happy, healthy, beautiful 16 year old girl who wants to learn to drive and loves horseback riding?  I can’t tell you.  But her mom and dad knew.  And I knew.  We just, knew, that she would be ok, that somehow, she would make it.  Make it she did.

I have had the great fortune of not only being in touch with Kathy all these years, but also Tina herself over the last year or so on, yes, Facebook.  Tina and I talk almost every week.  I tell my oldest son Zach, who will be 14 in October, the story of taking care of her when she was at CHOP and how I talk to her now on FB and he just thinks that’s the coolest thing - so do I!

I went to work at CHOP looking for a cutting-edge career.  What I found, was far more valuable.  Tina and her parents taught me a lot.  About sometimes letting your faith in things you don’t understand guide you.  About how science and medicine need to be careful about not having tunnel vision so they can see what is in front of them.  I learned that sometimes my stubborn streak and tendency to let my emotions take over is not always a bad thing.  I also was given the gift of knowing why I was there, in that place, doing what I was doing, at that time.  I was there for Tina.  Serendipity.  She needed someone to fight for her and fight I did.  Literally.  To this day, aside from my own, wonderful children, I can say without hesitation that Tina’s survival is what I am most proud of accomplishing in my life.  I know that I was not alone, there are a few other people out there that were an integral part of keeping her alive and getting her home.  Dr Polin especially.  He has since moved on from CHOP, and is currently the Director of Neonatology at Columbia University Medical Center in NYC.  I think he’d be very proud of Tina too.

This was my part of Tina’s story.  I know her mom and dad could tell you a better one. As her parents I can’t and frankly don’t want to, imagine what it was like for them.  They were the reason I knew I had to do what we were doing. Mark and Kathy, you guys are amazing!

Tina herself has been asking me a lot about writing lately.  Hopefully one day, she will tell the world her own story.

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