Friday, August 29, 2008

Yoga and death

One of my teachers once described yoga as practice for death. I'm not sure precisely what she meant, but it feels true to me. Indeed, the final and most important pose in every practice is savasana, or corpse pose, in which you lie supine on your mat, often with a blanket draped over you (like a shroud), and release all your muscles, allowing the (dead) weight of your body to sink into the floor. As in meditation, you focus your attention on your breath and resist the temptation to scratch, fidget, adjust your limbs. Slowly, mysteriously, you begin to detach from your physical self. Dispassionately, you observe itches and twinges almost as though they were happening to someone else. And as you lie there, relaxed, dispelling discomfort with your breath, and accepting any residue that remains, you begin to feel that this might be something like death—and, incredibly, you can handle it.

For the year or more during which I was undergoing intensive treatment for breast cancer, I was beset with relentless anxiety about dying—except during yoga. The deep, slow breathing alone helped calm me on a physiological level. And the twists and stretches and flexes seemed to wring out the nervous energy that otherwise coagulated in my gut as dread. Letting go of any "goal" for each posture and focusing instead on the process, the actual experience, allowed me to yield to the present. Being fully in the present freed me (temporarily) from my fears about the future—particularly my fear of death.

In addition, there was something about recapitulating the movements of thousands of generations of yogis before me that made me feel as if I were part of an ageless process, and ageless myself—like a rock or a drop of water or air, eternal. And strangely, it was comforting instead of terrifying.

Maybe that's just me. And even I, enthusiast that I am, can achieve that equanimity only for moments at a time. But those moments are delicious and leave me hungry for more.

Thursday, August 28, 2008

Namaste, Om, Hare hare and all that ...

There is probably nothing that makes a person say yech to yoga like the various vocalizations that are part of a typical New York class: Namaste, om, the call-and-response chants, the odes to Hindu gods. I, too, feel queasy about opening my mouth and making a joyful noise. First of all, I'm tone-deaf, so I can't carry a tune—not even a monotone—and I'm embarrassed about that. Second, reciting foreign words in a sing-song feels silly. Third, voicing hymns to gods, particularly ones that I do not personally worship or that I associate with cults, feels false, even creepy. But I think this is my problem, not yoga's. And I'm trying to get over it. I think I'm succeeding.

In yoga, chanting has become for me a way of breaking free of ordinary restraints, including my own resistance. When I open my mouth and let loose a sound that I aim to be more or less in the same range as that voiced by the rest of the class, I let go of my self-consciousness and take a leap of faith that the practice I'm embarking on is not about performance or being judged but about throwing myself fully into the experience before me. Every time I join the others in singing om, say, it's a commitment to take yoga on its own terms.

Om-ing has other functions as well. Singing om together synchronizes a group of individuals and gets them on the same wavelength—literally. A great roar of om vibrates the brain—in a good way—of everyone in the studio. And the communal singing—and vibrating—breaks down the barriers between the mats by serving as an acknowledgment that everyone is united in the yogic quest. The syllable om is thought to incorporate all other sounds and is said to be the sound of the universe. When we chant om at the beginning and end of each class, we unite not only with our contemporary classmates but with yoga practitioners throughout time as we resonate to the song of the universe. I do it with pleasure and conviction now.

The devotional call-and-response chants in Sanskrit are a little more problematical for me. Aside from the difficulty of synchronizing my wayward voice with those of better-tuned folks, I find it odd to mouth the sounds of a foreign language, which is essentially meaningless to me. However, I understand the principle. Sanskrit is thought to be the oldest language in the world—some say it is so old that it is the tongue of the gods—and it is the liturgical language of Hinduism, Buddhism and Jainism, and the one in which the major yoga texts were written. So we chant in Sanskrit for the same reason the Catholic liturgy is delivered in Latin or Jewish prayers are sung in Hebrew: for authenticity, to be as close to the source as we can be and to prevent the dilution and inexactness that come with translation. I force myself to participate. Many aspects of yoga that I initially resisted have come to be profoundly meaningful for me. I figure this may too. I give it a chance.

Then there are the incantations of gods' names. Like the asanas, which call into play opposing forces—flexion and extension, downward rooting and upward lifting in the same pose—the gods typically embody dual characteristics. Shiva, for example, is viewed both as the destroyer and as the clearer of obstacles. By intoning the gods' names, we are not so much praying as acknowledging our own complexity and calling on the best expression of our innate qualities. Or not. This is where my enthusiasm for yogic ritual fails. I just cannot make myself wail "Hare Krishna" or "Hare Rama." Just can't.

But one day I may. I've come a long way. And I know I have a long way I'm going to go.

Wednesday, August 27, 2008

Seen one mutant, seen 'em all

I hope this doesn't make me a racist, but I just can't tell mutants apart. Doesn't matter if one has holes in its face and another is a blue giant and another has pointed ears and a snub nose—they all look the same to me. And as I move from frame to frame in the graphic novel I'm trying to wade through, I can't remember whether it was the Comedian who died or Rorschach or who. So I have to keep backing up through the pages to the beginning.

"Watchmen" was on a best-100-books-ever-written list, so I thought I should read it, but I seem to have lost some kid instinct for this stuff—if I ever had it. Deepest I ever got into comics was a couple of forbidden Archies. It's really hard to figure out who's talking, and who's thinking, and what frame comes after what frame. Plus, the plot is gruesome! The whole exercise is a little more strenuous than I expected. However, I'm convinced there's some value in mastering this strange genre, though I'm not sure what.

Tuesday, August 26, 2008

Transition—a labor of love

In childbirth, there's a period that is notoriously painful during which the cervix dilates to its maximum expansion and the fetus moves into the birth canal in preparation for being expelled. This is the time when even women who had been adamant about natural childbirth cave in and plead for drugs, anything to kill the dreadful spasms. The intense contractions are not infrequently accompanied by trembling, vomiting, irritability, despair, hysteria, disorientation, hormonal surges of overheating and chills. The extreme pain induces hallucinatory experiences. When people compare the agony of, say, kidney stones to childbirth, they are talking about this stage of labor. And its name is transition.

When I told my friend H about the emotional paroxysms our family has been enduring as we prepare to send C to college, she likened it to the transition of childbirth. And it's a wonderful analogy: the pain, the nightmarish aura, the wrenching separation of child and parent, the catapulting of the child into a new world and a long trajectory of growth and discovery, the slow healing of the bedraggled mother (and father). And the blessed brevity (we hope) of this anguishing passage from past to future.

Sunday, August 24, 2008

If it's Sunday, this must be a sermon

There's a common misconception that yoga is all about stretching. Not. First of all, it's important to remember that yoga isn't, primarily, a physical practice. The asana practice is just one—and not even No. 1—of the eight "limbs" of yoga. Second, the asana practice aims for strength in equal measure to flexibility. For any muscle that is being extended, there is a muscle that must be flexed to facilitate and support that extension. Indeed, injuries occur if a muscle is yanked into maximum stretch without the reciprocal contraction of a complementary muscle. To safely and effectively stretch your hamstrings (the muscles at the back of your thigh), you must firm your quadriceps (the muscles at the front of your thigh).

One of the core "scriptures" of yoga, Patanjali's Yoga Sutras, is a compendium of short, pithy, sometimes enigmatic aphorisms—a strand of pearls of wisdom. One sutra, "Sthira sukham asanam," can be translated as "Asana is steadiness and ease." In just three words (in the Sanskrit version), Patanjali gives you yoga—and health—in a nutshell. Every position must combine strength (steadiness) and ease (relaxation)—or flexion and extension. Together, these produce balance. Strength, flexibility and balance are the foundation of physical health. If you've ever been to a physical therapist, you've probably been assigned exercises that increase strength as well as those that increase flexibility. The yoga practice is like physical therapy for your whole body.

Of course, since yoga is not all about the body, the principle of Sthira sukham asanam applies to other domains as well. Steadiness, flexibility and balance are pretty much the definition of mental as well as physical health. However, whereas in the body you can identify specific muscles to be flexed and others to be released, the mental sphere is subtler. And therein lies the beauty of yoga. Like a metaphor, the physical practice spells out in concrete terms the elusive intangibles you're seeking in your mental life. Having the concrete image helps you find the counterpart mental "muscles" that must be worked to achieve emotional balance. It's like an osmotic process, in which the wisdom achieved in the physical sphere effortlessly seeps into the mental sphere. That may be one reason you step out of yoga practice exhilarated, light, hopeful.

Converts? Anyone ready to accept yoga into her heart (and onto her mat)?

Saturday, August 23, 2008

Intrusive thoughts

Finally, I'm feeling better—and not just feeling free of physical pain but also feeling emotionally exhilarated by the return to health. Perhaps only another cancer patient—or another hypochondriac—can relate to the relief of having your body do what it's supposed to do: fight disease, repair the damage, get you back on your feet.

Nearly three years after my diagnosis, cancer still colors every moment of my life. Each little ache (today I've got a sore area on the right side of my lumbar spine, a tender spot on the irradiated side of my chest, a bruised feeling on the bottom of my right foot, painful neck glands, a little gas—and that's just today) generates an ominous question mark: Is this the symptom that will change my life forever?

And it's not just the aches. In yoga class this morning I think, Will I be able to get the same succor from these familiar routines if I get a recurrence? Or will the magic have worn off or be undermined? If cancer spreads to my bones, will I be able to practice the physical asanas? I know they're just one aspect of yoga, but to me they're vital in dissipating the nervous energy I'm afflicted by. Nagging my daughter C to do some chores to get herself ready for college, I wonder, If I get sick again and, say, die, will my kids be o.k. without me? At the health-food store, I debate whether to get C a sweet treat, knowing that my having had cancer raises her risk of getting cancer, and many nutritionists believe avoiding fats and sugars offsets risk. Later, at another health-food store, I'm tempted to get myself a treat. I resist that temptation but then succumb to another craving when I get home. Was it worth dying for those few spoonfuls of ice cream?, I berate myself. I find a couple of great T shirts—ones that obscure my flat-chestedness—at a street fair and buy them, then wish I hadn't since not only is the cotton they're made of not organic (and we all know that cotton accounts for 25% of the world's pesticide use) but they're also made in China. Should I throw them out?

And those are just a few droplets in the continuous stream of intrusive thoughts that plague me on a good day. Indeed, I was actually congratulating myself today on how far I've come in breaking free of obsessive thinking. Will I ever be normal again?

Friday, August 22, 2008

Pain

I've always thought I'd want to live to be 100. But with my breast-cancer history—and the toxic treatments that paradoxically saved my life but will probably shorten it too—I doubt that I'll enjoy that kind of longevity. In any case, I can see how the aches and discomforts of ordinary aging might kill the desire to see each new day.

It's alarming how quickly pain erodes the will to live. One two-day bout with flu and sinus headache, and I was ready to throw in the towel. I feel a bit better today but chagrined by my weak spirit. This time I actually took the comfort meds—Dristan, Day-Quil, Sudafed—though they didn't do much good, and I felt plenty sorry for myself, all alone in my room, quarantined from my family, knowing I was a disgusting sight as I honked and snorted and sopped up the snot, my nose red from chafing, my eyes rheumy, my hair plastered unattractively to my scalp in clumps.

Would I really want to live to be 100 feeling like that?

Thursday, August 21, 2008

Arrrrrgh!

One thing I don't get: Why doesn't the pain of an ailment match its seriousness? I have a trivial little flu, and I feel as if my skull were giving breech-birth to my eyeballs, every molar were abscessed and my ears were having angioplasty with weather balloons. On a scale of 1 to 10, I'd put my pain at about 8. By contrast, the malignant breast tumor that could have killed me generated zero pain.

In a day or two, this flu will abate and I'll be able to see it as one more uplifting proof of the body's ability to heal itself. Right now ... I'm not there yet.

Tuesday, August 19, 2008

Bad memories make good memoirs

Over a rooftop dinner (whole sea bass with wasabi, lemon slices and flowering scallions wrapped in foil and grilled, avocado-and-bell-pepper tossed salad, fresh corn-on-the-cob, and lime-and-agave-syrup-ade) with neighborhood friends JS and GW, the talk turned to eccentric parents—Louise Bourgeois, my own mother, JS's mother, the parents of Jeannette Walls in The Glass Castle. In that vein, more or less, JS told the story of a 15-year-old girl she knows who was about to be orphaned, and not one of the 12 siblings of her terminally ill mother was willing to take her in. JS drew the girl aside and told her, "Take notes—they will come in handy when you write your book. Bad memories make good memoirs." The girl was (according to JS) much cheered by this suggestion.

I thought it was excellent advice, so I passed it on to my daughter when she arrived a bit later. C appeared confused. "But I had a happy childhood," quoth she. Are there sweeter words in the parental universe?

A great dinner all around!

Monday, August 18, 2008

The ghost of X.Y. High School

So once again I was a no-show at my high school reunion. This was a biggy—the 40th anniversary of my nongraduation. The fact that I didn't join the procession in 1968 to get my diploma (I took off for Colorado as soon as classes ended) tells a lot about my attachment to the school and the tenor of the times. As I told my friend RR, who attended both the graduation and the reunion, I had only half a dozen friends in high school. I know what happened to three of the six people I cared about (including RR), and the other three were no-shows too, so if I had gone I would have felt as if I were at someone else's high school reunion.

But the flurry of e-mails (How did they ever find me, 2,500 miles away? Was it you, RR?) did rouse memories of what it was like to be an Out-crowd teenager in Silicon Valley in the '60s. I felt like a ghost haunting the halls of X.Y. High School. The casual cruelty of the In crowd ("Wow, I like your tan," sneered a blue-eyed, bronzed, blonde surfer girl when I returned to school pale and wobbly from foot surgery) was too predictable to deeply wound. But there were self-inflicted wounds of mortification: my too-big body; my sparse, shabby wardrobe; my hyperactive sweat glands; by jewfro hair (looked like pubic hair—on my head); my overeager smartness; my secret feelings of inadequacy relative to my honors-class cohort. If I hadn't felt conspicuous because of all those things, I would have felt invisible. I was a giant nobody.

And I pretty much remained a nonperson my freshman year at an all-women's college. Not until I transferred to an all-men's college did I begin to feel three-dimensional. (Ironic to find your sense of self in the very situation that's commonly thought to sabotage it.) And even though it was something of a blow after college to re-enter the real co-ed world where people weren't universally knocked out by my incredible beauty or my novel turn of mind or my sparkling personality, I haven't lost my sense of self again. Nonetheless, I guess I'm still not sure enough of my 3D solidity to take the chance that some suburban princess might wave her wand and render me invisible once more.

Sunday, August 17, 2008

Revelations from the mat

When I was a student writing papers for school and when I was a reporter writing articles for a newsmagazine, I would sometimes go to bed anxious because I couldn't figure out how to finish whatever I was working on. I needed a unifying theme or a killer punch line or an apt example or a clever title or a tricky transition or a dynamite tie-it-all-together conclusion—sometimes all of the above. I would worry about going to sleep without finishing the job. But sometimes, magically, I would dream the missing parts, and when I woke up, if I wrote them down quickly, before they evaporated from memory, they were—incredibly—perfect.

Sometimes in yoga, something similar happens. I'll come into my practice twisted with anxiety or guilt or anger or stress or some unresolved conflict. In the course of stretching, twisting, flexing, releasing, inverting, balancing and focusing on my breath, I'll notice that a physical technique I'm using has a psychological counterpart. Instead of yanking on my feet in a forward bend to stretch my tight hamstrings, for example, I'll notice that if I back off and micro-bend my knees, my hamstrings will ease. And suddenly, it will come to me—right there on the mat—that I can apply the same principle to some unyielding situation I've been confronting in my home life, perhaps a standoff between myself and my daughter C. And it will work: a little flexibility not necessarily on the issue that is straining our relationship will dissolve the tension.

Or standing on my head, I'll realize that some conundrum I've been puzzling over suddenly makes sense if I examine at it from another vantage point, turn it on its head, look at it upside down.

Or I'll realize that in wrenching my spine into a deeper twist I'm compressing my vertebrae rather than opening them, so I need to concentrate on straightening my spine rather than torquing it, and somehow that will clarify to me that in my personal life I need to let go of a goal, relax and focus on the process.

So much of what you aim for in yoga is just a concrete corollary of the more subjective qualities you strive for in the rest of your life: balance, flexibility, strength, stability. And practicing these skills in the physical domain of yoga hones their counterparts in the mental sphere of work and the emotional arena of home.

So yoga becomes not just acrobatics at the gym. It's life itself.

Try it. Really, you'll like it.

Saturday, August 16, 2008

Cancer and the uplift of down dog

When I was diagnosed with breast cancer I was not only stunned but also a little hurt. I was stronger and healthier than any of my friends. I ate vegetables and exercised daily. O.K., I drank more alcohol than the single glass a day a woman is allotted, and smoked till I was 30—but still. I had done my part. Why had my body betrayed me by harboring an enemy like cancer?

I felt like a cuckolded wife. But unlike a woman whose husband has cheated on her, I couldn't just throw the bum out. So the process of recovery required not just surgery, radiation and chemotherapy but also help in coming to terms with a body I no longer trusted. I needed a really good therapist.

I did find a really good therapist—she hypnotized me too, and I'll give you her name if you need her—but in large measure, yoga was my therapist. Breathing into my terror; scanning through every muscle, organ and limb; stretching, twisting, squeezing, releasing—I examined my body from the inside out.

I grew stronger, more flexible than I had been before I got "sick." While I was in treatment, I did my first handstand, my first freestanding headstand, my first side crow. My body began to belong to me again. I realized that far from betraying me, it had done its best to resist the advances of the enemy. And it was doing its best now to fix the breach. We were a team—my body and me—and we were collaborating to regain our health.

The progress I made in my physical practice was psychologically comforting. It was proof that my body—and the rest of me—could change, could heal. I might feel hunched and weak and heavy and tired as I dragged myself to yoga class, but I would walk home upright, with a light step, strong and energetic.

Even a single pose, reiterated, revealed my body's remarkable malleability. My spine might feel stiff and unyielding in the first down dog of a sun salutation (a series of poses repeated several times as a yoga warmup), but by the fifth iteration, it would feel limber and alive. If my body could alter so radically in mere minutes, I realized I was capable of monumental change long-term.

Now instead of feeling betrayed by my body, I feel grateful for its wisdom as revealed to me through the practice of yoga. At the moment when I was most alone and in danger, yoga threw me a lifeline by showing me my own resilience.

Doesn't that make you want to at least try it?

Friday, August 15, 2008

Yoga is for misers—and that's a good thing

Yoga was made for skinflints. No equipment necessary. And that nothing-in-excess economy is part of its beauty. In the same way that a poem contains a novel's worth of content and every word modulates the meaning of every other, so in yoga every pose is a choreography of squeeze, stretch and twist, each enhancing the other and creating a cascade of effects that realigns the entire body.

The use of the breath exemplifies the magical efficiency of yoga. Breath is the soul of yoga—and it costs nothing, weighs nothing and can't be left at home by accident. The breath is simultaneously automatic and controllable, and yoga puts those voluntary and involuntary aspects to multiple purpose.

*Like a mantra, the breath is used as a focusing agent to concentrate the mind and still distractions, transforming the physical asana practice into a moving meditation.

*Like a metronome, the breath provides the rhythm for asanas (poses), which are typically held for one, three, five or eight breaths, and vinyasas (sequences of quickly executed, linked asanas), in which each movement is coordinated with an inhalation or an exhalation.

*Like your pulse, but easier to monitor, your breath—or breathlessness—lets you know when you're overdoing it. When you start to pant, you know it's time to scale back.

*Like a combination bellows-and-fan, the breath can be regulated, as in pranayama (breathing exercises), to heat you up or cool you down.

*Like fingers in a massage, the breath can be directed to selected muscles to deepen their stretch.

So go ahead, buy those fancy pants with the lotus blossom embroidered on the bottom (I did!) or that luxe two-tone eco-mat (I bought that too!) or those bamboo blocks (I'm mulling those over), but know that you really don't need them. As one of my yoga teachers always says, "Anything you could ever want, have or need is right there inside of you." All that's required for yoga practice is a good set of lungs—and those are right there inside of you.

Wednesday, August 13, 2008

Yoblog: Falling in love

Anyone who knows me probably wishes that yoga had remained in India or that I would go into savasana (corpse pose) and stay there. For I am a yoga evangelist. Plug your ears, and cover your eyes. I am about to embark on a series of occasional posts that will tell you more than you want to know.

I have never been at ease in my body. Big for my age (5 ft. 10 by the time I was 13, with size 10 feet), I had the strength and physique but not the grace of a competitive swimmer (though I splashed about for my country-club team in my tweens and teens). Wearing clothes that were too large for me, I lumbered through the halls of my high school hunching my shoulders to obscure the sheer mass of my outsize body. I felt like a giant in a kindergarten. Oh, sure, people occasionally said stupid things like, You should be a model. But they weren't serious. They were being polite about my freakish, obscene size. I was a wannabe Shrinky Dink, always trying to make myself smaller. (Somewhere I may still have the newspaper article I clipped about an Australian woman who had six inches removed from her shinbones—I wanted the name of her surgeon for future reference.)

I don't remember precisely when I became a yoga convert. I took a class or two in college, joined a tiny yoga co-operative (there were three of us, total, who met weekly for about three months) in San Francisco in the early 1970s, and began to take class more regularly when I moved to New York and joined a gym in the late '70s. It was a gradual thing, like being best friends with a guy and then having it dawn on you that you're in love with him.

What made me realize I was in love with yoga was the comfort it gave me to be myself. Yoga encourages you not to contort your body into an idealized size or shape (the whole pretzel stereotype is a willful misunderstanding) but to fully inhabit the physique you have, to get bigger rather than smaller. What a relief, after a lifetime of compression to finally stretch out! I felt as light as a gummed-up collapsed balloon being inflated full.

As graceless as I am (still!), I could never dance to the rhythm of music, but in yoga, movements are calibrated to the slower beat of the breath, and I can do it! And even if I can't, it doesn't matter—I'm in the process.

And in yoga, the process—the path, not the destination—is all that matters.

Tuesday, August 12, 2008

Revolt of the Stepford mothers

"The desire to be likable, it is really a pain in the neck," says Louise Bourgeois in the emponymous documentary at the Film Forum. Say it again, sister! Frank, feisty, eccentric, cranky, she seems up to the task of resisting the temptation to please (though she is lovable, if not exactly likable), notably in an anecdote told by her son Jean-Louis about how one day, when her family was not adequately appreciative of her cooking efforts, she dumped a roasted leg of lamb out the window. Jean-Louis retrieved it, rinsed the grit off and set it on the table, and the family sat down to eat in silence.

It's a funny anecdote, but there's something disturbing about a woman who is so vocal (and visual) about the deep, lasting wounds inflicted by her father's infidelity and by her fear of abandonment yet who seems insouciant about the effects of her own irritable caprices. I have no idea what kind of mother she was overall. Jean-Louis doesn't whine. And she says merely, "My answer as a parent is, I do what I can. I never promised you a rose garden." But that scene suggests a somewhat chilling childlike self-indulgence.

The movie kept nipping at my memory after we left the theater. LB reminded me of someone, but I couldn't put my finger on whom. Then it came to me: my mother! My mother yielded to similar impulses: One day she approached my father while he was eating breakfast and snipped his tie in half with a pair of scissors. "I told you I hated that tie," she said.

Unlike LB, however, my mother, though once maddened by the stultification of parenting in a Stepford suburb, mellowed as she got older (and moved to the city).

Monday, August 11, 2008

Peckerdillos

I used to be a supporter of John Edwards. His platform was the best of all the candidates', and his sunny disposition was refreshing. Now his egalitarian agenda rings hollow, and his sunniness, viewed under the cloud of his insanely bad judgment, looks like idiocy. Hearing him try to explain away his peckerdillo as the result of his breathless rise from humble roots to vice-presidential candidate was just plain embarrassing. Weren't those humble roots supposed to anchor him in simple virtues and common sense?

Elizabeth isn't the only person Edwards betrayed. His dickheaded behavior and thickheaded denials betrayed the democratic process and put the whole world at risk. You may feel a candidate's private life has nothing to do with his or her qualifications for public service, but we live in the real world, and in the real world, peckerdillos like Edward's are exposed and exploited by political rivals. It was criminal negligence for him to celebrate his entry into the presidential race with a sexcapade. If he had duped more Americans like me into supporting him, he could have become the Democratic candidate. Breaking now or postconvention, the scandal would have booted Edwards and made McCain a shoo-in (shoe-in?): more crappy politics, more war, more pandering to the rich. As it is, Obama has a chance. Of course, as my son J (who lives in a Latin neighborhood in Brooklyn) points out, Obama may "dip his churro" somewhere it doesn't belong too. We just don't know about it yet.

And how the hell do you prounounce Rielle?

Sunday, August 10, 2008

Flatland revisited: the androgyny strain

As a breastless woman, I am plagued by concerns about my appearance that go beyond ordinary vanity. I worry that in clothing, my flat chest will draw attention and even offend (see previous flatland post) and that out of clothing it will upset children (perhaps adults too).

As if those issues were not enough to keep a woman in her nightie, there's another I wrestle with. As a tall woman with short hair (it's so scanty post-chemo that growing it out isn't an option), big feet (my mother once told a shoe salesmen, "I'd like some shoes for myself and some boxes for my daughter") and a flat chest, I sometimes feel as if I have just two alternatives: wearing a dress and looking like a transvestite, or wearing jeans and being mistaken for a man.

Indeed, when Other was in the hospital, an aide repeatedly addressed me as "sir" even though I was wearing a bright pink skirt and silver earrings. That incident pissed me off, since obviously, even if I wasn't successful, I was clearly trying to pass as a woman, and the damn aide should have given me the benefit of the doubt and indulged my harmless fetish.

It's not that I have anything against cross dressers—or men—but there's something about having my gender identity misunderstood that creates dissonance for me. I'm a truth teller (o.k., I've lied to Other about how much I spent at Daffy's, but that's my greatest sin), and to perpetrate a misconception about myself, even inadvertently, bothers me.

My relief at my disease-free survival trumps my petty clothing concerns, and every day I am consciously grateful to be pain-free and alive, so in a way my daily wardrobe struggles are a reminder of my wonderful good fortune. But sometimes I forget to see them that way.

Saturday, August 9, 2008

Ye Olde Five Dollar Store

As feckless urban rich idiots (FURIs?) flood our neighborhood, and big-box stores and upscale wino-bars and brasseries move in to service them, I look back with nostalgia on the GODs (good old days). Could it be just 10 years ago that the Five Dollar Store closed its doors for good? In its heyday, it opened onto St. Mark's Place under signage with something zippy like Sheherezade or Shazzam (nobody ever called it anything but the Five Dollar Store), but it ended its existence in reduced circumstances on a neglected stretch of Fifth Street between First and Second Avenues. Filled with factory seconds, warehouse overstock and designer samples, it was a mixed (rag) bag of trash and treasure. Often the clothes had odd stiff places where John, the proprietor, had placed iron-on bandages over small incisions where labels had been snipped (a condition, apparently, of their sale). John was a big, sweet, slightly "off" guy, in late middle age by the time I knew him, with a hank of startlingly black hair that fell into his eyes as he lovingly pressed his lowly wares in a little back room. He once told me he saw himself as a kind of charity, providing low-cost work and party clothes for the poor. That made me feel a little guilty over all the cheap goodies I snatched from the racks for my own use. After all, I was thrifty but not precisely poor.

Sometimes there was pure gold on those hangers—a shipment of White Rice and Endless Knot batiks! Flax!—and I would buy a dozen garments at a time. Other times, the pickings were slim indeed, and I would buy something I didn't want just to be polite. But for a decade or more, my closets and drawers—and when she was still young and unspoiled, my daughter C's too—were filled largely with Five Dollar Store bargains. I've never been known for sartorial splendor, but I did have an "interesting" (with all the nuances that quotation marks can provide) wardrobe, one unlike that of the army of Ann Taylor clones marching off to work these days (not that I have anything against AT—I myself wear a couple of AT jersey tiered skirts). There was no "matchy-matchy" (as C would say) look to it. It was unique. Only another customer of the Five Dollar Store wore outfits remotely like mine—and only if she had beaten me to the racks.

Friday, August 8, 2008

The view from flatland

I know that almost every woman has some locus of dissatisfaction in her figure: saggy breasts, big belly, small behind, whatever. So it's probably a little ironic that I actually think I have a great body—for a 58-year-old woman with no breasts. I didn't get the dread dog ears (flaps and wens of skin), keloid scars, lumps and crevasses that are the chestscape of many women who have undergone mastectomies. I have a nice neat flatland. Most important, I have not (yet) developed lymphedema, the elephantine swelling of arms or chest that sometimes accompanies breast surgery. Not everyone would feel lucky to be me. But I know enough to revel in my good fortune (and the prodigious skill of my surgeon).

Still, my particular figure presents certain difficulties. After a mastectomy, a woman has three options: reconstruction (in which new breast "mounds" are created by a plastic surgeon), wearing prostheses (a.k.a., falsies) or going "form-free." Too cowardly for plastic surgery, I am left to choose between falsies and my true self.

In theory I don't object to falsies, but they require a scaffold to hold them in place, i.e., a bra—something I rarely wore in my pre-cancer life and can't get used to post (I hope it's "post") cancer. There are days when I would kind of like to wear falsies, but then there are definitely days when I can't bear the idea. One would think I could wear them some days and go flat others, but something in me resists shapeshifting. I want to have a consistent body image. Didn't someone say consistency is the hobgoblin of small chests—or have I got that wrong? Though I have a drawerful of devices (and—ever hopeful!—another pair in the mail), I think I'm committed to the hobgoblin of flatland.

But flatland has its detractors. Before my mastectomy, a brutally frank friend tried to talk me into reconstruction, telling me about a woman in her gym who wore tight T shirts and no prostheses after her mastectomy. My friend was horrified by this woman's "in your face" attire, but I was overjoyed. "My sister!" I thought to myself—and yearned to meet her and ask her all my premastectomy questions. Perhaps she would even bare her chest so I could see her scars (I was ravenous for information before my surgery)? But my friend—I know she sounds horrible, but I think she meant well—repeated the "in your face" description to me several times, and it has stayed with me.

I certainly don't want to offend or horrify people with my breastlessness—or bring it to their attention at all. In the breast-cancer community there is suspicion about women who make a point of their baldness or their bustlessness or their pink ribbons or their "Survivor"-branded gear. Some are criticized for making their illness into a political issue; others are perceived as milking their victimhood to prolong its perks: the kindness of strangers, the deep and loving attention of friends and family members. I don't have a beef with either path—picket! wallow!—but don't feel a calling to one or the other.

Nonetheless, it's difficult to dress comfortably and at the same time completely obscure the topography. I wear mostly black (to camouflage the absence of shadows) and experiment with busy patterns, off-center designs, loose crisp fabrics, and scarves and shawls and other drapery. But I find myself inadvertently curling my shoulders inward as if I could somehow shield my chest from view. I have given up the elasticized tops that I used to wear for yoga—too revealing—so now I have to stuff the ends of my T shirts into my pants for inversions. I hide in dressing rooms or bathroom stalls to change at the gym—even though I'm tempted to give someone else the thrill of sisterhood that the report of the "in your face" woman gave me.

I know my friends would like me to just forget about my chest. And I would like to too. But it's difficult. It's always there (or, rather, not there), and every day I have to make choices about how to dress it up or down. Putting your clothes on is such a mundane act, and yet it's fraught with meaning for me. Should I be "in your face"? Should I hide my "deformity"? And how? I'm mired in the self-consciousness I had hoped to have outgrown by now. Even though I really, really do like my body these days.

Wednesday, August 6, 2008

Mea gulpa

Just to show that even a longtime patient with a sensitive (some would say, oversensitive) nose for people's stinky behavior in medical environments can blunder:

Yesterday while Other was having his plumbing Roto-Rootered, I ran out to get a bagel with tofu and lox. I didn't want to miss the surgeon when he emerged from the OR, so I rushed back to the waiting room to eat my lunch there. My paper bag rustled loudly as I removed my bagel and unwrapped it. People around me glared. As I gnawed my way through it, one woman nearby pointed at me and muttered to her companion. Well, what can you do? Lox are smelly. Get over it. Finally, the doctor came out of the OR and summoned me to a corner, where he reported how the procedure had gone (excellently!). As I made my way back to my seat, I noticed a sign directly over where my head had been, entreating everyone to refrain from eating and drinking in deference to patients who must fast in preparation for surgery.

Oh.

Tuesday, August 5, 2008

The feminized male

Other has always prided himself on being a feminized male. Now it's not just an attitude. After today's kidney-stone procedure, he is bleeding into his underwear (a little) and has a string hanging from his penis (to enable the stent to be pulled out in a few days). Now we gals know what it's like to have to wash our underwear and deal with strings, right? (Though for me the memory is fading five years into menopause.)

If anyone has ever felt any discomfort uttering the word penis, an episode like this is the cure: PENIS! PENIS! PENIS!

All went well, and if Other drinks his fluids and minds his diet, perhaps this will be the end of such discussions.

Monday, August 4, 2008

Breast cancer, a personal history

On September 4, 2005, when I was 55, I discovered a Jujubee-size lump beneath my right breast. Six weeks earlier, my yearly mammogram had noted nothing suspicious. I made an appointment with my gynecologist, who said it was a cyst and suggested I wait six months to see if it changed. "If you're really anxious about it," she said, "you could see your dermatologist or a breast surgeon, but I don't think it's anything to worry about."

I felt like a hypochondriac as I made an appointment for an ultrasound in preparation for seeing the breast surgeon. Although the lump was visible and palpable, the ultrasound showed nothing. The breast surgeon examined me and said the lump was a fibroadenoma, a benign growth. As long as I was there, however, she said I might as well have a fine-needle aspiration. That procedure revealed fast-growing, highly irregular cells. An immediate lumpectomy with sentinel-node biopsy was scheduled.

The pathology report revealed I had an unusual kind of cancer: hormone-negative, her2neu-positive invasive lobular cancer. This meant the cancer was both "sneaky" (lobular cancers tend not to show up on imaging tests) and "nasty" (her2neu-positive cancers tend to be aggressive). In addition, the margins were not clear, and there was a micrometastasis in the sentinel node. A second surgery removed my axillary nodes—they were clear—but left lobular carcinomas in situ (LCIS) in the tumor margins. My surgeon assured me that LCIS were nothing to worry about. She said they were markers, not precursors, meaning that they indicated a predisposition to develop cancer but were not themselves cancers. I did not need further surgery, she said.

On an impulse, I sought a second opinion. My second-opinion doctor, an oncologist, said these were extremely high-grade LCIS and should be surgically removed. While I was trying to figure out whose advice to follow, a PET/CT found a lesion on my liver suspicious of metastasis. My wretched diagnosis was now much worse. My surgeon, oncologist, second-opinion doctor and liver specialist were now in agreement: I should begin chemotherapy without delay. A liver metastasis trumped LCIS.

So I had the standard four rounds of Adriamycin and Cytoxin, four rounds of Taxol, 25 radiation treatments and a year of Herceptin. I lost my hair, my fingernails turned brown and fell off, and my skin turned gray—but my breasts looked great! The lumpectomy scar, in the crease under my breast, was invisible, and that breast was actually bigger than the untreated breast. Meanwhile, the liver scare receded when subsequent MRIs suggested the lesion was a hemangioma (a harmless cluster of blood vessels).

However, I became more and more concerned about the LCIS. I learned from my reading that their presence in one breast raised the likelihood of cancer in the other. Since my original tumor was not detected by mammogram or ultrasound, I had no confidence that either breast was cancer-free. I was doing breast self-exams daily—a joyless pastime. By the time I was midway through chemo, I was sure I wanted a bilateral mastectomy. I didn't care about my breasts. I wanted peace of mind. As soon as I finished radiation, I consulted a breast surgeon at another hospital, who agreed to do the surgery. One caveat: she wanted to wait six months for the radiation burns to heal.

Initially I assumed I'd have reconstruction, but the plastic surgeon told me implants were not an option because I'd had radiation. He said I could have a DIEP flap, in which fat scooped out of my abdomen would be transplanted to my chest, but because I was slim, the resulting "breast mounds" would be "modest." It was a lot of risk for a minimal effect. I spoke to women who'd had DIEP reconstruction. One was thrilled with hers, but two others were unhappy. One was in constant pain 10 years later.

What had gotten me through the emotional and physical trauma of cancer was daily yoga. Perhaps because my cancer initially escaped diagnosis, I thought about dying nearly every moment of every day. Only yoga gave me relief from these "intrusive thoughts," as they are called. I couldn't face putting yoga on hiatus to recover from reconstruction that might not work.

I know the real danger of breast cancer is not recurrence but metastasis. But having already done all I could to prevent metastasis—chemo and Herceptin—I was intent on reducing my risk of recurrence. I did worry that I would have regrets, but a friend suggested I write down my reasons for the bilateral mastectomy so that if I had doubts I would remember why I had pursued it. That was excellent advice—though doubts have yet to arise.

I asked my surgeon for a "10-year-old-boy look," and that's exactly what I got. I went into surgery at 4:30 on the afternoon of October 4, 2006, and was out of the hospital the next day at 6. The only real discomfort was nausea from the anesthesia. I never needed the prescription pain medications I was sent home with. I was surprised by my lack of reaction when I saw my naked chest for the first time. It was as if all emotional attachment had disappeared along with my breasts. The two drains were a nuisance, but they came out a week later. There was some fluid accumulation, which was aspirated, and an itchy rash that moved around my chest for a month or two. I was back at work—and on my yoga mat—two weeks after surgery.

My insurance paid for state-of-the-art prostheses and bras, so nearly $2,000 worth of falsies and pocketed lingerie fill my drawers, but I almost never wear them. They're not practical for yoga—the first Downward-Facing Dog would spill them onto the mat—and since I didn't wear a bra before my mastectomy, I've had trouble getting used to wearing one now. Anyway, I kind of like my flat look. I really do look like a 10-year-old boy, which is not a bad look for a 58-year-old woman.

I am still troubled by "intrusive thoughts," but they're getting a little less intrusive and a little less obsessive.

Sunday, August 3, 2008

Dinner in the green room

Last night we had a heavenly dinner. We took Metro North along the leafy bank of the Hudson River in the late afternoon to Irvington to visit our friends SB and EA. S picked us up in his adorable Mini Cooper (shouldn't this be spelled Couper, from coupe?) and took us to his little house built into the hillside below the Old Croton Aqueduct Trail. (Being transported by train makes for predictable arrival, as E pointed out, so the hosts needn't worry whether their guests got the time wrong, forgot the plan or are just running late.)

The garden was just slightly past its prime, with hydrangeas in a full range of purples, from pale to royal, voluptuously blowsy. The house was filled with the tarty fragrance of lilies, each dripping a semen-like goo from its stigma and dusting the table with a spicy red powder from its stamens. We proceeded to the backyard, or the "green room," as they call it, where their sun-drunk cat basked in the last light of the afternoon. As the crickets began their chant and the fireflies flashed their love lights, we dined on crusty bread, goat cheese, and grilled vegetables—zucchini, summer squash, eggplant, red peppers and radicchio—served with plain and cilantro pestos. As dusk descended into dark and the mosquitoes began to whine, a thunderstorm rolled in and we rushed into the house, where we finished off the meal with a sour-cherry tart in a buttery crust and chocolate-dipped fruits and nuts (the latter we had brought with us from Russ & Daughters).

Before the conversation could enter its first lull, E looked at her watch and announced we had nine minutes to make the train. Time for only a pee and a kiss goodbye before we were Mini-Cooped back to the station and made our way home.

Saturday, August 2, 2008

What's a crone to do?

My bones are dissolving, and I don't know what to do about it. First it was osteopenia, or borderline osteoporosis. My gynecologist recommended a bisphosphonate—a drug that slows the breakdown of old bone but also, it was discovered later, slows the building of new bone and can cause irreversible osteonecrosis (bone death) of the jaw. It supposedly reduces fractures—in some people—but only in the first five years. When I resisted, she referred me to an endocrinologist. He seconded her advice and said I was overexcreting calcium. I still decided not to take it. For a year I did stair-climbing and weight-lifting to see if load-bearing exercise would build up my skeleton or at least slow its deterioration. My next bone-density test showed not only osteopenia in my hip and femur but full-blown osteoporosis in my wrist. My gynecologist and endrocrinologist were adamant: I must take Actonel. That was in February. I keep putting it off. Evidence surfaced that bisphosphonates may reduce the risk of metastases to the bone in breast-cancer patients. I finally filled the prescription but didn't open it. Then a few days ago, a report came out that women treated with bisphosphonates sometimes develop spontaneous bone breakage. Wait! Don't you take bisphosphonates to prevent that?

What's a crone to do? I'm worried that bisphosphonates are going to turn out to be another drug, like HRT, prescribed primarily for women that—oops!—wasn't adequately researched and has unforeseen side effects, like, say, cancer. If men took them too, I'd be a little more sanguine. But women and minorities—nobody seems to take our health seriously.

I'm concerned not only about the Actonel that I haven't been taking but also about certain yoga asanas that I continue to practice even though they're discouraged for people with osteoporosis. They're the fun ones, and I can't bear to give them up. And even though I've resisted Actonel, I've taken calcium supplements most of my adult life, but now I worry about recent reports that they can increase the risk of heart attack in postmenopausal women. Should I stop taking it?

Tomorrow is Sunday, the day I vowed I'd start a trial month of Actonel (I'm too embarrassed to show up at my next gynecological checkup and admit that I've blown her off even after all the effort she has gone to, including referring me to the endocrinologist and writing to my insurance company to justify ordering a yearly bone-density test rather than the customary every-two-years regimen). Will I or won't I? I really don't know.

Friday, August 1, 2008

Tripping the light

Last night I was walking home, tired and cranky from too much work, and it was really pissing me off that there were so many rich, young (spoiled) diners and drinkers spilling from the flossy restaurants and bars that infest NoHo these days, reeking of perfume, flicking their nasty cigarettes, dropping their litter and shrieking into their cell phones. The whole scene is so dispiriting, I was thinking. I feel like a loser staying home while there's a party raging outside my windows half the night, but it's not a party I would want to go to even if I were invited. I was thinking sourly about how I'd like to move to Brooklyn or Hoboken, only property values are tanking, so I'm probably stuck in the party zone with all these riffraff for the rest of my life.

Then it dawned on me that the reason all those young hotties spilling their cleavage down to their zatch were out on the town carrying on and ruining my neighborhood with their jangled vibe is that they're looking for what I've got: a steady mate and a couple of nice kids. Perked me right up!