Maternally Challenged

Another Week, Another All-Clear! I'm On a Roll!

Got a voice mail from my doc, The World's Most Wonderful Gastroenterologist. I love him because he talks to me like I'm an intelligent person and we are two intelligent persons discussing complicated topics. Those of you who haven't spent as much of their lives being a patient as I have may not know, but that is a rare thing in medicine these days. Anyway: "Tracy, I've been trying to reach you. I have your path[ology report] here and it's okay, nothing to worry about. Call me tomorrow--ask for Stephanie, she'll know how to reach me--and we can discuss it in more detail."

Again--thanks, everybody. You guys are settin' the bar pretty high in the friendship department here. I hope I can live up to it if the shoe's ever on the other foot, which I hope to God it will never be. But I'm just sayin'.

Another Week, Another Biopsy

Yes, I know, it does seem like I am working hard to get attention and sympathy these days, but I am not making this up.

Last week, I went for an endoscopy (a lovely procedure where they stick a little tube down your throat to look at your upper GI tract). This is something my doctor wanted to do because about 10 years ago he'd diagnosed a hiatal hernia and folks like me have to be scoped once in a while. No big deal, right? Being Medically Unusual, I've gotten used to having lots of weird things done to my body. As long as you give me good drugs beforehand, I'm cool.

Except that this time he found something called Barrett's Esophagus, which is a disease of the esophagus which ups your chance for esophageal cancer. He took a biopsy and I'm supposed to get the results tomorrow or Tuesday. So of course I hit the Internet and discover that folks with this condition have about a 1 percent chance of getting esophageal cancer in any given year, and that as long as you're getting scoped regularly, esophageal cancer is pretty curable. People die of it because it doesn't cause symptoms until very, very late--which, obviously, this isn't. Plus, my doctor didn't ever use the "C" word, and what's turned up so far is, in his words, "Not too serious."

It's funny, though, how little words can haunt you. "Too." Hmmm. It doesn't help that I have a friend who is dying of esophageal cancer as we speak, and I haven't even spoken to her lately because she can't talk anymore.

After the Full Crisis Mode I went into on the mammogram scare, I thought I'd try to just handle this myself, which was a complete load of horseshit. I can't handle anything by myself. In fact, I should not be allowed outside the house without adult supervision. As it is, I am periodically overwhelmed by fear, and as soon as I dump one delivery, another arrives. And even though I know that the very condition of being afraid is a futile attempt to control the universe--as if imagining some unwanted outcome will somehow make that outcome less likely--what's also true is that fear is a monster which does not engage in rational discourse.

So: I admit it. Once again, I'm not fighting a disease here so much as a state of mind. And the last go-around on this taught me that there are ways of doing that a whole lot more effective than diving down a hole, covering your ears and chanting, "LA! LA! LA! I CAN'T HEAR YOU!" to the universe. What I'd rather do right now is just own up to the fact that I am weak and scared and pretty f--ed up at the moment. Again.

And Why Should You Escape?

So today we are sending out the last of the Christmas cards, some of them with a letter enclosed, and it occurred to me that all four or five of my readers out there might be interested in our Yearly Recap, too. Hell, it took  me a WHOLE DAY to write:

At this house, our motto for Christmas letters is “All the news that fits, we print,” but we still pledge to keep it relatively short. For 2007, this will be no problem because, frankly, there are a few stretches of 2007 you wouldn’t want to hear a lot about. 

The bad news first. Tracy underwent some ECT treatments last winter for a severe depressive episode and we’ll spare you the details because, actually, we don’t remember them. ECT is known for doing a number on one’s memory of recent events, so it’s been a year of surprises: outfits we don’t remember buying, e-mail correspondents we don’t remember having met… On the plus side, it also wiped out the memory of several really bad Disney movies, and it helped Tracy recover. ECT is very effective that way—but then, amputation is effective on gangrene, too, and there are good reasons why neither treatment has ever really caught on. Still, while humans can’t sprout grow new limbs, they can and do grow new brain cells. It was a long haul, but we are pleased to report that things are now back to what passes for normal around here. Work-wise, Tracy has several projects going: you’ll see her in the Civil War Times soon, she’s working on something for the NYU Law Journal which will involve traveling to The Hague to interview an eminent judge who sits on the World Court, the paperback edition of her book came out this summer, and there may be another book idea out there somewhere. Life goes on.

In extraterrestrial news, David’s working on a NASA project that would, if funded by the Powers that Be, map the universe’s distribution of Dark Energy. What is Dark Energy? you ask, to which the brightest minds at NASA would answer: We dunno. All scientists know is that it is a mysterious force which accounts for about 25 percent of the energy in the universe, and it is, like, totally awesome, dude: it sends stars careening around galaxies, it can bend space and time, and it keeps that donkey kid in back of you kicking your seat for the entire duration of a trans-Atlantic flight. The official name for the project is ADEPT (Advanced Dark Energy Physics Telescope), but around here we just call it The Map of Where Is, Is. 

On the kid front: Rebecca is now 11, making her officially a ‘Tween, and so we have been introduced to the Great Big Honkin’ Attitude years. Not that Rebecca has ever lacked an Attitude, but up to now she had not brought it to bear on clothing. All that changed when she and Tracy went shopping for back-to-school clothes this year, and Tracy’s idea of fashion (subdued things with interchangeable components) fell victim to Rebecca’s fashion vision (spangles, sparkles, sequins and drapey things cut on the bias, all in hues unknown to nature).  Compared to this kid, Porter Waggoner would have looked like a funeral director. Well, okay, maybe that’s exaggerating a bit, but still: you see the potential for conflict. Rebecca is also deeply into the Cat Warriors books, and can diagram all the cat clans and interconnections thereof for anybody who displays the faintest interest, as well as for lots of people who don’t. (Our advice: don’t.) She has also caught the Horse Virus from her Aunt Nonny, and as any parent knows, “adolescent girl” + “horse” = “second mortgage,” so thanks a lot, sis. Rebecca takes riding lessons once a week at a nearby stable, where, besides learning how to ride, she is also learning to work with an implement known as a “pitchfork.” Our hope is that not only will she learn some horsemanship but that her expertise may someday transfer to using implements known as a “yard rake,” a “mop” and a “broom.”

Suzanne started first grade this year and has already won two professions of love from little boys in her class, which puts her one up on mommy at the same age. But then, Suzanne has these adorable freckles, which gives her an unfair advantage. She is a bundle of spontaneous bursts of enthusiasm (told for the fourth time to get out of the bathtub one night, she replied, “Okay, Mommy, but first I have to DO THE WET NAKED DANCE YEAH! YEAH! YEAH! BABY!!”—and there went another 10 minutes) and non-stop creative energy. At home, this means piles of paper, markers, paint, clay and other art projects in various stages of completion all over the place. At school, this recently resulted in a phone call from the vice principal informing Tracy that Suzanne and an unnamed male co-conspirator had been thwarted in their plan to tie each other up during recess. Suzanne has been banned from even touching a jump rope until after the first of the year; fortunately, the school supply list does not include "whips" or "chains." Otherwise, she keeps us busy with Inscrutable Questions (“Who invented broccoli?” and “How dark is pink?”are a sample) and creative manglings of common expressions (notably, “Fruit of the Loo,” which Tracy is thinking of marketing in the U.K. as a new brand of toilet paper).

No exotic vacations this year; we spent ours this summer a whole 100 miles from the house, at a mountain cabin in the Shenandoah Valley, where we went to a county fair (lots of fun, and who knew pigs could be so squeaky clean?), spent the day at a water park, did a bit of hiking (which prompted another Inscrutable Question, this from Rebecca: “Why is the Appalachian Trail so steep?”), and learned that a tiny little mountain chalet is way too small for three high-maintenance females and one outnumbered husband/father about two millimeters from the end of his rope. The kids had a blast; Tracy and David survived.

So that’s the year. And now that we think about it, it hasn’t been dull at all. Really: how many people get to map the universe? Or get paid for putting words on paper, for pete’s sake? So, as usual, once we look at the big picture we realize the good vastly outweighs the bad, and that goes triple since the recent pathology report came back marked "benign." (See previous posts.) Compared to 99 percent of the world, we are filthy rich; by any measure, we are incredibly blessed. We hope this finds all of you similarly situated. Merry Christmas.

Benign

The call came while I was negotiating the parking lot with a balky six-year-old and an arm full of packages, and I knew instantly it was The Call. I let my kid wander around unsupervised while I dropped everything--literally--and opened my cellphone.

"I have some good news for you," said the doctor, and that's really about all I remember his saying, other than the words "benign cyst" and "no malignancy" and "not until next year."

So I am left with a very bruised breast, unspeakable relief, and a new understanding of fear--and the human connections that can heal fear. Because the fear was the worst. I was pretty sure--reasonably sure--that even if the lump did turn out to be cancer, that it wasn't going to be a very big cancer (my own doctor hadn't felt it, two weeks ago) and I know that very early cancers are pretty curable these days. I knew this even though the word "cancer" tends to put me in full panic mode, since I watched my father die an agonizing death from it 26 years ago, which was way, way too soon. Breast cancer would not be anybody's choice, certainly, but I live in a country with some amazing medical technology, just down the road from some of the nation's premier health care institutions, and I have faced some pretty bad things before now. Cancer--at least, very early very curable breast cancer--there was at least a tiny chance I could handle. At least,  with a lot of help.

What I couldn't handle was the fear. The fear was what laid me low--specifically, fear of dying before my children were grown. Everybody fears death, but I feel fairly confident in speaking for a large majority of the planet's mothers when I say that there is a fear worse than the ordinary human fear of death, and that's the fear mothers have, the fear of leaving their children too soon. On that first day I said to the cosmos: "I'll deal with cancer, but you'll have to handle the fear." And you know what? From the anonymous cancer hotline counselor who listened to me sob for awhile, to the people who e-mailed me with words of encouragement, to the good friends who distracted me--the universe seemed to come together as if it had been planning for just this emergency, and with only me in mind. I was taken care of, and I felt it. After, I dunno, four hours of being completely and totally freaked out, I slowly began to feel calm again, and at night I went to sleep feeling as if I was wrapped in a silk cocoon of other peoples' love. I joked to one friend that I could practically see the good vibes, and it wasn't entirely a joke. Not to sound all New Age-y and all, but there is some kind of cosmic energy out there that I don't understand and I'll say no more about it except: I'm glad it's there. And I'm glad all you other humans are out there too.

Not Me. Couldn't Be.

This week I learned that an old friend has cancer. Her kids are about the age of mine, and so this news--after the initial shock of envisioning this person with a life-threatening illness-inevitably put my mind onto the unspeakable fear that every mother has: what if I die before my kids are grown? Because I know that's what my friend is thinking. That's one thing that comes with motherhood: the fear of your own death actually becomes secondary--to the fear of losing your children before it is time. It's a cliche, but it's true: you love your children more than life itself.

So when the call came from the mammogram folks, the ones I'd seen earlier this week for my usual yearly visit, I was primed for a freakout. The test has gone smoothly; I'd left thinking I'd gotten the all clear. Not so. "We saw something unusual," the lady said. "The doctor wants you to come back to another picture." Which I did. And then: "We still can't see it very well; we want to do a sonogram." And then, in a moment in which I felt myself disassociating from my body, I heard the words, "We want to do a biopsy."

I hit the internet the minute I walked in the door, before I dropped my coat. From it I learned that 80 percent of biopsies turn out to be of benign breast conditions. I learn that the survival rate for cancer is very high, especially if it's caught early. And it doesn't matter, because then the fear descends--the fear that something bad is about to happen, that I will have to leave my kids before I want to.

I spent some time this afternoon on the kitchen floor, sobbing. Now that freakout is over, and I am keeping it together, with the help of one or two good friends. Something here is getting me through, I don't know what, but I'm grateful for it. Somehow or other, it's gonna be okay--and by that I don't mean I'm confident I don't have cancer. I just mean that, cancer or not, it's going to be okay. At least, that's where I am at this moment. There's a 90 percent chance of another freakout in the next few days, but: one day at a time. Which is what I hope my friend is thinking, too.

If you are sending out good vibes, send some to her. And while you're at it, send some to me, too.

Giving Up The Addiction

A couple of years ago, I had a book contract that went sour. I still don't know exactly why. My editor was a highly respected name in the publishing world and I was thrilled to be working with her. Trouble began, though, when I turned in my first three or four chapters. I knew they could use improvement--what first draft couldn't?--but I was not prepared for the terse and scathing e-mail I got, something along the lines of "Well, this is frankly disappointing." That was it. No critique, nothing about what needed work, no guidance. This happened three or four times over the course of the next 18 months, which rank as the most excruciating in my career. I'd been a professional writer for more than 20 years and things had gone wrong, but nothing like this. I was baffled, distraught, utterly demoralized. On one particularly bad day, I actually crawled under my desk and sobbed. Eventually, things got so bad that my agent negotiated an end to the contract--which the editor's publishing house agreed to, on one condition: I had to repay my six-figure advance.

When my agent told me this, I had to check to make sure my ears were screwed on properly. I had to repay them, when I had tried in every conceivable way to fulfill my end of things, had asked repeatedly what I was doing wrong, had begged for guidance, and my editor had barely answered my e-mails? I couldn't believe it. I called the Author's Guild.

"It sucks," their lawyer said. "You're right and they're wrong. But if I were you, I'd pay up. Believe me, I've heard worse. And they've got a battalion full of high-priced legal talent. What have you got?"

I took a deep breath, and I took his advice. (The book, incidentally, is The Ghost in the House: Motherhood, Raising Children and Struggling with Depression. Another publisher, HarperCollins, bought it; since then it's sold two foreign rights, is now in paperback and has done quite well.) But I was writing checks to that editor's publishing house for a long, long time. 

Fast forward to last week. A non-profit group I've been a member of for some time sent out a mass e-mail about a book contract just signed by one of the group's former officers. The e-mail said that the book would be based in part on things that had been said by members in online discussions over the past several years, and it expressed the sincere hope that we would all continue to contribute our thoughts and experiences. There was a clearly implied hope that someday lots of us would buy the book.  The amount of the advance was not disclosed. But in the usual course of things that money goes straight to the author, minus a percentage to his or her agent to be "earned out" against future royalties, if any (and there usually aren't, unless the book hits the best-seller list).

The only reason this is interesting at all is that a couple of years ago, two members of the group (I was one) were barred from even discussing two topics they had written about--topics which were highly relevant to many members. One of the people who made this rule was the person who last week announced her own book contract. And the reason we--this other member and I--were given was that we had written books of our own, the mere mention of which, we were told, would be abusing our membership for personal enrichment by, you know....selling books. When people expressed an interest in the topics anyway, the group's leaders actually shut down the e-mail loop temporarily.

So. Two incidents--one pretty important in my life, one fairly minor. Both times, I was treated unfairly. Both times, I went ballistic. The first time, I had no recourse; I just had to take it. The second time I spent, I am embarrassed to say, an unbelievable amount of energy trying to reason with the folks in charge. And when reason did not prevail, I yelled and screamed (both online and in person). I wrote angry e-mails. I talked my husband's ear off. All in all, I did a credible imitation of Yosemite Sam in a full-force swivet. I got utterly fixated on the fact that these folks just did not understand, and I couldn't get away from the idea that it was my job, personally, to make them understand.

And both times, the Universe said: So?

And I said (condensing madly here, because actually this process took a couple of years): But I'm right and they're wrong! I'm right, I'm right, I'm right! And I'm being penalized and it's just not fair!

And the Universe said, Okay, but what's your point?

That one was easy. The point was being RIGHT, goddammit. And being right was a kind of high. Self-righteousness is the spiritual form of crack, and just as hard a habit to break. You give up your self-righteousness, and then turn around and realize that you're self-righteous about giving up your self-righteousness. Giving it up, really giving it up, is like a little death. Well, not "like"--it is a kind of death. Because you're killing off that kindergartener in yourself that's jumping up and down screaming about fairness.

The way I arrived at this conclusion was that after awhile, this posture of Being Right became a kind of psychic black hole: it swallowed up tons of energy and gave nothing back. I was very, very slow on the uptake here, but one day I was thinking about how that editor had shafted me when a new thought occurred: "I bet she doesn't remember your name." And the same thing last week: that e-mail got me all riled up again about this incident several years ago, and I fired off several rounds of e-mail before my frontal lobe came back online. And then I remembered how much time I'd spent online a couple of years earlier, how I had bored my husband to utter stupor with every itsy-bitsy detail.

And then I remembered something else--an incident that had happened just before I left the Washington Post, when I'd done a story about some financial hanky panky at a major animal welfare group. This was a non-profit that got donations from hundreds of thousands of little old ladies around the world, who dug into their Social Security checks or whatever and gave $5 here, $10 there...and the leaders of this group were living in what could only be called palatial splendor. The percentage of income that went to executive salaries in this organization was way up there. I asked one of those guys living in one of those palatial homes about some deal where he had padded his salary in the guise of some real estate deal. I remember that he made a little expression of distaste, as if I'd just belched or something, and he picked a piece of nonexistent lint off the leg of his extremely expensive suit. I got mad then, too. I wrote my story, and maybe some little old ladies out there stopped sending in their money--I don't know--but I do know that this man in his expensive suit went right on enjoying his palatial lifestyle as if I had never existed. Maybe I gave him an afternoon of heartburn, but that was about as much as I accomplished.

And then, finally, I got the point: It is not my job to fix anybody but me. I have a friend who says that our job is to send our energy outward--to create, explore, connect--and that anything which obstructs that process is inherently wrong. That sounds right to me. And so what was wrong here, truly wrong, was not what these people had done to me (or to the little old ladies of the world), but what I'd done to myself--how these events had lured me into an addiction of sorts, one which took a whole lot of energy and turned it inward.

And so now, by saying this, I hope that I have turned that around.

Fear

A long time ago I had a boyfriend who was, shall we say, not the right guy for me. He was extremely brilliant, well known in his field, financially secure, and eight years older; I was completely in thrall to him. He was also possessive, pathologically jealous, controlling and verbally mean. After a very short time with him I put my self-esteem in the closet and ceded control of my life to this person, who exploited the situation to the max. With him, I made just about every mistake I will someday warn my own daughters about. But I'll say this for him: he's the reason I learned an important lesson about fear.

I didn't even learn to swim until I was 30, that's how afraid of the water I used to be. When I was a kid I had a swimming "instructor" whose idea of teaching kids to swim was to practice blowing bubbles, then take us to the deep end of the pool and make us jump in. I guess you could call it the Total Immersion Technique. Whatever it was, it gave me such a fear of the water that whenever I got in water over my head I would immediately hyperventilate. At 30, I did finally get over that fear enough to actually learn to swim at the YMCA, so I give myself credit for that, but still: getting in water over my head remained cause for serious concern. When I swam laps, I did it at a health club where the pool was built solely for that purpose--four feet deep all over.

So anyway, The Boyfriend wanted to go scuba diving in the Caribbean. He had his certification, and since I had granted him control over my life I decided this was something I had to learn how to do. I signed up for lessons, did the course work and finally, one spring evening, found myself at a hotel pool with my classmates, ready to take the final exam. It consisted of putting on your weight belt and fins, picking up your BCD vest, your mask, your oxygen tank and all the assorted hoses and paraphernalia and jumping into the deep end of the pool, which was 10 feet deep. There, at the bottom of the pool, you would be expected to a) insert your mouthpiece, b) put on your mask and clear it, and c) correctly put on the rest of your gear. Then, and only then, you could ascend slowly to the surface. 

I watched everybody else do this thing, and then, finally, the moment of truth could not be postponed any longer. I have never felt that kind of fear before or since. It was visceral. It didn't matter that I knew I was in the company of several more than competent swimmers, that the instructor himself knew CPR, that no matter what happened I wasn't going to die....no, reason had nothing to do with this. This was simply my body screaming: No no no no no no! I couldn't breathe. I could not imagine floating in that end of the pool, much less willingly putting on weights and sitting at the bottom. Let's get this over with, I said to myself grimly, and stepped into the air.

Then I was at the bottom, and horror overwhelmed me, and pure, blind panic. I groped for my weight belt, unhooked it, and kicked like crazy to the surface, where I swam over to the side of the pool and held on, white-knuckled, hyperventilating. Utter failure.

The instructor came over and squatted next to me. "Take your time," he said quietly. Somebody retrieved my gear. I went over to the ladder and got out of the pool. And somehow, a measure of calm came over me. I won't say that suddenly I was unafraid--far, far from it--but that moment of being at the bottom proved to me that I could get myself out of a really scary situation if I had to, and survive, even if I didn't look exactly graceful doing it. In a few minutes, I was ready to try again. And this time, somehow, I did it. This time, when I came to the surface, everybody was clapping. I wish I could say I felt exhilarated, but I didn't; I just felt profoundly relieved. I went home and had a stiff drink.

But something about that moment must have stuck. I'd always been fairly confident of myself in situations relating to my work, but this was the first time I'd ever seen myself as just a person, in a situation I had no natural abilities for, facing fear. A tiny seed of self-confidence was planted, and slowly began to germinate. And when that relationship ended, which of course it eventually had to, I got through it okay. I didn't look exactly graceful, but I survived. In some ways, the end of that relationship was a lot easier to survive than my scuba diving final exam.

Several years later, I met met the man who is now my husband, and during our honeymoon in the Caribbean we went scuba diving. I remember we were just noodling around one day, seeing the sights, when my husband grabbed my hand and pointed out an underwater rock formation. We both swam over to explore. There are moments in your life that are like Kodachrome prints, still moments of wonder and awe, and this was one: we both looked up, and through an opening at the top, we could see sunlight coming through. And above us, swimming in that diamond-sparkling water, were hundreds and hundreds of tiny, brilliant, cobalt blue fish.

Chemotherapy for the Mind

That's what ECT (electroconvulsive therapy) reminds me of. Strictly speaking, taking antidepressants better fits that description, since there are chemicals involved in that and none in ECT (except the ones they use to put you to sleep, and powerful chemicals they are), but somehow the image of chemotherapy seems better suited to a procedure in which it is a mighty close call which is worse, the cure or the illness. I don't wish to scare anybody away from ECT--it's clear to me that it can be a lifesaving procedure in certain circumstances--but let us be clear here: whatever it is that causes ECT to lift depression also comes perilously close to messing around with the essence of what makes us human.

I knew going in that ECT was apt to have an effect on some of my short-term memories. I wasn't prepared for the fact that last weekend I took my daughter to see "The Bridge to Terebithia" and that I do not recall a single frame of the picture. I even went to the website, hoping that some stills from the movie would jog my memory--but no. It's as if it never happened.

That's a disappointment I can live with; after all, I can always go see a movie again. But it did raise the issue of what other memories I might lose if I kept this up. And I have to admit to some serious disappointment with is the way the psychiatric profession has handled this whole issue. On one hand, there's my doctor, who hasn't kept up with the news on what is a valuable therapeutic procedure, and who dismissively refers to doctors who use ECT as "shock jocks." My doctor is a good guy, and I expected more open-mindedness from him; it's disappointing to see bias creep into his professional judgment. But that, in the end, paled in comparison with the disappointment I felt at the hard sell I got from Sheppard Pratt. When you think about it, it's clear that ECT is an extremely cheap therapy--a few cents worth of electricity, a few minutes of an anesthesiologist's time, somebody who can interpret an EKG and monitor vital signs. This is the medical equivalent of restaurant iced tea--something you can create for pennies and sell for dollars, and did they ever sell it. I heard stories about people who kept coming back for 20, 30, 40 treatments, about people who loved it so much they had to be turned away. I heard about the benefits of "maintenance ECT." I heard marvelous stories about the wondrous curative effects of ECT. What I didn't hear was any serious discussion about a) its specific applicability to me and b) the particular concerns about memory loss posed when you make your living from observing and recording what you see. There's no doubt in my mind that I could have signed up for twice-a-week treatments for the indefinite future and the only thing that might have thrown a monkey wrench into things would be if Blue Cross began to raise some objection, thus interrupting the money flow.

In the end, I walked away with two lessons here. One is that yes, ECT can be helpful in some circumstances. It is by no means the blunt instrument of mind control that its opponents have made it out to be. If anything, its peril lies in the fact that it is so cheap and easy to administer--and, oftentimes, so fast and effective. Why? Because it's not something anybody should undertake casually. The potential for misuse calls to mind the old United Negro College Fund motto: "A mind is a terrible thing to waste." Or another, from Roman times: "Caveat emptor"--buyer beware. And that's sad: you'd think that if ever there was an endeavor that should be insulated from the brute forces of the marketplace, it should be the so-called healing professions. Yet if anything, here is where they seem to be magnified.

The Nuclear Option

For about four months now I have been slogging through a prolonged period of depression. It's actually not the worst I've ever had, in the sense that I have not been actively trying to destroy myself and I've been capable of doing routine work, but it's been bad. The phone rings, and I don't answer. In the mornings I count the hours until I get to go to bed again. I am detached and flat with my kids. My libido is--pffft! Worst of all, I cannot think of a reason why I should continue to be here, what possible interest there could be for me on this planet for another five years, let alone another 25. I have started and put down a dozen books; my concentration doesn't last past chapter two. And if reading is impossible, writing is even more so, which is why there haven't been many blog entries lately. My career as a writer seems over; every day, I feel a little bit deader.

A lot of things have led to this, none of them anybody's fault; it's just the way life is sometimes. My mother died just over a year ago, and I miss her acutely. I published a book I had poured the last three or four years of my life into, and--unlike my first book--the interest from the mainstream media was nonexistent. (Which is not to say that I regard it as a failure or not worth doing; whoever is reading this has probably run across my book; the fact that the mainstream media didn't pick up on it has nothing to do with the importance of the topic; and I know it's helped some people.) But still: the book was written against long odds, and I guess I had hopes that it would spark more of a public conversation than it did about the topic of depression and motherhood, so there's disappointment, to say the least. This year has also been a year of health issues, probably not coincidentally: surgery on my knee, an unusual number of colds and stomach bugs and fevers, arthritis in my neck and lower back. This was the year we established a health club membership and I was going to finally lose those 20 pounds (again). Didn't happen.

But mainly, it's just the fact that it's winter--February, to be exact--and this has always been my worst month. It comes every year without fail. This year it came early. And every day for the past three or four months, I have felt a little bit deader, a little bit less like ever coming back to life. I upped my meds, and that didn't help. I started in on the benzodiazepines again, even though they are addictive, for the same reason that you reach for morphine when you're having surgery: it blocks the pain of constant anxiety...even though there will be hell to pay later on.

Depression takes a toll, and not just on you. Repeated episodes of depression have been associated with decreased volume in the hippocampus, the area of the brain where emotion and memory are integrated. For people who think antidepressants are a crutch, here's some news: a lifetime of untreated depression can literally leave you brain damaged. And that's saying nothing of the damage to your family: the husband who gets a hologram for a wife, the children who beg, " Mommy, can you spend some time with me?" only to hear, "No, I can't, I'm sick." They get fooled, because the person they know as mommy is still making dinner and picking them up at school--she's not on life support in a hospital anywhere--but she's not really mommy. She's the person who is inhabiting mommy's body, and, increasingly, that person is a ghost. (Which is why I chose the title I did for my book,The Ghost in the House.)

All of which comes as background for my reason to take a step which may sound extreme: electroconvulsive therapy, or ECT. Yeah, I've seen One Flies Over the Cuckoo's Nest, and I know that what people think when they think of ECT is of a drooling Jack Nicholson at the hands of a punitive medical establishment, a shell of his former self. ECT began a bit that way, but even in the 1960s it was nowhere near as barbaric as Ken Kesey described. Today it's often done on an outpatient basis, and among its more famous consumers is Kitty Dukakis, wife of former Democratic Presidential candidate Michael Dukakis, who has written her own book (with co-author Larry Tye) entitled Shock: The Healing Power of Electroconvulsive Therapy. Mrs. Dukakis' experience is extremely atypical, in some ways: she gets "maintenance" ECT about once a year, since her experience with depression follows an extremely predictable pattern (which, come to think of it, mine does too). I also have two friends who have gone through ECT, one of them twice and one of those times back in the bad old days before they sedated patients or gave them muscle relaxants to mitigate the physical effects of the artificially induced seizure, and before techniques were developed the minimize the (usually temporary) memory loss associated with ECT. Even so, both of these people said it helped them.

How does it work? Doctors don't know. But then, they don't know much about how antidepressants work, either, just that they usually do. The brain is still very much a mystery to science, even though we know more about it than we ever used to, and it may well be, as a scientist at Eli Lilly once told me, "If the brain were simple enough for us to understand, we would be too simple to understand it." About all we know is that a low-voltage electrical current, when passed through a portion of the temporal lobe, will induce a temporary seizure, and that this in turn changes the levels of neurotransmitters in the brain (which is what antidepressants do, by a different mechanism). Still, it remains extremely controversial. My own psychiatrist was not thrilled with my idea; he calls the ECT doctors "shock jocks." But one of the things you learn when you have a chronic illness is that, in the end, it's not your doctor who will be living with the results of what you do or what you don't do. It's you....and your family. In the end, my psychiatrist wrote the referral, and said he could understand my decision even if he didn't agree with it.

I had my first treatment yesterday. It was like getting hit by a truck (and I can say that with some authority, having survived being hit by a car as a teenager while getting off a school bus). Today, I have some muscle aches. It also gave me the mother of all migraines, and for an hour or so I was extremely disoriented. But then things slipped back into place, and now I can even remember the anesthesiologist saying, "You're going to sleep now" as he pressed the syringe into my IV. I also know that last night I looked at the sunset with real appreciation, and that after I went to bed I cried for a long, long time. They were healing tears. I felt much better after I was through.

Am I doing the right thing? God only knows; I don't. All I know is I have two little girls that I love, and a husband I love, and things I want to do. And when I die, whenever that day comes, I don't want anybody to be able to say it was for lack of wanting to live.

Just Say Yes to Drugs

There's an old joke about a horse trainer who was giving his jockey some last-minute advice just before some fancy horse race in England. Just as the trainer pulled a humongous blue pill out of his pocket and fed it to the horse, the race's overseer, the Duke of Marlborough, walked up. "My good man," the duke expostulated, "what in heaven's name do you think you are doing!?"

"Oh, it was nothing, guv," the trainer said, thinking fast. "Just a treat. I eat 'em myself all the time." And he pops one into his own mouth and then offers one to the duke. "Have one yourself, your lordship."

"Hmmm," says the duke, not entirely convinced, but he takes the blue pill, chews on it for a moment and finds nothing immediately remarkable. "Very well," he says. "Good day."

The trainer then turns back to his jockey. "Right," he says. "Now, as I was saying, once you get out of the gate, just go to the outside and give 'im 'is head--because today, the only two animals that can outrun this 'ere horse are me and the Duke of Marlborough."

This old joke occurred to me for some reason as I was waiting at the pharmacy today to fill my fourth prescription for major, heavy-duty painkillers in the last week. In fact, I am Under the Influence right now, which is the only reason I can think of for putting information on the Internet that could make every junkie in the Washington, D.C. metropolitan area start thinking about digging out his burgling tools (assuming junkies read blogs, which I'm guess they don't; I'm guessing they probably pawn their laptops to buy, you know, drugs). Anyway, Blue Cross seems remarkably indifferent to my sudden intense interest in Oxycodone and Percocet and, oh hell, I forget what else because I'm slightly high right now. The lady at Giant handed over my new 70-pill prescription without a blink, though I might have detected a certain look of disapproval. Don't know; don't care.

I'm eating these things like candy because a) the knee which I had surgery on a week ago still hurts like a m.f. at time, especially at 4 a.m. (why is that? WHY?) and because b) I have the kind of tolerance for painkilers that normally one sees only in, oh, say, 1,500-pound racehorses. Why is this? I do not know. I know only that I am Medically Unusual. My second child was born while I was under the influence of an epidural which never completely "took," which is sort of like being invited to your own disembowelment, only with a happier outcome. I kept saying, rather anxiously, "I can still feel something," and my husband kept telling the anesthesiologist, "She can still feel things" and the anesthesiologist kept saying, "Ooookay" and twisting little knobs or something, and my baby was out and bathed and in a warm blanket while I was still saying, "I can still feel..." The last thing I can remember from that particular day was the anesthesiologist saying to my husband, "I'm giving her some nitrous oxide. Tomorrow she won't remember any of this." Yeah. Right.

Anyway, this is why I tend to regard a prescription which says "Take one pill every 4-6 hours as needed" not as rigid instructions, but more as a starting point for negotiations. I am not a junkie, truly I'm not, I do not take these things when I don't need them; it's just that when I do need them, I need them a lot more than other people do. Someday, doctors will do some more research and discover that different people process the same medication--who'da thunk it!--differently, and that maybe even things like hormone levels and time of day affect the way the body metabolizes different drugs. I know this for a fact in regards to my own body, but this, I believe, is what scientists regard as "anecdotal evidence." Anyway, enough BUI (blogging under the influence) for me; time for nighty-night. And no, don't call me. I'm not sharing.