Patie's Open Salon Blog

Don't Tell ME That Came Out of MY Mouth

Sun, 27 May 2012 11:05:32 -0400

Don’t Tell Me THAT Came Out of MY Mouth!

Part 3 of the series: Dementia from the Inside Out

Parts 1 and 2 can be found at:

http://open.salon.com/blog/patie

(There are too many)…experiences to make peace with (thus we must learn the art of) partial accommodation and accept that (symbols are not truths).

Cary Tennis with modifications by Patricia McRae

About two weeks ago I found myself in the kitchen staring at my daughter, Tall Girl (TG) with my mouth wide open and hands clasped over my mouth as in Edvard Munch’s The Scream (or the Cry). I had just spent the past five minutes going off on a rant and ending with: And I will not spend one minute more of this life I have left on inconsequential crap like that! Well crap wasn’t exactly the word I used but you get the idea. So what is so unusual about that?

I have always been the peacemaker, conciliator aka the one who listens in my family, not one to raise her voice. I have always jokingly said that I should never count on winning physically in an altercation; I was too short and too slow, but I could talk you to death. So I developed a skill set to control the physical and mental chaos that dominated my family. This continued into adulthood gradually losing the physical and verbal chaos of my childhood home. One of the characteristics that drove me in choosing my children’s father was that no one in his family’s house screamed at one another nor did they threaten one another with chairs poised over their head. I think I married him for the peace in his family as well as I knew deep in my soul that he would never raise a hand to strike me…and he never did.

I finally figured out that silence could also mean there just simply was not much going on in the way of attachment.In my demented case, it is hard for me to be silent or thoughtful. I feel anxious and scared that ranting could turn into screaming and then they might put me away. I don’t know how to stop feeling scared. I mention this to help me, or anyone else needing it, to not take symbols as absolute truths. And because I have become less reserved in my communication, while unnerving if you live with me and are accustommed to softer kinds of behaviors, is nothing less than I am, as a human, entitled to.So try and imagine my shock when I felt that my five minute rant symbolized a jettisoning back into the chaos surrounding me in my childhood.

The creeping sense of losing control resembled huge lava flows, where as soon as one passes, another rises up. Add to this the multiple stories I hear of patients with dementia becoming physically violent and requiring restraint. I feel so badly for one friend who wrote and said that the facility where his relative now lived was doing something wrong when a 100lb woman takes out half the staff. I can only speak for myself when writing this. I think we all bring so many different things to the table that to try and make sense of it on a generalized level is overwhelmingly challenging. Add to this the internal fear that begins as we see our own loss of controland fear that one is losing control of one’s physical environment.My dementia is etiology unknown, meaning they are not sure what kind of dementia it is. They just know what it is not e.g. Lewy’s bodies, vascular, etc. The closest thing they can come up with is mild to moderate cognitive impairment. And if yesterday is any example of what to see in the future, it is scary…full of fear…anger.

So what was so bad?In the larger scheme of things not so much. In the scheme of things in the sense of managing and being in control of one’s life, quite a lot. Some good things that DID NOT happen is I didn’t have a car wreck nor forget my way home nor bust out my bank account over which I still have control. But the famililar fuzzy, prickly feelings that were starting in my head began to get scary because I COULD SEE the chaos and it not only frightened me but my immediate response was to want to escape, start swinging, etc.

When I could not get either daughter on the phone I threw the phone(not my style at all) and pointed the truck for home telling Beau he’d have to navigate. I was able to hold it together during the visit to the pulmonologist until the end when I realized I could not say with certainty how much of a particular drug I was taking. Fortunately it turned out to be I had already been taking the dose he wanted to change me to. What he would have ordered was what I was actually taking, but I could not assure him of that. During this exchange I could feel my insides beginning to buzz and tremble as he suggested we not make any changes while TG was returned from vacation. It had only been a MONTH since I had seen him and I was fumbling more or so it seemed to me.

By the time I got to the vet to pick up the once and former stud muffin, Beau the newly neutered dog, I was trembling so hard inside my ears were ringing. As the vet started rattling off the sequence of his treatment for heart worm medication, I began to panic inside and shaking internally to the point I thought I’d have to start running. She looked at me and said, ‘You’re having a really bad day, today aren’t you?’ Tears flooded down my cheeks embarassing me further and increasing my frustration over the fact that I seem to start crying when I cannot hold it together as well as I used to. Fortunately my vet had taken care of her own mother until her death this past year and recognized the panic in my eyes.

Bless her, she sat down and had the appointment book brought in to set up a return appointment and told me the next two things that would happen. My head was buzzing so loud I could not tolerate more than a couple of pieces of information.TG was at home and returned my call. I was still very edgy and anxious after getting home and she knew what to ask and say. Perhaps the collection of them below will help those of you with dementia and those of you who, bless you, are their caregivers:

1. Reassure them they are safe. I was terribly worried about having an auto accident tho I am not prone to such. But last week I had an experience that scared me to death. I thought my accelerator was stuck as I came over one of the many berms where I live. In retrospect I realize I was hitting the accelerator rather than the brake. I had forgotten where the brake was and kept pressing the accelerator instead while grabbing for a non-existent hand brake. I had totally forgotten the hand brake was located on the left foot side. I engage in a lot of self censorship in deciding what and when I will do something. I know the day will come when I won’t drive so much but for now this is not that day.

2. Frustrating stuff: asking that we be concerned about stuff which at our current state of life and health does not mean a tinker’s damn. Fer Pete’s sake we are losing control over our lives and that light at the end of the tunnel is a freakin’ train loaded with old peoples’ diapers! Now having said that, I also recognize that to live and live fully one cannot remain at the edge of a precipice . You have to jump or pull back and find comfort in the seemingly mundane pieces of life. One reason I love my delicious grandchildren is that they are good at doing that. The oldest ones pretend they need and want my advice, the toddler reduces the world to its simplest and the 3 month old reminds me that someone in the world still needs what I have to offer.

3. Remind them that this is just ONE day when Old Man Dementia seems to rule. Remind them that in even the worst end scenarios of dementia there will be some good days. You and me, the demented ones, might not know what those days are, but they will give comfort to our families.

4. Final tip: Don’t hesitate to take control of your loved one’s medicines if they are repeatedly messing them up. The other thing is to regularly meet with the primary physician to go over the drugs the demented one is taking. In a world where one is treated by a primary physician as well as a host of specialists, studies show that demented patients medications can get mixed up, so be sure there is not something chemically toxic going on. Also be sure that there is nothing physical going on. Other studies have shown that physical causes for dementia are often overlooked and if the person is unable to communicate, a urinary infection, increased heart pain, congestive heart failure might go unidentified and untreated, exacerbating the dementia.

It’s a gorgeous and hot Memorial day weekend! Enjoy it if you do nothing more that snooze in the sun.

Ghosts and Dementia

Sat, 28 Apr 2012 10:04:51 -0400

Ghosts and Dementia

Part 2 of the Series: Dementia from the Inside Out

I’m having a post nocturnal dementia hangover this morning. What does that mean? Well it means that I jolted myself awake, gasping for air and sensing something was off. Something was off: my c-pap mask which had been tightly and correctly in place when I went to sleep. For the first time in a long while and since using the Cpap machine I’ve not had to get up endless times at night. But I swear I have absolutely no recall of removing the mask and placing it neatly across my headboard.

CPap stands for and is a specialized kind of breathing therapy used to treat OSA (obstructive sleep apnea) and some forms of REM(rapid eye movement) disorders. After exhausting the standard tests for finding the cause of my dementia, my neurologist referred me to a sleep disorder physician. They might have well called him a witch doctor or shaman for all I believed about this therapy when I walked in. He explained, however, that if I had OSA and/or REM there was an excellent chance that the neurons could regenerate themselves at least well enough to forestall the advance of the disease. I’m a wordsmith, a writer, a lover of words which are important to my life. I said: I’ll take it. So the process and trips to the sleep med lab for sleep studies etc began. I made it a point to use the same route to the doctor’s office since both daughters had busy things going on in their lives. I only got lost once. As I write this it seems easier, in retrospect, than it was. I had to get my head twisted around the idea that someone watching me sleep all night was not legalized perversion.

When did *I* first become aware that something was going on? I think if it had been left up to me I’d have just kept ignoring it and rocking on till I seriously hurt myself. The first thing we noticed was ‘night terrors’ where I’d scream out and thrash about. But when someone else got to see it I was in rehab for my newly replaced knee cap. About 3 a.m. I felt someone’s hands on me, rumbling noise in the background as I began to surface: Dr. McRae! Dr. McRae! Are you alright? Three nurses were hovering over me as I slowly shifted into higher consciousness. Me: Sure I’m fine, what’s up?

It seems I had been screaming so loudly I had awakened just about everyone on the small 13 bed unit. Were you dreaming? they asked. Well, yeah. I dreamt I had been fighting the Battle of Fallujah in Iraq for three days and we were winning when you woke me up. They were not amused and I cannot blame them since the entire ward was up and rocking by this time.

They decided to call in a psychiatrist (with my consent..I mean why not?) who’s first question was: Are you depressed? I just looked at him and said: Hmm lessee, right before you came in because your schedule wouldn’t allow a 5 minute leeway to take me off this medieval torture instrument called a bedpan leaving it to leak up my back as we now chat, I have a compression device on my operative leg and stay hopped up on some really good drugs and you don’t serve ice cream. But no, I’m not depressed and I don’t know why I scream at night but I seem to be doing so. Please do not prescribe anymore medications for me. Tell them just to wake me up.

Night terrors became a part of my life and my daughters learned to adjust to them, make space for me to sleep in the farther end of the house. The next turning point, however, was when I began watching me talk to people as I hovered somewhere above the. Who the heck knows where? I do know now working with the sleepmed doctor that people with OSA and REM do something that can be called ‘slip sleep’ meaning that as my body goes through the stages of awakening, one or two stages might be slow in catching up so they sit and watch as the other levels move in, then the late stages play catch up. Okay my sleepmed doc would faint if he saw that explanation. But, I hope, that which is lacking in professional jargon is made up by clarity of explanation.

Waiting and watching my sleep levels reclaim themselves began to change physically as I watched myself being thrown out of my bed….literally. Since I’d crash against the side of the box springs, headboard etc., the waking process was, to say the least, quicker. Tall Girl (TG) sat with me and helped research what we could do. In *my* particular case partial bed rails was not the answer since I was so active waking and sleeping. Then we decided to rearrange the furniture in stages of difficulty to fall through. That helped till one night I missed the bedside table and went tumbling down. This resulted in a visit to the doctor with me calling out, It’s not elder abuse, it’s not elder abuse. My body was so bruised we took photos of it. I looked like someone had taken a Louisville slugger to me.

The final turning point after that episode was what is called hypnogogic paralysis and is experienced by about 18% of the population and is caused by disruptions to the normal sleep patterns, most particularly the shortening of dream sleep cycles. In my case I thought I had heard something under the house though how something got under our bricked in house was a mystery not to be dealt with in that particular moment. My thought though was that I should call TG who lives at the other end of our house. Then I realized I could not move my body to get to the phone. I could move my head but anything below that was frozen. I felt this sense of rising panic and then began self-talking to myself:Well what do you have to work with? Well you are still breathing, so that’s good. The breathing needs to slow down and get deeper so switch to yogic breathing if you can. That immediately began to release the paralysis. Now THAT was scary. I’m not brave. It is just there were not many other options that I could see. My doctors told me it was just stress. Seriously??? Seriously??? Forty years later and they cannot come up with something better than that? So I went to see the therapist, a lovely woman who deals with issues facing women’s health care. Nope. Nothing much had changed there either.So this brings us up to the beginning of the series and TG confronting me about possibly having dementia and last night’s really weird episode of my CPap mask being removed. I’m not ready to do the paranormal route as an explanation. It’s easier to believe that my sweet, small bolonkas discovered the Velcro used on the outside and pulled it back and the hose, for whatever effect its weight might have, draped nicely over the headboard. Having partially accused my doggers, do read this excellent article on the use of guide dogs with dementia patients. As I mentioned earlier, the machine was still on and can only be turned off by pressing the on/off button. In any event I have a dementia hangover this morning, something most of us have when our sleep is interrupted. So I think I’ll watch The Iron Lady and take a nap…with no dogs keeping me company while I wear my mask again.Copyright 2012 Patricia McRae Part 2 of the series: Dementia From the Inside Out

Dementia From the Inside Out

Fri, 20 Apr 2012 09:04:01 -0400

Dementia From the Inside Out

After about a year of being anything but settled, I put my 2^nd cup of coffee on the edge of the desk and looked forward to reading some of my friends’ essays on Open Salon. I had sworn when I joined Open Salon that I’d never be one of those folks who just silently fell off the grid. I became one about a year ago as me (and my family) began the tedious rounds of testing that finally yielded a diagnosis just two months ago. I hadn’t figured out how to get back on the grid until Scanner published his piece about his mother who has Alzheimer’s. Hi Scanner, Lea Lane, Joan H, and Hells Bells for a few…the few I can remember.

Also I wasn’t sure how to write about this. I’ve written freely and graphically about my mentally ill child now substance free for 7 years; about teaching in a prison and learning a new definition of power and I’ve shared freely my life experiences with musicians This year, though, I’ve become one of those people doctors have diagnosed as being demented or having dementia, etiology or cause unknown. Not Alzheimer’s, not vascular dementia, nor the other assorted variations on the theme most of which are irreversible. Just plain old dementia or mild to moderate cognitive impairment…hardly a diagnosis, more of a description. It has also been a year that Pat Summit at Vanderbilt U announced she had Alzheimer’s and is continuing to coach basketball and of country singer Glen Campbell announcing he has Alzheimer’s and then doing a short musical tour. Thank G-d for them stepping up and being in the open about it. It has given me strength to write this. What I do know is that there is an abundance of information out there about care givers and G-d bless them!

I believe, however, that the times care giving falls short is because there is a lack of information on dementia from the ‘inside out’. I also believe that occurs because there is such a delay about acknowledging that is going on with your demented elder or friend. By the time it is obvious to everyone, it is too late for the afflicted one to explain what is going on. That is my purpose in writing this: to explain what I experience from the inside out. As I often tell my daughters: Take the best and leave the rest.

A bit over a year ago, Tall Girl (TG), my eldest daughter, was driving me home from her sisters; no particular reason for her driving except that I like to be a passenger and see stuff. Unless, of course, you don’t count the last two times I got lost at dusk and took two hours to get home. Thank goodness for the big Shell bubble that become my point around which I was able to get back on the track to home. When we got on the freeway, she pops the question: Mom, Now don’t take this wrong and it’s not meant to hurt you but do you think there is any chance you might have early dementia? I broke down in a flood of tears. One I was so relieved that I didn’t have to pretend anymore and second I could tell her I kept finding scrunched up pages I had written in the refrigerator and wondered who did it. So we began the aggravating, pulling, pushing that is seeming to resemble care these days. It has taken a bit more than a year to get the tests done, collated and discussed. I want to write about it while I still can so that care givers might get some insight into what dementia looks like from the inside out. But let me doff my hat in appreciation of caregivers first. It is true that the first people to identify something being ‘off’ is the person living with them. Tall Girl (TG) lives with me and caught me leaving the stove on twice the week before she asked me this. My youngest daughter, Baby Girl or BG just scoffawed at the idea saying I was just getting old. Well that getting old part is true, I’ll be 70 this September but it is more than the ‘normal’ aging changes folks undergo.

First I’d like to recommend http://www.caring.com as a core reference. It looks more than a bit commercial on the outside but on the inside it is rich with information on dementia. No matter what level of dementia a loved one is facing your lives will be forever changed.

So why did I believe TG? For about a year earlier, things began to change. At first I wrote it off to getting older, but I’m a wordsmith by trade and inclination and I knew I’d never write some that crap coming out of my fingers tips. I had a book contract…for the first time in a long while and I was so excited and happy about it..except it was harder and harder to get myself to sit down and write and I’m a pretty disciplined writer.

Once TG and I had the big reveal I was able to return to my morning writing routine. I do better in the mornings than in the evenings. TG knew it was okay for her to ask me what I was writing, if I was writing and if not, why not and sometimes it was okay for me not to write. The part I think bothered her the most was I began to spend more time in bed, feeling just generally exhausted. TG insisted I was depressed. I snapped back (that being unusual in and of itself since I am not by nature a ‘snappy’ person.) and told her that I was very very sad but not depressed and if I was depressed, so what? Now this is where your *mother* begins to get snappish at you for telling her what she is feeling. One should certainly know what one is feeling without being instructed by someone else. So maybe a case (mild to be sure) of pique on mom's part is okay. After all she is losing more than you might understand. In my case it was a year that another piece of my identity fell off when it became evident that I could no longer run our show/breeding kennel for Havanese and Bolonkas and had begun the difficult and painful task of finding homes for the dogs. It has also been a year when a brother, two aunts died. My supply of energy for social events just disappeared and my isolation increased.

What I hate? I hate feeling my mouth open working and the word I want will not come out, not then, not in the next few minutes. The response of people is one of a studied impatience and effort to find and offer the word. Then there is the terrible sense of ‘nothingness’. How does one describe nothingness..the sense there is nothing there. It is as if you are watching yourself scratch the inside of a balloon expecting a screech and there is nothing..nothing…nothing…nothing. It is different from silence and I think that is what is frightening.

I’m not sure how connected this is to feeling vulnerable. After the great reveal I know I drove TG crazy always asking her where she was going. It was different from the teen years with required check-in times. But the kind of queries I was using sounded to her like I was talking to and treating her like a teenager. I finally figured out that I felt vulnerable and unsafe out here on my five acres. Once we figured out why I was bugging her to death, she volunteers her travel information, sometimes putting her phone number on a sticky and putting it on the refrigerator. I figured out that I just needed to feel like I could reach out and touch her, emotionally, psychologically. It actually didn’t matter where she was…she could have been in the same or the next room when I’d follow her around. It was terribly hard on her and still is for both my children to come to terms with this.

I hate knowing that I’m going to have to give up my truck eventually but I’ve had two fender benders. For now I do not drive at dusk and do not leave the house until sun is well up. I hated my daughters having to come to my doctor’s appointments with me. Just tell them no, right? Well that seems an affront to their generosity of time and spirit plus I am just as liable to forget what the doctor said. We have gotten better at this. Both daughters are on my HIPPAA permission so the doctor can talk to them if need be. I make it clear to the doctors though that I am the patient and do more on my bad days than most people do on their good days. So please do not talk over my head to my daughters. I also emphasize that I need them to write all instructions down, especially any med changes. I’ve been fortunate in having found a primary care physician, a cardiologist, pulmonologist and a sleep med doctor who understands this. I travel with a pad and pen.

I’m supposed to carry my cell phone at all times. I don’t. I’m not being obstreperous, I just forget to tuck it in my purse when I leave the house. I have a pill minder now, but I am the one responsible for filling it. Recently I’ve had to come up with an idea of how to mark the bottles when the supply is running out mid week. Another thing I find distressing is that I forget how to operate things I’ve operated for years. The forgetting how to do it is not steady or consistent. I might be an engineer par excellence one day and then just sit staring at the mixer wondering what the heck I am supposed to do with this. I hope you can hear a theme running through here: let mom be in as much control as you can allow her. I think the idea of using her car to drive to visit her and take her for ice cream is wonderful.

I enjoy going to the mall especially with BGG who loves the play area in the mall but I HATE shopping. Figuring out change, engaging numbers on almost any level can set me off into a panic attack. TG shops with me and stands with me at the check out station. Some days I’m up to using the debit card, others my mind just doesn’t want to handle it provoking irritability on my part. I just looooveee (sarcasm intended) the days I think I can do it and then I just stand there staring out into nothingness while my brain is, I presume, scrambling to figure out what the hell I’m supposed to be doing.

Family: My granddaughter has been a life saver, when not being a back breaker! And the birth of my grandson, a down’s syndrome baby has forced me out of thinking about this too much. Baby granddaughter (BGG) has been a miracle and this will be the first time her mom and aunt read about this. BGG is now 22 months old and brilliant if I do say so. But in addition to the brilliance she seems to know when I am in ‘nothingness’. At those times she comes, grabs my hand and says: Go, go , go Patie and heads for the back deck, a favorite place of mine. In this sense she reminds me of the enormous empathy I get from my dogs. I am desperately frightened that I won’t have my dogs at all. Trying to keep up with people, issues, etc is exhausting and with BGG and my dogs they are the supreme empathizers letting me just be, cuddling and sniffing.

I do only microwave cooking when I am at BG’s house with the kids. A stumbling block, though, is similar to the one we encountered with TG, my daughter with bipolar disorder. Not everyone has access to each and every part of us, so we forget sometimes when we interact and the interaction gets messed up, that we are talking to or trying to communicate with someone who has a neurological impairment such as dementia or bipolar disorder. It’s like you are chatting along and the person you are chatting with comes up with something so off the wall you sit there gobsmacked as the brits would say. TG tells me that if I think she is funny, I should be sitting where she is looking at me…it’s a bloody demented riot! Humor is a life saver! And sometimes the more macabre the better.

My girls were a bit aghast a couple of times when they accompanied me to the bank and heard me say to the teller: Look, Mary, I was diagnosed with early dementia about two months ago so this is going to take some time. It’s hard to let my girls into my financial affairs. I’d rather keep going without sex than share that information. BG is a hard nose number crunching accountant around whom I feel intimidated some time. Please understand part of that operates around my inability and anxiety producing efforts to deal with numbers and stick forms eg triangles etc. So we are working it out getting the accounts straightened out (I had 10 accounts spread from SC to PA and I’m not wealthy in any way!) Just small accounts for this, then for that etc. Once they are all transferred or closed banking business will be conducted from one account. I’m sure I will be put on an allowance in the future and, inasmuch, as I know that is a good thing, I just hate the idea of it.

Staying put: My family knows how important my ‘farm’ is to me. So as long as TG can stay with me, and everyone sticks to the ‘check in’ schedule, we’ll try to keep me out here. My daughters worry it is too isolated. Well it is but I like it like that. Can you imagine what it is like for a wordsmith to try and have a social interaction with someone and the words just won’t come out? Painful! And I watch the person getting more impatient and I just cannot make words come when they will not. Please, if anything of mine you read begins to look like gibberish, don’t be shy about letting me know!

We have a Center on Aging adjacent to our little library and that is about as far as I care to go from the homestead. I do most of my doctor appointments on my own, but that’s because we have 3 calendars working! And I’m still able to drive the 22 miles to BG’s house to visit, play with the kids and take photos. I have gradually moved to photographing more as the words continue to disappear. And that seems to be working in keeping me in the here and now.

They want me to do puzzles….eeek! I have tried, seriously but it is just so much work in my head..makes my scalp hot. But I found another kind of puzzle: http://www. ancestry.com Doing genealogy work is doable for me right now and enormously rewarding.

Scanner, thanks for writing about your mother which gave me the strength to write this. And if others have ideas that are working for them, please share!

Patie

Apropos of Normal

Wed, 20 Oct 2010 08:10:22 -0400

You know, we just never know what is going on in people's lives. In the early 1980s I had the privilege to interview Kurt Vonnegut. Looking back on it I remember him as one of the most helpful and kind interviewees that I'd ever interview (Alan Ginsberg falling into that category as well). Little did I know what he was living thru tho I learned later he, himself was clinically depressed. So he's always had a special place in my heart and memories.

Then I ran across this review of his son's book:

'Only More So': Mark Vonnegut's Battle With Bipolar : NPR

http://www.npr.org/templates/story/story...

In his new memoir, Just Like Someone Without Mental Illness, Only More So, pediatrician Mark Vonnegut explains how bipolar disorder has shaped but not defined his life -- and he describes life with his father, novelist Kurt Vonnegut. I've not read it yet but shall but I wanted to post it for all of us this past couple of weeks who have been struggling with the affected folks in our own families. I am so glad to find a book where someone can talk about what it has been like to live a life time with this illness.

Abortion a half century ago

Tue, 21 Sep 2010 09:09:46 -0400

This is a parallel posting to Dr Spudman's piece on abortion. It started as a comment and just became too long despite editing.

I've been away letting the magicians work to keep my bits together well enough to stick around for a while. I thought I'd drop in for a few seconds and, of course, went to Spudman's blog.

40-50 years ago German measles (rubella) was rampant at the children's hospital where I worked. I was a young married woman with one child and wanting another. One day the ward was filled with infants who had been infected with rubella or were suffering the consequences of the birth defects it caused: Cataracts or glaucoma
•Heart defects
•Hearing impairment
•Growth retardation
•Small head
•Mental retardation

Life was not so neat in those days. There was not yet a rubella vaccine, no way to do titers to see if moms were carriers, nothing much to do except wait and hope the fates were kind. And after giving mouth to mouth to two of the infants whose hearts had stopped, I heard the Chief Resident Bob come up behind me, lean down and whisper in my ear:"Patie are you pregnant?" I felt the blood drain from my face because my husband and I had been trying for another child and I was in the middle of missing my first menstrual cycle and hoping I would not miscarry again. I looked up at him, my hand covering my mouth, tears pooling. "I don't know...I'm two weeks late. OMG what do I do?"

Without batting an eye, he said "Get an abortion". I plopped down on the nearest stool in a state of shock. I knew about the 'committee' made up of white haired old farts who decided if you were sane enough to continue the pregnancy.Chief Resident Bob whispered: "Don't worry, I'll come testify and we'll get others to testify that having the baby will impair your mental stability so the abortion can be performed." I thought my heart would drop out of my chest it was beating so hard.

"Bob, I don't want to be known as crazy! I'll lose my job! Is there any other option?" Bob pointed out what I knew too well; the local dirty shaman, Mexico or Europe. Then he reminded me that if I were not to choose the route he suggested, I could be arrested for committing a crime. Flashes of the young hispanic woman handcuffed to a hospital bedrail after she came in for a botched back alley abortion knoced at the back of my head. A deputy kept guard over this slip of a woman who was now charged with murder. I was shaking so badly I had to go home. I NEVER thought this was anything I'd discuss with my husband.

The next day I told Chief Bob that I'd go before the committee and trust I'd not lose my job (no ADA policy then). Two days beforeI was due to appear before the committee, my menses began to flow and I began negotiating a transfer to another unit. That day I became a feminist.