The Drive

 

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View of a road from the train through Austria.

I loved taking long road trips around the US, both seeing new destinations, as well as driving there. We’d gather up all our things– our clothes, our food, our tents, our games– and we’d head off towards the forest of huge Sequoias in the North, or the vast deserts to the East. Even when we just took day trips to the hills nearby or the beach an hour away, I never minded driving. When we left in the morning (or let’s be real, in the early afternoon, since we never got out on time), the car trip meant that the fun was all ahead. When we started on our way home, usually long after the sun had set, it meant our comfy beds were waiting for us. On dark stretches of road, we could see the stars outside the car window.

Sometimes, later, when I was the one behind the wheel, driving in the car felt like both my adventure and my home. Often, I felt like I could easily skip my exit on the freeway, and just keep going into the sunset, to find whatever waited for me at the edge of the world.

But I never did keep going. I always took the exit. Why did I do that? The world is so vast and there’s so much to see. Why not just let the moment take you away? I guess there was always a reason: work in the morning, people waiting at home, laziness to make the trip back, discomfort at the thought of facing the unknown. Maybe the reasons made sense, or maybe they were just excuses. In any case, I never answered the call of the road.

Now, I don’t have a car, and I don’t have the same chance. Taking the train is just not the same. I don’t know if it’s the other people chatting nearby, or if it’s just the constant foreignness of everything around me, but there is neither the excitement of adventure, nor the anticipation of homecoming. Rather, there is a feeling of constant displacement, like my trip is anchored between nowhere and nowhere else.

On the train, I can’t just skip my exit, and let the rails carry me away– the conductors don’t take a liking to that. On the train, I can’t let my mind wander as I become a part of the vehicle, controlling its motions over the smooth asphalt as easily as I control the motion of my own body. On the train, I can’t stop to grab a bite at an interesting hole-in-the-wall, or to explore a little-traveled corner of the world.

Instead, I must submit to the vehicle and the system propelling it onwards. I must agree with the system on my intentions ahead of time, and accept its plan for me. I must fight the timetables, and struggle through the crowds, and all my things must fit in a handy bag. Oftentimes, I don’t even get the window seat.

Of all things, I never thought I would miss the drive.

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Walls and Birds

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Here, the sun beats down brighter than in the north, and the air smells of the sea. There is another scent there too– one of stone and golden sand and very fine dust. Ten generations have walked passed these walls; walls saturated with the histories of those who lived and died within them and without.

Birds gather on the palm trees and stone arches, displaying their many-coloured plumage. Each of them comes from a different place, and their colours range from shimmering green, to vibrant red, to snowy white. Despite their varied origins, they chirp happily to one another, their voices raising a cacophony of noise to the heavens. One flies away, and for a moment, the others fall silent, but only for a moment. They know this place is just a stopover, and each of them understands the pull of the seasons, for they must all hurry back and forth across the world, ever in chase of the best meal in the south or the best home in the north.

The old walls stand as they ever stood, stoic to these comings and goings. They drink the heat of the sun in the daylight, and keep the cold at bay during the night. Patience is their only virtue, but they have it in spades. Some of them are destroyed and rebuilt to serve new purposes. Others are worn down by the years until they are only dust, and this dust is spread amongst​ the same winds that carry the birds to their next destination.

In our travels, we are not unlike the birds. Some of us chase the summer sun, others run from winter’s cold– or towards it– and others still know only that they must leave, but never why. I wonder if the walls are ever perplexed by our migrations, haphazard as they must seem. But one day, even the walls will travel on the wind, just as we do with each passing generation. Perhaps they look at us in envy, wishing they too could so easily experience the change of scenery, before they turn to dust and ruin. Or perhaps they laugh at our whimsy, before turning their faces back to the warmth of their beloved sun.

(These are the birds outside my window that keep me up at 4:30am… but it’s hard to stay mad at them. The picture here, and the one above are from my trip to Malta.)

Liberty and Justice for All

My family has Jewish heritage, and life in the Soviet Union wasn’t great for us. I don’t remember it, because I was too young when we left, but my parents told me how it was. My mom couldn’t follow her dream to be a lawyer because of her race; food was scarce at times; you couldn’t trust the people around you. Despite the challenges of having to learn a new language and culture, of having to make a new life from literally ~$300 and a suitcase each, of leaving loved ones behind, and of expecting another child (my mother was pregnant at that moment), my family decided to leave. That was how bad it was.

We left the Soviet Union right as it was collapsing to go to Israel. We didn’t speak Hebrew, and we weren’t religious, but because of our Jewish blood, Israel took us in. Three years later, the US accepted us thanks to my dad’s then-boss, who sponsored a visa for my dad to be able to come for work. We got citizenship in the US as fast as we could, but it still took forever (~10 years), because of constantly shifting laws and bureaucracy. Since then, I have felt like whatever happened in the past could stay in the past. Since then, I have known peace, comfort, and acceptance. I became an American, and I have always been proud to correct people when they tried to say that I was anything else. I will always be grateful to my parents for facing that terrifying unknown, in order to make a better life.

I’m afraid of what is happening in the US and the world today, because it resembles what happened in past decades. I have to believe that many of us in the US– most of us, in fact– are better than this, because otherwise I will give in to lament, and eventually, to apathy. I think that we can still turn this around. I don’t have the proper words to express my feelings, so I hope you’ll forgive me for asking the poets of the ages to come to my rescue.

From the United States Holocaust Memorial Museum :

First they came for the Socialists, and I did not speak out—
Because I was not a Socialist.

Then they came for the Trade Unionists, and I did not speak out—
Because I was not a Trade Unionist.

Then they came for the Jews, and I did not speak out—
Because I was not a Jew.

Then they came for me—and there was no one left to speak for me.

— Martin Niemöller (1892–1984)

Inscribed on a plaque inside the Statue of Liberty:

Not like the brazen giant of Greek fame,
With conquering limbs astride from land to land;
Here at our sea-washed, sunset gates shall stand
A mighty woman with a torch, whose flame
Is the imprisoned lightning, and her name
Mother of Exiles. From her beacon-hand
Glows world-wide welcome; her mild eyes command
The air-bridged harbor that twin cities frame.

“Keep, ancient lands, your storied pomp!” cries she
With silent lips. “Give me your tired, your poor,
Your huddled masses yearning to breathe free,
The wretched refuse of your teeming shore.
Send these, the homeless, tempest-tost to me,
I lift my lamp beside the golden door!”

–Emma Lazarus (1849–1887)

Hate

refugees_welcome.jpgWe have seen the rise of terrorism and hate in the US, as neighbours, classmates, and colleagues turn against one another in fits of reprehensible rage. I am not talking about who won the election right now. I’m only talking about the daily acts of terrorism from people on all sides such as the shooting at a polling place on election day, the brutal attacks against LGBT people, blatant racism, and numerous attacks in the streets against basically anyone who is not a white cis-gendered male. Note also that this is not all one sided. People are talking about assassinations, about reaping what you sow, about seceding from the nation. Some are blaming whites for what is happening, which makes as much sense as blaming all non-whites. You can’t fight racism with racism; that just spreads more hate.

Who won the election is of little importance in comparison to the enormity of the crimes Americans are committing against one another today, on all sides of the political spectrum. This is completely heartbreaking. Look, it’s not rocket science: treat others as you would want to be treated. Stop trying to split up into an “us-vs-them.” We all live on the same little blue planet (though for how much longer, I fear to speculate). You cannot blame politics for your shitty attitude– no, that is entirely on you.

In the wake of all this terrorism and hate, I feel completely at a loss. Whatever I say here has been repeated many times before. Anyone who reads this post would have already heard it. Anyone who agrees with it, will continue to agree with it, and anyone who disagrees with it will continue to disagree with it. Most likely, anyone who is reading this is not one of the assholes that is committing these crimes anyway. My small words can’t make any difference. Even if I was home right now, I don’t know what I could do. Half a world away, I am helpless to do anything at all.

I guess we just go on with our lives, and try to be the best people we can be, despite the hate. I guess we do our best to hold each other up, particularly when we see harassment in the streets. I guess we just try to be strong, and face the hatred head on with reason, compassion, and empathy, trying to hide the fear that makes us tremble inside.

Expanse

bridge03.jpgA wide river mouth stretches out to both sides of the narrow highway bridge. White clouds hover lazily above the fir-coated hills of the opposite river bank. Fishing birds dance on a sandbank, that will later flood with the incoming tide. My car zips down the curvy road, first towards and then away from that wide expanse of river, land and sky.

The birds rise up in concert and settle back down on a different sandbank, ever busy with the hunt for their next meal. So too it is with me. If my time was my own, I would instead lay down on the warm sand and stare into the clouds. Their peace would fill my lungs until I floated to that distant shore.

Or would I? Even if my body is at rest, my mind leaps from stone to stone, wildly searching for the answer to an unknown question– without busyness there is boredom. Perhaps my only hope of reaching those clouds is in brief moments of longing such as this.

I imagine these birds are not the kind to travel very far South for the winter, instead dispersing amongst their breeding grounds nearby when it gets colder. Do they look to the skies when the geese fly high above them in formation, and wish they, too, could travel to a distant shore? Are birds that self-aware?

Like the birds, I live in my own bubble, and am not aware enough to see outside it. Any amount of polish on the bubble’s glistening shell only makes it shine ever brighter back at me, until I am blinded by my own reflection. Still I work and polish, until the oil-slick rainbow is as bright as possible. Stubbornly I think that if I keep rubbing at it, the film will start to tear, and I will simply fall into that great expanse.

The birds on the sandbank rise up again, this time flying in a cluster above my car as I cross the highway bridge. I’ve reached the opposite bank. Looking back across the river, the place I came from looks so distant– not unlike the shore I stand on now once looked, when I gazed at it with longing from the other side.

Children

We never grow up. Not really. I squeeze the liquid soap bottle and watch the light dance off tiny glistening bubbles. They surround me as they make a slow, swirling descent through the small kitchen. I’ve always thought those bubbles were wondrous. I thought I would grow up, and do so many incredible things, but I can’t remember what they were now. I learned to hide those hopes from the world, because hiding them was expected of me. I hid them by convincing myself I could have them later, by convincing myself that it was all ahead of me. We don’t cry in public, because we tell ourselves we can do it later, in private. But later is too late, and so we never cry at all, even if we need to.

Sometimes I feel like giving up. Like crawling into bed under all the covers and letting myself cry all I want. Sometimes I try, but I find that I just can’t bring myself to do it. It always feels a bit too much like a ridiculous luxury. When I was a kid, I cried all the time and never felt ridiculous about it. There was always someone there to fix it. But now I have to be the one to fix it for myself.  There’s no one to cry to. Crying is wasteful.

So I remind myself of the incredible things I have already seen and done, of all that I have and my incredible fortune. I remind myself of all the wondrous things still out there, that I just have to reach for. I remind myself that no one can realize those hopes for me. It takes work and dedication.  And so I set about carving a weaving path through life, and even if it looks like the squiggly lines of bark beetles at the end, at least it will have been my own.

Holes in my shoes

I feel like I should start this post with “Dear Diary.” Well here goes. I try not to talk about it too much, but a couple of years ago I was diagnosed with a form of hyperthyroidism called “Grave’s Disease.”

It sounds really scary, but actually, a lot of people have it, and the rate of incidence is higher in women. The gist of it is this… Your body over-produces a hormone called TSH which is meant to stimulate the thyroid to create another hormone called Thyroxine (or T4), which is supposed to regulate your metabolism. For hyperthyroid people, the body produces way too much TSH, making your thyroid overproduce T4. This leads to all sorts of bad symptoms — overly fast metabolism, weight loss, goiter (i.e. swollen thyroid gland), constant hunger, heat intolerance, heart palpitations, excessive sweating, anxiety, ophthalmopathy (thyroid eye disease)… the list goes on, but those are the main ones I have experienced. Fortunately, my symptoms were not as bad as some other people have experienced with Grave’s disease.

Anyway, it turned out I was allergic to the main medication that people go on in an attempt to regulate the thyroid, methimazole/tapazole. I went on propylthiouracil (PTU) to try to regulate it. PTU has some nasty side-effects, the worst of which is potential for liver damage… so when my thyroid failed to be regulated 18 months later, my doctor recommended a more final treatment. The options were surgery to cut out the thyroid (or part of it, I guess) and taking a radioactive iodine (I-131) pill.

The main thing about doing one of those treatments, is that your thyroid is now destroyed… essentially you are giving up on the possibility of getting it regulated again. So this means that patients almost always go hypothyroid (i.e. since your thyroid is now partially destroyed, it doesn’t produce enough T4). The treatment to hypothyroidism is just to take a hormone supplement pill every day for the rest of your life… not so bad, considering the supplement is super easy to manufacture, cheap, and available just about everywhere.

Additionally, each of those treatments have their own potential for side effects. For the surgery you have to take a week off. The surgery has all of the risks that any surgery has: scarring, anesthesia, bleeding — 1/500 people have to go back under the knife if the blood vessels they tie up get loose and you start bleeding internally. Plus, since the neck is a delicate area of the body, there is risk to the surrounding glands if the surgeons mess up. Mainly, the risk of damage to the parathyroid glands, which regulate calcium in your body, and the risk to the vocal cords (i.e. you get to be hoarse for the rest of your life).

The radioiodine, on the other hand, is a much simpler procedure. You just take a pill on Friday, stay home over the weekend, and then head back into work on Monday feeling mostly fine. There are some minor temporary “feeling shitty” type side effects, but it’s not so bad. There is risk also of thyroid storm– your thyroid cells die all at once, releasing a bunch of T4 all at once, which can be very dangerous– but this is very rare. One concern is the worsening of thyroid eye disease, but my thyroid eye disease wasn’t really that bad, and my ophthalmologist said it was ok to go forward with it.

However… and you might have already guessed this… but the radioiodine is, well… radioactive. Taking radioactive materials into your body has the potential for cancer in the future.

So here’s the thing… They give radioiodine to people who already have thyroid cancer to try to kill the cancer off. When they do that, they give way more than they would give a patient with Grave’s (I have heard 10x more, but I am not sure about the accuracy of that number). Studies have been done, and it has been shown that the amount they give to cancer patients does increase the risk for other cancers by a small amount. Studies have also been done on the amount of radioiodine they give Grave’s disease patients (around 30 millicuries), and as of press time, they haven’t been able to conclusively show that this amount of radioiodine increases the risk for cancer — there is too much noise in the data to prove this.

So, after consulting at length with my doctor and my ophthalmologist, under their recommendation, I went with the radioiodine treatment. It seemed like the safer option. The idea is they give you enough to kill off enough of your thyroid so that you go hypothyroid. This reduces the risk of a relapse of hyperthyroidism, and since hypo is easy to treat, it’s not a big deal.

I think they gave me around 25 mCi. They wanted to give me more, but I had a very large goiter and they were worried about thyroid storm.

So here I am half a year later, in a new location (moved for a job), with a new doctor… I have relapsed, and I am hyperthyroid again. I am facing the same decision once again: surgery or another dose of radioiodine… only the potential cancer-causing effects of radioiodine are cumulative, and another dose raises my chances of getting cancer in the future. With that said, they still don’t actually know if the cancer risk has gone up or by how much, because even at two doses, there is still either too much noise in the data, or not enough data to know for sure.

I haven’t been able to come to a decision on this. I have talked to my new doctor, as well as to a surgeon she recommended about the risks of the two treatments. I’ve talked to friends, family, I’ve been trying to contact my old doctor to get her opinion, I’ve done research, I’ve paced around in circles wearing holes into my shoes…

…and I’m no closer to a decision. I’m afraid that talking to a million more doctors won’t get me closer to a decision. And all the while, I am anxious, not just because of the decision I have to make but because of the hormone imbalance in my body. I am super sweaty and have occasional heart palpitations. I feel like my work is suffering– I nearly started crying at work today for no reason other than I also have these crazy random mood swings. If I don’t make a decision soon, I will need to talk to my current doctor to get onto the PTU again, just to keep the symptoms down. Thank the stars Portland is cool and rainy, because my sweatiness and heat intolerance is… er… intolerant.

I know it’s not that bad. Like I said, some people have had way worse experiences, both with Grave’s Disease and in life in general. That’s why I try not to talk about it much… I feel bad complaining, when so many people have such great difficulties to overcome. But I can’t help but fret and wear holes into my shoes.

EDIT: After talking to the doctors and weighing the risks, I decided to go with the radioiodine treatment again. Last time, I was temporarily living with my parents for this part. I remember my mom following me around the house, wearing one of her flowery shirts, clinging to my dad’s old soviet Geiger counter, and gasping every time it beeped. This time I’m living with my boyfriend, so I expect it to go smoother. They are giving me 15 mCi… very little, but hopefully just enough.