News flash: Hot flashes are good! Or at least not bad for you!

Is it hot in here?

A new study of menopausal women shows that hot flashes aren't all bad. We found that women who experienced symptoms when they began menopause had fewer cardiovascular events than those who experienced hot flashes late in menopause or not at all, says endocrinologist Emily Szmuilowicz, lead author of a study that will be published in the June issue of Menopause magazine. (For some reason, unlike AARP, Menopause magazine doesn't automatically find you when you're at that age.) You can read an abstract of the paper, titled “Vasomotor symptoms and cardiovascular events in postmenopausal women” here. Or the Northwestern Memorial Hospital press release, which is easier to absorb, here.

[painting: Hell by Bosch]

Man speaks for woman

O O O this should not bother me, but after all I'm the Bitch, and so many things can bother me that wouldn't bother a non-bitchy person. There's a woman who was diagnosed with breast cancer at Sloan-Kettering, just one of 200,000 women who will hear that the test was positive this year, and the noteworthy thing about her is that she's the Wife of a Doctor. A Doctor at Sloan-Kettering, and ain't that ironic or crazy or what-have-you, and since this is the age of irony, her husband gets to write about the experience in the New York Times. Am I jealous? Yes. Is that what's fueling my ire? Yes. No. Am I annoyed that he writes in an ungainly fashion and strains when he makes comparisons and isn't very interesting? Yes. Am I jealous? O, we covered that. Sort of. It's in the New York Times blog, not print, and since cyberspace is everywhere and nowhere, in a way you could say that it is not in the New York Times, or you could say it is there and everyplace else in the known world. But even at the blog, aren't there editors? Must not be, otherwise we wouldn't have such sentences as: The late nights along the Seine were as dark and dreary as the sunshine was bright that Wednesday morning on the Upper East Side of Manhattan.

The author is a doctor at Sloan-Kettering. What kind of cancer doctor? No one says. He admits that the white coat has been his protection against involvement and emotion. But anyone who's ever visited a hospital could tell you that. He also has pull, not surprisingly. He tells us that they got an appointment with a friend who's a breast surgeon: When I told him Ruth had felt a lump, he had made room to see us right away.

Which is nice. And I'm sure they have insurance, which is good because I doubt that professional courtesy would pay for all her subsequent treatments. Which is good for them, especially since they seem pretty young and it appears from this first installment that the cancer has spread to her lymph nodes. (Though you've read here that removing cancerous lymph nodes may not be required, after all.)

Of course, a more erudite decision on the part of the Times would have been to tap (virtually) the shoulder of the Cancer Bitch and offer her the blog spot. She could write: When the Cancer Bitch has Blood Cancer, a comedy of manners that has not yet ended. But the tap was not received, no messages were left. And a more relevant and important and serious decision would have been to get an uninsured woman to write about her breast cancer. Or, second best, the husband of said woman. Or daughter. Finding such a person would be easy--it is said in these parts that a scoffing full professor (the kind who hires adjuncts) once said he could spit outside the window of his office downtown and spray any number of PhDs, the point being that those with doctorates in English should be grateful, o so grateful, hat in hand and bowing and scraping, if and when they were offered a couple thousand dollars for teaching a course as an adjunct. So too, unapocryphally, you could walk to to the county hospital here, named for a politician, John Stroger, who spent his last days, comatose, in a private hospital (Fancy Hospital, in fact), and find hosts and hosts of people without health insurance. Interestingly, ABC News told us: Stroger lost a brother who was turned away from a segregated hospital in the South, and the availability of quality healthcare became his pet issue. He struggled for decades -- sometimes alone -- to make sure the Cook County Hospital remained open. There was a libertarian Republican named Tony Peraica who ran against Todd Stroger, son of John, for Cook County Board president, and I didn't like Peraica's politics at all, but I had to appreciate one commercial in which he said he would improve Cook County Hospital so that it would be good enough for John Stroger to go to. Peraica lost and Stroger died and Ariel Sharon remains cocooned in his own coma, and I think no one in Israel has the chutzpah to pull the plug on him. The photo above right is of a sculpture of Sharon by artist Noam Berlavsky.

The transformation implied in the blog, I think, is that a doctor regains his vulnerability and dare we say humanity, not to mention humility, when he is the spouse of a patient, and not a Doctor draped in sanitary whites. This is a tricky concept, because we writers would tell him that the story is his--but if he makes the story too much his own, he will seem like a cad because it's his wife who was stricken. The best thing for him, in order to remain a sympathetic narrator, is to contract a serious disease himself. But such things take time.

The Bitch Ponders, Part 5

Before I left for the conference I was talking to L about the Friend Who Will Not Friend Me on Facebook because she's been mad at me since the Carter Administration, and L said calmly, Maybe she was a friend for a season.
A friend for a season.
Yes, she said, some people are just friends for a season. When the season's over, you have time and space for more friends.
It sounds like clearing out your closet of old clothes so that you'll have room for new ones. What is so precious about old friends anyway?
They remember the same things you do, even if they remember differently.
At lunch with my old friend A, we talked about how in 1984 we stayed in S's house in San Salvador, and I said, How did that happen? And she said, You were friends with him, you arranged it.
It must have been so, though I have no recollection about how I made arrangements with S for us to get into his house when he was gone. Gone where? On assignment somewhere in Latin America. I remember that he and another foreign correspondent, J, maybe his lover? we wondered, arrived just as we were leaving. I know that I knew who he was. Maybe we were friends. Or friendly acquaintances.
There's someone else from that long-ago newsroom who is now living here and I can' remember: How friendly were we? What I really mean is: Does he remember me? I must have spoken with him but I don't remember ever going out with him in a group or talking to him at a party, though I must have. We were all, as one editor liked to put it, insecure over-achievers, in our twenties and thirties and we worked hard and some of us suspected that the Glory Days had ended when an iconoclastic editor had left (just before I got there). In his place were corporate citizens. Now of course we look back and see that those days in the mid-80s were the glory days, when the Miami Herald was much much fatter, and the Sunday magazine still existed, on glossy newsprint, and the Miami News still existed as a spindly competitor, and Management gave us money to travel to do national stories when there was really no good reason to do them except some editor's whim. And I wrote some good things but I was wrapped and cloaked and covered and corseted by anxiety. If only there had been SSRIs in those days! I did take an anti-depressant for a spell, which gave me cotton mouth and buoyed me up some but ultimately didn't do the job. I remember telling M at the next desk that I was taking them. (My reunion with M after 26 years is covered in the previous post.)
Old friends give you back part of your life. They remember what you were like. They burrow deep into you. If you're lucky.

The Bitch Ponders, Part 4

After dinner one night at the conference, a group of us went to a party in a bar hosted by some literary magazines. I was talking to K, and a guy came up to her, and he looked familiar. I looked at his badge then told him to look at me. He looked and recognized me. It was M, whom I'd thought that I might see at the conference, since I knew he had entered a creative writing program. How odd that sounds--entered. But that is what you do--enter, begin, enroll in, matriculate into. We had been friends, confidants in the newsroom, but we hadn't seen one another since 1985. We both said the other looked the same. He was all hepped up on the notion of story, of story as a basic human need, hard-wired into our bodies, or wherever that hard wire goes. Our DNA, that's where. Then there were three of us--a Coastal poet he'd met on the street--and they were equally exhuberant about story. Everything is story, they said, and I said, no, ideas aren't story, description isn't story, and they said, no, it's all story. M had started a magazine which features the stories of "ordinary people," and other "ordinary people" are hungry, hungry for these stories! He is in love with story, she is in love with story, and I like a good joke now and then, but I think there's reflection and meditation and argument, though I could accept the argument that an argument is a story, because it moves linearly, or should. He was full of zeal for story, and for the character in his newish book, he was like an actor who learns his lines and character so well that he falls in love with them and him and must tell you about them or portray them because he has built so much energy around them. I would have preferred gossiping all night about the people we'd known in the 80s but it was pleasant enough to pal around with this old and this new friend. Oddly, we did not make story out of our friendship. But we could. And so there was one old friend who was still a friend, though I hadn't doubted it. Some friends you just fall away from when one of you leaves town. Despite the miracle of modern technology, etc., etc. And if you are in the same town one night, all the elements that created it are there and the friendship comes back alive.

The Bitch Ponders, Part 3

So I talked (immediately, the wonder of cell phones) with an old friend right after The One snubbed me or appeared to snub me. The friend said something to the effect that the erstwhile friend must be screwed up to act that way. I don't know. Sometimes we just want to avoid entanglement.

The next night I dreamed that my friend A from the Miami Herald was part of a case that was being heard by the Supreme Court. I also dreamed that the Erstwhile Friend had indeed kept in touch with me from time to time, sending me photos that I had forgotten about, and that she had a reason for not staying in touch. It had to do with not wanting to live in her past.

When I had lunch with A on Monday, she happened to mention that she'd written to Supreme Court Justice Sonia Sotomayor. Hah! Am I gifted with second sight or what?

I had a good friend from junior high who, I am told, wants to keep the past the past. She doesn't look to connect with old friends on Facebook, which would mean connecting beyond cyberspatially. Oddly, her mother is willing to friend her daughter's old friends. Are we baggage? Are we time-stealers? It could be she feels she probably doesn't have much in common with us any more.

This is what you don't understand when you're young: that there are some people who will prove to be your Lifelong Friends; and also that you have a place in family (well, some of us do) and because that place is set by forces beyond you (your conception, for example), it is solid, you can see it, your name, even, on a family tree, and your place and relationship with others are therefore unshakeable and irrevocable. There were those before you and those branching after you, even if they're nieces and nephews and young cousins and not your own offspring. Family can of course turn its back and change its name and walk out on you forever (providing fodder for infinite contemporary memoirs), but much of the time it will be there and family will serve as the Ones Who Knew You When. They will be your Old Friends, whether you like it or not.

Lunch with A was quite natural and wonderful and I had decided, though we hadn't seen one another since 1987 or so, that we would always be Lifelong Friends because we had shared a night when we both thought I was dying (cause: street food in Guatemala City), and a morning where we thought the revolution had come to the street in front of our hotel. We tied white socks around our arms to signify neutrality and ventured outside to find out that the 6 a.m. smell of gunpowder had come from a parade at dawn. At dawn? It could not be a civilized country, because who would hold a parade that early? Or was it Honduras? I should ask.

--to be continued--

The Bitch Ponders, Part 2

[Samuel Johnson, 18th century]

To continue the post before the one before this one:

I also thought that at the conference I might see M, who I worked with at the Miami Herald, he was my friend and neighbor (as in don't talk to your neighbor, schoolteachers would say; he was in the desk behind me, I think) and confidant. I knew he was getting an MFA in creative nonfiction.

So I am at the conference. I am invited to the cocktail party put on by ** University, where The One received her master's recently. Before I go, I'm standing in mezzanine level of the hotel and looking down and I think I recognize her in the lobby.

At the cocktail party. There she is. She is at the buffet and I am at the buffet and she is talking to someone and we are this far apart--but she is talking to someone and I say nothing.

Then I am talking to the person I came to see at the party. We talk for quite a while. Then we part and I am at the cocktail party saying hello to a young writer I know from a Jewish women's reading we did together. Then I am in the next room and I see The One and she is talking to a man in a dark suit. Next time I turn around to approach they are still talking but they have moved about three feet away. And the next time, three more feet. I am defeated. I do not want to pursue. It seems too difficult, psychologically, to trail them and insert myself inside their conversation. And then the next time I look, they're gone.

I am so agitated. I am so so sad. I am 90 percent sure that she saw me. I talk to an old friend from those days who says it is sad that The One cannot forgive me, that she is still holding on to that anger. That she should move on beyond that. I go downstairs to catch up with people I'm eating dinner with and I'm still sad and I tell them and slowly during dinner the sadness and agitation dissipate.

I still don't know if I'm thinking about The One and making the Sighting so important because she has rejected me. I remember a friend who broke up with his girlfriend then wrote her letter upon letter, and I thought it was way way too much, that he was besieging her, but then he went back to visit her and they are now married 15 or more years with two smiling children. I thought his pursuit was extreme, but I was wrong.

What am I so eager to talk about with her? What am I so anxious to discuss? I want to talk about the teenagers we were when we were starting college, and I want to know if journalism was ever as difficult for her as it was for me (crying in sheer anxiety before interviews), what she's learned in the years that she pursued that profession while I pursued style and "self-expression," why she decided to study "creative writing" and what she learned that was different from her everyday. My everyday is taken up with the study of the masters of the essay, and the current practitioners, and reading that I will use in my own work that I struggle to find a structure for. Only an idiot would ever write for free, but we, my brethren in the creative writing world, do it all the time. (As Samuel Johnson put it, No man but a blockhead ever wrote, except for money.) We are innovators and thinkers and we are trying to convey meaning shaped in pieces that will last quite a while if not forever, but these pieces are not valued enough, and so though no one crosses our palms with silver, we offer our carefully-honed work to magazines that serve a thousand or five hundred or fifteen hundred. We write these things because we have to and how odd odd odd it is that someone who is making a living at journalism would choose to study how to write more exquisitely and for a much smaller audience.

Or maybe she is wanting to write books, and for a large audience.

--to be continued--

No no, don't go for the nodes

We interrupt Cancer Bitch's complaining about a lost friend to deliver the strange news about the necessity of removing lymph nodes. Apparently surgeons don't need to take them out as often as they've been doing. The Journal of the American Medical Association reports on a study of women with invasive breast cancer who had lumpectomies, radiation and sentinel node biopsies. That means that the lymph node closest to the cancer tumor was removed and examined. Usually doctors have responded to a cancerous node by removing more nodes. The new study shows that women who had a cancerous sentinel node removed only, but no other lymph nodes, had the same survival rate as women who had the same treatment (lumpectomy, radiation) and had 10 or more more lymph nodes removed. The problem with removing multiple nodes is that they increase your risk of lymphedema, which is swelling of the arm. Women with lymphedema are the ones wearing those compression sleeves (and people say they're a drag to wear, even if you cover them with cool designs from My Sassy Sleeve, shown above.)

The New England Journal of Medicine reported on a similar study last month. The American Council on Science and Health noted that the New York Times didn't report on the earlier study. This new report, says the ACSH's Dr. Gilbert Ross, makes it apparent that we have at least two strong studies that show pretty clearly that for certain populations of women with small breast cancers, the survival benefit from radical lymph node removal is outweighed by lymphedema and other complications.

So, Woodman, spare that tree!