Barely promoted

Remember Annajane?

This morning Will Saletan linked to a creepy little story on brain degeneration and sleep apnea:

Writing in this week's issue of Nature Neuroscience, Feldman and colleagues said they deliberately killed brain cells in the pre-Boetzinger complex of the brains of rats -- a region believed to be the "command post" for breathing in mammals.

Then they monitored the rats' breathing.

"We were surprised to see that breathing completely stopped when the rat entered REM (rapid eye movement) sleep, forcing the rat to wake up in order to start breathing again," said Leanne McKay, who worked on the study.

"Over time, the breathing lapses increased in severity, spreading into non-REM sleep and eventually occurring when the rats were awake, as well."

Feldman believes the same thing could be happening in elderly people, especially those with degenerative diseases such as Parkinson's, which are marked by disturbed sleep.

I think I've been picking up some new readers lately, ones who may not remember that my bipolar mother died in her sleep at a mental hospital just before Thanksgiving. (It was the night before I was supposed to start stims for this last IVF cycle, the one that worked.) She was extremely underweight and had recently fractured her collarbone, but otherwise in the same physical condition as she'd been for several years. Her brain had been scanned a few months earlier during a depressive episode so bad, so dementia-like that Creutzfelt-Jacob disease was a concern, and there was some atrophy then. But I don't know what regions, and her doctors disagreed on whether the changes were normal for decades-on bipolar disorder or not.

I've been trying to ask Nanna a little about my mother's pregnancy and my birth, but she doesn't know much, and I don't think she ever did. It sounds like Annajane wasn't really speaking much with her own parents at the time. "She called us up when it was all over, the day after. I would have come down if she'd called earlier! She was awake the whole time, I think. Did it natural, you know." (I'm guessing that even in 1970 there were some options between the full knockout my grandmother had had and nothing at all. But I'll never know what Annajane experienced.)

I would have found it nearly unbearable to talk with Annajane about my pregnancy. She would have related every little thing about it to her own experience in carrying me—of course!—but, whenever or however she tried to draw connections between us, whether she was hypomanic and hostile or depressed and desperate, I pulled away. I didn't want to be connected to her, and extended contemplation of this most fundamental tie would have been very difficult.

I have been telling all my providers that my mother was bipolar, and died recently. If nothing else, I'm at higher risk for postpartum depression, and they should know that. But telling people always brings up the gap between what people hear when I say the word "mother" and the role she actually played in my life. Will the fact of her death hit hard as part of what I'm about to go through? Or will it, shamefully, be easier that she's gone, that her long-term care is no longer hanging over me, that I wil have full control over what I tell my child about her and about my upbringing?

I do feel bad that she never knew that Beaker and I were trying—indeed, that I repeatedly lied when she asked last summer. I think I did about as good a job of lying as I did when she and Nanna harassed me about what I was doing with boyfriends in high school. But she was so much less sharp herself that I don't think she noticed.

The news from Weatherwood

Remember how last summer, I spent like two weeks visiting my family? Seeing my mother at the hospital every day. Forcibly dragging my grandmother to an orthopedist (who said her vertebrae were crushing, one by one, and there really wasn't much we could do) and a cardiologist (who said her palpitations were the result of atrial fibrillation, and put her on some mild drugs). Getting a damn cordless phone for the apartment, over my idiot uncle Ricky's strenuous objections, so that I'd be able to talk with Nana even if she couldn't get out of bed to come to the phone in the kitchen. Reading all of Jane Austen's novels, too many of them for the first time.

Then this summer I spent five indolent days there. No car, burgeoning belly, many aches and pains—lots of excuses to do absolutely nothing. (Well, okay, I started a knitting project, and did test swatches and everything, but I'm sparing you the geekery until I have a camera and can illustrate the discussion.) Didn't even manage especially good conversations with Nana. Instead I got to listen to Marina hint about how difficult she finds my uncle to deal with. Duh, lady, but, um, you're the one who married him, you know?

The only useful thing I did was supply my grandmother with a new set of books: she's decided she wants to read the great Russian novelists, and reread George Eliot, while she still can. I also explained to Ricky how to find novels at Borders, if they're not on the tables in the front of the store (I'm not making this up), so that he can manage more of future resupply himself.

Things have gotten worse there since I left. Nana's back has gone out again. Ricky doesn't have the emotional strength to make her go to the doctor, and Marina knows her position is too fragile to push at all hard. I'm not going to push incredibly hard either, because it's probably another vertebra crushing down and there's almost certainly nothing that can be done. She is making it out of bed and getting dressed, but she's in a lot of pain and being very bitchy about it to both Ricky and Marina.

(Memo to self: calcium, damnit! Weight-bearing exercise, too. It's not just my grandmother: my mother had scoliosis and fractures. And she was only in her 60's. My bones are doomed.)

Plus, the cordless phone has died. Best current guess (Marina's, of course) is that the jacks that were just installed last summer have given out. The last time I called, Nana was in too much pain to get to the wall phone. I can't talk with her directly until it gets fixed, and I don't know if Ricky (with his huge phone neuroses) even wants to get it fixed.

The only good-ish news is that Marina has kept pushing on making the apartment less disgusting. The ancient wall-to-wall carpet, saturated with decades' worth of the output of my mother's undertrained dogs? They've ripped it out. Marina is insisting that my grandmother let the painters (that the landlord will pay for!) come in. And she got my grandmother out to Macy's to choose a new rug, which will be delivered after the painting is done.

Recent conversations

Me: Wait. His vows were about how well she takes care of him, and her vows were about how well she'll take care of him. Is this healthy?

Beaker: No, but at least today's vegan catering is good. Unlike the rehearsal dinner.

----------

Friend A: We've been trying a little elimination ccommunication, too.

Me: Fewer diapers to change?

Friend A: Yes, and we know that he already knows what the potty's for. I'm sure he can tell when he has to go, too. He just doesn't want to tell us about it.

----------

Me: My grandmother is, like, totally uninterested in my pregnancy. I mean, it's necessarily about the body and kind of icky and all that, but still. No discussion of her own pregnancy. Or my mother's, which is what I'm actually curious about. And, what really gets me, is that I have no idea who took care of me when I was an infant. No idea.

Friend B: Why don't you ask?

----------

Me: I've been wondering: who actually took care of me when I was an infant?

Nanna: Well, your mother was in the hospital so many times that year. It was mostly me, really. I think she was always a little jealous about it.

Me: Was she living in the city while she was pregnant?

Nanna: Yes, and she had you down there. But then she went into the hospital right afterwards, and you were so tiny that you went with her. We went down to get you, but of course she was very angry with me^*, and she didn't want us to take you... but we managed to.

Your uncle Ricky was saying just the other day how he thought that year when I was taking care of you was the happiest time of my life. He was about sixteen then^**, so he was aware of the whole business.

----------

Ricky: You know, it's just getting worse. Today I had to go, like, after every other call.

Marina: I keep telling you, the coffee will just go through you! Why do you keep drinking it?

Ricky: Well, it's a real CATCH-22 TYPE SITUTATION, ISN'T IT? Which is worse: do you want me to FALL ASLEEP WHILE I'M DRIVING because I'm so TIRED?

I wonder if I still have any of those pills around, the ones I got for free? They're some sort of di-, dia-, something.

----------

Marina: You shouldn't sit with your legs crossed like that. I had a friend who crossed her legs and her baby ended up with the cord wrapped aroun his neck. She stretched her arms over her head, too.

----------

^*My mother was an angry manic. Most especially angry with her parents.

^**Eighteen, actually, and starting down his own ultimately tragic drug and rock'n'roll path. Barely graduating from high school. Et cetera.

Compared with your parents

An excellent (starter?) question from the survey accompanying the Times's series-opening article on class:

Compared with your parents when they were the age you are now, is your standard of living now much better, somewhat better, somewhat worse, of much worse?

For Beaker: somewhat worse. His Ivy-league-educated lawyer father had just entered private practice. His job, with its ample pay and excellent benefits, allowed his (also Ivy-league-educated) wife to stay home with their three young children; they had just moved into a larger house in a lovely suburb.

Beaker, displaced academic spouse that he is, does pretty well salary-wise, especially since we usually live someplace pretty cheap. But my job provides all the benefits, all the security. We need both of us to be working.

For me: much better. When she was 34, my mother had just started her last period of major instability—well, until the one that lasted to the end. For most of the previous seven years, she and I had been living with her parents (I think she'd been in and out of hospitals during my first year). After her father went bankrupt and her parents had lost their house in the suburbs, she tried to live on her own in a near-tenement apartment in Manhattan (yes, with a clawfoot bathtub plumbed in the living room). She broke down, badly, and was taken away to spend months and months in a mental hospital. I went into foster care.

But: for her parents? When they were in their mid-thirties, my grandfather was a successful technological entrepreneur, my grandmother mothering two children very comfortably just outside a small midwestern city. She was starting to get restless, and they moved to New York just after their third child was born. Although they had less snotty schooling, they were mostly their era's equivalent of Beaker's parents.

It's where they were then, and how they rasied their own children, that makes me leery of claiming any sort of lack of privilege in my own upbringing. And it's how their children turned out, and how uncomfortable the late stages of their lives were (and are), that makes cold shudder down my body whenever I catch myself counting my current blessings. Can we really control anything?

I promise I won't sue

Here's most of a short article in today's Times:

Older patients with dementia who are given antipsychotic medicines are far more likely to die prematurely than those given dummy pills, federal drug regulators said Monday. The warning adds to growing worries about the safety of the widely prescribed drugs.

The Food and Drug Administration said that it would now require manufacturers of the medicines to place black-box warnings - the agency's most severe - on the labels of all the drugs. In 2003, the agency required manufacturers to add a warning about an increased risk of diabetes from antipsychotic medications.

Zyprexa and Symbyax from Eli Lilly, Risperdal from Johnson & Johnson, Seroquel from AstraZeneca, Abilify from Bristol-Myers Squibb, Clozaril from Novartis and Geodon from Pfizer are all affected by the warning.

The drugs belong to a class of medicines developed since 1989 that are supposed to be safer than the older class of medicines for psychosis, like Haldol. In high doses, Haldol and drugs like it can cause a debilitating condition called tardive dyskinesia, a lifelong affliction that can involve uncontrollable trembling, tics and jerky movements.

Doctors have become so comfortable with the safety of the newer medicines that they are now among the biggest selling in the world, with some physicians using them to treat a wide range of conditions, including schizophrenia, depression and dementia in the elderly. Indeed, some psychiatrists prescribe cocktails of antipsychotics to patients with persistent mental problems.

Zyprexa is the biggest drug expense for many state Medicaid programs, the health insurance for the poor.

But the safety of the pills has come under increasing scrutiny. Studies now suggest that the newer drugs are only slightly less likely to cause tardive dyskinesia, and worries about other side effects are mounting.

The Food and Drug Administration said that it had analyzed the results of 17 placebo-controlled trials involving the drugs, which are known as atypical antipsychotics. The agency found that elderly patients with dementia who were given the pills were 1.6 to 1.7 times as likely to die as those given placebos.

The causes of death varied, although most died of heart-related problems like heart failure or infections like pneumonia, the drug agency said.

My mother was on at least four of these during the last 7 years, and at least two of them most of her last year, although the antipsychotics had been stopped and restarted briefly shortly before her death—when they were getting very worried about her weight loss.

Her doctors were aware of the rising concerns about these drugs: her blood sugar was being monitored, for instance. Even on the newer antipsychotics she had odd neurological symptoms (e.g. her mouth "worked" almost all the time), but no one ever pinned down a cause. (I don't know why they didn't think it was tardive dykinesia, but they didn't.) They often gave her old-line drugs like Haldol, too, of course.

No autopsy, no cause of death.

No bus

Twenty-five years ago the New York public transit system went on strike. And I missed school.

Elementary school alternated good years and bad years. Second grade? Bad. New school, unpleasant teacher, incomprehensible math (they taught us to add and subtract in base 3 before base 10), and worsening undiagnosed myopia. Third grade? Fabulous. Fourth? Not so good. Fifth? Wonderful. Having my two best friends in my class, especially. We played freeze tag, highly strategic freeze tag, every day at recess.

I can synchronize family events with my academic progress, although there's no emotional alignment of the memories. My mother's breakdown, the one that got me sent to live with Ray, was in the middle of second grade. Ray moved to a larger apartment early in third. And my grandparents got a court order blocking me from going back to Ray's during Christmas break of fifth grade.

I had to finish out the year. The school only went up through fifth grade and I was doing so well there. So my mother took me down to school every day. We walked to the station, took the train to Grand Central, took a bus downtown. After school, she met me at the door and we reversed the journey. I think it had all been cleared with the principal.

Annajane was thirty-seven, only three years older than I am now. I have no idea what she did between 9:00 and 3:00 for those six months. She was less depressed than she'd been when she first gotten out of the hospital, and she didn't cry most days. But she was very thin and had already lost a couple of front teeth. I could tell she was different from the other mothers. Back then, even in New York City, most fifth-graders weren't met by parents every day; there was little risk of her being revealed to other adults, but I was still embarrassed.

She had a pastel cotton shirt, one wide stripe in each of pink and yellow and blue and green, with white cuffs and collar, that it seems like she must have worn almost every day that spring. I had a shirt with narrow stripes in the same colors and she liked the near match. I found her widde-striped shirt, worn to indecent translucency, every time I had to pack up her things last year; she'd taken it to both adult homes.

After looking at a modern account, I suspect I didn't miss much school, and probably didn't need to miss any. Apparently it was spring break for part of the strike. The long-haul trains kept running, and the two miles from the train terminal to the school would have been quite feasible to walk—I did a comparable distance many, many days in high school, saving the subway fare to supplement my allowance.

But, just like my family would never have considered taking taxis in Manhattan, we never even considered walking. My mother never learned to drive, and my grandfather took the only car to work, anyway. The bus was the right way to go, but there was no bus. So my mother and I stayed home.

"Is that..."

"... a baby in your tummy?" a two-and-a-half year old asked yesterday. "And you have these..." pulling at the front of her shirt with her hands, "... for nursing, too." Yes, I am popping. And my boobs are continuing to grow, close to two band sizes up and three cup sizes out now. I started off short-waisted, flat-chested and fairly thin, and until about a week ago simply passed for a more typical American woman of my age. No more. I expected to show early, and now the silhouette is determinative. Some days there's enough skin and muscle stretching that walking is unpleasant. No stretch marks yet, although I have an irregular oval of blue veins around my (rapidly depleting) navel.

The wavering and wobbling I've felt deep inside, well below the navel, for a couple of weeks now, are getting more consistent. Even though we haven't made it to rat size yet.

The integrated screening results came back: Downs odds of 1/31,000, and everything else fine, too. I'm not sure I believe they could possibly have enough data to back up a number that tiny, but we're skipping the amnio.

Unsurprisingly, Nanna has turned out to care a lot about becoming a great-grandmother. Not enough that she'll call me herself, but it's less acceptable than ever for me to miss the weekly call. She talks sometimes about her own pregnancies, but she's never yet mentioned my mother's—and really, I don't even know whether Annajane was in regular contact with her parents when she was pregnant. I'm pretty sure she wasn't living with them. (Nanna herself has been doing quite a bit better. She's making it out to church every week, and a couple of weeks ago she got my uncle to take her to the local Borders afterwards. That was probably her first trip anywhere besides church or doctor's office since my mother's funeral. Marina has taken a home health care aide job that gets her out of the apartment 10 hours a day. Nanna hasn't said so, but I bet she's exulting in the time alone.)

Leaving the mounds behind

Today the Times makes fun of all the special-interest groups butting their noses into (or sniffing the butt of?) plans to renovate Washington Square Park. Particular scorn is reserved for defenders of

... the mounds, a closed-off manmade formation of three black lumps that rise a few feet from the ground, not far from where chess hustlers beseech passers-by to try their luck at the Game of Kings.

Some people might see the mounds and think: The city really ought to remove these eruptions from the face of the park.

The city plans to do exactly that, and to replace them with a play area for adolescents. But the Mounds People see them as beloved remnants of a playground that was state of the art in its day, the scene of first downhill steps taken by their toddlers. What's more, says Leonie Haimson, a spokeswoman for a group called Save the Mounds, "They're the only hills for miles around in Lower Manhattan."

I loved the mounds! Well, no, actually I loved the splintery redwood jungle gym next to the mounds, with the tire swing and the poles to slide down. Where (Puerto Rican) Manuel and (biracial) Aimee explained the facts of life, using mysterious hand gestures, as we all sat at on the horizontal ladder that held the tire swing eight feet above the ground.

My (government-subsidized, 'cause I was in foster care) afterschool program took us to the playground in the southeast corner of Washington Square every afternoon. Mostly the mounds were too dangerous to go near, because they were so perfect for the little plastic skateboards of the time. Boys three years older than us swooped up and down, yelling about how much better the Yankees were than the Mets.

Why the parenthetical descriptors? Dr. B recently paused to present her "street cred" and to explain why she thinks it's important to tell people that academics grow up in all sorts of ways. I agree. Heck, that juxtaposition is two of the three themes of this blog. (Of course, I do sometimes drop in little factoids just to shock.)

But something strikes me about her entry, something that also struck me in Dalton Conley's memoir, Honky^*. Something I wonder about in my own background, too. I went through foster care, etc. Dr. B. went through inner-city schools. Dalton lived in the projects. But, there's always a but: but her parents were middle-class liberals. His parents were raised middle-class and became artists. My mother was crazy, and so penniless that my college education was entirely free, but her parents were out in the suburbs backing her all the way. They mostly raised me, anyway. My foster father, despite all his problems, despite his lack of a high schoool diploma, did more to encourage me academically than any of my blood relatives. (And he earned his keep at a small academic press, editing other people's dissertations into books.)

Was I deprived? Or was I incredibly lucky? What from how I grew should inform my relationships with students from difficult backgrounds? Or, am I not really like them after all? Very few people at Granolan, or in Granolaton, know anything at all about my childhood. Am I betraying compadres by passing? Or is the surface version, of just another white girl from Weatherwood and all the right schools, closer to the truth?

And is there no way of making it to the top, educationally, of making that strange journey through the class system, without some sort of a "but" being there?

^*I've meant to blog about this book for a long time. See, I went to an extremely similar Greenwich Village (which just wasn't the same kind of neighborhood then as it is now, in part because none of the neighboring areas had gentrified) public elementary school at about the same time. But, while Dalton found his to be a preserve of whiteness and wealth, compared to the neighborghood in which he lived, I found mine to be a universe of economic, racial and intellectual diversity—compared with the suburb I'd come from, and to which I returned for junior high. I wonder if gaps like that—just where is the starting point of your comparison?—are part of why the comments to Dr. B's entry got so warm.

I've never wanted to live in California

I haven't written much about my foster father, Ray. On the one hard, the three or so years I lived with him (mid-second-grade through mid-fifth-grade), and the faith he always had that I wouldn't turn into my mother, were both life-saving. On the other hand, he's an alcoholic pedophile who's turned into a kind of creepy bitter loner as he gets old. We don't talk very often now, and it's mostly about birds when we do.^*

I think my mother more or less stalked Ray for as long as she knew him. He's ten years older than she. They were clearly friends, and probably lovers, before I was born (simple blood typing suffices to prove he's not my biological father; eye color, too, for that matter). When she moved to the city with me, in 1976, after my grandfather went bankrupt, the only apartment she could afford was in an extremely scummy part of Manhattan. Ray let her use his address to get me into one of the good public elementary schools. And when she cracked up hard (walking up and down the middle of 14th St. naked, apparently, while I was locked into the apartment), she signed custody over to him. (Yes, it pissed off her parents but good.)

Ray grew up in San Francisco and Marin County. His father died very young, and his mother remarried. He has three much younger half-siblings who live out here still. In 1978, and again in 1982^**, he flew me out for a summer vacation. Big TWA widebodies, leaving from the Saarinen terminal at JFK: the only way to fly, baby.

We stayed with his mother and stepfather, in a lovely little mobile home park in San Rafael. No, really, it was very nice, carefully landscaped and all double-wides on foundations. I don't know if it was intentionally a retirement community, or whether that was just who-all ended up living there. There were little lakes, and a pool and a hot tub. I walked barefoot in the (ouch!) spiky grass and sunbathed by the pool.

As I lay baking, I tried to figure out which way was east, and I thought about how far three thousand miles really was. And I wondered if Ray was planning for us to just stay in California, like my grandmother kept saying he was^***.

If anyone had asked, I would have applauded such a plan. We were building towards an epic, nasty custody battle, and the side I was living with had me pretty thoroughly brainwashed already. And, let's face it: my mother was crazy, and my grandmother was extremely bitter—over losing her house, losing her daughter to illness, losing her granddaughter to an atheist of evil intent. Weekends with them sucked a whole lot.

But I've been left with a sense of double consciousness when I'm out here, ever since. I could have gone to grad school in California. I remember standing, looking out over the ocean, on a beautiful sunny March day (sun! March!), and realizing that, despite the weather, despite the beauty, despite the fabulous program I'd been admitted to, I didn't want to live someplace so alien. I'm always aware of the distance. There's a little undercurrent of betrayal that feeds my distaste for the brown hills, the dust, the traffic, the derelicts, the uninsulated houses, and the eucalyptus groves.

^*The last time I saw him, we walked around Central Park. We saw a green heron by the Beveldere, and some fancy ducks, and then watched the Pale Male powwow for a while... a chick was being fed. I didn't see him when I was in New York this fall. He didn't come to Annajane's funeral. And I haven't told him I'm pregnant.

^**Yes, the second trip was after the custody battle. I don't know how, or why, my grandparents agreed to it, and the tension was much higher than it was for the first trip. I also lived with Ray the summer after 9th grade—after that, I found academically-based ways to leave home whenever school wasn't in session.

^***Of course, it was ultimately my bloood relatives who kidnapped me, more or less. They got a court order one Christmas that blocked my going back to Ray's.

Detritus

If today weren't Sunday, I'd know already. They're having me tested 12dp3dt, even though the Cornell standard seems to be 11.

Beaker saw some old friends of ours while I was still in New York. He told them where I was, and why. "Have you considered adoption?" the female half asked blithely, and explained that adoption will give her a few extra years before she really needs to worry about the kids thing. I'm so glad I wasn't there.

I went to see Nanna the day before my transfer and told her more about what we were doing—I had to, to explain why I was still in New York. She didn't ask about what the Pope would have thought, and she said she'd pray for us.

I've never done an HPT. Ever. Not even once. I have one in the cupboard now, that came free in a box of OPKs—somehow I missed the big blue "bonus" stickers. I'm not going to use it.

I've spent the day shivering and reading bad novels. Yesterday we went Christmas shopping, mostly for my young nephews. Malls are not good for Beaker's asthma this time of year, and this one somehow had three candle shops and a Bath & Body Works—their stuff chokes even me.

A friend who used her little ovulation detector for a total of 3 cycles on the way to having her two kids pushed hard for me to test myself. "It's always worked for me!"

I've been getting bloodwork done at our tiny local hospital, close enough to walk to and probably about to go bankrupt (hey, at least I don't have to wait in line). Their phlebotomists have left horrible bruises.

Two of my friends are midway through pregnancies that, given their medical circumstances and ages, would have to be described as "miracles." They both have been profoundly kind.

Annajane's birthday was the day after Christmas (Beaker and I always saw his family at Christmas to avoid the associated psychodrama; I was cruel because I wanted to be happy). Nanna has declared that Christmas is cancelled this year. Beaker's family will be celebrating on the 28th, so I may try to get to Weatherwood for the 25th or 26th.

I keep chanting my axioms to myself. It doesn't help. Nor does remembering how dead, how grey, how flat my body and my soul felt after our earlier failures.

It's time to charge the cellphone.