Saturday, April 21, 2012

a bewildering question

If you can hang with me, I have a stir-fry recipe waiting for you at the bottom of the page. But first I want to talk for a bit.

Here is one of my favorite poems by Marie Howe. The Billy in the poem is her brother, who died of complications from AIDS.

I ask a lot of questions of myself. Most of them are not as weighty as the ones Howe mentions. Sometimes I write my questions down. What follows are a few recent examples.

- Found pictures of Devil's Pool. Want to visit during the dry season so that I can frolic on the lip of a 364-foot waterfall. Wondering: what does the mist at Victoria Falls smell like during the rainy season?

- Who came up with the interface for Google Maps Street View? It makes perfect sense - picking up the wiggling little man and putting him down on the street, so that the world swirls around and then rearranges itself into a real scene, almost like disapparating and apparating - but I know I never would have thought of doing it that way. What happened in that meeting? How did it come up? Or was it a team of people who arrived at that brainstorm together?

- Spent last two evenings reading Comfort Me with Apples. Last night, ordered pizza. Watched Dumb and Dumber. Ate sea-salt-and-caramel gelato. Climbed at midnight into the big, white guest bed (it's a weekend night, so why not a little variety?) with my book and kept reading by the light of the pretty bedside lamp. Just as I was getting sucked into Ruth Reichl's description of how to eat Thai food (you use a fork to "shovel" it onto a spoon, as it turns out), I flipped to the next page and encountered two huge splotches of blood, so aggressively red-brown that they might be fresh, bookending the otherwise immaculate pages of my library book.

My question: Whose blood??  Is it yours, 10/04/2006?  Or yours, 05/31/2002? Perhaps you, 01/08/2008?

Or is it... someone else's blood?

Okay, I ask a lot of weird questions. Thus, I also do quite a few Internet searches. I know that Google is controversial because it makes searching so easy that it might be letting us off the hook too easily. And indeed, I don't know whether it is making me stupider or changing the way my brain and my memory operate (and further, if so, whether that's a good or a bad thing). I use the hell out of it, just like most people I know. But perhaps I should add that I also fondly remember the days before electronic library catalogs, and I once wrote a poem in praise of the smell of the card catalog ("the very scent of 25-cent thrift store romance novels"). I miss those limited subject headings, as frustrating as they were, because they forced me to get more creative with my search terms.

But alas, those days are gone, and in their place we have the glorious ease of Google's auto-complete searches. Let me offer a partial list of my recent Google search questions from the past couple of months:

      - how do you pronounce pieter brueghel
      - what does gif stand for
      - what was the population of europe in 1914
      - what makes a good documentary
      - what day of the week was 04/18/1996
      - how do you cite a news magazine in mla style
      - is it vita or vitae
      - do you call an ed.d doctor
      - are tulips poisonous for cats
      - how does overtime work in the nfl (okay, this one was D's question)

And here are some search words and phrases. I'm not going to hyperlink these (I'll just backlink a couple that have to do with older posts), as it's really so much more gratifying to go searching for the answers yourself:

      - the year without a summer
      - syndic
      - they might be giants spider
      - portmanteau
      - oneirodynia
      - sun and moon data for one day
      - brede
      - brown recluse bite (a friendly warning: do not type in this
           search phrase if you don't have a strong stomach - it will
           also bring up images.)
      - like one who on a lonely road
      - rheuma
      - one convenient africa
      - microwaved sweet potato
      - we are those people robinson jeffers
      - bright sided
      - grace slick
      - belem
      - coyotes in alabama
      - l'occitane
      - alone together
      - ruffner mountain
      - ferpa
      - hipaa
      - sydenham chorea
      - i see rude people
      - jet skiing mississippi river
      - melancholy
      - heather akers

Recently, I was thinking how, when I was a kid, I felt as though everything I didn't know yet was a black cloud looming over my head, and it followed me around everywhere. You know, there are plenty of other, more positive metaphors out there for wanting to know more stuff. I could have visualized a gate opening to an expansive, lush landscape. I could have seen myself digging into a rich soil. I could have been flying further and further out into a universe full of new stars and planets. Instead, the image was always oppressive: the weight of what I didn't know was crushing me.

My mom wrote this about me in February 1979, when I was four years old:

I do not deny that I was a bit of a handful when I was really little.
These days, I'm working very hard at becoming a handful again.

It was portentous that I found a way, at four years old, to ask questions that rendered eggs and green beans more complicated than they actually are. I also think it's typically backwards that I wasn't ever afraid of the dark until I became an adult and suddenly found myself preoccupied by a fear of zombies. And also IT. (Please just ask my loved ones. One day last fall, I told my mom that the afternoon before, I had been horrified to see a couple of red helium balloons caught in a tree outside the bedroom window. I had already decided that if I woke up the next morning to find they were still paranormally buoyant after 24 hours, I was GOING TO FREAK THE F OUT.)

I wish I wrote down all my questions because I think of new ones all the time.

Luckily, I'm in love with someone who has a similar intellectual curiosity—and who also happens to be better at science than I am.  A few pages after the journal entry you see above, I found an explanatory aeronautic diagram that D drew for me, appropriately enough, when we were on a jet flying to Europe. 

One day while we were living in Manhattan, I encountered an elderly Russian woman in line at the Associated Supermarket at 96th and Lex, where I usually shopped. She was the kind of woman who wondered lots of things, too.

I wrote down the exchange because I thought she was so astute. It was like she was trying to solve a mystery: The Strange Case of Heather's Grocery Basket. And also, it's obvious, she wanted someone to talk to. I admired that last part. I remember Dave, my church's pastor, once giving a sermon about getting involved with people. I don't think he was talking so much about hard-sell evangelism as he was about building relationships and meeting people where they are. He said something like, "The New Testament is full of stories. Christ's message is built from stories. And people want to tell their stories. Ask questions. If someone is crying, you might ask her what's wrong. If you meet someone who's on crutches, you might ask him what happened." Not everyone wants to talk about it, but after all, in that case they'll probably just tell you to bug off and mind your own business. Dave is a guy who asks questions. He let me read his travel journal from when he backpacked alone around Europe in his twenties, and that was the impression I was left with. Dave just walked around, talking to people everywhere he went and finding out more about them. It wasn't as if he was proselytizing about religion; he still had years ahead of him, working as an accountant and then an Alaska weatherman, before the thought of seminary would even occur to him. Overall, the notion of asking more questions strikes me as good advice. It's also the kind of thing I can never quite manage to do: posing unsolicited queries to strangers. But my extreme introvert tendencies are a subject for another post. 

My friend Stacy and I have talked before about how, if we get into a bind we can't solve or have a question that we can't answer, the first place we go is looking for a book about it. We were laughing at ourselves, because it's such a nerdy (and self-sufficient eldest child) way of solving problems. I guess many of my school friends and I have had so much practice with research, between college and grad school and then more grad school, that it honestly feels like the natural next step for any dilemma. I am depressed. There must be a book about that. I am troubled by my family. Let me go read about that. Big life decision? Google, library, and Amazon searches.

I used to think that medicine had all the answers. If you got sick, you went to the hospital, and the doctors walked back to a special room and looked up your ailment in a big book (something like the massive Oxford English Dictionary that squatted on a stand in the center of my middle school's library) that included every possible contingency and variable that might affect your condition, and then they treated you according to a systematic set of steps spelled out in the book. Nice and neat: all T's crossed, all I's dotted. I never thought much about how treatments and medications must necessarily evolve over time: like anything else in science, they emerge through trial and error, through asking questions, some of which lead to successes and some of which lead to dead ends. Likewise, while some of these experiments are made on other animals, many of them, particularly in the advanced stages immediately preceding FDA approval, happen on members of our own species. My sister's treatment, and the observations I've gleaned from life with D, have thoroughly disabused me of the notion that there is any such Bible of Medical Treatment. D is an amazing doctor. He makes executive decisions that I wouldn't have the nerve or the fortitude to do, and he does it every single day. If any one of my family members was in the hospital, I would want him to be the person treating him or her. 

But even he will tell you, once you've followed the standard-of-care and the established protocols, beyond that, much of medicine boils down to making the best decision you can at the moment, based on what limited information you have. That's the essence of the Hippocratic Oath

My sister decided to undergo the standard treatment for chronic myelogenous leukemia: a bone marrow transplant. The doctor explained that they would kill her marrow completely with chemotherapy and radiation - a process that would take approximately a week - and then give her the transplant intravenously. If all went well, she would shortly begin to grow new marrow in the dead space. Her blood type would even change, because her donor's type was different from hers. It was going to be like a second birth: she would have a completely new lifeblood flowing through her body. On her actual birthday, two months before her transplant, Rhea went into her unfortunately-scheduled appointment armed with a list of questions, along with a couple of apparently innocuous ones about her future. The answers to those turned out to be the most devastating. No: my tanned and healthy-looking sister would not be able to lie in the sun for at least a year - if she even survived her transplant. And no: after the radiation treatments, she would never be able to have children.  

Unlike the typical CML patient, Rhea wasn't a middle-aged man. She was an eighteen-year-old girl. So there were question marks everywhere. Who would be the donor? None of us was a close enough HLA match, so the marrow came from someone called "Daz" (Rhea's donor wasn't allowed to know our names or divulge his real name, but in the card sent with his marrow, he told us his nickname and wrote that he'd worked in the medical field for several years. While Daz's marrow wended its way through the tube, looking a lot like Hawaiian Punch, and into the Hickman port that led straight to her heart, Dad joked with Rhea, "Do you know where this 'medical field' is located?" She smiled slyly and said she had read that there actually were three or four "medical fields." I added that a major problem was irrigating the "medical field.") After the transplant we waited - and asked more questions. How long until the new marrow started growing? When would we know if it had taken? How quickly should the white count rise? What complications should we watch out for?  The doctors and nurses and fellows and residents gave us concrete (but qualified) answers for all these questions.

The story of Rhea's sickness is long, and it will suffice for the moment to say this: after the successful graft of her new marrow, she had an unforeseen reaction to one of her medicines, and that became the first of a closely-spaced run of dominoes that fell, one-by-one, over the next six weeks. The doctor replaced the problematic medication with another that made her susceptible to infection. Her new marrow took hold so strongly that it began to attack her own body. So they gave her steroids to reduce the pericardial, gastrointestinal, and skin inflammation caused by her graft-versus-host disease. And then, severely immunosuppressed from the transplant and the steroids, she contracted a fungal infection in her brain and lungs called aspergillosis

I don't know how long she had the infection - maybe a week or so. She went rapidly downhill and then died the day after Christmas. 

On Christmas Eve, Mom and I brought in some presents to cheer her up. Rhea was having trouble with her hands - some of her fingers had gone numb - and she was increasingly confused, so I stood at the foot of the bed and opened the packages, showing her the goodies. As soon as I had finished, she suddenly announced, "I'm going to die." Then she accused Mom of not telling her everything, of hiding information from her about her condition. Mom had been bluntly honest with Rhea about everything all along (this is the same woman, after all, who was adamant that even at two and four years old, her children would know and use the correct anatomical names for all the human reproductive organs), so she and I both just looked at each other, baffled at Rhea's paranoia. When we pressed her further, Rhea got confused and couldn't remember a specific time when Mom had kept something from her; she was just angry because she felt she hadn't been told everything. 

Mom went out into the hallway to talk to a nurse, and I sat on the edge of Rhea's bed in the dimmed light just before bedtime. We chatted for a minute, and then she said again, "I'm going to die." I asked her, "Why do you think you're going to die? What made you feel that way - a feeling, or something else...?"  She didn't answer.  She just asked me, "Do you think I'm going to die?" 

You want to hear my answer, but you already know what I said. I said no. That the doctors were giving her powerful medicine (amphotericin - or "ampho-terrible," as they had nicknamed it) and they hadn't stopped treating her. That I was very worried about her, but I didn't think she was going to die. 

She gave me a long, direct look. I don't know if she wanted reassurance or if she thought I was naïve and deluded and overlooking the obvious. The last words my sister ever uttered to me were a question, and what haunts me was her expression when I answered. I don't know what her look meant. I don't know what I should have said instead. All I know is my answer wasn't enough.  

By the next day, she couldn't speak anymore. A day later, her eyes would no longer open.

photo credit
After she died, I went searching for aspergillosis. This was 1997, pre-Google and really even before the Internet became the preferred means of searching, and so I think I found the word in a real-life dictionary, probably the American Heritage one I'd had on my bookshelf since the Lion's Club gave it to me in fifth grade. And indeed, what I found there wasn't much more than what I already knew: aspergillosis is an infection caused by a fungus of the genus Aspergillus, which includes many common molds.

But then my eyes moved up from the entries for aspergillus and aspergillosis, to the one for aspergil. According to the current version of the American Heritage Dictionary, an aspergil is an ecclesiastical "instrument, such as a brush or perforated container, used for sprinkling holy water." Apparently, whoever discovered this fungus gazed at it under a microscope and noticed its resemblance to the sacred implement used to baptize and bless. In other words, the dictionary didn't answer my question, either. But it did suggest that something mysterious and sacred lies in everything, even in the ugly fungus that killed my sister.
photo credit

This simultaneously pisses me off and heartens me.

In the end, I think there is wisdom that can be found - from literature, from sacred books, from scientific periodicals, from gurus and analysts - but there is no secret room with a big book that spells out the exact answer to every question, unless what you're calling a room is the Heart of the Divine. I am Christian, and I believe in the Bible's message, but I'm not naïve. If we could figure out everything for ourselves, if the universe had no mystery, its God wouldn't be much worth worshiping. I don't trust anyone—a person of my own faith included—who dogmatically asserts that he or she has all the answers. Huge questions exist. They're like the rocks I've seen in pictures of Cannon Beach: massive, imposing, disrupting the horizon and the progress of the waves - but also making the whole thing beautiful, awesome, profound.

What do I believe? That here on earth, in this life, there is only the repeated attempt to do the right thing, to try and answer the questions as well as we can with what little we know. Over and over. Each day. That is what courage is. And that will have to be enough.


I was trying to figure out a recipe to post here, and my only inspiration was to think of a time when I was bewildered by food. When I mentioned it to D, he suggested our first trip to NYC together, when, after some Internet research, I insisted we eat at Sweet-n-Tart on Mott Street, which billed itself as a very authentic Chinatown restaurant. Apparently, it has closed since then, but I remember the menu being almost indecipherable, and D and I learning accidentally that one of their signature dishes was cooked in pig's blood. However, we each found plenty to eat that was palatable to us, and though it was a foreign experience in more ways than one—we shared one of the restaurant's tiny communal tables with an Australian couple we'd never met before—we were happy to learn something about the different cuisine and customs of Chinese-Americans.

So, in honor of that trip to Chinatown, here's a recipe I made up this week, just feeling my way along. Don't worry: there's no scary offal in it; it's totally vegan (except for the butter in the rice, which you can omit). I serve this stir-fry with jasmine rice because I like it the best of all rices. I know it isn't necessarily authentic, but c'est la vie.

veggie + tofu stir-fry with jasmine rice

1 can straw mushrooms, drained
1 can baby corn, drained and cut into chunks
1 can bean sprouts, drained
1 zucchini, halved lengthwise and then sliced
bunch of green onions, chopped
1 container extra-firm cubed tofu, drained
3 large cloves garlic, minced
1-inch piece of ginger, peeled and minced
1/2 cup dry white wine
1/4 cup tamari, divided
several tbsp. rice wine vinegar
several tbsp. sesame oil, divided
1 to 2 tbsp. olive oil
2 tsp. cornstarch
1 to 2 tbsp. cold water

Heat a large nonstick skillet over medium-high. Add olive oil and sesame oil, tofu, garlic, and ginger. Sauté, stirring occasionally, until browned. Add generous dashes of tamari and rice wine vinegar. Keep sautéing until all the liquid has evaporated and tofu is browned on a couple of sides.

Add zucchini and green onions. Stir and add a bit more oil if needed. Sauté for a couple of minutes.

Gently stir in canned vegetables. Add white wine and additional tamari, sesame, and rice wine vinegar to taste, if desired. Reduce heat and simmer for a couple of minutes, until everything is heated through.

Stir together cornstarch and water. Add to sauce, boil, and let thicken.  If, after a couple of minutes, it's still too thin for you, add a little more cornstarch mixed with water.

Serve ladled over rice.


And here is how to make no-fail, perfect jasmine rice:

Measure one cup of jasmine rice into a sieve. Rinse thoroughly over the sink with cold water until the water no longer runs cloudy.

Add 1½ cups of liquid to a medium saucepan over high heat. (I usually use whatever I have on hand that will equal that total amount. Broth, or a combo of broth and water, is great. So is about 1¼ cups of water plus ¼ cup of dry white wine.)  Add drained rice to the liquid in the pan, as well as a pat of unsalted butter, a healthy pinch of salt, and some pepper. Bring to a good, rolling boil. Immediately, stir it once and then slap a tight lid on it. Lower heat as low as it will go, and leave it completely alone for 15 minutes. Whatever you do, do not raise the lid, not even to peek! Trust me. After 15 minutes, turn off the heat, but keep the lid closed. Let it sit and steam for another 5 minutes. At that point, raise the lid and fluff rice with a fork. It should be perfect. It is also heavenly with some chives and lemon zest stirred in just before serving.


Mark Baker-Wright said...

There's so much here, I can't possibly hope to do justice to it all in my comments, but two reactions:

1. Reading the words of your mother when you were four reminded me of my grandmother. Brilliant woman (a five-time undefeated champion on the game show Split Second), often writing in a stream-of-consciousness, thereby providing intimate insights into who we are....
2. You may remember Kim Trapnell. After she died during Spring Break 1994, I found out pretty much everything I could about aneurysms. I think it's a natural way of coping with grief....

Heather Akers said...

Thank you for your response, Mark. I have enjoyed reading your blog, as well. I loved your post about your grandma and the game shows. I'm glad you have the audio of her experience on Split Second. I have a few recordings of my paternal grandfather talking about his own history, and those stories are so precious, particularly because they come from a time when it wasn't so easy to preserve audio and video.

And yes - I do remember Kim. I remember her death being so profoundly shocking and sad. At the time it happened, Mary Jo and I were freshmen. We had only been required to take one semester of composition, so that spring semester of 1994, we were both taking an upper-level English class with Dr. Gray, and Kim was in our class. It was so surreal and tragic to come back from Spring Break and learn that we would never see her again.

I agree with you: I think it somehow helps us feel we have some measure of control over circumstances, when we try to learn more about the ailment that claimed our loved one's life. It's a way of "mastering" it. So is writing about it, I guess...