Ten years ago:

One of the happiest moments I had in Michigan took place under bright lights on a man-made hill. I was flat on my back at the bottom, and I had just shot a bunch of snow down my collar. I was cold and wet, but I felt alive and happy and complete for the first time in months.

The adventure had begun only two hours before, as I was counting out the register at the store after working another open to close shift. Allie pushed the gate open and asked if I had any plans for the night, certainly knowing that kind of thing was impossible. She informed me that she was going to abduct me for a while, and to hurry up closing the story so we could get going already.

"Where are you taking me?" I asked, once we had dropped off the night deposit.
I laughed at her. "Right. And how exactly does one sled out here? You'd need a hill for starters."
"The city built one out on 24th a few years ago."
"The city built a hill. That's fucked up."
"So I'm going to take you home so you can get changed, and then we'll get the sleds and go."
"Um, I don't own snow pants or anything."
"Just put on a couple pair of jeans or something, I donno."
"I don't own any jeans."
"Well, fuck then. I'll have to dress you too."

Allie was living with her sister in a house about a mile from the apartment, but in a part of the city that I had never really been to before. Her sister worked odd hours, and was already asleep when we arrived. As quietly as she could, Allie went into her room and proceeded to dig out a bunch of clothes that had been left by her boyfriend, and taunted me into slapping as many of them on as I could fit. He was a bit shorter than I, and the pants came up lacking when I wriggled into them. We compensated with a few pairs of socks pulled up over the last pair of jeans. Then sweater, sweater, Red Wings jersey to finish off the get-up. I felt like I could either go sledding, or trick or treat as an awkward fat kid in seventh grade. She tossed some cheap plastic toboggans into the back seat, and we went back out into the night.

The hill was on the VanRaalte Farm, and was pretty much a mound of dirt put next to a parking lot. While it was a rather large berm, I would not have called it a sledding hill. But my standards involve something closer to a vertical drop, so perhaps they were a little high for the Midwestern terrain. The city took advantage of their one hill through the prodigious use of streetlights. The park was kept open late so that weird people like us could get high and go sledding late at night. We had the whole place to ourselves.

I argued about going first.
"I haven't been sledding in about a decade." I said.
"You should go first then."
"No, you go so I can see how it is done. Like a refresher."
"Well, you sit on the sled and then you slide down the fucking hill. Does that sound familiar?"
It did. I went first.

Sledding at four years old is scary and fraught with danger. Sledding at eight is one of the pinnacles of winter. Sledding at twenty-one is not nearly as exciting as it seems like it should be. I pushed myself and went maybe a third of the way down the hill, plowing the fluffy snow up in front of me. "Woo," I mumbled, dragging the sled back up the hill. Allie did not have the same age/thrill problem that I had embodied. She got a running start and dove head-first down the hill, snow quickly flying into her face and over her. I remember thinking that our techniques were a perfect illustration of how we both approached life.

We packed the snow with successive trips, and by the eighth or ninth run we were starting to build up a packed powder run. A slight deviation in the path down the hill resulted in a spine cracking change in speed, so my primary goal became making it down to the bottom of the hill in one piece. Allie continued to recklessly throw herself down the course, taunting me for my wussy technique. Usually, I would not respond to that kind of peer pressure, but there was something in the way: I wanted to have her approach to things. I wanted to be as fun and seemingly carefree as she was then. When was the last time I had fun without regarding the consequences?

I don't think she was expecting me to actually run and go down head first. I don't think I was actually expecting I would do it either, but I was mid-motion before my brain caught up with my actions and it was much too late. Landing chest-first on all of those sweaters didn't hurt as I had expected, and neither did the first blast of snow and wind to my face. What did hurt was suddenly veering off of the packed trail about two thirds of the way down, losing the sled out from under me, and rolling the rest of the way to the bottom.

I was looking up at the sky at that point, starless and overcast and purple from the city lights and the pending snow. I was listening to Allie yelling as she came down the hill to see if I was still alive. I was thinking that I should never have done such a stupid thing, and hoping that I hadn't thrown out my back. But I was also happy and alive, and for that brief moment the world melted into me and I felt better.



Allie and I hung out the next night as well, driving and walking around town. She took me to the grocery store, where we spent an hour wandering around as I tried to remember what it was I needed so badly. We walked around downtown, smoking cigarettes and chatting and watching the snowflakes melt on the heated sidewalk. Eventually we ended up back at her house for pizza and cable, and it was the first time I was there while her sister was actually awake.

Writing about Allie's sister is hard for me, because I don't have all of the answers. There is a lot of confusion in there, and maybe some ignorance and misunderstanding. But the whole thing was full of good intentions and happiness. I actually tried to meet up with her when I was in Holland last weekend, but I never heard back. Maybe she was busy, or maybe things are weird; I don't know. But it is impossible for me to talk about my time in Michigan without talking about her, so I will muddle through somehow. To compromise all of these things, I'll call her Isis.

Isis was very much Allie's sister. They had a lot in common, but where Allie was spontaneous, Isis was more grounded. Isis was only a year older than I was, but she had bought her house several years before. She had a really good job at one of the larger Holland companies, and while her working hours were strange she did very well for herself. She had things organized and settled, which I found both a little disturbing and very interesting. It was almost exactly the opposite of the way I had been living since I left home.

Allie ran off to call her boyfriend, and Isis and I sat at the dining room table playing with her cats. It was the first time I had seen cats play with a laser pointer, and I found it more absorbing than was acceptable. But we chatted a bit, and I did my usual bout of complaining about how I was out here in the Midwest with nothing to do, but living in my own apartment and building a life for myself. I didn't talk about the previous few months because I had promised myself that I wasn't going to dump all of my baggage on people the first time I met them. We chatted for a while, and I lamented the lack of a decent bar in Holland.

"Well, there is one up on 7th Street, but it's behind a restaurant so you probably didn't notice it."
"Yeah, I don't know that one at all."
"I'm going up there with a friend tomorrow night. You should come with us."
"Um, sure. Alright."


Notes on a life in exile: A retrospective
Previous: January 22, 2010 <|> Next: February 4, 2010


Third time's the charm, apparently.

I have a "suspicious mass" in my brain. Suspicious, as in, a 2 centimeter mass that is presumably metastasized breast cancer.

I'm okay, for the moment. Not entirely surprised, but it is going to mean more treatment, probably gamma knife surgery, and another round of chemotherapy. I wonder what the record is?

The good news is (and I know you'll kid me for this) again, we caught it early. I'm learning to really trust my gut instinct that something is not quite right. I've been having more headaches than usual - this is a pretty minor thing, and not usually how a brain tumor would show up. Good thing I noodged my oncologist into the MRI anyway. Hooray for early detection.

As usual, send me goofy snail mail, and send love and support to wertperch. More as soon as I know anything.


Grundoon called me at 2. I was trying to find the hematology oncology clinic at Madigan to ask about an inpatient. I answered the phone and said, "I can talk for two minutes."
"I have a two centimeter mass on the MRI in my left frontal lobe."
I was at a desk in Internal Medicine so I couldn't swear aloud. "Ok, I can talk for longer. Crap."

I felt derailed as I went to track down heme-onc. The Family Practice team had drafted me because they were so swamped. I was helping a medical student with three complex patients. This one had a negative MRI of her head, but we suspect a breast cancer recurrence because she came in with a calcium twice normal and has a normal parathyroid hormone.

I found the oncologist. I said, "I'm not going to quite be coherent because my sister just called and has a brain metastasis recurrence of breast cancer." We discussed the inpatient and my question was answered. No formal consult needed, a "curbside".

Then the oncologist said, "Don't give up hope on your sister. I have a patient who had a brain lesion treated 4 years ago and is doing well. There is still hope."

And that made me tear up. Grundoon and I both go into strong brave mode in a crisis, compartmentalize the emotions of fear and grief. But to have the oncologist say this and her kindness leaves me undone. I don't cry much, a few tears by the elevator. I went downstairs and finished all that I could, then checked out to the team and left by 3:15, to drive the 1.5 hours home, get dressed in black. Our chorus sang the Mozart Requiem, wonderful soloists and orchestra, practicing since September. We will sing it again on Sunday afternoon. I didn't cry during the performance. Our director was teared up by the end. She cried right at the start of a practice last week because she'd asked us to memorize the start of one part. She teared up and said, "Every face was up and I can see you all. You all did it."

This am I was very up. I was on call last night and was called to labor and delivery. When my hospital of 10 years and I parted ways, I decided that I was not leaving town. I would open my own clinic. The loss was that the hospital said that "The district has no plans to share call with non-employed physicians." They were blocking me from doing obstetrics by refusing to let me in the call group. I thought I would not be catching any more babies.

So the delivery was a joy, and the Madigan staff were very kind about me being a novice on the computer and with the paperwork. A delightful 6 pound 7 ounce baby girl.

Joy and fear, sorrow and happiness juxtaposed. I was so happy in the morning about the baby that I thought, oh, dear, no doubt something will break this mood. I'd better drive carefully and pay attention. I thought the MRI would be negative because headaches are definitely not a typical presentation.

Wrong, wrong and wrong.

But there is still hope, says the oncologist. Remember that.

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