Sunday, November 4, 2012

Update and Review

Well, I've had several requests for my complete manuscript recently regarding the memoir I am attempting to get published.  I had one agent tell me she wanted the life lessons in the memoir to be more universal which is difficult because to me the life lessons I included in the book are authentic to the circumstances I faced as discussed in the book.  A second agent never got back to me.  And a third agent said the market was flooded with memoirs at the moment and she could not pitch it to an editor.  I started to inquire if I could just go pitch the book myself, but you can't get in the door to the big six publishers unless you have a literary agent. 

In the meantime I read Deborah Feldman's memoir Unorthodox.  She discusses growing up in a Hasidic community in New York.  Since I've never known any Hasidic folks her story was revealing.  I was dismayed by her growing up in such a repressive community.  I mean, why can't girls go visit the library and read books in English as opposed to Yiddish?  I couldn't believe that she had to have her head shaved after getting married and then subsequently wear a wig.  Fortunately, she comes across an English instructor oddly at her school who challenges her on so many levels.  Sometimes when somone assumes you are unable to achieve something, you will go to new heights to then accomplish that one thing. 

I believe she thought that upon marrying in the traditional manner of her community she would also gain more independence; however, sadly, she becomes even less free.  She is sure of the notion that she does want to get a collegiate education, leave her Brooklyn community for a more Democratic, real world community, and also to ensure a better life for her son.  It was impressive that she was able to locate a literary agent and obtain a talented editor to assist her with the publication of this book.  And she is only 25 years of age which makes me feel ancient.  I think this book proves that if you want a new life badly enough you can definitely find a means to acquire it and also taking risks is essential to achieving what you want and value in life.

Saturday, September 8, 2012

The Long Goodbye by Meghan O'Rourke

This memoir by Ms. O'Rourke is touchingly written about her experience during her mother's colon cancer diagnosis, the mother's subsequent treatment and recurrence, her mother's eventual death, and the transformation that occurs in both her and her family members as a result of the mother's death at an early age.  Initially, I think we all have the concept, whether acknowledged or not, that our parents have been constants in our lives and will forever be constants.  Alas, no they are humans with frailities and are susceptible to the changes time inevitably brings to all our doors.  When Ms. O-Rourke's mom is diagnosed in her early fifties with colon cancer, there is a reassurance of okay, this is what we are unfortunately dealing with, but there is treatment available which will in time stabilize or cure the disease.  And in many instances with a cancer diagnosis, the patient does experience remission only to have the ugly beast known as cancer to rear its ugly head once again after months or years.  The worst feeling is when the cancer patient is informed there is nothing more we can do for your illness; we have exhausted all treatment options; the disease must run its course.  Maybe you can take part in experimental treatments or clinical trials, but our current medical capabilities are no longer beneficial to your care or case.  That's when the reality slaps you up side the face.

When your parent experiences cancer and its treatments, you as their son or daughter start noticing changes. If in this instance it is a parent you begin to watch them become more childlike.  They can't get around like they used to; they start to maybe appear dishelveled; they have little energy; and they can begin to have memory lapses or vision changes.  You find yourself in a role reversal with your own mother or father.  In Ms. O'Rourke's mother's case, the mental and vision changes are so pronounced that both daughter and mother find themselves back in a hospital emergency room with Ms. O'Rourke being the one to suggest that maybe the cancer has spread to her mother's brain.  The subsequent scans prove she is correct.  Now you are not only acting as a parent, but a doctor and detective.

During Christmas Ms. O'Rourke's mother passes away surrounded by her family and the seasonal decor dotting the family living room.  That's the way the mother wanted it to be.  The funeral home arrives to pick up the body for cremation.  And at this point, Ms. O'Rourke longs for the rituals some families and religions have to honor the dead as well as comfort the grieving.  Rituals like sitting shiva, wearing black, viewings, receptions, and people bringing food to the family home.  Eventually, Ms. O'Rourke and her family scatter the mother's ashes at the beach, and some are later scattered by the grandmother and siblings by a tree at a lake the family frequented. 

It's hard when you lose a parent even if you know it's coming.  Sights, sounds, and smells will remind you of the one you have lost.  Sometimes you think you hear their voice parenting you once again, but in reality, it's you learning to parent yourself.  Family members vary in how they handle death.  Some may withdraw from the world; some may turn to various forms of escapism; some try to work themselves to a frenzy to bring back a sense of normalcy; and others remain lost trying to find a way to move forward and make sense of a new reality without the relative who has departed. 

The whole experience of losing a parent is explained well by Ms. O'Rourke.  It just goes to show that a memoir about disease, death, and transformation can be a learning experience.  I did not find this book depressing; I found it to be highly reealistic and thought-provoking.  The use of poetry throughout the book complements the writer's anguish and needs during a tumultuous time in her life.  I applaud Ms. O'Rourke's endeavors and sincerely hope I get the opportunity to share my memoir with the world one day.

Saturday, August 11, 2012

Review: God's Hotel by Victoria Sweet

The latest memoir I completed reading was God's Hotel by Victoria Sweet.  This was a doctor's memoir of her over 20 year experience at one hospital named Laguna Honda.  She examines the theory of "Slow Medicine" requiring a physician to get up close and personal with a patient as well as to spend time with him/her in order to fully understand the patient's medical issues.  She discusses also the politics inherent in going from "Slow Medicine" to a system called "Delivery Of Health Care".  Dr. Sweet did an intensive study of a nun named Hildegard of the 12th century and her pioneering ways in terms of administering quality medical care.  Finally, the reader gets to see the hospital's transition from a 100 year old medieval castle to a gleaming, 21st century new hospital and all the positives and negatives contained in both facilities.

Initially, Dr. Sweet speaks of her strategy for treating patients which involves a thorough workup including patient history, physical examination, and blood tests as well as x-rays.  Since this is a hospital for the sick poor, the doctors have limited access to new diagnosing technologies and they each generall read their own x-rays.  Because Laguna Honda was made up of wards whereby patients were often together in one open area, there became a sense of community among the patients, nurses, and doctors.  Dr. Sweet learns what it is like to be a patient because she sees her patients two, three, and four times a day.  It is so vastly different from the hospitals of today where you might see your surgeon prior to surgery, remain in the hospital, be visited by one of the surgeon's associates, and never come back into contact with your surgeon until after you have been discharged and return to his/her private offices for a follow up visit.

Dr. Sweet learns that just when you think there is nothing more you can do for a patient, there really is, but it lies in the little things.  For example, obtaining a different diet for the patient, having the patient examined and fitted for glasses, or even obtaining shoes and clothes for an indigent patient.  According to Dr. Sweet the analogy that is best for the doctor/patient relationship is to see the patient as a plant and the doctor as the gardener.  The secret of healing is the relationship between doctor and patient.  This relationship takes time and it's not according to administrative standards, an efficient use of a doctor's time. 

Dr. Sweet studied Hildegard of Bingen, a 12th century Benedictine nun who studied medicine under monks and in monastaries before building one of her own whereby she could treat patients in her fashion.  Hildegard's medical strategy involved removing any obstructions the patient has in order to heal and then restoring life spirit to the patient through Earth, Water, Air, and Fire or rather good nutrition and vitamins, proper liquids, deep sleep, and sunlight.  Hildegard's strategy for treating a patient would be to observe the patient, check patient's vital signs and respiration, examine the body part disturbing the patient along with the patient's blood and urine.  Finally, Hildegard would give a prescription for the patient inclusive of a regime for how to live and then also a herbal mixture.  The precription or regime for how to live would include Dr. Diet (foods to eat), Dr. Quiet (how much exercise and sleep for a patient), and Dr. Merryman (how much sex a patient required and the emotions needed for optimal health to be achieved or restored. 

The interesting part of Hildegard's medical system was that it was based on a system of fours and the effects the four seasons had on plants, animals, and humans.  She felt a patient needed the right balance of the four humors inside the body which depends on seasonal changes outside the body.  Dr. Sweet actually went on a pilgramage to Spain in order to learn what the experience of being an "other" or "stranger" or even "patient" might be like.  In other words, what is it like to leave home and immerse yourself by speaking a different language, eating different foods, and encountering different expectations.  For the average patient a hospital stay might indeed make you feel like a complete stranger with all the medical jargon, interesting hospital food, and how your life suddenly changes because of a chronic illness or disease.  One day you are a healthy teacher and the next you are learning to cope with disability; your own world and priorities are turned upside down. 

The best things Dr. Sweet seemed to take from her time at Laguna Honda Hospital was that a patient needs hospitality (little things like a toothbrush, soap, shampoo, proper diet, clothes, shoes).  Also a hospital needs to provide the patient with community or a place where they can share and learn from others experiencing an illness similar to theirs with staff that promotes activities and an atmosphere of inclusiveness.  Finally, a hospital needs to provide charity whether that is in taking extra time to make sure a patient receives proper care after discharge, the patient has a decent place to stay or live, as well as indulging a patient's emotional happiness which may be catering to their likes/dislikes whether it involves food, music, or activities. 

I enjoyed this memoir quite a bit.  Some of the cases encountered by Dr. Sweet were scary and unpredictable.  At times I felt like my teeth were going to drop out when I read what was being experienced by a patient at Laguna Honda.  It was also eye opening to see how much politics influence health care.  I think the main reason I enjoyed this memoir is because it gave me a chance to see how a doctor views a patient, hospital red tape, and how they develop and implement their personal philosophy of medicine.