The Becky Blog
Memorial Day weekend is always one of the hardest weekends to be on call at Good Sam. I've gotten up both nights and made the drive down from North Phoenix. It can be pretty fatiguing, but truly, I would not change my priorities. My practice, and my patients, come first at this time in my life.
This is the sort of case that makes me really feel good about what I do.
This gentleman hadn't been feeling well for several days. His back has been hurting off and on. It's a new kind of pain for him, and he wonders if it's work related (he lifts heavy objects). The pain is between his shoulder blades. He doesn't have much of an appetite, and he feels nauseated.
Finally, after work on Friday, he can't stand it any more, and he comes to the Good Sam Emergency Room. He has the very good fortune to encounter one of our excellent emergency physicians, who has been conditioned to think of any pain "from the nose to the knees" as possible cardiovascular pain. She orders an EKG and cardiac enzymes. The electrocardiogram comes back absolutely normal; but the enzymes are just minimally elevated.
Could it be a lab error? Should she repeat the enzymes? Should she send him home with a prescription for a muscle relaxer and tell him to stay off work for a few days?
She decides to contact the cardiologist on call. That would be me.
So I see him about 10:00 Friday night. He is now pain free, but still feels a little nauseated. I look at his medical record: hypertension, with poor medication compliance; slightly high cholesterol. He is 52 years old and has a family history of heart disease. All the pieces of the puzzle are there.
I admit him to the hospital, and first thing Saturday morning we go to the cardiac cath lab. When I insert the catheter and take the first picture, the diagnosis is made. The circumflex coronary artery is almost completely occluded. This artery is located on the posterior side of the heart, and all the EKG leads are positioned on the anterior side. That's why the EKG didn't detect any abnormalities.
My scrub tech and I get to work. I thread a tiny wire down through the blockage into the distal portion of the rather large circumflex artery. Several balloons, two stents, and lots of anti-clot drugs later, he has a wide open artery and is feeling fine. I sent him home today in good condition.
I love what I do. Sometimes I can't believe they actually pay me to do this.
And now, for a complete change of pace:
I can't get the Mississippi Delta out of my blood. Don't even want to try.
So I have found this site, which is simply the greatest Delta web site imaginable:
I am serious! Junior rules. You will find incredible recipes for non-heart-healthy Southern goodies, plus details on the differences between juke joints and honky tonks (you need to know this).
I am reminded of how easy it is for a doctor to think of her patients on only one level, when they are each one so complex and interesting in their own worlds. Among my patients are popular authors, former professional athletes, cowboys and Indians (literally), college professors, and a couple of superb Western artists.
I had treated a gentleman for over a year for recurrent arrhythmias. Finally it was time to hospitalize him for definitive treatment. When I visited him in the hospital room, I met his wife for the first time. She was such a delight to spend time with in conversation, and I learned much more about her husband. He is too modest to talk about his hobby, which is horticulture. In his greenhouse he raised so many gorgeous flowers which are not indigenous to the Arizona desert, and would not have survived outdoors.
She had brought several examples for me: huge yellow dahlias, a fragile calla lily, and a stalk of salmon pink gladiolus. The glads reminded me of a time so long ago, when I was in medical school and living in the medical student apartments. A small stream ran just to the east of the Medical Center, before the new construction drained and covered it, and in the stream were gladioli growing wild. Every spring we were treated to a gorgeous ongoing display of pink, lavender, orange and crimson glads on our walk to and from the apartments.
I was so honored that they would share their hard work with me!
At home we arranged them in a clear vase, and I was struck by the contrast with these living flowers and the glass work of Dale Chihuly's "Ikebana" series, on display at the Phoenix Art Museum.
Gifted men and women can produce great beauty, but the originals, signed by the Artist, are still without parallel.
If someone asks, "Who are you?" what do you say? If I were to describe myself in as few major categories as possible, they would be four in number: physician; parent and friend; transsexual woman; and Christian believer.
That last category has been the most difficult in recent years. I have, since young adulthood, perceived an awareness of a Spirit beyond my own. I do not think this is auto-suggestion. I feel love from this Spirit, and I am empowered to share love. When I allow the Spirit to guide me, I am transformed psychologically into a more loving, more aware person.
As I study the life of Christ, I see this love everywhere. It is pure and complete. In what sense was Jesus Christ the Son of God? I don't have to know the exact answer to that question, as long as I know that I want to be like him in every possible spiritual way. "Giving my life to Christ" in that sense is logical and satisfying. Through Christ I can connect to the Spirit - to God - and receive strength, comfort, and hope.
It sounds simple enough. But to my dismay, the institution we call "Christianity" goes far beyond the simple, child-like faith Jesus proclaimed. Men - and I am not using a generic for "humans" here - men have made God into their image rather than allowing themselves to be made into God's image.
Christianity has become organized into hierarchial institutions, each of which makes its own rules as its leaders see fit. Each claims to know the will of God - not only for its own, but for all humankind. Of course, there are many points of disagreement between these institutions. Someone must be misinterpreting the signals, don't you think?
Many of the groups do have one thing in common, however. They all tend to mistrust and condemn anyone who doesn't adhere to their party line. Especially they find scapegoats in persons who experience unusual life circumstances. How easy it is to find gays, lesbians, and transgenders "sinners" if those are not conditions which you yourself experience!
And so, the dear people of the Southern Baptist Convention have let me know that they will pray for me (translation: pray for me to go back to living as a man), but they would prefer not to see me around. I have no problem complying with this. The extreme conservative tilt of that group over the last twenty years would have driven me away under any circumstances.
The Methodist Church is another story. Many Methodist congregations, including a number here in Phoenix, are "Open and Affirming," meaning that they accept GLBT Christians without judging them. So we might expect more good sense from the Methodist leadership, and it seems from the news that such is the case. The decision of the United Methodist Bishop in the D.C. area to allow a postoperative transsexual minister to pastor a local church is very encouraging. Read about it here, then return to this page.
Of course, not all Methodist men are happy with the Bishop's decision. One Morris Hawkins is quoted as telling the Bishop he made a mistake. "I think it's a sin, a violation of the creation of God," he is reported to have said. I doubt if Mr. Hawkins has ever had a conversation with a transgender person in his life. Surely he would have a bit more compassion and understanding than this. He speaks out of his own ignorance and phobias. But he must be challenged. We cannot be silent and let this sort of thinking prevail. Hawkins can dismiss us, because he does not have to live every day with the transgender issue as we do. We must not allow ourselves to be dismissed.
As my friends and I discussed this matter online, Karen made these very astute comments, with which I completely agree:
You know, I never cease to wonder why a transparently poor argument becomes the standard one. I mean, why does nearly every self-righteous religious fool espouse the same garbage? Reasoning from within the belief system, they always claim God made someone male at birth, therefore it's a violation of God's will for someone to become a woman. Why isn't it obvious even to complete fools how contemptibly stupid and arrogant such an argument inherently must be? Would these same folks argue that someone born with a heart defect ought to be denied surgery to repair it? Isn't that by the same logic thwarting "God's plan"? Obviously, if God didn't intend one die of a heart defect, no one would be born with such a defect? Naturally, good folks don't see it that way. They say that the medical arts are there to correct the problem, so you can't say God didn't intend that we should use them. If you ever accept that a circumstance of birth is not a dictate from God to do nothing, what does status at birth prove about the intentions of God? Of course the argument is more pathetic because it presumes the arguer personally knows God's intention and is the proper arbiter of God's will. How does the complainer know God didn't intend to give the individual a lesson through adversity? How can they know God didn't intentionally give an individual gender dysphoria along with a male body at a time when SRS is available precisely to allow free will to guide that person through an experience of growth and learning through a hardship most never confront?
How can they know that wasn't God's will?
All-in-all, seems to me more than a little arrogant and absurdly self-aggrandizing for someone to claim it his right to speak for his deity, not because God has ever make his intent clear in scripture, but because the arrogant fool assumes he knows best the will of his God and has a duty to voice God's will. A proper Christian ought to reflect on what Jesus would have said about anyone like that. Somehow I've doubt it would be flattering.
I've often referred to such legalistic fundamentalists as "the new Pharisees." I can imagine what Jesus would have said about them. I added to her comments with this:
Actually I see some positive points in this story, including the fact that there's a protagonist named Rebecca Ann(e). You go, sister!
But the fact that Rebecca's appointment has even gotten this far would not have happened a few years ago. I do think Erin Swensen's example has softened some hard hearts and made it easier to accept us in mainstream denominations like Presbyterian and Methodist. Erin chose to live in openness and be a role model - not an easy choice, and not feasible for everyone, but without her and others we will never make progress in society.
I think there is progress in tolerance and acceptance among people of sincere faith, by which I mean faith in a higher power whose focus is love - love for ourselves, for each other, and for all creation. I don't mean a faith of "believe just as I do or burn in hell." Such a belief was never the intention of Jesus. Many branches of Christianity have been hijacked by power hungry, androcentric homophobes who have no clue about the physical nature of gender dysphoria. Their message of intolerance will not survive in the warm light of truth that emanates from lives well lived by persons willing to take their abuse.
Enough for now. Speaking of warm light, it's a beautiful day, and I'm up to Prescott after church for a round of golf!
One of the oldest, and one of the very best, TS support Web sites needs your help.
The TS Road Map site was the place where I first learned about Dr. Ousterhout and his radical facial surgery procedures. I read the author's story and was sufficiently impressed to schedule my own surgery, and I've always been grateful to her. She has moved toward personal anonymity over recent years, but she has continued to maintain her wonderful site and add to it frequently. Pages such as "Customizing your transition timetable," "Self acceptance," and "Internet safety and the option of stealth" are treasures available nowhere else.
Now my friend finds herself caught in the economic downturn, and it's hard to come up with the expenses needed to host her own domain. I can tell you from personal experience that these expenses are substantial. She needs our help to continue to stay up and running. Will you please visit her site and look at the ways you can help? We must not allow the TS Road Map to disappear.
The following editorial by Cynthia Tucker, editorial page editor of the Atlanta Journal-Constitution, appeared on June 23. I reproduce it here for your consideration. Tucker's editorial archive can be viewed here.
There is little good news from the anti-terror front these days.
The whereabouts of Osama bin Laden are still unknown; the entrenched Washington bureaucracy is fighting the new proposal for a Cabinet-level homeland defense department; and al-Qaida has regrouped to foment jihad in Kashmir, the area hotly contested by two new nuclear powers, India and Pakistan.
In other words, world affairs remain depressing.
Still, there was this small notice mixed in with recent news about reorganizing and retooling the FBI: The agency will scale back its efforts in the so-called war on drugs. It comes as a relief -- a bit of good news -- that the FBI has shifted its priorities away from corner crackheads and petty methamphetamine dealers. With terrorists threatening to explode dirty bombs, spread smallpox and put cyanide in the water supply, it seems silly for a major law enforcement agency to expend its precious resources hunting down drug offenders.
The so-called war on drugs, which always amounted to a war on drug users, has long been a form of official terrorism -- an overzealous but unimaginative effort to stop irresponsible Americans from abusing their own bodies. Much like Prohibition, the war on drugs has created more problems than it has solved, incarcerating hundreds of thousands of nonviolent Americans and guaranteeing a black market, which, in turn, has sparked an epidemic of violence.
Had there not been hefty profits in selling banned substances, drug gangs would not have sprung up to sell them and to war with each other as they fought over turf. Similarly, there would be no South American cocaine cartels, which have earned enough profits from narco-trafficking to purchase armies to destabilize their native lands.
This seems as good a time as any for the White House and Congress to quietly end the war on drugs. There is no great enthusiasm for it among average American voters. Why not go ahead and quietly ease back from a 40-year "war" that the nation has no chance of winning?
While it would be politically risky for any formal announcement of retrenchment -- and even riskier to legalize banned substances -- the war on terror provides plenty of cover for scaling back. For one thing, billions more will be needed to safeguard American soil from terrorists. What better place to get it than from the money set aside for punitive anti-drug efforts -- from police raids to prison beds? The entire budget of the Drug Enforcement Administration, which has grown from $65 million in 1972 to $1.8 billion this year, could be shifted to homeland defense.
With the nation's federal law enforcement agencies concentrating on terrorism, the abuse of illegal narcotics could be confronted logically -- as a public health problem. If America made a serious commitment to drug treatment and rehabilitation, rather than incarceration, our streets might actually be safer. The violence of the drug war has largely been an unintended consequence of the law enforcement effort to squelch drug sales. (Again, see Prohibition.)
That's not to say that major drug cartels would disappear if police stopped going after petty drug dealers. As long as there is money to be made from illegal drugs, criminal enterprises will hang around to reap the profits. The biggest and most dangerous of those criminal enterprises should always be in the gun sights of law enforcement officials.
But shifting money from the drug war to the war on terror will also interrupt some of those drug cartels. As the U.S. Customs Service tightens borders to stop Islamist terrorists, inspecting packages, trucks, trains and container ships, it will inevitably stop more shipments of illegal drugs. So why not beef up Customs with money from the DEA?
After more than 40 years of trying to stop Americans from using illegal narcotics -- wasting billions of dollars and countless lives in the process -- U.S. politicians and policy-makers ought to be ready for a new strategy. The war on terror has brought precious few blessings, but the opportunity to back away from the war on drugs is one.