Sunday, May 31, 2009
Painting: Freedom Goes Up in Flames
This is the first painting I completed in acrylics. It is titled "Freedom Goes Up in Flames" and yes, that is an airplane with flames. I have been surprised to hear the wide variety of interpretations people have come up when looking at it. There were some surprises and some reactions that I completely expected. I got a bigger kick out of hearing what they thought it meant than I did out of explaining what I intended it to symbolize.
So, as a little experiment, I want to hear your interpretations. Go ahead and go now to the comments, drop me a note and tell me what you see. I want to assure you that there are no right or wrong answers. Whatever you see, whether you are spot on or come up with something I had never considered, it is a valid opinion and I would be honored to hear it. Go on! Leave me a comment - don't make me beg! - then come back and read where my head was when I painted it...
LINK TO THE COMMENTS SECTION
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What I Meant:
Like I said, this is titled, "Freedom Goes Up in Flames" and it is the first painting I completed in the new acrylics. The important parts of this painting are the colors as each color corresponds to a specific emotional response I had during an incident at an airport.
BFF and Kid-5 took a cross-country vacation via airplane. They flew out from the airport that is a few hours from our house because of the drastic price difference. To that end, I got to play chauffeur and take them to the airport (and pick them up again 5 days later). The whole of the month before they left, BFF worried and stressed and fussed about the details of managing this trip across the country by herself with a 2 year old in tow. The entire week preceding the departure was filled with tension and anxiety and the actual morning that we left should have turned us both grey-haired and sent us into straight-jackets for life. We were late getting out, got lost on the way (stupid GPS sent us to the wrong place!) Finally we arrived at the airport, got checked in and headed to the security checkpoint.
As I watched them walk away, I felt my emotions swirling like a cloud of colors. This might be in part because I had just started painting and colors were in the front of my mind. As I paid attention to the emotions/colors, they seemed to settle into images so that I could paint them. And paint them I did...
First I felt this strange combo of worry (how would she handle Kid-5 all by herself on the planes?) and excitement (they are going to have so much fun!) It created that gray-green color of the grass and (pardon the pun) laid the groundwork for the whole thing.
So close on the heels of the worry/excitement that they seemed almost simultaneous, the relief washed over me. In my mind, this became a bright periwinkle. It became the sky in this painting, though I didn't quite capture the color - not purple enough to be truly periwinkle.
Following the relief, a sense of fatigue swirled through me. Not just fatigue, chronic fatigue, the kind that is ever-present and seems to stretch forward into eternity with the promise of never completely going away. This became the gray-tan road.
At this point, I could no longer see BFF and Kid-5; they had passed beyond my line of sight towards the gate. I turned around to go back into the high, open area of the terminal. We had been running late arriving and so had not had time to look around at all the shops and restaurants and the gorgeous view out the wall of glass. Curiosity bubbled up, a bright yellow feeling that swirled around itself and lit up my mood. Thus the sun found a place in my painting.
My eyes roamed the terminal, taking in all the sights. Movement outside the two-story glass window drew my attention. I watched a plan launch itself into the sky. As bright blue as Tom Bombadil's eyes, freedom launched itself into my consciousness and completely filled my thoughts. I was free. I didn't have to be anywhere or do anything. No kids were whining at me; no house scolded me in its need to be cleaned. The light on Mom's taxi read "OFF-DUTY" and my time and my energy were my own to command. The desire to jump on a plane and disappear overwhelmed me. I stood rooted in the terminal, wondering where I could go and which ticket counter to try first. I took a step towards the escalators to go buy a ticket with the image of a bright blue airplane lifting off settling onto the painting forming in my mind.
I didn't even land that first step when reality struck. I couldn't get on a plane. I couldn't afford a plane ticket, let alone what came after it. And my time wasn't my own; the schedule, even with Kid-5 off my books, remained packed. I had obligations, responsibilities, commitments. A weighty shadow settled over me, killing the sudden emotional high I had just experienced. This became the shadow on the ground: I was tethered to the ground - not free at all. It became the jetwash behind the plane: this shadow follows me no matter where I go.
As my mood crashed with the realization that the freedom I briefly deluded myself into thinking I had was, in fact, a delusion, other emotions joined the color-swirl. I felt angry, resentful, frustrated and disappointed that my idea had crashed and burned. The negative feelings threatened to consume me as the flames threaten the plane.
My freedom had gone up in flames.
A few things to note about this painting. First, and most important, is that despite being engulfed in flames and representing an experience that ended negatively, the plane is still flying UP. It isn't plummeting to the ground. This is the stubborn streak of optimism that can be found in even the most depressing of my pieces. It is also representative of the fact that, if I had truly wanted to, I could have possessed that freedom. I could have gone to the ticket counter and purchased a ticket to somewhere, gotten onto a plane and taken off without notice or planning or forethought. Despite the shadowy weights, I could still have forced my freedom.
Another thing about it: this was my first attempt at mixing acrylic colors. Thought I wasn't able to reproduce two of the colors from my head onto the canvas, most of the colors I ended up with worked alright. In fact, given my lack of experience (let alone instruction) in visual art, I am pretty proud of this painting. No one questioned what I had depicted: an airplane taking off into a blue sky, consumed with flames, its shadow cast on the grass below and leaving a trail behind it. Interpretations varied wildly (and fascinating to listen to!) but the objects themselves were not called into doubt.
Saturday, May 30, 2009
How and Why I Paint
I think I mentioned that I have started painting. It feels strange to me that now, at 30-mumblemumble, I am taking up painting, an endeavor that I have never really contemplated before. But now that I've started, I love it! Like most of my writing, I don't do it for others. I am not really interested in becoming a world-renowned artist. I don't care if my paintings look like they were done by a hyperactive three year old. I don't paint to practice or improve my technique. Painting is, for me, a form of therapy. I really wish I knew more about art therapy so I could maximize the potential of this newfound passion. Eventually I will find a resource to do this but for now, I paint things that mean something to me.
Truth be told, I started painting as a self-defense mechanism. The fact is, I am a cutter. Yes, there it is, admitted out loud on a public medium. Go ahead and judge me; I don't care what someone reading this thinks. Okay, I do care what people think but not enough to not put this "out there". Here it is again: I am a cutter. I cut and burn when I reach a certain threshold of stress, anger, or pain. I've done a lot of reading about people who do this paradoxical behavior. Turns out there are a lot of people who engage in self-harm behaviors and there are plenty of reasons they do it.
General Info on Self-Harm
The most prevalent seems to be a desire to feel something, anything, like it affirms that they are still alive despite feeling detached and disconnected from everything around them. Another extremely common effect, and this typically overlaps with the prior one, is a sense of release. All those emotions pile up in a person, creating this unbearable pressure. Cutting (or other self-harm behaviors) generates a release of this pressure, an outlet for the storm of feelings inside them. For some, causing tangible physical harm to themselves can actually be a way of avoiding committing suicide. There is also the matter of the body's physiological response to injury, such the release of natural chemicals that function as pain killers and heightened awareness of their surroundings.
Cutters can get trapped in a psychological cycle that has been likened to (and debatably even labeled as) addictive. The psychological pain and pressure build up in the person until they start to numb everything around them yet feel as if they are going to explode and evaporate into the ethereal. To relieve the pressure and reassure themselves that they are still alive and are still human, they self-harm. With the self-harm comes a powerful emotional and physical release, like taking a deep breath after being submerged in water a little too long. In the moment, the body pumps chemicals, the mind can relax, and the pain is transformed from a shadow on their soul to a more external, tangible injury. In the moment, their equilibrium feels restored. The problem here is that The Moment doesn't last. Like a drug fix, the high subsides and the cycle renews, often exacerbated by additional feelings of guilt, shame, fear, anger and other reactions directly related to taking action on the self-harm urges. So the pressure builds, the numbness settles, and off they go again. There is a very real reason for likening it to an addiction.
From what I have read, this type of cutter is the most common. Self-harm may also be triggered by a desire for attention (Look! I'm different, special, because I do this thing that is "x-treme"!), an attempt to manipulate others (If you leave me, I will do something drastic and it will be all your fault!), a desire to punish themselves (I deserve the pain this will cause me because I am bad.), as a cry for help (Look how badly I'm hurting. I can't tell you so please notice me and help me.), a need to create a tangible representation of psychological pain (I hurt so much on the inside; I want my outsides to match my insides.), or even to relieve boredom (Nothing is giving me that adrenaline rush anymore; maybe this will.). Frequently these reasons overlap, exist together, and may even be subconscious – they don't know why they do it; they just do.
Okay, now that the psychology lesson is over… lol
Surprise, surprise, I am not one of the majority. I don't cut to feel and I don't get that rush of release from it. When I cut or burn, it is more along the lines of either punishment or the tangible representation. Sometimes there is an element of the cry for help but as it is almost always completely overruled by fear of discovery, I don't normally rank that as a primary motivation. My cutting and burning also tends to be symbolic, a letter or shape that speaks to me of larger, painful concepts. While I don't experience the addictive cycle that many cutters have, once I reach a certain stress/pain threshold, the self-harm urges grow until I feel I must express them or I will lose whatever tenuous grip of reality that I have left.
Easter through mid-June every year are incredibly rough for me. Sixteen years ago I made some bad choices that haunt me still. Every year I drag myself through a vicious emotional hurricane. Last year, for the first time in about 5 years, I managed to stay out of the hospital. I still messed up my arm pretty bad, but at least I stayed out of the hospital. This year, I wanted to do better.
Why I Paint
During a brainstorming session with my Guardian Angel, the idea of painting came up. The part of me that houses the self-destructive urges from this time of year latched onto the idea. I would be able to express those feelings on paper, in much more detail that I can show with an exacto-knife on my arm. The promise of a larger canvas and wider range of colors on my palette appealed to me. My Guardian Angel arranged for me to have the supplies I would need to get started. Immediately, images of things I wanted to paint began to swirl in my mind's eye.
The next day, too impatient to wait for the acrylic paints and brushes, I commandeered some of my kids' paints and I poured out my first picture. All about texture and color, it held more passion than I could have imagined. I'm most likely not going to post that picture. It's more direct and specific and lays bare the nature of the mistakes I made all those years ago. I have a hard enough time looking directly at that issue on my own without blasting it into the open world. Suffice to say that each color was important; the colors mixed to create each shade meant something. The texture of each area held meaning. And when I was done, I felt pride and excitement at the statement I had made, not ashamed and guilty.
The next day, the acrylics arrived. Paints and brushes, canvases and an easel… all at my disposal, for my creative energies, to change the raging emotions inside me into something visual, tangible, and self-affirming rather than self-destructive. Since then I have completed 5 more pictures. I am going to try to share those, as well as any others that come along whenever possible. Just to make myself clear, though: I'm not painting to perfect technique or to be able to reproduce a landscape or a person. Light and shadows especially escape me. And I am fine with that. I paint for the meaning behind the paintings. It's cool when people can tell what it is I painted because it looks like the item, but if they can't, it's still not my priority to "fix" my technique to please others. I paint, like I write, for me.
I don't know what you call it for paintings – in writing it is a copyright. Whatever it's called, all of my paintings I share are mine. Please don't save or repost them without permission. And certainly don't give credit for them to someone else.
Friday, May 29, 2009
No Small Thing
Today I took the pill bottle out of my pants pocket and put it in a cupboard.
Things are getting better. I think I'm gonna make it.
Thursday, May 28, 2009
Dear Doctor (pt 2 - to Dr. Rob)
A Response from a Patient:
I am not angry with you (throughout this, interpret "you" to mean "my PCP" or PCPs in general). Most of the time, I'm not even frustrated with you. To the contrary, I want to do everything in my power to make your job easier because then I believe you will do your job better. The problem is... I don't know how to do this. And most likely, the majority of your patients who struggle in these areas aren't the ones to read blogs with excellent posts that address this topic. So a question to ponder: how can you get your information into the hands of those who would most benefit from it? Maybe a FAQ brochure next to your check-in/check-out counter? I don't know.
I do have a few clarifying questions/comments on your points...
1. Someone to trust: If I make an appointment with my PCP, I am required to state THE problem for which I am visiting. The message this sends to me is that I am only allowed to have one topic of concern per visit. This leaves me unsure what to do when I have 5 - 6 little questions pile up to the point I finally make an appointment. My solution to this is to make the appointment for the most critical or time sensitive issue. I then bring a complete list of what I wanted to talk to him about. When the nurse brings me back, I hand her my list, point out the one I made the appointment for and tell her I would like to go over as many of them as I can and need to know how many appointments I need to schedule. Since I began doing it this way, my PCP has never requested I make additional appointments. But that doesn't mean he isn't saying rude things about me because of it; I have no idea.
So my question for you is: with PCPs being so busy and so bogged down in red-tape, what is the most effective way to deal with lots of small issues? Does my method work? Or should I be calling his phone nurse? Or...? (A typical laundry list might include, "When do I need to get my thyroid checked again?" + "I'm having pain my knee when I do x activity" + "I read an article advising strep throat NOT be treated with antibiotics - can you shed light on this?" + "Do I need my asthma meds still?" + "My mother is convinced all of my depression symptoms are from my microwave; can I tell her that's not true?" --- The point being they are all unrelated and relatively small. PS - I'm NOT asking YOU those questions; they are just examples. LOL)
2. On fragmenting... My PCP's office does not have an x-ray machine. If I've fallen and injured a body part that is now swelling, I go to the urgent care center instead of my PCP's office because I can go right then and they DO have an x-ray. Likewise, when my daughter wakes up in the middle of a Saturday night shrieking because her ear hurts, I take her to the urgent care center in the morning because the PCP isn't open on Sundays. Are these the kind of visits you are talking about that cause fragmented care? Or do you mean the patient who rarely bothers with the PCP, instead going to the urgent care center or ER, whichever is closer at that exact moment? Should I be calling the PCP before I go to the urgent care center if it means using the answering service? For that matter, how do we know when it's appropriate to use the answering service?
3. Being my own keeper... I am fine with this. I ask all my specialists to send my PCP a copy, though half of them don't half the time. The only question I have is timing of updating the PCP. If I go to the ER with a surgery-worthy broken bone, do I call and let the PCP know during the next convenient set of business hours or just update them on the various comings and goings since I last saw him? Do you want to know that I went to Specialist X and we decided NOT to change anything? Or that I went to the urgent care center but it turned out to be a nasty bruise and not broken? If I end up in the hospital for medical stuff, do *I* need to call you or will they? What if I end up on the psych ward - do they tell you then? How do I know what to call you about and the timing on being notified?
One problem I have with the "don't assume that no news is good news": as a patient I feel this is a double-edged sword. If I call, the nurse acts like I'm wasting her time. If I don't call, I risk the results having fallen through the cracks. If I request they call me with the results regardless of outcome, they get positively snippy and don't call half the time anyways. Is there a specific set of magical words to use on the nurse so she doesn't bite my head off?
4. No PR work: This is extremely difficult for me as a patient. There are a couple of reasons (for me) why this is a tall order.
Firstly, I want to understand the whys and hows, not just follow directions blindly. I read a lot and I've seen a lot and I tend to be more medically literate than most people I know. But I am no MD. I have found it is a VERY thin line to walk between asking the questions I am thinking/worrying about and putting the doctor on the defensive. For example, when my daughter's doctor wanted to start her on Zoloft for anxiety and panic attacks, I was concerned about effects of SSRIs on kids. (She was 9 at the time.) I said, "I have read a lot of information that raises concerns about SSRIs in kids." (Politely, not sarcastically or rudely or challenging.) To which he replied, "Let me guess, you read it on the internet?" (making "internet" into a whole new class of swear word.) Reluctantly, I backed down. I also switched doctors. The point is that I want to be as much a part of the process as possible but this seems to make most of my doctors uncomfortable, like I am challenging them, when that is not my intention at all. So I guess my question to you would be, how do I become part of the decision-making process and let my doctors know that I read and research these topics without putting them on the defensive and/or being ridiculed?
Secondly, sometimes I feel just plain silly. For example, I have chronic headaches and have not been able to find the cause or trigger for them. At one point I went to my PCP about them, armed with about a million "possibilities" including everything from my mother's assertion that microwaved food is the cause of all of my problems to fears of a brain tumor. Some potential causes were anecdotal, some were results of internet research. But it really does sound silly and melodramatic to ask a PCP if I could have a brain tumor and it is the kind of thing that I have been laughed at (by a medical professional) for saying. So how do I ask about the possibilities running through my head without being mocked or dismissed? I have resorted to some creative tactics to ask my questions. In the case of my chronic headaches, I made a list of the "Top 10 Suspected Causes of my Headaches" and included, in random order, such things as hypertension and vitamin deficiency but also wacky things like squirrels chewing on my spinal cord. He got a real kick out of the list and it opened a dialog for brainstorming reasons. Now, every time I come in, he asks me how the squirrels are doing. (I love my PCP! He's HUMAN!!) I guess this one can be resolved with a combination of increased communication - making sure you know that I want to be included in the brainstorming for a cause process - and vigilance on the part of the PCP - you may hear "suggestions" (which are more often fears) that are so far out of the realm of possibility as to be funny to you, but to your patients, we may think it could be that very thing. So don't laugh, even when you want to, or we will stop talking to you.
A third thing that leads me to put on a PR face is a defense mechanism, pure and simple. I know that you see a billion patients every day. I can't help but fear a potential comparison between how one or more of them handle the same symptoms I am having as opposed to how I am handling them. When I come in with sun rash all up and down my arms, on my face, my legs, even my ears and scalp and I itch so bad I can't sleep or sit still, I judge myself and project that judgment on to you. *I* knew the sun would give me a rash but I stayed outside all day to watch my son's championship baseball game anyways. Do you blame me for now needed a round of steroids? Are you thinking, "It serves her right; she should have known better." Because *I* am thinking it. Are you thinking about the guy you saw that morning with poison ivy head to toe that was in much worse shape than I am in and only mildly ruffled it? Are you thinking that I should suck it up and stop whining? I worry that you are thinking that because *I* am thinking that. When you see my name on the schedule for the third time this month, are you thinking, "Oh, God! Not again. What a hypochondriac, what a wuss!" I worry that you are thinking that because *I* am thinking it. Even if I feel like crawling under a bush and dying, I want to seem strong and in control because I feel that you are judging me by the same criteria that I am judging myself. Now, I know my PCP doesn't judge me like this; it's not his style. But I still make sure I can find a smile and a joke for him somewhere in me even when half-blind with migraine pain. It is human nature to want to appear competent. You are in the unique position of seeing me almost exclusively when I am at my worst. So out comes the PR face. I'm not sure how to "fix" this except to ask you not to weigh my demeanor too strongly in the criteria for making a diagnosis. If I say I hurt, don't judge how badly by the expression on my face, ask me for a 1 - 10 number. If I say I hurt at a 7 even though I greeted you with a smile, either believe me or ask me other questions to narrow it down. (When my kids say something hurts, I ask what kind of pain, I poke and prod even in places that shouldn't be affected - like the tip of the chin for a headache - and I base my conclusions on those rather than the statement that something hurts and the look on their face.)
As far as me not saying I'm not going to follow your directions (like taking the prescribed med), I guarantee there will be a reason. I recently read a poll asking doctors if they address cost with their patients. I strongly urge you to do this, always. I'm not in the least bit concerned that you are buying into Big Pharma when you do this; I think you are checking for barriers to compliance. I think there are a few standard questions that should take care of 99% of the concerns your patients may have remaining when you think you are done... "Do you understand why I said XYZ?" "Do you understand our game plan for treating XYZ?" "What other questions or concerns do you have about XYZ?" (Asking what questions I have is preferable to asking if I have any because it is more inviting of a dialog as opposed to be slightly paternalistic and patronizing.)
5. Idiots - I agree that famous people can be idiots. But they can also be right. And because I don't know the difference, I need to trust you to tell me. If I bring up something that Oprah said, please tell me if she is right or wrong in that case, without mocking me. The same goes for when I read something that I don't know if it's BS or not. In the movie "The American President " with Michael Douglas, his advisor tells him, "People want leadership, Mr. President, and in the absence of genuine leadership, they'll listen to anyone who steps up to the microphone. They want leadership. They're so thirsty for it they'll crawl through the desert toward a mirage, and when they discover there's no water, they'll drink the sand." To which he replies, "Lewis, we've had presidents who were beloved, who couldn't find a coherent sentence with two hands and a flashlight. People don't drink the sand because they're thirsty. They drink the sand because they don't know the difference." Try to bear with us as we attempt to decipher which water and which is sand.
6. You can't "fix" everything - I know that sometimes it seems like I go to my PCP for every little thing. I try hard not to pester him but I truly don't know where else to go for information. I typically take a wait and see approach unless something has me in tears, interferes with my sleep, or scares the bejeebers out of me. Truthfully though, there are so many mixed messages out here, I don't know when I should call you or not. My daughter had a headache and an upset stomach for two days. She also had a science test and no fever or vomiting. I sent her to school. She called afterwards wanting to skip play practice because her throat hurt. I called the PCP to see how long to let it go before making an appt. They said come in for a strep test. Thinking they were insane and test happy, I dragged her to the office for a test, thinking "Dude! No fever and mostly a headache and stomach-ache. WTH?" She had strep. That isn't what bugs me. What got to me is that the doctor (her dr's partner, not her regular ped) reamed me out for not bringing her in sooner and sending her to school. This same doctor reamed me out for bringing her in when she had a fever and icky-sounding cough for 3 days. One article says treat strep or risk heart trouble, one says don't bother treating it as it will go away. One doctor says a fever is over 100 degrees, another says 101. And then there are all the tv ads that says to ask my doctor if this med is right for me.
The point to that rant is that I don't expect my PCP to fix everything. I am quite content if he says, "Don't worry about this. It's caused by XYZ and will take care of itself." The reason it sometimes seems as if I want you to fix all problems is because I don't know the difference between a nasty cold that won't away and pneumonia that will land me in the hospital if not treated. (I've had both.) Please don't feel like you have to throw a prescription at me to keep me happy. I've come to you to find out a) what is wrong with me? and b) what do I do about it? Sometimes you can fix it, sometimes you can't fix it, and sometimes it doesn't even need fixed. But knowledge is power and sometimes it is the only cure I need.
Wow. This got REALLY long, REALLY fast. Sorry about that. If I could sum it all up and offer a suggestion from this patient's POV, I would tell you it's all about communication. If we know each other's expectations of each other and reasons for them, we can be a team. Neither of us is perfect but I think we are both working towards the same goal: healthy, happy lives. Our relationship is built more on whether or not we are heading towards that goal together rather than whether or not we reach that ideal.
Sincerely,
[me]
Wednesday, May 27, 2009
Dear Doctor (pt 1 - Intro)
It was indeed long, rambling in many places, ranting and soap-boxing in areas, but very helpful in my own mind. It helped me clarify and organize thoughts and questions I didn't know I had. Once I finished addressing the 6 points from his post, I realized I had a whole host of other things that I wish I could communicate with my doctors and/or doctors in general.
Therefore, in the spirit of torturing any remaining readers of this blog - uh, I mean organizing and clarifying my own thoughts on the topic - I'm going to do a series of posts about it. This is the first post, the background information. It contains the links to doc_rob's post, which you should read before you read my response or it won't make sense. I will update this post with links to the other pieces in the series as I create them.
Dr. Rob's original post
Part Two - reply to Dr. Rob's post
AFK or MIA?
First let me say to any former readers who still check here, I hope I didn't upset you or let you down. I am still alive and kicking and, relatively speaking, alright. The anniversary of my own personal hell came and went and I have thus far survived, even without a hospital visit.
I have taken up painting, something entirely new to me, and although I royally suck at it, I am REALLY enjoying expressing myself in this manner. I plan on posting pictures of some of my paintings. Tremendous thanks to my Guardian Angel for his support emotionally and materially in this new endeavor.
I have also discovered the addictive world of Twitter. I adore the flow of information from the vastly diverse sources all in a compact form on one page and/or texted to my phone. It is so much more than random updates about trivial things going on although there are plenty of those too. (Being the emotional voyeur that I am, I enjoy those kinds updates as much as the news links.) I am myself over there, not anonymous like here, so I am not going put up one of those cool bird logos that say FOLLOW ME ON TWITTER! If anyone really wants to follow me, leave me a comment and I will get back with you.
I hope this is the beginning of my return to the writing world. On D-Day itself (the aforementioned anniversary), I began a story which has the potential to be cathartic and liberating. I love the title I have chosen for it: "Diagonally Parked in a Parallel Universe" - I saw it on a t-shirt over at CafePress. (If you ever want to waste a whole bunch of time, do a topic search over there and just flip through an infinite number of pages of designs. My favorite: http://shop.cafepress.com/crazy-funny They may offend some people but I am all for making fun of myself (including my sanity) as often as possible!
So, in the spirit of "more to come", I am running off now to Kid-3's baseball game. I will try to post pictures tonight...