Dealing with it from the inside

I posted this on FB yesterday, but I think the term “panic attack” is kind of a misnomer. When we say “[x] attack” we normally mean “an attack caused by a/an [x]” – a bear attack is caused by a bear, an epileptic attack is caused by epilepsy, a heart attack… well, in the same way that’s kind of a misnomer too. Anyway, a panic attack isn’t like that. It’s not something caused by panic, it’s something that causes panic at inappropriate things or moments. The problem isn’t that I’m panicking over my bills, my work, or my life choices, it’s that there’s something in my head that’s causing me to react to that (or something else) as though I were being attacked by a bear, and that something will find a stimulus to latch on to, no matter how ridiculous it is. There is a core problem, in some but not all cases a medical one, that causes people to respond to things in an inappropriate manner. It’s not their choice to do this, they don’t want to do this, but despite that they still do.

How do I know that? Because last night at work, and just about as soon as I walked into work this morning, I started having the symptoms of a panic attack (for the record, those for me are: elevated heart rate, respiration, sweating in the absence of heat; increased irritability, impatience, aggressiveness and fear response; irrational thoughts and quick, inappropriate responses to external stimuli. Some or all may be present at any given time.). It didn’t start because I walked in to work, I think (because I deal with that stress just fine every day), but it chose that moment to manifest because that’s the earliest point in my day that I deal with any significant amount of stress. So, strictly speaking, it probably started some time before that, and I only noticed it when it found something to latch on to, and that required just the tiniest bit of stress. That’s how it works.

It’s kind of like an autoimmune disorder, in a way. When you have a regular immune response to something, it is scaled appropriately. When your immune system sees a kidney cell,  it says “Hi kidney cell, how ya doing?” When it sees a virion (viral particle), it kicks it out and says “no ticket.” When it sees a whole invading army of bacterial Nazis (yes, for some reason your immune system is Indiana Jones. No, I don’t know why), it sounds the inflammatory alarm bells and sets off a systemic cascade that recruits a whole bunch of white blood cells to help repel the invasion. When you have something like Crohn’s or Lupus or Rheumatoid Arthritis, your immune system responds to seeing something completely normal – a kidney cell, cartilage, or your own intestines – by setting off the alarm bells and trying to repel the invaders. In this way, a panic attack is similar. A panic attack is your brain reacting to perfectly normal things – school, life, work – or nothing at all by going into fight-or-flight mode, releasing adrenaline into your blood and causing you to physically prepare for the bear to come a-clawin’ at your face.

The way I remember learning about it, many reactions in your nervous system do not involve your brain at all. For instance, when you jerk your knee after the doc hits it with the rubber mallet, for instance, that cascade reaction only involves nerve cells in your leg and spinal cord. Most of the time, your heart rhythm is controlled by your heart. I imagine that to varying degrees, most autonomic functions in your body are that way. It feels like that’s happening here, too, in a tail-wagging-the-dog sort of way. Let me elaborate. It feels like there is something in my body or brain which is outside of my conscious control, which is causing adrenaline to be released into my blood. This causes a whole host of automatic responses that mostly encapsulate the symptoms I listed above. The effect on my brain is to encourage hyper-focus on my immediate surroundings, because that’s absolutely the correct response in a genuine situation where you ought to panic. So, the brain searches for the ‘source’ of the panic, the bear or whatever, and works to eliminate it or remove the situation in some other way. That means that any tiny situation which seems vaguely stressful can become this huge looming thing, simply because your brain decides to latch on to it and make it your whole world for the time being so that you can hyper-focus on it, solve it, and stop the alarm bells. In a normal situation, that would be the best response.

In this situation, that’s a problem. Because there is some persistent, invisible issue at hand, none of the proposed solutions work. Your brain, making a most reasonable assumption, assumes that the thing that it thought was the source of the problem was not. It goes looking for a new source, and the process repeats itself. This results in you panicking about small, meaningless situations and problems-that-aren’t; hyper-focusing on things you can’t address, like bills or why you chose the major you did in college; and just generally being jumpy, irritable, and acting as though every little problem is the end of the world. So in that way, it’s not an attack by panic, it’s an attack that causes panic at inappropriate times or for inappropriate reasons.

Hm. I’ll have to think about this some more. I’ll try to remain calm while I do, and deal with this from the inside.

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Obamacare saved my life

The Affordable Care Act (“Obamacare”) has divided America. Town halls, state houses, and news rooms are consumed with the debate over whether it is what we need, and whether it is what we want. None of this matters to me, though, because as strange and unbelievable as it sounds, the Affordable Care Act saved my life.

In 2006, I was diagnosed with an ear infection. It made me deaf in my right ear, but it seemed to resolve itself, so I put it on the back burner. At the time, I was a starving student. In 2007, I became a starving graduate. In 2008, President Obama was elected. Soon thereafter, the Affordable Care Act was signed into law. In early 2011, I got a letter in the mail from Blue Cross-Blue Shield. The ACA required my insurance carrier to cover children with pre-existing conditions, but at the urging of Sec. Sebelius they opted to cover all pre-existing conditions on insured persons. This seemed innocuous, but would not stay that way for long.

In December 2011 I discovered that 5 years prior, the doctor called it wrong. What he called an ear infection was actually a large brain tumor, and if I didn’t have surgery immediately I would soon be dead. I was rushed through a battery of tests, and only days later I was operated on by two of the finest surgeons I think one could have. One was the chief of neurosurgery, the other the chief of otolaryngology (“Ear, Nose and Throat” surgery), and their joint operation lasted nearly 16 hours. I lived, but it was a near thing. A less steady hand, a less precise method, and I would be dead right now. After I left the ICU, I saw the bill: more than $1,000,000 before insurance, and about $5000 after.

Without the Affordable Care Act, my insurance wouldn’t have covered the tumor, because it predated my insurance coverage by several years – a pre-existing condition. Without insurance, the hospital would have had no reason to not shuffle me down the street to the state-run charity hospital. Without the the best doctors, the tumor that nearly killed me might have finished the job. For all its flaws, the Affordable Care Act saved my life. When there is talk in Washington of repealing and replacing it, I always ask myself: if that had been done instead, would I be dead right now?

———-

I wrote the above at the request of a friend, as a short opinion piece for a small publication. I realize that there are points within it worthy of a spirited debate, and there are more sides than I present. Five hundred words is not long enough to tell the whole story, but that’s all I had. Was I at fault for not acting sooner (I was without hearing in my right ear for 5 years, after all)? Would it really have been classed as a pre-existing condition, given that it was misdiagnosed? Does the fact that this happened to me counter-balance the other ethical issues, like job losses and disruptions to families, that perhaps happened elsewhere? Is the good that it did for me weight enough to make it good policy, if at the same time it encourages society to move in the wrong direction, if indeed it does that? These are all good questions, and I’m not here to answer them for anyone but myself.

What I know, however, is that even though I think parts of the ACA are less than ideal, even though I think it doesn’t go far enough, I cannot malign the Act itself on that basis. It saved my life. It is costing some people some money, and if that makes their lives difficult or impossible then that’s a bad thing. I sympathize. I’m living paycheck-to-paycheck, too, and it’s tough. On the other hand, I’m living, and that means I’m better off than I might be otherwise.

Story of a Tumor: Intensive Care (pt. 3 of 5)

In previous entries, I was diagnosed with a brain tumor and had it removed through brain surgery. During the 13 hour operation I was resuscitated three times, which means I also died three times very briefly. During that time I believe I was offered a choice, and I chose to live. Not because I was afraid of death, or because it was painful, but because I had things left to do. I love my fiancee, I wanted to fulfill my promise to marry her and be with her, and I wanted to know what our life together would be like. After I decided I’d rather have a painful, tough, struggle-filled life than an easy, quiet death, I woke up.

Memory is a funny thing. I’ve been thinking about my time in the ICU for a week now, and I can still only recall brief snippets of specific experiences. Still, even though the events are a blur, the sensation is still very familiar to me. The fear, the pain, the uncertainty, the monotony, the routine, are all very easy to recall. Specific people, places and events are tougher to bring to mind. But still I try, because I want to remember. As unpleasant as it was, it was an experience, a lesson, and I don’t want to ever forget it. So if this comes across as a chaotic jumble or seems disconnected, that’s because it is. Try as I might, it’s hard to tame that beast into a coherent narrative.

In the bland language of medical science, I spent about 12 days in the ICU and three days on the hospital floor before being moved to a longer term, inpatient rehab facility across town. I then spent about 19 days in inpatient rehab before leaving the hospital and spending several months more in active outpatient rehab. Eventually, I transitioned back to work and life. While in the ICU I was intubated (placed on a breathing tube) and put on a respirator two times, on supplemental oxygen for several weeks, treated for a pulmonary embolism (a small blood clot that migrated to my lungs), placed on a feeding tube and had a tracheostomy inserted into my throat, along with being on almost constant pain medication and being treated for regular panic attacks. My blood pressure shot up dangerously high and my oxygen saturation dipped dangerously low at several points, requiring additional medical intervention, and for nearly two weeks I didn’t poop. You wouldn’t think the last one would rank with the others, but this turned out to be very important.

Before the surgery, my niece (who is ridiculously cute, and I’m not just saying that as her uncle) gave me a small stuffed animal and a get well soon card. He was called Mr. Squiggles, and he stayed with me throughout my experiences in the ICU. I don’t precisely know why he was as great a comfort as he was nor why I chose to have some of the affirmations and mantras that I did (more on that in a minute), but he was and I did. When picturing what I’m about to tell you, though, know that he is a 1 foot tall stuffed brown monkey. He has a tag, and on it my cousin wrote her own name in the “From” field and “Uncle Luke” in the To field. He is beside my computer to this day.

Despite the last line in the previous entry, there wasn’t really a clear point at which I “woke up” from my surgery. Instead, my third dream (of spinning fast and being bombarded by noise) simply seemed to stretch on and gain new focus, transitioning so gradually from dream to reality that even now I couldn’t tell you where the transition happened. However, at one point I realized that I was no longer sitting on a therapist’s couch spinning (which is where I thought I was initially in the dream), and was instead on a large, reasonably comfortable bed in a somewhat dark room with an old TV turned onto Maury Povich, and had been there for some time. I had an IV in my right arm and in my left arm, an oxygen mask on my face, a catheter to catch my urine, and there was a nurse doing something. She motioned to my waiting family members, who came in and said hi.

They told me it had been three days since the surgery, when I asked. My mother and my wife told me later that I had been talking to them before that point, but I honestly don’t remember any of that. I guess the cranial swelling does a number on things like memories, even if things seem fine. But I was talking to them then. I remember the first few days as being full of periodic pain and growing weakness, like my strength and energy was being sapped away by something to the point that even moving was a serious challenge.

On the third night, the pain started. It wasn’t that bad the previous two nights (although certainly present in some measure), but it got much worse on the third night. When it got worse I called a nurse and told them about it, that my chest hurt and it was getting worse. Then I told them again, because it got worse. Then I told them again, because it got worse. Then I told them again, because it got worse. Then they told me the doctor had gone home and couldn’t prescribe any more pain meds, and that I’d have to wait for the morning. I was on the maximum dose of Dilaudid they were allowed to give me at that point, and had also given me a couple other meds I can’t remember. They also wanted to get an ultrasound of my chest to see what was going on, and for an odd reason that might also offer relief of my pain, but that would have to wait for morning too. I nodded and said okay. When they left, I sobbed. I’m a pretty stoic guy, and it takes a lot to make me cry, but that news just took the last wind out of my sails, took away my last hope of relief in that solid, concrete pronouncement.

I spent the next six hours in undiluted, unabated, unabashed agony all by myself in that dark, quiet room. Every breath was agony because the blood clot was in my lungs, it felt like a staple in my chest holding the two sides of my lungs together. I spent the time trying to breathe slow and deep, because even though it felt that way I knew that pushing past the pain would help. What I really wanted to do was stop breathing altogether to make the pain stop. I tried shallow breaths a few times, but that made my oxygen saturation drop so I avoided that after a while. When I found a pattern that worked, I kept it. Thereafter, I spent my time rubbing my thumb back and forth on the tag on Mr. Squiggles and repeating the words on it to myself over and over again. There aren’t any words on that tag any more; I’ve rubbed them all away. It felt like the pain was so intense it was literally going to wash away my sense of self, take my identity and sanity away from me. I needed a constant reminder of where I was, who I was, and what I was fighting for. When just that didn’t suffice, I whispered to myself, “I love you, Laura.” She always gave me great comfort, was my anchor and my foundation, and that hasn’t changed a bit. Even though she wasn’t there just then, she helped.

In the morning, after their daily pow-wow, the doctors decided I needed to go on a ventilator. My blood wasn’t oxygenated enough on its own, try as I might to breathe deeply and fully, and I needed the additional support that being intubated and placed on a respirator would provide. They didn’t ever tell me that, though. What they told me was “sit up.” and whenever I inquired what some drug or procedure was it was always “your medication” or “this will help you sleep.”

And so it was that a few hours (or a few days, I don’t even remember) after they placed me on a respirator and breathing tube, I removed it and started to remove my own IVs. I stopped when I got to my catheter, because I lost my courage when I started to pull the rubber tube out of my urethra. That hurts a lot, by the way. Alarms went off, nurses ran in and held me down, then a respiratory therapist re-inserted the tube I’d removed. They placed me in restraints, also, but they didn’t do a very good job (protip: don’t put the quick release to a slipknot within reach of the person you’re supposed to be restraining), so about two hours later they came in to change my medication to find me stroking Mr. Squiggles, my hands unbound. They tied them up again, and I demonstrated that I was entirely capable of slipping the restraints again. That battle went on like that. Later that day, Laura and my parents visited. Laura asked what happened. I used a pointer and an alphabet board to indicate my answer, because I couldn’t speak.  My responses were significantly less sensible than this, but for ease of reading I’m going to keep my responses to what I intended to say rather than what I did say. I was on pretty heavy sedation at that point, so it was hard for me to coherently express myself.

“Why did you extubate yourself?” Laura said

d-i-d-n-t
a-s-k
p-e-r-m-i-s-s-i-o-n

“Who didn’t?”

n-u-r-s-e-s
f-o-r
b-r-e-a-t-h-i-n-g
t-u-b-e

“If they asked first, would you have let them?”

y-e-s

“So if I get them to ask you for permission first and tell you what they’re doing to you, you promise not to try that again?”

y-e-s
m-e-d-i-c-a-t-i-o-n-s
t-o-o

“What about your medications?”

t-e-l-l
m-e
w-h-a-t
t-h-e-y
d-o

“Okay, I’ll talk to them about that.”

After that point, when they answered my questions and treated me like the learned, educated guy that I am, I was very well behaved. You see, I’m a bit weird. When a person orders me to do something, they’d better have the authority and leverage to back that order up, because if I can then I will rebel. Even, perhaps especially, if the order was to do something I was already inclined to do. If I’m asked, though, I’m on the other hand much more cooperative. So, it was in the best interest of the nursing staff to ask me if it was alright that they do this, that or the other, rather than simply tell me that they were doing those things to me. I understand that they are pressed for time, and that that is nto really how they were used to things working, but it’s my body and I will assert ownership if I have to.

In the end, though, it was probably a bad decision. It’s entirely probable that many of the problems I had later with vocal cord paralysis came at least in part from extubating myself like that, and so it caused one of the most unpleasant parts of my longer-term arc of recovery. At the moment, though, it was what I had to do in order to get a little bit (or maybe just the semblance) of control over my own life. I hated and hate being treated like a piece of furniture, or like a person incapable of understanding what was happening to him or making informed decisions for himself, and the ICU nurses started out treating me like a mix of that. It wasn’t their fault, though; most of the time, that’s the safest assumption for the patients they are dealing with. It’s better to be wrong in the right direction, after all.

The days after that pretty well blended into one another. My room was lit almost identically regardless of whether it was day or night, and I was on pretty much constant sedation so it was hard to tell time. There was a clock, but a few problems conspired to make it very hard to read. First, there was the sedation. Propofol, which is the anesthetic I was placed on pretty much constantly, is called “milk of amnesia” for a reason. So I could be aware of my surroundings and reasonably clear-headed one minute, and then completely asleep or otherwise out of it the next. Therefore, if I did successfully read the time off the wall, there’s really no way of knowing how long that reading would be relevant, as at any time I might skip ahead an hour or two without even knowing it. Second, there was my vision. That requires a bit of explanation.

The tumor was growing on my right acoustic nerve. As previously stated, it was about 4 cm on the large axis, which was along the nerve itself, and about 2 cm in each direction extending out from the nerve. It turns out that the optic nerve, oculomotor nerve, trochlear, vestibulocochlear, facial, and trigeminal nerves, and a couple others are normally about 1 cm away from the acoustic nerve inside a bundle of nerves within the brain in a region called the Pons. That means that the tumor was growing and displacing them, too. It hadn’t grown around them, but it had forced them out of place and they were running along its surface, making the surgery to remove it somewhat more complex. When they did remove it from my acoustic nerve, that nerve was so stretched by the tumor and the surgery that it was pretty much useless. A few other nerves sustained some damage too. This nerve damage manifested as my balance being completely off and my feeling like I was spinning when I was standing still, my right eye not being able to move past a certain point, my right eye not seeing nearly as well or protecting itself with tears nearly as well as it normally did, the right half of my face having almost no sensation and no motion whatsoever, and my being unable to swallow or speak at all. This last may also have been caused by swelling that resulted from me extubating myself earlier, also, but the degree to which those two events contributed to my observed outcome is pretty much impossible to assess.

I’m right-handed, and therefore right-eyed. My vision in my right eye went from 20/20 to approximately 20/200, and I was unable to move my right eye farther to the right than staring straight ahead. Also, my right eye was tilted a degree or three off from true, so that I had (have) no depth perception and I have persistent double vision. All of that made it nearly impossible to read a clock on the wall. I eventually figured out that my vision got substantially better if I closed my right eye. My parents buying and placing an eye patch on me for that purpose also helped.

After a few days, the doctors started to take an interest in this. It turns out that after the surgery my eye got so dry and was rubbed on by a piece of gauze they placed to hold it shut, so that I developed an ocular ulcer on my eye and had to have it stitched shut. They placed a temporary tarsorophy on my eye in order to do that, which basically consisted of a plastic bar they wove both of my eyelids onto, in order to semi-permanently close them both around said bar and avoid having anything touch my eye for a while. I remember the operation to install the tarsorophy very vividly, because it scared the crap out of me.

In order to perform the operation, they injected some demerol into my face to numb it. I was already on Dilaudid and Propofol at that point. That meant that my body, which was already in a dreamy, disconnected state to keep me separate from the pain, started to numb even more. To me, being on Dilaudid felt like I had two bodies. There was the meatbody, which hurt a LOT and was just kind of sitting in the corner at the moment. Then there was the mindbody, which is where I really was, and was just a passive observer for all of this. If I wanted to communicate with the world I needed to do it through my meatbody, and that required feeling all of its pains and problems and engaging the thing I was trying hard at that moment to ignore. Well, you would expect demerol to only affect my meatbody. That’s not what happened, though. I felt the numbness and vacancy spread over my head in my mindbody, felt it regardless of whether I wanted to feel it or not. That scared me, because numbness felt like oblivion, and it felt like the next thing that was going to go numb would be my brain itself. I’d be gone if that happened, I feared. All the hard work I was doing to preserve my consciousness and personality would be for naught if the drug took away who I was, if I was so lost in the fog of anesthesia that I couldn’t find my way back.

I was so scared that I asked my brother if there was some sort of interaction between Dilaudid and Demerol that I should worry about. There wasn’t of course, because the docs know what they are doing and were monitoring me closely, but I still had to check. After about an hour it started to get better. About four hours later the Dilaudid started to wear off, and at that moment I made a decision. The painkillers were a necessary tool, but when overused they were dangerous. Not only were they addictive, but they also had the same power to cause me to lose myself that the pain did, if used overmuch or improperly. I also wanted to genuinely feel the pain, because this was my life and I wanted to live it, even the bad parts. The more I felt, the more I learned. Of course, I could only take so much pain, so I didn’t refuse all medication, but I decided at that point to absolutely minimize the painkillers I was on. Pain can’t kill you, after all, so completely eliminating it wasn’t necessary or helpful.

That night, an ironic and troubling thing happened. The night nurse on duty was a young man whose name I forget. He was a big fan of peace and quiet, of his patients sleeping the night away and not bothering him overmuch. I, however, was spending the night trying to find the right setpoint to minimize my painkiller use. That meant that I gave up on sleeping that night. This bothered him. Therefore, whenever I asked for something that night, the answer to the question of what I wanted was always “more medication.” Since I was asking through a really problematic letter tablet, and wasn’t able to point out letters in an accurate or swift manner, I can’t entirely blame him. Usually when patients complain, they complain about pain. Usually they just want more painkillers. Also, most patients want to sleep at night, and I usually tried, but that night was different. Still, when I meant to ask for a new blanket, I got Dilaudid. When I wanted him to retrieve my letter tablet because I could not, I got another painkiller. When Mr. Squiggles fell off my bed and I couldn’t get him without disconnecting my IVs, I asked him to pick up my stuffed monkey for me. I got another painkiller, that he told me was actually prescribed for someone else but “it was okay.” After that, I learned to just not call for help. I laid back in my mindless haze and tried to meditate through it, to maintain my sanity and my Self through the disconnecting, disconcerting haze of all the chemicals.

In the morning, one of my favorite nurses came on duty. Since I was pretty sure what had just happened was against regulations and laws and good practice, I tried to tell him about it. After ten minutes of trying to explain using the letter tablet and getting nowhere, then having a different patient call him, I just gave up. It wasn’t that big of a deal in all probability, and it was just something I’d have to remember to not let happen again.

That day, I started to turn a corner. For the previous week, I had been given no food whatsoever. Predictably, that caused me to lose a lot of weight. When I went into the OR I weighed 165 lbs. When I left the ICU I weighed 90 lbs. Most of that weight loss happened in that first week. That day they decided to try feeding me for the first time, to see if my digestive tract had turned back on. Before that point the cranial swelling was bad enough that they were afraid they would have to operate on me again, and wanted to keep me in a state ready for surgery at all times. They fed me a tiny amount of food through a nasogastric feeding tube, equivalent to a bite or two, and watched what happened. I didn’t poop. This made them suspect that my digestive tract had not turned on. My brother pointed out that maybe feeding me one bite of food was not sufficient to reach that conclusion, that maybe they should give me a whole meal. They did. I still didn’t immediately poop. They were worried. My brother pointed out that people rarely poop immediately after eating, that maybe they should wait a while. They agreed, but stopped feeding me in the mean time and withdrew the feeding tube.

After a few days of my not pooping, and their installing and then removing a nasogastric feeding tube a few times, they set me up for another two surgeries. Because of problems with throat paralysis, they wanted to install a tracheostomy (the thing you see in movies where a choking person is fitted with a pen/straw/tube in their throat to let them breaths – that’s a tracheostomy, albeit a very crude and non-sterile one) to help me breathe and to install a PEG tube, so that instead of being fed through a tube in my nose I would be fed through a tube leading directly to my stomach. The trach would allow me to be removed from the ventilator, and the PEG would allow the nasal feeding tube to be removed. At the same time, to facilitate all of the injections and medications I was receiving and to keep me from looking like a heroin addict, they wanted to install a PICC line. That is basically a thingy that allowed them to inject drugs into my system without having to actually pierce my skin to do it, instead injecting them through a line that they’d already placed. On the day I got those three surgeries, one of my nurses commented that I was “cooking with gas” now. I remember her fondly; she was very cheery, and helped brighten an otherwise dismal experience. I think at one point I tried to set her up with another of my nurses who at this point I’m fairly certain was actually gay, and also 15 years her senior. Whoops.

The last three nights in ICU I remember being a mix of things. My mom bought me a Playstation 2, a small flatscreen that could be placed on my bedside table, and a copy of Grand Theft Auto: San Andreas and Grand Theft Auto: 4. It was just the right thing. Right about then, mindless violence and randomly wandering around the city committing felonies was a perfect fit for my mood. So at night, I played Playstation. By day I talked with my family. The major impediment I faced in those last days in the ICU was panic attacks, which struck about three times per day. There was no pattern to when they struck that I could discern, no pattern of thoughts or topic of conversation that triggered them. They just happened. I reasoned that that meant they were physiological, not psychological. When they happened, they felt like a weight on my chest and a vise on my heart. My heart would speed up and my breathing would get quick and shallow, not because I was scared or wanted it to but just because it felt like the pressure just drove them to do that. My heart sped up, not because I was scared but because I couldn’t make it slow down. The same was true of my breathing. I tried to get them to slow down, I desperately tried because I did not like that feeling, but it’s pretty hard to calm down when everything in your brain is telling you “BAD! WRONG! MUST STOP! RUN AWAY!” despite there not being anything to run from. It felt sometimes like I was dying, and after my hard work to stay alive and sane that was really worrying. But those thoughts came from nowhere, and when they told me that I was fine and there was no reason to think that, they didn’t go away, so I didn’t know what to make of it. Once, I held a whole conversation with my father about his dream farm in Oklahoma where he could live away from society, raising pigs and goats and crops, and all the while I was unavoidably thinking about how I was about to die and there was nothing I could do to stop it. I just learned to tell my mind to shut up, and even though that did nothing to abate the physical symptoms, it did make it a bit easier to handle.

My last night in the hospital was spent on the hospital floor, not in the ICU. They transferred me out when they had figured out which inpatient rehabilitation hospital to send me to, but were still working to transfer me there by getting a spare bed. I remember that that night held one of the more embarrassing experiences of my life. When I got into the room, a very special order accompanied me: “Enema”. The nurse assigned to the floor and to my room was a moderately attractive latina nurse who in other circumstances I would have been happy to pointlessly flirt with. In these circumstances, well, yeah. So there I was, on a bed wheeled into the room, unable to sit up or move without help, and this woman’s orders are to put a tube up my butt and rinse out my insides on the off chance that stimulates me to poop. She does, and because I’m too weak to stand, I don’t rush to the restroom like one normally does when receiving that treatment. Instead, the action was contained to my hospital bed. In front of her. My next thought was “well, I guess flirting is out of the question now…”

And then I was transferred to the inpatient rehab hospital, which I will cover in the next part of this story. I left plenty of things out of this part (“Good lord, how can sitting in a chair be exhausting!” and taking my first assisted steps, and the annoyance of my nurses hearing “Call Laura and wish her Happy New Year!” when I meant to say, “Call Laura because I need her and want to hear her voice just once.”), but this story is getting long enough already.

The Story of a Tumor: Surgery (pt. 2 of 5)

First, a quick recap. On the way home from the Christmas party a few years ago, I went blind. For about 8 seconds, starting as I hit the gas at an intersection a quarter mile from my apartment, I couldn’t see anything. Freaked out as I was, I managed to get home safely. Then I talked to my brother who is himself a doctor, and he suggested some follow-up appointments for me the following day. I went to them, and after an MRI I was diagnosed with a rather large (4.1 x 2.4 x 2.1 cm) acoustic neuroma, which was blocking an important cranial sinus cavity and causing fluid to back up around my brain. This caused my blindness, a deafness I previously believed was due to an ear infection, and swelling in my optic nerve. After I got the diagnosis and was scheduled for an ASAP surgery, my parents drove/flew into town, and we made ready for my surgery in New Orleans at Ochsner Medical Center.

The night before surgery was warmer than you’d expect for the middle of December, or maybe I just couldn’t feel the cold. That’s somewhat unusual for me, since I am usually very prone to feeling the cold and reacting to it rather poorly. Tonight was different, however. My phone would not stop ringing, and I had to do about a dozen different things before the night was done. Through it all it was important to reassure everyone that I wasn’t scared, even though I was terrified, because my showing fear would just cause them to worry more. Them doing that would hurt them, and not help me a whit, so I couldn’t abide that. So there I was, being stoic and cold about it, even though I was staring death in the face more plainly than at any time in my life to that point. Then, the phone rang.

It was always the same conversation.

“Oh, hello [person]. How are you?”

“[Answer, usually that they were generically good]. I heard what was going on from [person or Facebook].”

“Yeah, it’s… a Thing. I don’t know what to make of it yet. [concise explanation of pt. 1 of this post, summarizing events up to this point.]”

“Does it hurt?”

“No, oddly. I can’t feel it at all. The doctor said it has been in there for at least 4 years and I never knew it, but if they don’t remove it then the symptoms are only going to get worse.”

“Do you mind if I pray for you? I talked to [religious figure/group] in [name of church] and they said they would pray for you, but I wanted to make sure you wouldn’t mind.”

“No, I don’t mind at all! The more the merrier, really. I’m really touched they would do that, and I really hope you have a [happy holiday of choice].”

[2-5 minutes of polite conversation.]

I didn’t mind, and don’t mind, and certainly all the well wishes were really gratifying. I don’t think prayer in any form ever hurts, so I was happy to receive all the well wishes I did. That said, after about a dozen iterations that night alone, the conversation did become somewhat tiresome. The calls started to slack off around dinner time.

At around that time, I called the Notary Public. Although I had drafted the Living Will, Last Will and Testament, and Power of Attorney the night before, they needed to be signed and notarized before they were official. She arrived an hour or so later, and two of my friends witnessed the signatures and seals being placed on the document and in her official register. The whole thing took about an hour, and cost around $50. At the end of it, though, I had a document that ostensibly empowered Laura to take care of my affairs if and when and while I was unable to do so for myself, and two that made sure that if I was unable to do so then my will for myself and my things would be carried out in any event.

Afterward, with my parents arriving in town, it was time for dinner. We went to an Italian restaurant in town and ordered enough food for everyone, then tried desperately to avoid talking about the reason why we were all in town at once. It was actually a very good dinner, in which I was genuinely able to forget my cares and worries for an hour or two and laugh. We joked, we ate, and it was all over way too fast. Then we drove back home, and after about an hour my mother started obsessively cleaning. I took that moment as a good one in which to visit the apartment manager’s office.

When I told them what was happening, they were very concerned and upset and just as clueless about how or why I would need to be telling them. That I was about to go under the knife and might be dead this time next week, or have no income and thus no ability to pay for an apartment, didn’t seem to register with them at all. Just as irrelevant to them was the fact that this might violate the lease, and mean I was financially or practically unable to keep it. So talking with them was very frustrating and not at all reassuring. What I badly needed at that moment was reassurance that my life wasn’t going to implode when I was stretched out unconscious on a hospital bed, and from that particular source I got exactly none of it. That night, it turns out that I should have called my bank and made sure that they understood that my Power of Attorney was real, but I didn’t. That would come back to haunt me later. My employer knew what was going on and they generously gave me leave to not be at work until it was all resolved. I might have gotten short- (or as it turns out, long-) term disability as well, but because I was just that day transferring from a temporary worker ti a permanent employee I wasn’t eligible for that yet. Therefore, for the entire period I was out of work my income was $0/month, which is very hard to live on. Thankfully, my temporary employer allowed me to retroactively file for COBRA insurance, which allowed me to carry over my previously-paid-for medical insurance despite my officially changing employers and insurance plans. The irony is if they’d followed the exact rules, then I’d not have had any insurance and been responsible for the whole bill myself, losing my insurance *because* I was working, and the new insurance not covering the tumor because it was a pre-existing condition. Complain about the Affordable Care Act all you want, but that situation is ridiculous, so clearly there is a need for reform. It also would have been personally ruinous if the staffing agency hadn’t bent over backwards and bent the rules just for me. We’ll do that tally in the next post, though. For now, there’s more story to tell.

Unexpectedly, I was able to sleep soundly that night after about an hour of tossing and turning. I don’t remember my dreams, but remember thinking in the morning that they were the kinds of dreams one expects to have the night before one potentially wakes for the last time ever. When I woke up, it was time to get ready. I had an internal chuckle at the idea of packing for two weeks when I might die in five days, but ultimately it was better to pack more than I needed than not pack enough. We drove to the hotel, which was attached to the hospital, and reviewed the schedule of pre-op appointments. First, a meeting with the neurosurgeon. Then, a meeting with an audiologist to check my hearing. Then, a meeting with the otolaryngologist (ENT; Ear-Nose-Throat doctor) who would be assisting the neurosurgeon. Then, another MRI. The following morning, I was scheduled for surgery.

The meeting with the neurosurgeon was short, to the point, and somewhat reassuring. The surgeon was arrogant and haughty like experts often are, emotionally distant in the way one expects of a person who has done this dozens of times, and exuded an air of confidence that this was entirely within his capabilities. Although that kind of attitude sometimes bothers me, in that specific case it was just what I needed. The chief of neurosurgery would be operating on me, and if anyone could do this well he knew it was him.

The hearing check gave exactly the result I told them it would. I was deaf in my right ear, and my hearing in my left ear was completely normal. The ENT confirmed this, and played the “bad cop” to my neurosurgeon’s “good cop”. I came away from that meeting scared, but not unnecessarily or unreasonably so, and somewhat shaken but ready for the next step.

The MRI was kind of cool. They placed eight tags in specific places around my skull and then took a detailed picture or the structures of my brain, so that in the OR they could re-create my brain with holographic imaging and operate with that overlaid as a guide to their surgical implements in order to avoid important structures and remove the tumor more completely. I saw none of that, though. To me, it was just more clank-clank-boom whir-whir thud-thud-thud-thud-thud click-click-click buzzzzzzz, time for nachos. I didn’t actually get my nachos that time, though. I think I had a burger from the hospital cafeteria, which was overpriced and overcooked.

For dinner we had sushi at one of my favorite restaurants in Metairie, which I ate while ignoring the stares from patrons who wondered what those weird tags were on my head. They were the radiation tags from the MRI, and they enabled the technicians to map my head to the holographic image they’d generated earlier that day. At that precise moment, though, I felt rather like a plague victim from the stares I was getting. It wouldn’t be the last time.

Later that night, back in the hotel room, we watched movies. My stepfather played around on the X-Box that my brother brought, and we tried to again ignore why we were all there. There was nothing to be gained by dwelling on something none of us could control, and since we were all together it was an opportunity to spend some quality time together. It took some negotiating, because many years prior my parents had divorced and I needed to navigate their complex relationship and the complexities of bringing together my family and Laura’s family temporarily, but we managed. People have an amazing capacity for resilience and compassion when united by a crisis.

Unlike the prior night, I didn’t sleep very well that night. I tried, but I ended up wandering around the hotel and the grounds of the hospital instead of sleeping. At some point that day every person that came there to be with me had a moment where they had me to themselves, and in that moment they shared their words of reassurance or guidance or advice. Some helped, some didn’t. But I realized later that much of that wasn’t about me, precisely; they had a need to say what they did, and a need for me to listen and accept it without reservation. They wanted to help in some small way, and even though I knew that was in many ways utterly impossible I appreciated it for the genuinely altruistic sentiment that it was. There was no way I was going to not be worried or scared shitless at that moment, at that place, no matter what I did, but it was very nice of them to try to get me there and lighten the load. They also needed to feel that I was going to be okay, because me being scared scared them, made them realize I might not be okay, so for all I was scared I held it in for their sake. They needed me to, so I did. I’d do it again.

I remember talking with my brother and my fiancee at a few points, and confiding my fear in them. I wasn’t scared of death, not really. What I was really scared of was disability. There were things in my life that I feared losing, things I used every day that made me, me. My voice. My independence. My ability to walk, to eat, to think. My identity. More than dying, I feared being obliterated, being unmade by having my personality unwritten or capacities undone. I prized my voice and my ability to tell stories with it, and the mind behind the words that let me craft the stories the words made up. There was nothing I could do about that worry, though. It just was, and I had a whole day yet to live with it.

About 4:00 AM the morning of, I went into the surgery center and checked in. It took me about an hour to get seen by the pre-op nurse, who set me up for my 6 AM surgical start time. At 5:15 I was taken back into the prep room, and told to take off all of my clothes and put on The Gown. I did, and then hid under the provided blankets because I hate the cold and it hates me. Eventually, they placed an IV in my arm which I think was saline. They were kind enough to warm it up for me, so it was like an injection of 100 CCs of Warm straight into my left arm, which helped. Then I said goodbye to Laura, who I’m sure was trying hard not to cry, and they wheeled me back to the operating room.

At that point, the anesthesia was hooked up to my IV and things started to get fuzzy. I’d like to first give you the account that other people gave me later, and then the experience from my perspective. I think both are of value.

The surgery took 15 hours. During the surgery I needed to be resuscitated three times, meaning that at three points my heart stopped beating. Throughout that they removed most of the tumor, cut off the blood supply to the rest, and moderately impinged on my cranial nerves in the process. None of this was unexpected, given that they were operating right next to the part of my brain that regulated my heart beat, breathing, digestion, and other suchness. After the surgery, I was kept heavily sedated for about three days. I don’t remember those three days, though I am told that I tried to do some communicating during that time.

They told me I wouldn’t dream; I remember specifically asking about that. They were wrong. I had four dreams after I was sedated. I can’t say whether they happened during my surgery or after, but my gut feeling is that they happened during given the details of the dreams themselves. I remember them clearly, even now, and the order they came in.

The first was more an out-of-body experience than anything. I was floating above my body watching the surgeons operating on me, and the nurses moving around the room. The whole thing is very expressionistic, floaty, something like how things appeared in What Dreams May Come. Maybe it’s just a composite of my expectations of the experience, but whatever the reason, that’s how it manifested. It ended with the monitors beeping loudly and people starting to move more rapidly around the room. I got the distinct feeling that something had gone wrong, and then the dream dissolved into something else.

The second dream was very dark. I could hear faint voices in the distance that sounded like my doctors and nurses, and I got the feeling that they were trying to revive me. I felt but did not see a distinctly feminine (not necessarily female, but certainly feminine) presence next to me but out of sight. The realization that came after wasn’t so much in words, but it amounted to something like a hand beckoning me on if I wanted. I looked up, heard the voices, and felt that if I took her offer then I would certainly be at peace. Unfortunately, there were people that my peace would hurt, so I declined. The third dream started.

After the darkness and quiet of the last dream the third was riotous. I was placed on a table, spinning. There were impossibly loud klaxons and blaring lights all around me. I was spinning faster and faster, trying to tell myself to calm down and control it. There were voices that said that if I didn’t get control of myself then I would lose myself in the chaos and confusion. I took in a slow breath and felt the ground beneath me, felt that I was not moving, told myself that I was still and quiet and that the only thing moving was my mind. If my mind would kindly sit down, this would get much easier. As I did, I felt that same presence near me but out of sight. Thoughts rose in my mind that were simultaneously my voice and not my voice which said, at the speed of thought, that this was what I was going back to. That I would have this to look forward to if I chose not to move on. If my hold on life, if my attachment was that strong, then I would suffer. I knew that was true, but at the same time people I loved would suffer if I moved on, and besides I hadn’t even got to marry my fiancee yet so I still had some unfinished business. I made a promise. There was another option, though. That was the last dream.

In the last dream, I was being wheeled around in a wheelchair by my wife. It was the future I guess. In this future my recovery had been swift but incomplete, largely painless but left me unable to walk or do some things on my own. If I wanted to avoid pain, this would do that. I refused. Pain was preferable to disability, and pain is only a sensation. Suffering is a choice we inflict on ourselves, anyway, so if I stayed sufficiently focused and unattached then I would be able to avoid much of it. We reached an understanding; a choice had been made.

That’s when I woke up. It had been three days, and I was on a bed in the ICU. The Weather Channel was on for some reason. It was the middle of the day, and I tried to ask for a glass of water. When I tried no sound came out. I was mute.

The Story of a Tumor: Diagnosis (pt. 1 of 5)

It all began after the office Christmas party. That night it was cold and windy out, but clear. The party was alright, but I went home fairly early since I’ve never been a fan of most parties. The only time I like parties is when I have a lot in common with the people there, and frankly the only thing I have in common with most of my co-workers is that we’re co-workers. Thus, at that very moment, I found myself on the road driving home. At home, I had a cat and an empty bed waiting on me; my fiancee was out on a job in Alexandria (she’s an archaeologist), and was due to come back the next day. I was also looking forward to a few hours of World of Warcraft, and maybe The Daily Show with Jon Stewart, then bed.

I was first in line at the intersection, so as soon as the light turned green I hit the gas. Right as I did, the world went black. I didn’t black out, the lights were still on, but I was blind. After a few seconds of ‘oh shit what’s happening’ I realized that if I didn’t get to a safe space, I was going to swiftly die in a car wreck. I took my foot off the gas, coasted to the other side of the intersection, and felt for the emergency lights on the steering column. They were right where they always are, which is I suppose kind of the point. Eight or ten extraordinarily long seconds later, my sight started to return to me. It cleared kind of the same way the windshield clears when the defrost comes on; it started at one or two different points and worked outward. When it came back, I sped up and drove the block and a half back to my house. I parked, went into my bedroom, and completely freaked out. My hands shook, my heart raced, my breath came in short fits, and I felt like my heart was going to come fling out of my chest. After I calmed myself down, I made a few calls. First I called my fiancee, to tell her what happened. Then I called my brother, to ask for advice.

Two days earlier, the same thing happened to me. As I was standing up out of bed in the morning, I lost my sight for eight or ten seconds. I wasn’t sure of the extent because it was also quite dark, but that it happened twice was enough for me to say it wasn’t just a freak occurrence.

The call came just as he was sitting down for dinner, I think. His daughter (my niece) was in the background, as was his wife and her sister. Her brothers were there as well somewhere. Calling him for medical advice is something I try to avoid, because everyone in our family does it and it drives him nuts. They all think that having a doctor in the family means they have access to free health care, and I hate to treat him like a thing to be used rather than a person whose company I enjoy thoroughly – because I do think he’s absolutely awesome. I took a deep breath and asked him if he had a minute. He sensed my tone, and said he did. I described the situation to him tersely, as he’s probably used to hearing from patients, and asked him what I should do. In the back of my head, I was hoping both that this was and wasn’t a simple problem, because I hated to disturb him for nothing. I’m sure he was fighting back some very real fear himself when he set me up for an appointment with his wife’s sister, who is an optometrist with a practice in town. He told me later that what was eventually diagnosed was the most likely diagnosis given my symptoms, so his training told him that’s what it probably was from the very start. I was to go to the appointment immediately in the morning.

My fiancee got home the following morning, just in time to be there with me for my appointment. That morning it was also cold, but the sky was bright blue and cloudless. I went into the Walmart Vision Center, asked for my brother’s sister-in-law, and was shown to the back. She looked me over, assessed my vision, and determined that my blind spot was approximately three times the normal size. That caused her to look at the back of my eyes to assess why that was the case. She saw a swelling in my optic nerve, and sent me to the hospital across the street for an MRI as soon as possible. She also called my brother to update him. Afterward, he called me and said he was on his way and would be there in an hour or two. That was my first sign that this was probably not a quick fix, or something small. My brother is, among other things, a busy man. In the past three years, I’ve never had a phone conversation with him longer than five minutes that he did not end because he got another call or had urgent business to attend to. It’s the life he leads, and as much as it upsets me sometimes I accept it because in so doing he is helping many other desperate people. My wants are trumped by their needs. That he would drop everything to come here, now, meant there was a need. It meant he was scared I might die, even if he never said it.

The glass doors of the hospital ER slid open, and I walked into the rather cavernous waiting area. The room was arranged in a somewhat twisting, irregular shape like an obtuse Tetris piece, bordered by about a dozen windows at which sat a dozen secretaries, waiting to take information and give assistance. On one side was a rather unobtrusive, beige door marked “Authorized personnel only” through which the nurses came to admit patients. I took a number and waited. While I was waiting, my mom called me.

My brother had called her and filled her in on my condition. She was scared, and it showed. Her voice was shaking as she asked me how I was, what I needed, what I thought and how I felt. I told her that I was holding my feelings in check at that moment, because there wasn’t a solid diagnosis yet and it wasn’t helpful to be scared of shadows. I told her that I hoped that everything would be alright, but that I would know for sure in a couple of hours. In there somewhere, she asked for a recounting of the past few days. I gave her that recounting, then told her that I opted not to tell her sooner because I wanted to know whether or not it was worth worrying about before I did. That my brother called her just confirmed for me again that he was scared, and that he thought it was probably worth worrying about.

After about an hour, a nurse I don’t remember well called my name. She recorded my height and weight, measured my blood pressure and pulse, and then showed me back to another room in which I sat for about ten minutes. The room was the same as any room in which you wait to be seen by a doctor – about the size of a large bathroom, painted beige with a raised bed in the center and a few seats around the edges. There was a container for needles on one side, a box of latex gloves, and a few posters on the wall about gastroenterological disorders like ulcers and acid reflux. He came in, asked me to recount my symptoms and the steps I’d taken up to that point, and I did. He nodded, and wrote an order for an immediate MRI of my head, with contrast. Afterward, he explained that it could be several things, and that an MRI would help him diagnose it more solidly, without recounting what he suspected it was. I suspect that he had a (legitimate, given his job)  concern that I would sue for malpractice is he said what he suspected and turned out to be wrong, and so avoided sharing his opinion.

By the time fifteen more minutes passed and it was time for my MRI, it was also past noon and had warmed up a bit. I noticed that when they led me into a trailer outside for my MRI, which I figured was housed outside because it probably rather heavily disrupted any electronics that were too near it. They hooked me up to an intravenous bag of contrast dye to help them differentiate between certain tissues in my body, and I went into the MRI. After 45 minutes of banging, clanking, clicking, buzzing, and clunking, the stretcher slid out and they released my head from the immobilizer. I had meditated the time away, so it seemed like next to no time at all. The only effect I felt from the MRI was a powerful craving for nachos.

The nurse showed me back to the room, to wait for the results to be read by a radiologist and a diagnosis to be made. While I was in the MRI, my brother had arrived. We hugged, caught up, and were joking around a little bit when the doctor came in. When that door opened, his smile disappeared and his demeanor shifted to all business. That was the same expression the doctor had, except his was a little more grim.

“We got the results of your MRI back from the radiologist, and there is a tumor about the size of a golf ball on your acoustic nerve, in your brain.” he said.

I asked him to explain it in more detail. Exactly where (the Pons) it was, what type of tumor (a schwannoma) it was, and what my prognosis was. He told me that this was very serious, and he was going to schedule surgery at their main hospital in New Orleans as soon as possible. I nodded, accepted that information, and considered the ramifications of what that meant and what I needed to do next.

“You’re not really reacting. Do you understand that this is a very serious diagnosis?” was the next thing he said, that I remembered. I told him that I did understand that, but that I figured it would do no one any good for me to have too great an emotional reaction right now. There would be time for that later. Inside, I was reeling. I don’t even know where to begin when describing my reaction. I was scared, angry, upset, sad… I was lots of things, but damnit even though I couldn’t control this I could control me, my choices, and how I reacted. How I reacted would also either help or hurt those I cared about, and the last thing I wanted was to hurt them.

The reason I lost my vision is that the tumor was large enough to block the free flow of fluid from around my brain, especially its drainage. That build-up of fluid caused my optic nerve to get squeezed and to swell. So, as a temporary fix they gave me steroids to reduce the swelling and get me ready for surgery. The doctor gave me a few prescriptions to take prior to surgery – a steroid (Prednisone) and an antibiotic. One side effect that my brother told me to expect was that I would get absolutely ravenous, which I was already. I hadn’t had more than a bowl of cereal to eat that morning, and it was past time for lunch. I still craved nachos.

My brother called my mother and my father, and let them know what happened. After that, we made ready to go to New Orleans the following Tuesday, for the pre-surgical examinations and appointments. My mother and father made plans to come to town immediately. Then, I had lunch. My brother had enchiladas, my fiancee had a burrito, and I had nachos. I also ate half of my fiancee’s meal, and half of my brother’s meal. Like I said, I was ravenous. He left town to take care of business back home, and I went home myself to make ready for the trip.

When I got home, the first thing I did was google a few things. The first was “Living Will.” Under no circumstances, did I want to be a vegetable. The next was “Power of Attorney.” More than anyone else, I trusted my fiancee to make my living will happen, with my brother the next in line. The final one was “Last Will and Testament.” I knew where I wanted the few things I owned to go, so filling out that template was rather easy. While I was doing that, I had a moment to laugh at the injustice of the situation I was in. Not even 30, and I was looking those things up. Not even 30, and I had to face a diagnosis that most people don’t face until they are at least twice that age. What an overachiever I was.

A Beginning

This is the start of something – hopefully, something that will last a while. It is (rather obviously) my blog. It is not about one thing, but many things, because my life is not about one thing nor am I interested in just one thing. Everything from politics to geekery to science to journalism to my own personal journey with some rough topics is going to be covered. Before I get to that, though, I want to tell you some things about me and about this blog that will help you to understand what’s going to come later.

About this blog

As implied by the title and stated by the tagline and as already stated by me a couple of times now, this blog is not just about one thing. The things it is about are broken into a few categories, which are listed below. Posts will probably come every few days, sometimes more sometimes less. I will endeavor to split the posts into a couple of types. Opinions and comments are just that – my opinions or comments on issues, unsourced and unvarnished, though I will endeavor to make them valuable, thoughtful, and meaningful to you as best I can. You are free to disagree, with either my views or with whether I’ve achieved my goals in presenting them to you. I welcome disagreement, and I’m never absolutely sure of anything, so as long as you’re not just trolling I welcome opinions and comments on my opinions and comments. That’s what the internet is about, after all. Articles are researched, sourced analyses of some topic of particular importance, written after the fashion of the articles I’m used to reading (as I cover below, my education is as a molecular biologist). I’m going to go out of my way to use plenty of sources and to use them in such a manner that you can check them out for yourself whenever possible, and so say so when it is not. In exchange for that, I ask that you read my writing with an open mind, check my sources, and if you still disagree then to speak to the evidence or address its shortcomings in your disagreement. Finally, analyses are detailed looks at one or a small number of items, such as a news story or article on some other site or blog or something. They obviously have at least one primary source, the one upon which I’m making my analysis and which will always be linked if possible, but may have more if I feel it necessary to make my point. So, that said, the main topics of this blog are as follows:

  • Politics: I am interested in a number of political topics, and those topics will probably make up a substantial number of posts on this blog. They aren’t restricted to any one area, since I have about equal interest in economic issues as pro-democracy reform as foreign affairs as  other areas. I’ll talk about them all as the fancy suits me, and try to keep the screaming to a minimum. I really don’t like screaming, and I’m tired of it dominating American political discourse. I’d like to do what I can to change that, however small or practically nonexistent the change ends up being.
  • Geekery: I’ve been a geek for a long time. I started playing Advanced Dungeons & Dragons when I was 8 years old, and have been ever since. I started video games on the likes of Kings Quest, Zelda, Sonic the Hedgehog, Mortal Kombat, Doom, and others. Right now, I only really play a few – World of Warcraft and Guild Wars II being chief among them. I still play Dungeons & Dragons, now in its 4th edition, and run it as well. I’m developing a role-playing game of my own, and am hopefully soon to start playing in Dystopia Rising. So as far as nerd culture goes, I’m pretty deeply embedded. I hope you’ll enjoy sharing my view from time to time.
  • Science: As I said a minute ago, my primary training is in molecular biology. I went into that field because I’m interested in science, because the living world fascinates me, and because I think that science will, already has, and continues to save the world. Because of that, from time to time I will share science that I find really neat, or will cover some topic that is widely misunderstood. This could be GMOs or particle physics or evolution or something else; whatever it is, I’m going to try to cover it in a tone meant for non-scientists, that explains, educates, and helps you appreciate just why I think that thing is just so darn cool. It also might be worth mentioning here that two or three jobs ago, I taught Biology and Physical Science for the Jefferson Parish Public School System.
  • Media: While I find science damn cool, I find science reporting to often be far less cool. It is uninformed, uninformative, and sometimes downright wrong. Other kinds of reporting are no better, often times. Occasionally I will find something worth sharing as-is, but it seems lately that more often than not a popular story needs a rider or some contextual or clarifying information alongside it in order to truly understand what’s going on. These posts will focus on doing just that, on analyzing and improving on and pointing out articles that are either just plan right or just plain wrong. I’ll try to keep it fairly limited, though, because you really could go on forever with analyzing the constant stream of words produced by the media.
  • Religion: In America, religion is part of public life. It touches our every day lives and affects things from public policy and law to foreign relations to Thanksgiving dinner. This widespread impact, and my own unique perspective on religion will frame the handful of posts I have on this topic. I don’t talk about it very much in comparison to the last few topics, but it will probably be mentioned and it certainly is, for the reasons noted above, worth mentioning from time to time.
  • Recovery: A little less than two years ago as of this writing, I was diagnosed with a kind of brain tumor called an acoustic neuroma (or alternately, a schwannoma). It had made me deaf in my right ear, and subsequently caused a host of other symptoms. Its removal caused some more side effects, including the temporary inability to walk, talk, eat, or move the right half of my face. Posts on this topic will be personal tales and comments on my recovery from this, dealing with the remnant symptoms and therapy and such.
  • Louisiana: I live in Baton Rouge, Louisiana. Some posts will be about life and issues centered on the city or the state, local politics or religion or any of the other categories listed above. In that respect it is really a meta-category, encompassing all of the other categories within it.

About me

In order for you to understand where I’m coming from on any of the above, it would help you to know a bit about me. I’m going to keep this fairly short though, so that you’re not just inundated with information about me.

I’m Luke, a 30 year old lab analyst from Baton Rouge, Louisiana. My views on politics are downright progressive, much more so than you’d think from where I live. I am also a Buddhist, waffling between a couple of different varieties and mostly in solitary practice. My training is primarily in molecular biology and genetics, and I’ve previously worked both in academic research about genetic regulation and in industry doing work on environmental and industrial analytical chemistry. My posts all come from that bias, and you should consider that in reading them, but those basic elements are just a short-hand as my particular views and life experience are much more complicated and nuanced than that. For instance, while you might think I think the opposite from reading the above, I support capital punishment in some instances and think that the world is much larger and more complex than a purely mechanistic explanation can possibly convey. I am not unchanging, though, so these statements may mean nothing a year from now.

This blog is called the “Renaissance Millenial” for the simple reason that I am a millenial (sort of, kind of, depending on who you ask – I was born in 1983), and I cannot manage to devote myself to one thing. Instead, I’m more of a Renaissance man, focused on writing and role-playing as well as science, politics, religion, and other topics. I posed a question to my friends on what they liked about my writing, and they didn’t come to a consensus, so I decided to dedicate this blog to my diverse interests and to turn it into a platform for expressing those interests to you. With that in mind, I hope you’ll find it useful.