Time, Death, and the Novel

Some books I have to read over and over, once a year or every few years, because they encapsulate a truth or a kind of beauty I can't get enough of, and with each reading I experience that beautiful truth -- or that true beauty -- in a new, more nuanced way. One such book is Annie Dillard's An American Childhood, though it also contains a chapter so painfully poignant to me, for a long time I couldn't bear to re-read it and had to skip over it in my second and third and fourth readings. It's a chapter about the nature of time, and time's passing:

What does it feel like to be alive?

Living, you stand under a waterfall. The hard water pelts your skull, bangs in bits on your shoulders and arms. It is time pounding you, time. Knowing you are alive is watching on every side as your generation's short time is falling away, as fast as rivers drop through the air, and feeling it hit.

Knowing you are alive is feeling the planet buck under you, rear, kick, and try to throw you; you hang onto the ring. Have you noticed yet that you will die? Do you remember, remember, remember? Then you feel your life as a weekend, a weekend you cannot extend, a weekend in the country.*

Ka-wowza, right? As I say, the first time I read it, this passage knocked the breath out of me, and for a long time after, whenever I returned to An American Childhood, I'd carefully avoid that particular chapter. It cut too close to the bone. It reminded me too much of how I had felt in mid September 2007, the week after my mother had been pulled from a car that looked like a sheet of paper crumpled into a ball, and for a few days after we had not known whether or not she would survive. The day of the accident, I flew home from Chicago to North Carolina, and sometime that weekend I left the hospital to walk around my parents' now-empty house, looking at all the framed photos. Here was my mother holding my cousin's new baby (oh, how my mother loves babies!). Here she was on the beach with one of my twin sisters on either side of her. There she was in her black-and-white wedding portrait with Dad; there she was, too, thirty-five years later, in a family photo from my brother's wedding.

Technically, this is not one of the photos of my mom

that are visible in my parents house. But I love it.

Here she is with my dad, circa 1962.

That night, those photos no longer looked like milestones along a path that would go on unfolding endlessly, as long as I wanted it to. The photos looked, suddenly, more like relics.

I remember thinking, Is this it? Is it over already? Is this all the time with my mother that we're every going to get?

Though my mother did live -- though she is, thank God, still holding babies and attending weddings and going to her beloved beach -- that week in 2007 when none of us knew whether she would live was the first time I felt the utter finiteness of human life. Why had I thought that my mother's life -- or anyone's -- would go on forever and ever? Against all the hard evidence the world offers us to the contrary, how had I assumed that our time together was boundless?

Time is precious, as one cliché goes. Time is a commodity, goes another. But often in our western culture, such sayings are used as a reason to rush on the next task or event, to move forward, to get on with things.Westward ho! Climb ev'ry mountain! The greener pastures are yet to come.

The more I think about this mentality, the stranger it seems. If this minute right now while I'm writing this -- if the minute right now while you're reading this -- is unrepeatable, is unique: if in fact there'll never be another minute again quite like this one, and we'll never get this minute back, why wish it away? Why burn through it? Rather than valuing the space I'm in here and now, why focus so often on what happens next?

With one part of my now fifty-year-old brain, I do appreciate all this hard-won knowledge about transience and mortality and the beauty of the present moment. I can stomach such knowledge better now, in the middle of middle age, than I could in my thirties, when I first read An American Childhood and that chapter on time broke my heart.

Even so, I'm as guilty as the next person of romanticizing the future. I participate regularly, often unwittingly, in the greener-pastures-are-over-there mentality that American culture seems to propagate. What can I do or achieve, I often wonder, that will make me feel better in the near future? Should I buy a new dress, a new yoga mat? Get a new job, or move to a brand-new locale?

It seems to be part of my nature to ardently look forward to the next thing, the next phase of life -- to think that everything will somehow be better, around the next bend in the road. I did it in high school, wanting the weekend to come. I've done it often since the 2016 U.S. elections. (When, oh when, will it finally be 2020?)

I'm not saying we don't sometimes actually need to make changes -- need them for important physical or emotional or even spiritual reasons. (The need for a change in U.S. leadership is an obvious example. And my last yoga mat, I'm here to tell you, really was a piece of crap.)**

But earlier this week I came face to face with my own impulse to change things as soon as they get slightly unpleasant or difficult -- to submit to the romance of What else? or what next? And that confrontation has made me want to think more deliberately about time and how I live within time.

Earlier this week, I found myself growing restless -- mentally restless. I kept thinking, Am I doing what I should be with my life? Maybe I should start teaching English again. Should I volunteer as a tour guide at Durham Cathedral? Should I become a yoga instructor?

I even felt restless with Durham and England, for the first time since Dave and I made the move. It's been twenty-two months that we've lived here now, so I wondered: Is this super-delayed culture shock?

Finally, two nights ago, I sat down with Dave and told him how I was feeling. I said, "I don't mean that I necessarily will make any one of these changes. But I'm feeling these sudden, kind of strong urges, and I want to tell you about them."

I told him. He listened. Then he said, "Don't you think this is mainly about your novel?"

As some of you know, I've been writing a novel. I've been working on it pretty hard for the past two years. Most of the time I find this work absorbing, even all-consuming, in a deeply enjoyable way. Most of the time, writing the novel has felt to me as violin playing feels to the character in Alice Munro's wonderful story, "My Mother's Dream": "It is a problem that she has to work out strictly and daringly, and that she has taken on as her responsibility in life." For the past two years, as I've sat down at my writing desk day after day, "the problem is still there in its grandeur," as Munro writes.***

Dave Janzen,

who is so marvelously wise

This summer, however, I am closing in on the end of this work. By July or August, my novel will most likely be out of my hands, on its way out into the world.

But what if it never gets very far? What if this novel is in fact not very good? What if, as with my last yoga mat, I'm just thinking or hoping that it will be awesome, but it's really a piece of crap?

I don't normally think this way. (If I did, I probably could not keep writing.) But seeing the finish line approaching this summer has stirred up these fairly rare anxieties. I can think whatever I want to about my work so long as I keep it close to my chest -- so long as I never declare the novel finished and send it out to an agent. But once I do, there comes the real, public test.

My desire to move or to change something, Dave suggested last night, came from such recent anxieties. "You're in a more uncomfortable space with your work now," he said, "and so your mind has started casting around for basically anything else you can do."

Ka-wowza again, I have to say. Dave was right. I knew it as soon as he said it.

"The real challenge," Dave added, "is to stay in this less-than-comfortable space. Stay with the work, stay in the moment. Don't try to jump out of it."

The challenge, in other words, is to be where I am, to do what needs doing in the given day without being too distracted by what comes before this or after. It reminded me of one of the major precepts of yoga -- or the one, at least, which has been coming through to me more clearly and resonantly lately.

Sometimes when we're holding a difficult posture in class, the yoga teacher will say, "Your body will want to move out of this posture. Your brain will come up with all sorts of tricks to get you to move, to change your position. But see if you can breathe through it. Can you breathe into the moment? Can you achieve stillness in any way?"

My writing desk

Stillness in yogic practice isn't really about lack of physical movement, or it's not mainly about that. It's a mental stillness -- an absolute okay-ness with where you are, even if there are unpleasant elements. This doesn't mean that we shouldn't make a change when our context  has become dangerous or damaging. As my yoga teachers also say, in encouraging us to stick with a hard posture, "If you feel sharp shooting pains, then you should move -- you should get out of the posture."

On the other hand, they usually, gently add, if all you're feeling is just some discomfort, try to stay with it. Keep breathing. See what you can learn from this space, from this moment, from being right here, right now.

I'm gonna stay in this saddle, then, despite some nervousness and a few bruises. To put it another way, I'll keep standing under this waterfall, trying to breathe and to love it.

*     From pages 50 to 51 in the 1987 Harper and Row edition. I have compressed from the original.
**   Check out the  helpful review site, The Best Yoga Mat, to make sure you really like your next mat.
*** From pages 318 to 319 in 1998 Vintage International edition. I have compressed from the original.

Grace Brackbill Hostetter -- In Memory

My grandparents' engagement photo,

1939

My maternal grandfather and grandmother, B. Charles and Grace Brackbill Hostetter, were married on May 3, 1939. She was twenty, he twenty-two. My grandma, a life-long gardener and all-around lover of plants, had wanted to be married outdoors, in her parents' back yard in eastern Pennsylvania, among the lilac bushes that usually bloomed at that time of year. It was an unseasonably cold spring, however, and rain fell on their wedding day. Married indoors--and without lilacs, after all--Charles and Grace nonetheless enjoyed an uncommonly long and happy union.

This month marks the 78th anniversary of their wedding. Charles died in 1997, a few months short of celebrating 58 years of marriage to Grace. Grace, however, lived on in the kind of robust health and bright spirits that inspires me more and more as I get older. My grandmother died this past August, almost 98 years old and utterly herself--strong minded, humorous, sometimes impatient, gracious to everyone she met--down to the end. As my own mother recently reminded me, this Mother's Day (celebrated in the U.S. on the second Sunday of May) is the first our family has known without Grace Brackbill Hostetter. In my grandmother's memory and in loving honor, I've decided to dedicate today's blog post to her.

Grandpa and Grandma Hostetter and me, c. 1989

My grandmother lived in different parts of the U.S. and in different parts of the world, including Jamaica, Trinidad, and Nigeria. At her memorial service last August, I gave a brief reflection on my memories of her life in North Carolina, the place where her life and my life most overlapped.[i] What follows is a version of that reflection, originally given at Harrisonburg Mennonite Church.

* * * * *

My sisters and brother and I grew up next door to Grandpa and Grandma's. It's a house that has been, in various years, reddish-brown and off-white, but which in my mind will always been green--because that was Grandma's favorite color, the color she wanted her house to be.

For us King siblings who were lucky enough to live one driveway down from our grandparents, that house is one image we share--as we also shared meals around Grandma's dining room table, and car trips to Black Rock or Sunset Beach; as we shared Lake Hickory with her on countless summertime swims.

Grandpa and Grandma--with some of Grandma's beloved

plants--outside their house in North Carolina.

When I recently asked my siblings and their children for memories of Grandma in North Carolina, they gave me such beautiful answers that a host of new images emerged. When a grandchild or two got the urge to built teepees in the back yard, Grandma went out and made teepees with them, with long sticks and African cloth that she supplied from her house. She took grandchildren out walking the lane to collect litter (an environmentalist before it was trendy). Babysitting her great-grandchildren, as she did one day a week for many years, she'd take them swimming or on nature walks, or teach them to make chocolate pudding. She came to everyone's birthday party. None of us ever knocked on her door; we just rang the doorbell as a signal that we were coming in, and then we just went in.

She made chicken and waffles, and homemade rolls, and the oatmeal raisin cookies she'd always offer because they were healthy, when you really wanted chocolate chip. She believed in taking care of her health.

Both of my grandparents were serious swimmers. "When we were little," my sister Sandy recalls, "Grandpa and Grandma would come over to our house to ask if we wanted to go swimming at the lake or at [a neighbor's] pool. We always knew that Grandpa wanted the pool, and Grandma wanted the lake. But Grandma loved swimming so much, she'd always go with you to either place, to the pool or the lake."

Grandma in the last week of her life (August 2016)--

still interested in talking to everyone around her.

Grandma listened to us. She made us feel loved. But it wasn't just us family members who received her love. Grace Hostetter never met a stranger. She was interested in everyone's story.
"We were so lucky," my siblings concluded, one way or another, when I asked them for these memories. "I'm so grateful to have had her--this force of Nature!--in our lives for so long."

As I worked on these reflections of my Grandma's life in North Carolina, it dawned on me that she was the first truly cosmopolitan person I knew. My grandmother showed me the world is made up of so many different countries and cultures--so many different kinds of people, each with their own way of thinking and talking and eating and dressing and praying--and that this diversity is fascinating, is one of God's gifts.

My parents took my sister Linda and me to visit Grandpa and

Grandma, and our uncles Phil and Rick, in Nigeria in 1972.

When you're a kid, you receive this information not through lectures or lessons, but through small daily signs, like the embroidered turban and robe Grandma brought back from Nigeria and wore to give talks in churches about her experience there--or like the sleeveless purple tie-dyed mini-dress that she made from Nigerian cloth, and wore so stylishly in her 60s and 70s. (A dress, I might add, that several of us granddaughters borrowed from her in our 20s, and occasionally continue to wear.)

Or there was her African ground-nut stew, an elaborate meal which as a child I merely tolerated--and which made me feel like a grown-up, when I finally acquired the taste. Grandma was the person you went to in Hickory when you needed a slightly more exotic ingredient. She'd reliably have fresh ginger, and garlic bulbs, and coriander.

She also collaborated with me in some of my early experiments in fashion. I had the ideas, but she had the seamstress's skills, and the interest to boot. My favorite clothing collaboration with Grandma was a pair of newsboy-style gray woolen knickers, circa 1982.

Newsboy knickers!

From Grandma, I also learned to make your daily practices, your everyday lived-in spaces, beautiful: to serve your desserts in small crystal dishes with stems, each one set on a small china plate, or to make centerpieces for your table by arranging candles inside a small houseplant.

Grandma had aesthetic vision. She cared about how things looked. She cared about how people looked, too, including herself--not exactly a quintessential Mennonite trait, but one I secretly loved her for, because it was one way in which she was gloriously human, involved in this concrete world.

Grandma with all 8 of her children, Christmas 2015

At the same time, I always knew that Grandma loved God and believed in serving God through serving other people. It's a legacy alive and well in her children--in my mother, I my uncles and aunt, in the people all of them married--and these people, the extended Hostetter family, were my first role models, my first teacher of how to be a compassionate, God-loving, other-loving citizen of this world.

This is the family--this is the legacy--that my grandma, Grace Brackbill Hostetter, helped to create.

---

[i] These are memories mainly from my adolescence, the last time I lived in North Carolina. I may try to write more, in a few weeks, about my later impressions of Grandma, as I left my 20s and she entered her 70s.

Adventures in UK Healthcare, Part 2: Or, My Immersion in England's North East

“Would you like vodka or gin in this cocktail?” the anesthesiologist asked as he put me under, just prior to my surgery at University Hospital of North Durham in March.

It’s the last thing remember, before I woke up 5 hours later. At least I had gone to sleep smiling.

That anesthesiologist looked more like Gene Parmesan than any other person I’ve ever met, and he and I already had quite the repartee going. I’d met him an hour beforehand, in a consultation room where we ran through some basic pre-surgery questions.

Gene Parmesan

But when I first walked into that consultation room and greeted him, he’d startled me by exclaiming, “Well, there’s an accent that feels like home!”

I couldn’t tell if he was joking. He did not sound American to me. “Really?” I said. “Where are you from?”

When he said, “Glasgow,” I was even more confused.

“You think I’m Scottish?” I said. It’s possible that my American accent has been altered somewhat by 20 months of living in England, but I’d never dreamed a Scottish person would take me for one of their own.

But I understand now what happened. When I first spoke to him, his ear caught out a sound that was, at least, different – an accent that didn’t belong to the North East of England.

In my room at the Durham hospital,

March 2017

In the Durham hospital, it seemed, everybody was local: almost all of the staff, and every other patient but me. I was immersed in North Eastern culture as never before. Of all the patients and nurses and nurses’ aides who spent their days on Ward 9 with me, I was the only non-English person. Everyone was white as the snow except for the doctors who dashed in and out on occasion, many of whom were of African or South Asian descent. The only accents I detected that were not North Eastern belonged to those fleetingly-heard doctors, too.

That Scottish anesthesiologist, I think, felt some instinctive affinity for me – or my voice – simply because I didn’t sound like almost everyone else in our milieu. Though he and I ultimately agreed our accents are not the same, in the Durham hospital we did have in common a sense of standing out in a crowd.

I was in that hospital for 5 solid days, and I kept my ears open. The North Eastern accent became a kind of background music that played all day long and all night. I was so immersed in this particular sound, I heard it even as I fell asleep.

The North Eastern accent is very distinctive: to my ear, it is high-pitched and lilting, with extra emphasis on the long vowels. It was also, to my ear, exotic. It was strange to me; it was new.

It’s not what I’m used to in Durham, which may be surprising, since Durham is a town set smack dab in the middle of England’s North East. But Durham is an anomaly in this region. It simultaneously partakes and does not partake of the local North Eastern culture.

While I’d never claim to be an expert on North Eastern culture, I think I can say that the popular musical and film Billy Elliot tried to capture certain aspects of it. If you’ve seen the movie, you’ll know that Billy Elliot – filmed in County Durham – portrays this part of England as far from the centers of political power and wealth.[i] The North East of England was once defined by blue-collar jobs such as shipbuilding and mining. Now, as those jobs have disappeared, the region is on the whole economically depressed. These circumstances, combined with the North East’s geographical isolation from England’s capital and larger cities, cause some to view it as a sort of English backwater.

On the other hand, it is a part of the country where communities are close-knit and people are generally very friendly, and the pace of life is gentle, laidback.[ii] People seem proud to belong here – to identify as being Geordie.[iii] There’s even a vocabulary particular to the region – a vocabulary I find entrancing. Here’s a sampling of it, based on notes I took from my Durham hospital bed:  

Eeeee =           Oh my; oh my God

            Bairn =            Child; kid

            Champion =    Awesome (e.g. “Eeeee, that’s champion!”)

            Aye =              Yes; sure

            Ta =                Thanks

            Us =                Me (e.g. “Go on & give it to us!” – as the speaker extends a hand)

            Me =               My (e.g. “She was me mentor in school.”)

Meself =         Myself

            Dead =            Very; extremely (e.g. “My garden was dead sunny yesterday.”)

            Canny =          Quite a (e.g. “He’s a canny lad;” "I've a canny few syringes here.”)

            Pinch =           To borrow (e.g. “Can I just pinch that folder off you?”)

There's the North East of England!

If I’ve gotten any of the above vocabulary wrong (or attributed a North Easternism to an expression that is actually more widely used), I hope my UK friends will forgive. The point is, all this North Eastern-ness felt new to me. In the local hospital, I was surrounded by it for the first time. It is possible, I learned through this hospital stay, to live in Durham for a while, as I have, and never interact much with North Eastern culture.

Within the context of the North East, the town of Durham often feels like a world set apart. As the home of a World Heritage Site cathedral and castle, as well as a world-class university, Durham has a very different flavor than most of the surrounding small towns, many of which were mining towns in the last century. Walking around Durham most days, you’re more likely to hear Southern accents (the university students and profs) – or languages other than English (tourists and expatriates) – than you are to hear the local accent.

Durham, in my experience, is a surprisingly cosmopolitan town. Even today, in my yoga group, 6 of us were standing around afterward, and someone said, “I think each one of us is from a different country!” It was true. We went around the circle and each said our home country: Germany, Iran, Poland, Sri Lanka, England, and the US.

Durham Cathedral

Adding to this international atmosphere is the fact that various blockbuster films have been shot in Durham over the years, including Elizabeth and some of the Harry Potters. Even as I write this, the latest installment in The Avengers is being filmed in Durham Cathedral. (Dave called from his office to tell me. He’s been watching the film crew set up there all morning.) Does this mean that Robert Downey, Jr. is now prowling the streets of Durham? I can only hope this is true.

It makes sense, given my own predilections and life experiences, that I’d be drawn to this more global aspect of Durham, and that my friends here are – almost exclusively – fellow expatriates, or English people from different regions. In the classic “town and gown” divide, I’ve lived almost entirely on the “gown” side.

The Durham hospital, for me, was where local and global cultures finally met.

Some of the gowns in the town!

By the morning of the day after my surgery, I felt more or less like myself, at least mentally speaking.[iv] I began to converse with anybody who walked into my hospital room. The younger nurses’ aides, especially, found my Americanness to be a great novelty. “I’m so glad you are here,” they’d say kindly, as a way to make me feel welcome. Sometimes they asked, “How do you stand being so far from home?”

Or they’d joke with me about how I’d have to write to my family to say how well I’d been treated in Durham. “Tell them you’ve got a penthouse suite with a view of the sea!” one nurse quipped. Really it was a room about 10 feet square, with no TV or WiFi, nor yet with a toilet or shower. (Those were a ways down the hall.) My room over looked the emergency room entrance, one floor below – my window open, I heard ambulance crews unloading there every night – with the sea about 10 miles away.

One nurse’s aide stopped alongside my bed to list all the places she’d lived. She counted them off on her fingers. Consett, Chester-le-Street, Bishop Auckland. To someone (moi) used to the wide spaces of the US, those towns are all suburbs of Durham – a 20 minutes’ drive at the most. “But I got homesick there,” the aide said of her residence in those other towns. “I had to come back to Durham.”  

Lake Louise, in the Canadian Rockies

Summer 1992

It would be easy – too easy – to paint the staff of Ward 9 as provincial. But that wouldn’t be a fair representation. They were as lively and interesting a mix as you might found in any town Durham’s size, if you look hard enough. One nursing staff member had spent a week in Toronto, on a birthday trip with her father; from there they’d flown to Calgary, rented a car, and driven across the Canadian Rockies to Lake Louise and Vancouver. She listed the places of interest they’d driven through, and one by one I remembered those places, too – from the same drive I’d taken, with my friend Jennifer Lindberg, when we were in our mid 20s.

There was also the male nurse, obviously gay, whom I’ll call Andy. With his Geordie haircut and a fully, beautifully made-up face every morning, he sang 80s pop songs as he made his rounds – and was obviously a favorite among the staff. Andy was the one who determined, my second day on the ward, that my bed was too short for me. He went to the trouble to find an extra block of foam and to wedge it at the bottom of my hospital bed, to give my mattress more length. 

Cup of tea, with NHS logo, and

my compression-stockinged feet

Meals on Ward 9 were a big part of the day. At least, they provided regular markers of the day passing. Breakfast at 8:00; a hot drink and biscuits (i.e. cookies) at 10:00, then lunch at noon. (I was often delighted to have, as a cross-cultural experience, the choice between fish and chips or pork pie.) Around 5:00 we had tea – in other words, supper – and then a hot drink again. My last several days on the ward, I often missed the hot drinks cart as it came around because I was in the halls, walking. By then, however, the nursing staff knew all about me. They’d leave a cup of tea by my bed – black, with one packet of sugar, the way I like it – without having to ask anymore. Once when I came back to my room and found my tea waiting, Andy winked and said, “We’ll be charging you board next!”

While 5 days seemed a very long time to stay in the hospital, the memories I took away are of people’s almost unmitigated good humor and kindness. The staff consulted me about when I wanted my morphine drip stopped, and when I was ready to have the Novocaine-administering ports in my abdomen removed as well – and finally, when I wanted to go off Codeine. (In this way, by the time they released me, I was no longer taking anything but Paracetamol, i.e Tylenol.)

Walking the halls of Ward 9

I also remember the nurse who brought me a fan in the night when my temperature rose, and then directed the breeze deliciously onto my face. Another nurse, seeing me pace the short hall of Ward 9 for an hour – I was restless! and I wanted the exercise! – encouraged me to get dressed and wander the hospital freely.  

Of course, there were aspects of my hospital stay that felt strange, even alien. There was the aforementioned room, Spartan by most US standards, with the bathroom away down the hall. (I was grateful, though, not to be a room with 5 or 10 beds, as I’d been warned could easily happen. As I walked around Ward 9 myself, I spotted several rooms with multiple beds—all of them occupied. It seems, on this count, I simply lucked out.)

But as strange as some features of a UK hospital stay seemed to me, I know I was strange to the people who took care of me, too. They handled me with good grace. Sunday lunch, for example, is a huge deal in England. It’s usually a “Sunday roast” – a meal comprised of roast meat, roast potatoes, Yorkshire pudding, and some sort of nominal veg. Apparently it is as an important and cherished a Sunday tradition as going to church used to be.

But when Andy came around, Sunday lunchtime, to offer the beloved Sunday roast, I asked, “Could I just have a sandwich instead?”

Sunday roast

He did not, or could not, hide his horror from me. “A SAND-wich?!” he said, with one hand at his throat. I might as well have said I felt like eating a baby puppy.

But to his credit, once he got over his shock, Andy found a cheese sandwich for me.

---

[i] And if you haven’t seen Billy Elliott, I recommend it; the film is funny and tender and genrally brilliant.

[ii] To paint in broad strokes, I might say that the North East of England – politically, economically, and culturally – is to the rest of England as the South of the U.S. is to the rest of that country.

[iii] The term “Geordie” used to refer to anyone from England’s North East. If I understand correctly, it’s often used more narrowly now, for inhabitants of Newcastle and its suburbs.

[iv] This essay, apparently, will not dwell much on medical matters. But I did come through surgery well; I did recover from it very quickly. My surgeon wanted me to stay in the hospital for what seemed a long time, however, because I lost a fair bit of blood during the operation; he wanted to get my hemoglobin levels back up before he let me out onto the streets.

Adventures in UK Healthcare, Part I

One of Durham's many hills -- with a

good-looking man halfway up it!

This winter, as I looked ahead to a major surgery in March, my primary fears weren’t so much about my health. No: when I woke at night, in the weeks leading up to my abdominal hysterectomy on March 22, it wasn’t to worry over that surgery’s outcome. For one thing, I felt very healthy and strong. I was walking a minimum of 3 miles a day (up and down Durham’s hills!) and taking fairly rigorous yoga classes 5 times a week. For another, my doctor had said that he thought the recent developments in my uterus—a thickened uterine lining, and a fibroid that had grown exponentially over the previous 6 months—were a direct result of taking Tamoxifen daily, as I have done and will continue to do in this decade following my incidence of breast cancer in 2014. My doctor had made me feel pretty secure that these new developments, while ultimately not good for my body (otherwise, why have this surgery at all?) did not signify cancer again. And that was the main thing for me.

August 2014 -- day after my double mastectomy,

in Chicago.

Nor was I very anxious about the surgery itself—though it would involve a 6-inch vertical incision from my navel to my pubic bone and would probably last 4 to 5 hours. This sounds kind of major, I know, but so does a double mastectomy, right? And I’d already had that adventure in 2014, in Chicago, the last year that Dave and I lived there. Based on my recent history, I felt confident that I’d come through my new surgery without complications and would bounce back to normal quite quickly. (Which, by the way and praise Jesus, has turned out to be true.)

This winter and spring, my fears turned instead on how my days in the hospital, after my operation, would be. I had reason to believe that my experience of major surgery in the UK would be quite different from the one I’d had 2.5 years ago in the US.

To begin with, my doctor here seemed to think I’d need to stay in the hospital for 5 or 6 days. I could not imagine what for. In the US, after my double mastectomy, I’d been released within 24 hours. I’d been proud of, and pleased by, this fact. Going home as soon as I could seemed the natural and preferable option – and after all, it’s common practice in the US, because of the extremely high insurance costs for a hospital stay. In the UK, however, doctors feel far less pressure to get patients back out on the street. So this time around, I was looking at close to a week in the hospital recovery ward.

University Hospital of North Durham: my

local hospital here in the UK

Not only that, but it sounded like I would not have much privacy, either, during this insanely long stay. My English friends warned me about it. No one in an NHS hospital, they claimed, ever got a private room, unless they were highly contagious. I should expect to spend my recovery days in large open ward, with 5 or 10 or maybe 20 beds all in one room. To make matters worse, I wouldn’t have much of Dave’s company; he wouldn’t be allowed on the ward except for two separate visiting hours. Here in the Durham hospital, Dave could visit from 2:00 to 3:00 PM and from 6:00 to 7:00 PM. Otherwise, I would be on my own – or as much on my own as a person can be on her own, when sharing a room with 9 or 10 others.

“That’s just how it is here,” one of my English friends said. “As the patient, you’ll be looked after well, but friends and family don’t get much attention. It's just an attitude handed down from the 1950s, when the doctors and nurses knew best and the family had busy lives to be getting on with (down t'pit or similar)[i], and this attitude hasn't really left us.”

Coal miners of County Durham, 1940s

None of these prospects – the long hospital stay, the ward full of beds, the short visiting hours – filled me with joy. In fact, they filled me with dread. (Hence the waking up in the wee hours, those first weeks of March.) Could my English friends have been exaggerating? It was a tempting thought. Based on my previous visits to the Durham hospital, though, I had reason to believe my English friends weren’t shitting me. In many ways, the UK healthcare system is much more hardcore than what I knew in the US. And since they are the people who’ve interacted with this system all of their lives, the citizens of England—I’ve now come to think—are somewhat more hardcore, too.

During some medical errands preparatory to my surgery, I got my first glimpse of these rather more hardcore ways. The MRI that I had here in England was done in the back of a truck. Yes, a truck. A truck which is driven around the North East, from one medical center to another. At about the same time I also had a D & C, a procedure which I’d had once before in the US and for which I had to be admitted to the hospital, given twilight anesthesia, and taken into the operating room. Here in the UK, a doctor performed the D & C on me right there in her exam room, with no anesthesia at all – on an examining table that didn’t even have stirrups. It hurt like a mother, and lent a whole new level to my understanding of the British stiff upper lip. On the other hand, the whole thing was over in maybe 10 minutes -- and gave me a real opportunity to practice my yogic breathing.

Based on these two examples alone, I’d say that the UK healthcare system is absolutely about doing what needs to be done for the patient, but doing it efficiently. With a degree or two less physical comfort – or luxury? – than what we’re accustomed to in the US. The most obvious reason for this, I think, is that US hospitals know the patient is shelling out major bucks for her healthcare -- or her insurance company is. In US medical centers, then, there's an element of wanting the patient to feel more like a customer: like she's getting her money's worth, so to speak. Getting the full-service treatment.

In the UK, meanwhile, that just isn't much of a concern. If you're a tax-paying resident of this nation, you'll get your healthcare: you know this. (And you will get it for free.) But no one on the medical staff is necessarily out to impress you. As far as I can tell, and rightly so under these circumstances, they don't see that as part of their job.

Speaking of which, let’s just think for a minute about hospital décor. It may sound like a trivial aspect, but the variance between the amount of money spent on hospital facilities in the US and in the UK is so striking – so vast – it seems a reflection of somewhat different priorities, too.

One tiny corner of the hospital lobby

in Chicago.

My hospital in the US, in Chicago, was a thing of undeniable beauty. You entered a marble-floored lobby with a 3-story-tall ceiling and a waterfall – a real waterfall – crashing down all 3 stories into a marble-lined pool. Ornate arrangements of fresh-cut flowers rose up from every reception desk corner, and as you walked beneath gleaming skylights toward the twin escalators, you passed A) an ebony player grand piano, and B) a huge free-standing fireplace with leather armchairs drawn up around it.

In the US hospital where I was treated, the waiting room for a patient’s loved ones was similarly well equipped : more leather arm chairs, more fresh flowers. Plenty of electric outlets for people’s laptops, and a free Wifi connection. Large video monitors, placed in the waiting room walls, allowed people there to keep track of their loved one’s progress; during my mastectomy, Dave could see when I was in pre op; in surgery; in post op. When my operation was over, the surgeon came to that waiting room to tell Dave about how it went. And then – oh glory of glories – Dave could walk up the hall and be with me, just as soon as I’d woken up.  

My hospital here in the UK is significantly less glamorous. Inside its walls, there’s not a flower in sight. No high ceilings, no marble floors. To say nothing of waterfalls or grand pianos. In the exam rooms, the sinks are often just that – little sinks, stuck onto walls, with the plumbing beneath fully exposed. Throughout the building, the hospital windows can be opened wide – and usually are, no matter the season[ii]. The color scheme is all mauves and pale turquoises that remind me of the 1980s, and chairs are in short supply. What chairs you do find are hard plastic, and the waiting rooms themselves are miniscule, Spartan – because no one there really wants the patient’s family and friends to spend their time waiting around.

In February, when we went up to the hospital for my pre-surgery consultation, Dave asked a staff member about this. Where would he wait while I was being operated on?

The nurse practitioner running our consultation seemed a little nonplussed. “We don’t really have a room for that,” she said. “If you want to be near the hospital, though, there’s a coffee shop down the street.”

Dave has stuck right by my side

through all the health adventures

of the past several years.

(Here we are in summer 2014.)

So then it was our turn to look taken aback. “But how will I know when Patricia’s out of surgery?” Dave asked.

“Well, there’s a phone number you can call, after a certain number of hours.”

“A phone number,” Dave repeated. “Okay.” When the nurse practitioner just barely nodded, he said, “How do I get this phone number?”

The woman sighed. Maybe she’d had a long day. Maybe she had cause to think that Dave and I were ridiculously spoiled. “Listen,” she said, “we don’t cater to you like you may have been used to, in the States.”

Having come out on the other side of this experience, I can say that this woman – I see her now, in her tidy blue dress, her little cap of brilliant red hair – was by far the least pleasant person with whom I interacted during my whole hospital stay. I can also say that, in her claim about the UK health system not “catering” to us, she was both right and not right.

Part of my new scar!

April 2017.

In a similar manner, my time of recovery in a UK hospital was both like and not like what I’d feared.  I had a memorable 5 days. Uncomfortable, yes, in some ways. But almost delightful, in others. In my next blog post, 2 weeks from now, I’ll write about those 5 days.  

For now, though, what can I say except that I had a major surgery, 3 weeks ago, and am now almost fully recovered? The surgeons at the Durham hospital removed my cervix, and my ovaries and fallopian tubes; they removed my uterus and the 1.5-pound (yes, holy lord) fibroid. After that, they did some “washings” of my abdominal area to test for abnormal cells. All the pathology came back normal, thank God, and that six-inch long vertical cut in my belly is starting to heal up quite nicely.

I am grateful for the good care I received. I am awed that, like every tax-paying resident of the UK, I received all this healthcare for free.[iii]

A little post-yoga-class

excitement! Today.

And I’m amazed by the body’s recuperative powers. Today I did my first one-hour yoga class since my surgery! It made me so happy, I was almost in tears by the end. It’s so good to know that, even after the trauma it’s recently been through, my body is still here for me.

---

[i] Meaning “down into the coal pit.” County Durham was a major coal-mining area of the UK in the previous century.

[ii] Hospitals in the US, like most US hotels, have windows that are sealed tightly shut.

[iii] For more on this topic, see my previous blog post, “A Tale of Two Healthcare Systems.”