Advocate for Your Health

Are you an advocate for your own health care?  Before you answer, I’m not going all health food guru here.  I’m the person who sits on my ass all day with my token Tai Chi and the dog walk exercise regime.  When you go into your GP, do you advocate for your health or do you allow yourself to be talked out of what’s wrong with you?

I see.

This week, another story about another woman with a sore belly and only after two years of not getting better, were tests done.  By then, the cancer had metastasised and it was too late for her.  She was in her twenties and died a few weeks after her wedding.

Oh my, did she not go to her doctor?  She did.  And that’s what I’m thinking about today.

So first, my sad tale.  No, first I want to say that I grew up in a medical family and married into one, which brings probably more than the average number of doctors into my social world.  This isn’t anti-Western medicine or NHS, although both those things contribute to the situation.  How could they not?  They ARE the situation.  That would be like saying cow’s milk had nothing to do with some people having lactose intolerance.  It’s not the milk’s fault but it is the problem.

Now back to me.  I wasn’t a pretty young thing who should be in the best of health at the time I went to my GP over a pain in my thigh.  I was American.  That was the excuse she gave me.  My expectations of the NHS were out of order.  Without doing any tests, she told me that I had arthritis (in my muscle, thinks me) and the pain wasn’t bad enough (I couldn’t sleep through the night) and I probably needed a hip replacement (how do you know without an x-ray) which I couldn’t have for fifteen more years.  Go away, girl.

A few years later, I moved and went to another GP who immediately referred me to the best orthopod in the area (according to my gasman husband) who did the x-ray and found a congenital defect in the hip socket which should have been dealt with YEARS before the anti-American GP.  So all those disturbed nights, all those New Year’s dances I sat out, all the miles of flowerbeds I weeded by scooting on my bum shouldn’t have happened. 

But I’m alive, aren’t I?  My new hip is the best thing since sliced bread.  And to be honest, having to watch my lunatic family dance during New Year’s was a hoot.  The thing is, I once listened to private stories for a living and I can tell you that my experience with the anti-American GP isn’t that unusual.

First, let’s think what a GP in the UK has to do.  See six patients an hour.  Yup, in ten minutes, greet, seat, listen, maybe examine and diagnose, turf out of the office and document a patient’s complex medical situation.  When I went to my GP because I wasn’t bouncing back after surgery, he looked surprised and said, Oh you’ve had surgery?  Then read my file.  This was the same person who busted his ass to get me the area’s best surgeon.  But that’s what he does.  Six times an hour.  He can’t remember everything.

Don’t go in all shy and hope for the best.  Go in with a concise description and perhaps your concerns.  Share whatever medical history you think is pertinent.  When we lived on base, our GP routinely verified a situation with the spouse.  Patriarchal, you think?  He did it because in his experience, people tended to underplay their suffering.  So ask the people who live or work with you how they perceive your symptoms.

GPs also have targets to meet or avoid which have financial impacts on their surgery.  So to practice medicine at the speed of light with Damocles sword over your purse, the default position is that the most common answer IS the answer.  In other words, you won’t be referred for abdominal surgery after your first complaint of a tummy ache.  If you’re young, you could have Crohns or cancer or an abscess or have eaten a dodgy take-away.  Don’t be fobbed off because you are young if the symptoms don’t go away.

If you have a history of mental illness, that will be the first stop for some GPs.  It won’t matter if the symptoms manifest physically.  You’ll be told it’s panic, anxiety, take a pill.  I have had clients with a mental health history who experienced severe allergic reactions that interfered with breathing and were told it was psychological, even when the client could identify the allergen and the attack responded to medication. 

Mental illness isn’t stupidity, and in my experience, usually not attention seeking.  Don’t be fobbed off because you’re tired of being told you’re nuts.  They’re just rude and you need proper care.  (And besides, who among us isn’t nuts?)

If you’ve suffered trauma, that does not make you a hypochondriac.  Abdominal pain?  Because you were raped.  Back ache?  Because you were raped.  In the wrong body?  Because you were raped.  No ovarian cysts, compressed discs, Gender Identity Disorder for survivors of trauma in some GP surgeries.

 Our bodies DO store our histories and emphatically store our traumas, but in my experience as a trauma therapist, conversion disorders (non-medical pain, paralysis, etc., because of trauma) aren’t as common as I’ve seen them diagnosed.

And while I’m on my soap box, trauma survivors – letting a doctor drug you up isn’t the answer.  Too many women after twenty-five years of a zombie life on medications, eventually sat across from me only to find themselves two years later, back inside their lives, medication free or greatly reduced, doing things they never thought they would do again.  GET A GOOD TRAUMA THERAPIST.  Or even a good enough one.  You never forget your trauma, but you can get back to your life.

Your doctor is not the enemy, but accept that it’s a relationship.  The anti-American GP was recommended to me by a colleague who had a great rapport with her.  If you and your GP don’t fit, ask for someone else in the practice.  Switching practices risks getting branded as a malcontent, but if that’s what it takes, be honest with the new GP. 

Your GP has limitations, only a few that I’ve listed here.  A GP isn’t a mind reader and certainly not a god.  You have to be active in your health care, even when you feel like crap.  It’s important.  You are important.  Be civil but speak up.  Ask questions if you don’t understand.  Go back.  Do not let social discomfort keep you from getting the best care.

If you are genuinely being discriminated against for any reason including race, mental health, trauma history, sexual preference, don’t ignore or accept it.  You will not get top notch medical care if you collude with the idea that you are somehow less-than.  And, you probably aren’t the only patient in that surgery experiencing that prejudice.  If you don’t have the internal resources to survive the complaints process, then move on to a GP without that prejudice.

Writers live in our heads.  When our body isn’t functioning up to snuff, we may ignore it.  If our GP doesn’t think the problem is worth exploring, we tend to believe it.  But don’t believe it if your problem doesn’t go away.  You’re creative.  And the only advocate for your body is you.  Find a way to be the best advocate for your own health care.

Let the Dark In

Last week in the Writing Closet, we listened.  This week, we speak, but not of ordinary things.  This week we speak of our darkness.

What Happened.

Something’s happened.  Something you don’t understand.  You’re not the type of person it should happen to or you’re not the type of person who would do something like that.  It doesn’t make sense. 

People say things like, what were you thinking?  What did you do to make that happen?  Surely it’s not as bad as you say.  Why do you have to be so negative?  Why are you always such a drama queen?  They look at their watch when you speak.  They say that you’re weak.  On and on until you learn to stop speaking about it.  You pretend it didn’t happen and everyone’s happy.

It doesn’t have to be physically violent, although it could be.  It doesn’t have to be monumental, even, except to you.  What is your What Happened?  Can you say it out loud, to yourself, when no one’s in the room, no one’s outside the door?  Can you whisper, This Happened, and still feel yourself safe?

Touched cheated lied hit cut stole betrayed fired punched spied vandalised withdrew slandered provoked seduced abandoned changed you.

If you don’t feel safe, then perhaps today is not the day for you to continuing reading this.  Mark the page.  Come back when you’re ready.  Before you go, let me remind you, although you already know it, that we all have these things in our lives.  All of us.  There is a conspiracy not to speak of these things, yet these are the things a writer must speak.  But before she does, she must feel safe.  Only when you’re safe, should you write.

Not What You Are

One of the ways to help you feel safer is to separate the act from the person.  You are not what you did.  You are not what was done to you.  You may be a person who cheats on her partner but also loves that partner to distraction.  Who you are could explain the Why, but what you do, does not define the Who.  You may be a person being stalked by an ex-lover and you also help the parents of autistic children.  What happens to you is your history, not your talent.  You are more human and more normal than these experiences, held in secret, let you believe.

If you can speak about what happened and still feel safe, you will write it.  This is a given.  The trick is how you write it.  We’ve been taught to follow that sacred dramatic arc, come hell or high water, to reach a resolution.  Popular entertainment teaches us that this resolution should eclipse the What Happened.  Now I’m going to contradict myself.

Rather than eclipse it, think about embracing it.  Okay, didn’t I just write that you need to separate yourself from the What Happened?  Yes.  And if you separate yourself successfully, you won’t have to obliterate it.  You can change it into literature.  The dark, like the right side of your brain or your animus or your psychological shadow is bursting with energy that you can tap into it.  But how?

Play with What Happened

When the EDL went to protest outside a mosque in York, they were invited inside for tea and football.  This is what you have to do.  Invite What Happened in for a cuppa.  Sit with it a while, get to know each other.  And when you are safe, play.  And by play, I mean ground yourself physically in What Happened.  Let your body feel the experience while at the same time, maintaining your own integrity as separate from What Happened, just as you would do when immersing yourself in a character you’re developing.  When you do, it will give things to you.  Some of these things may give you insomnia, but you will learn to use them.

My current manuscript keeps me up at night.  Not because of structure and form, not because of plot and characterisation but because of the question, Is it ever right to kill someone?  Euthanasia.  Abortion.  Death penalty.  War.  Murder.  Is it ever right . . . This story is a blatant sublimation of What Happened in my own life.  Well, blatant to me.  There’s not a lot of killing going on in my life, but the creation of that question did come from What Happened.   And believe me, it’s a lot more interesting than What Happened, because it takes the themes of the personal events and puts them on a universal stage.

Which actually is the basis of most therapeutic approaches to trauma.  Research shows that regardless of the treatment modality, the most important factor to a traumatised person is reconnection to the broader community.  The sooner that happens, the better her chance of recovery. 

We are, after all, social creatures.  What Happened in your life belongs to the society of US.  Get yourself safe.  Invite What Happened in for tea and football.  Embrace it.  Share it.  Say it out loud.

Eva Ensler

For inspiration, read this interview with Eva Ensler. 

  //bit.ly/10bQg8Y 

Not-So-Secret-Self

An Irish friend of mine once said that I find blue in a Galway sky.  I do hide behind optimism.  In the southern American states, women of my generation were taught to smile smile smile!  I suspect that the end goal was to raise compliant and congenial young women.  A lot of the Southern women I know, including myself, smile for reasons other than compliance.  Watch any episode of the Closer and you’ll know what I mean. 

I’m not about to start a campaign against the Smile Oppression of Southern women.  The smile is a particular tool from a particular sub-culture.  We all choose our battles and in those battles, we choose our weapons.  Every culture and sub-culture hands out disguises to hide our secret selves.  Mine apparently has great legs.

In a dream, my husband drops me off at the Success Station.  That’s something like the train station, but the only destination is Success.  Actually, it isn’t a station at all, but a building ledge.  I look down.  Rather than the height impressing (terrifying, paralysing) me, I notice my legs coming out of a pair of black Bermuda shorts.  They’re male legs, all toned and hairy, quite attractive if they weren’t on a woman.  I point them out to my husband with the concern they’ll be noticed in Success.  Perhaps I should go back and put on trousers.  My husband says people aren’t going to notice.  I look at my legs and think, should I care if they notice?  Perhaps I’ll go with these legs to Success and hope that people do.

Why is our first reaction to hide our secret self?

I read an article today by Lidia Yuknavitch that starts with a story about being in a bar with friends and a man she respects tells women to stop with the ‘sob stories’, aka The Sad Shit That Happened.  No need to go on and on until male eyes roll back into male heads.  The word is out.  Men get it.  Sad Shit won’t happen again.  In other words, will you shut the fuck up so I can have a pint in peace?  People laughed at what he said.

http://therumpus.net/2012/08/explicit-violence/

We hide our secret selves because people react badly when we don’t.

When my husband and I married a little over five years ago, his ex-wife started an harassment campaign.  It’s really difficult to get protection from that type thing.  The victim has to show he’s reasonable in his attempts to stop the harassment before the courts will step in.  What anyone who’s worked with domestic abuse will tell you is this period of reasonable behaviour is On The Job training for the perpetrator who learns how to manipulate the system.  We eventually had to move, my husband giving up a job he’d held for twelve years.  The harassment continues but at a distance.  My husband’s friends were more embarrassed than supportive.  Their reactions went from not wanting to be involved to saying she did this because he was too soft.  He learned to not talk about the most distressing thing in his life to the people who could have acted as support. 

Why is it that normal, respectable people who contribute to society don’t want to know?  A friend of mine who’d been raised in a Irish industrial school, went back as an adult and talked to a man who’d lived next to the school.  The man said he could hear the boys screaming but thought the Brothers knew what they were doing.  Are we that deaf, that children screaming in fear and pain on a daily basis, aren’t heard?  Or is it a case of Sad Shit overload? 

The mentor for my recent writing project said that my theme of alienation and isolation got in the way of what she thought the play was about.  I thought the play was about alienation and isolation.  While the mentor is probably addressing my technical ability, what if she’s not?  What if we as a species have begun to say, please don’t tell me anything more?  Yet if we can’t listen, then we're reduced to a group of secret selves sharing the same space. 

When I lived in Ireland, there was a small group of American ex-pats that hung together for social survival.  There was one particularly arrogant man who undoubtedly would have preferred all women have their tongues removed and perhaps a mandatory lobotomy as well.  He once called me stupid for not agreeing with him.  Having an enemy in a group as small as ours was like having a serial killer in a life boat.  I pulled out my best Southern smile and said, then you should be kind to me.  I had let go of the rope in his tug of war.  For as long as we knew each other afterwards, he treated me with respect.

Life isn’t black and white.  Look for the colour.  In my Irish example, I could be a little smarter and the man could be a little less arrogant.  My husband’s friends could see him (and themselves) as intelligent, skilled and successful but also able to be victimised.  The men in Yuknavitch’s bar can and do treat women as objects and yes, the women there can and do use their dis-empowerment as assault weapons.  Just like my Southern smile. 

We are capable of doing and experiencing horrific things.  Let’s make our secret selves not so secret.