“Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds—from 5 percent to 15 percent—albeit with a poor quality of life. Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.”
Ken Murray, How Doctors Die, The Best American Essays, 2012
Originally published in Zocalo Public Square
By Oliver Sacks, 1933 – 2015
“When people die, they cannot be replaced. They leave holes that cannot be filled, for it is the fate—the genetic and neural fate—of every human being to be a unique individual, to find his own path, to live his own life, to die his own death.”
New York Times essay.
(Click image to enlarge.)
My annual mammogram keeps migrating. It used to fall in August, then in September, and now this year it was in October, national Breast Cancer Awareness month. The exam migrates because I receive my referral from my primary care physician at my annual check-up, and if that appointment gets delayed then the mammogram appointment gets delayed as well. Admittedly, however, I’m usually not in any rush to have my boobs pancaked between two metal plates. A week’s procrastination here or there and eventually I find my scans scheduled smack in the middle of pink ribbon season. I’m usually apprehensive enough about the exam without being deluged by reminders that one in eight women will be diagnosed with breast cancer in her lifetime. Frankly, an entire month of heightened awareness seems like overkill to a person in my demographic: postmenopausal, childless, with a maternal grandmother who died of breast cancer. I already eye a glass of alcohol with suspicion, mentally calculating the increased risk at which it puts me and hoping that the effect might be counteracted by my otherwise healthy habits. I opt out of full body scans at the airport and beg off dental x-rays when possible, out of an abundance of caution. That the mammogram itself exposes breast tissue to potentially carcinogenic radiation is an egregious contradiction to which I’ve resigned myself.
Mammograms and I have a long history, beginning in my fourth decade, since only recently has the value of scans for younger women been called into question. Both of my mammaries have met metal every twelve months since I was thirty; furthermore, there was a period of about three years where my left breast got special attention, being squeezed and pinched and photographed twice as often as its twin. The fact is, when I was forty, I got the dreaded call-back: “Something” had shown up in the images of my left breast. A sonogram shed no greater light on what that Something might be—small calcifications, perhaps, but my breast tissue, as little as there was of it, was too dense to tell for sure. We decided to take a wait-and-see approach, following up with more frequent mammograms that would reveal whether the Something had changed or grown. I’m not sure why this specter of an actual anomaly taking up residence in my chest did not send me into a panic: perhaps it was because no one mentioned any consequence more dire than having my left side mashed flat at double the rate of the right. When, however, after numerous follow-ups a radiologist finally asked, “Why don’t you just go ahead and get a biopsy and have it over with?,” I became alarmed. The prospect of a giant hole-punch (as I imagined it) plunging into the most delicate and sensitive skin on my body suddenly made every possible outcome more concrete. I inveigled a meeting with Lillie Shockney, a breast specialist at Johns Hopkins and, at the designated hour carried my x-rays, like an undetonated IED, into Shockney’s office. The expert took one look at the films and said, “This is nothing to worry about. Nothing.” I floated out of there on a wave of relief. I had dodged the one-in-eight bullet, at least for the time being.
I now have more mammograms under my belt than I care to count, but that doesn’t make me any more blasé about them, especially when October obliges women to recall that breast cancer increases with age and that the average age at diagnosis is sixty-one. Oh, by the way, I just turned sixty-two. Sitting in the waiting room of Advanced Radiology a couple of weeks ago, I ran through the worst-case scenario in my mind, as a way both of steeling myself should it come to pass and of warding it off, because, as everyone knows, if you envision a catastrophe vividly enough, it can’t really happen. The office was busy that morning and I had fifteen or twenty minutes to contemplate this bleak future before the clinician with her clipboard opened the swinging door and called out, “Barbara.” I was on my feet before she got to “Newman,” because Barbara is my first name, which I answer to when it is used by medical personnel. Another woman stood up almost simultaneously, just before the clinician called “Barbara” again, this time with a different surname. The other Barbara and I followed the clinician back into a maze of halls and exam rooms to the changing area, where she entered one of two curtained stalls and I the next. By the time I’d taken off everything above my waist, deposited those items and my purse in the locker, donned a blue cotton gown with the opening in front, and locked the locker, taking the key (attached to a shiny round CD, so that no one would accidentally leave the building with it), Barbara was already sitting in one of a pair of chairs that flanked a coffee table covered with magazines.
I picked up a Redbook and leafed through it, meanwhile surreptitiously sizing up my companion. She was about my height (that is, petite) and (I guessed) about my age. We ventured a bit of small talk about the hospital gowns, which feature three short ties attached in such a way that no configuration of connecting them will secure the garment around one’s body. Suddenly Barbara burst out with (apparently) faux chagrin, “I hate it, I hate it, I hate it. I put it off as long as possible.” I told her about my own migrating mammograms. “It’s been two years,” Barbara responded. Two years! I suppose I should have tut-tutted at her negligence (this was a couple of days before the American Cancer Society’s announcement of its new guidelines recommending mammograms every other year for women fifty-five and up), but instead I admired her audacity. She’d done the equivalent of spitting in Hitler’s eye while walking a wire suspended over Niagara Falls. We went on to rail against all sorts of overscreening and overtreatment by the medical profession. It turned out that Barbara was a nurse, so her aversion to scans, tests, and prescription meds seemed to vindicate my belief that no good could come from them. I was just about to declare that I intended to forgo treatment if I was diagnosed with ductal carcinoma in situ, otherwise known as “not-really-breast-cancer-(yet),” when another gowned woman with a sullen expression entered the changing area and headed for my stall. “Hey,” I protested, “That’s my. . .” “My clothes are in there,” the woman snapped back and disappeared behind the curtain. Advanced Radiology was definitely doing a booming business during October: I couldn’t remember ever having to share my stall with anyone before.
A moment later, Barbara was summoned to the exam room. The image of a mammogram assembly line flashed across my mind, with Lucy and Ethel struggling to keep up with the mounds of. . . er, mounds. . . pouring down the conveyer belt. As if to provide a laugh track for my fantasy, sounds of giggling and friendly banter drifted down the hall. Barbara must have hit it off with the radiology technician. Maybe the staff went easier on patients they liked–for instance, skipping that little extra tightening of the vise at the end of each pose. By the time Barbara got back, the sullen lady had dressed and left, and yet another woman, younger, perhaps in her late thirties, had donned her blue gown and was sitting in the chair Barbara had occupied earlier. Barbara stepped into her stall, but as she pulled shut the curtain, she popped out her head and grinned: “I warmed them up for you.” Then it was my turn.
“Hello, I’m Jill. I’ll be performing your mammogram today.” Apart from that greeting, Jill and I exchanged no superfluous words, only her instructions and my murmurs of assent: arm out, turn here, grasp there, don’t move. The process was routine and swift, so swift that when Jill paused between shots, ensconced in the lead-lined booth where she could view the image she’d just taken, I had only half a minute or so to wonder what she was seeing and whether the pause was prolonged enough to indicate that she had noticed Something Worrisome. Before I knew it, Jill was leading me, CD key-chain in hand, back down the hall. “You’ll receive your results by mail in about a week.” How I appreciated that week-long reprieve! In the bad old days, a radiologist would be on call to read questionable scans and order additional tests immediately. Inside the changing room, the younger woman—glossy brown hair cut shoulder length, full lips and cheeks, gown held closed with an arm across the rib cage—was still sitting patiently. “She was right,” I said, “The plates weren’t cold at all.” The woman smiled wanly. “It’s my first time.” I thought of all of the many things I might say about what lay ahead for her, then limited myself to “It’s uncomfortable, but it doesn’t last long.” “That’s pretty much what my sister told me,” she answered. I ducked into the stall, retrieved my clothes from the locker, put them on (noticing that the top of my chest looked like it had been badly sunburned), and emerged again. By then, the young woman was gone. I dropped my blue gown on top of the others in the overflowing hamper and headed home.
Copyright © 2015, Florence Newman
Florence Newman is professor emerita at Towson University, where she taught in the English Department for 27 years. A specialist in Middle English literature, she has published and delivered conference papers on Chaucer, the Gawain-Poet, and medieval women writers. She grew up in Blacksburg, Va., reading books in her parents’ library and eating strawberries from her grandfather’s garden. She currently lives with her husband in Towson, Md., escapes occasionally to their farm on Virginia’s Eastern Shore, and travels farther afield when time, energy, and finances permit.
Doodlemeister.com is looking for first-person observations up to 1,500 words for this series. If need be, we’ll help you to edit and/or cut your piece. If you’d like to submit a story about something interesting you experienced, or simply thought about, please contact us by e-mail: firstname.lastname@example.org
When my bother, Vernon Leroy (Lee) Sizemore, retired from the military, he earned his living as a sign painter, a skill he had picked up in vocational high school and sharpened by—among other things—painting pin-up girls and fancy lettering on the noses of airplanes. In the years before his death, he was doing broadsheet window signs for grocery stores and night clubs. Some of his expert brush lettering signs were finished with glued-on glitter, especially those promoting bands and singers. Near the end of his life, he fell off a ladder while hanging an exterior sign and wound up with a severe right-side head injury. He was in a coma for months. Once he woke up, I visited him several times in Denver. He always had something interesting to say, riffs that would start O.K., then wander off into fantasy, not making much sense—but to my ears they were weird poetry. And when he drew Picasso-like portraits of people, me included, he always left the right side of the head blank. When I asked why, he said because that was the way they were.
Lee was a wonderful older brother. Because of all the good things he taught me during trips to museums and theaters, letting me tag along when he shined shoes in South Baltimore bars, and schooling me in basic sign layout theory, I’ve dedicated this post to him.
A collection of photographs like the ones above, on a wide range of subjects, are in the archives of FSA/OWI (Farm Security Administration/Office of War Information). These rich color images, taken within three years of the invention of Kodachrome, serve to inspire as much as to document. To see more of them on this site, type “WPA color” into the small search window in the sidebar on the right of this page. For the complete collection, visit the WPA site by tapping the link in the sidebar box marked “Photography.”
Other People’s Teeth
By Susan Middaugh
But for me, it’s teeth. Capped, gold plated or stained with nicotine, the condition of your teeth tells me whether you care about and take care of yourself. There’s probably a correlation between family income, dental insurance and a million-dollar smile. But sometimes there’s a disconnect which makes me scratch my head.
A successful career woman I know has three single-family homes, one for Monday through Friday and two for weekends and vacations. She has spent a considerable sum remodeling and decorating these houses and is a gracious hostess. But she has crooked teeth. To me, her mouth is a puzzle – on a par with crosswords, anagrams, and Rubik’s cubes. The contradiction is intriguing and makes her more interesting. Why has this woman neglected her appearance when she can afford to get braces? I was embarrassed to ask.
So I went to the library. It seems the career woman’s priorities are in sync with many Americans. In the year 2000, according to the Statistical Abstract of the United States, consumers spent an average of one thousand five hundred forty-nine dollars on household furnishings and equipment compared to spending two hundred and four dollars per capita on dental services.
My own dentist believes fear, bordering on phobia, prevents many patients — at least one out of five or more — from having procedures that would improve their appearance and/or their dental health. Some men and women are terrified of pain or needles. Others simply have different priorities for their discretionary income. Expensive cars? Yes. Crowns, bridgework? Not on the list. And there are also those, my dentist said, who are “blissfully unaware of how they appear to other people.”
President George Washington, who suffered from dental disease most of his life, was not one of them. He must have known the colonists would not elect a guy who had broken or missing teeth. Over a 40-year period, George Washington had four sets of dentures and was known to tinker with them till they fit properly. Our first President’s dentures were not made of wood, but of cattle teeth and carved ivory. The ivory came from hippopotamus, walrus and elephants. One set of George’s dentures contained eight human teeth which were fixed in place with gold pins. The museum does not say who the donor was.
Is this fascination with teeth apt to become a trend like hoola hoops, miniskirts or “Survivor” mania? Doubtful. During a Sunday afternoon trip to the Samuel D. Harris National Museum of Dentistry in downtown Baltimore, I was the only visitor.
Copyright © 2012 Susan Middaugh.
Susan Middaugh got her first and only set of braces when she was in her 40’s. She is a self-employed business writer in Baltimore who also writes the occasional personal essay. Her essays have appeared in the Christian Science Monitor, the Baltimore Sun and on the website New-Works.org. Susan is also a playwright with short and full length works produced in the United States, Canada and England. The One Act Play Depot in Canada has published her short play, Such Good Neighbors. Several of her personal essays have appeared on this blog. To find them, simply type her name in the little search window, or check out the archives in the sidebar, beginning in April of 2009. Also in the sidebar under the Blogroll, Business and Writing labels, there are links to Susan’s website, Have Pen Will Travel.
Doodlemeister is looking for short first-person observations up to 500 words, on any subject, in any style, for the Short Takes series. Whatever the subject, we have a bias for the lighthearted tone. If need be, we’ll help you to edit and/or cut your piece. If you’d like to submit a story about something interesting you saw, experienced or simply thought about, please contact us by e-mail at email@example.com
Adapted From Paris Review, The Art of Theater No. 10
Interviewed by James Lipton
Felix in The Odd Couple isn’t a watcher—or a doer. He’s stuck. He’s reached a certain point in his life and developed no further. Most of my characters are people who are stuck and can’t move. The grandmother in Lost in Yonkers has been stuck for the last seventy years. The mother in Broadway Bound—she’s really stuck.
I never think of the plays as being hits when I write them. Well, I thought Rumors, of all plays, would be a really good commercial comedy if I wrote it well. I thought The Odd Couple was a black comedy. I never thought it was going to be popular, ever.
I thought The Sunshine Boys wouldn’t be a popular play, but it was very well received. Chapter Two was another one I doubted, because when you touch on a character’s guilt, you touch on the audience’s guilt, and that makes them uncomfortable. Yet the play turned out to be very successful because it was a universal theme. Lost in Yonkers is an enormous success, but I thought I was writing the bleakest of plays. What I liked about it was that I thought it was Dickensian—two young boys left in the hands of dreadful people. What I was afraid of was that I would hear words like melodrama.
I wrote The Good Doctor soon after I learned my wife had a year and a half to live . . . . I was reading Chekhov’s short stories and decided, just for practice, to translate one of them into my own language, my own humor. I knew it was a diversion. After a performance, a woman grabbed me in the foyer and said, This is not Neil Simon!
God’s Favorite is an absurdist black comedy about Job that was written as an outcry of anger against Joan’s death. My belief in God had vanished when this beautiful young girl was dying . . . . so, I wrote . . . a black comedy and it did help me get through that period. Sometimes you write a play just for the sake of working at it.
With Lost in Yonkers I suddenly heard from critics who said, This is a new voice for Neil Simon. We want you to go deeper and deeper into this area. At the same time other critics complained . . . . It’s not as funny as the old plays. They wanted Barefoot in the Park and The Odd Couple. I could have spent my whole life writing the Barefoot in the Parks and Odd Couples, which I certainly don’t denigrate, because I love them—but where would I have gone with my life? I would have been standing still, grinding out the same story time after time after time.
What I’ve done, I think, is take the best of me and the best of my observations and try to deepen them to reform them and reflesh them. At some point along the way you discover what it is you do best.
Recently I’ve been reading Samuel Beckett’s biography. When he was about forty-four years old, he said he wanted to write monologue. It was his way of expressing himself to the world. He was shy too. In a sense, I think many of my plays are dramatized monologues. It’s like sitting around the fire and telling you the story of my life.
If you’d like to read what people such as Arthur Miller, Sam Shepard, Joyce Carol Oates and other famous — and not so famous — playwrights have to say about the art and craft of writing for the stage, type “On Playwriting” into the small sidebar window and tap the “Search” button.
Part XI of the Neil Simon series will post next Wednesday.