One child has been killed each hour in Gaza over the past two days
Kyung-Wha Kang, Assistant Secretary-General for Humanitarian Affairs and UN Deputy Emergency Relief Coordinator told those gathered at an emergency meeting of the United Nations Human Rights Council six days ago. Far away, I begin the mental mathematics. Adding it up, I know for sure only this about Gaza – children are dying.
The news comes fast and furious, twenty-four hours a day. Mainstream media. Social media. Mixed-up media. From their early morning studios, Starbucks in hand, the “experts” weigh in, all the while equivocating their way out of circumstances they cannot comprehend. How could they? How can we? We, with our children who fall asleep at night under the non-threatening whir of a ceiling fan or to the sounds of laughter down the hall with Jimmy Fallon and a TV audience in New York city.
The other day, I heard one member of the mainstream media criticize another for not providing enough context in its coverage of Gaza. I wonder how much context would suffice. Some of the children in Gaza – the dead children – knew only the context of innocent lives under siege, the sounds of bombs dropped from F16 fighter jets, the stench of smoke from piles of rubble that smolder still where their houses used to stand. What do babies know of context?
Context: from the Latin ‘Contextus” – interwoven, connected, or united.
I remember reading a book about Northern Ireland and realizing I am probably a Child of The Troubles, even though I was always, by nothing other than luck, in the right place at the right time – at a safe distance. Still, I know the dull thunder-clap of a bomb, the tremble of our kitchen windows in its wake. I know the stench of smoke from rubble that once was a hotel, a supermarket, a restaurant. I know that based on images flickering from black and white screens on living rooms in faraway places, strangers tried to understand the context of Northern Ireland, reducing it to tidy phrases about Catholics and Protestants, about calls for cease-fires, about heartbreaking hard-fought compromises that led, after three decades to a residual uneasy state we dare call “peace.” I know about bombings and rubber bullets and booby-traps like the kind that killed three Israel soldiers at the end of July 2014. I know about the disregard for the lives of innocent people, like those killed in Omagh, a small market town in Northern Ireland, the weekend before a new school term began in 1998. Or yesterday, in Gaza, when Israeli shelling killed 15 children who had taken shelter in a United Nations-run school.
How do we put this in context? How do we keep on working, loving, worshipping as we were taught, and wishing for better days?
In May the Lord in HIs Mercy be Kind to Belfast, based on his interviews with the people who lived there, with Protestants and Catholics, Tony Parker makes an unsettling but astute observation that those born and brought up in Northern Ireland’s complex context, have a mutual need to know, from the start, about a person’s background, so they can go ahead in the dialogue, in what may even become a lasting relationship, without saying the wrong thing, “the wrong word.” The schools we attended, our last names, the way we pronounce an “H” all became clues to help establish “who we are.” “Derry” or “Londonderry?” “The Troubles,” “the struggle, or “The Irish Question?” “Ulster” or “The Six Counties?”
On the words we use in the context of Gaza – a lexicon familiar to those from deeply troubled places – Soweto, Belfast, Sarajevo – there is no easy answer. I first heard poet, Damian Gorman, as his voice on a PBS channel filled my Phoenix living room some twenty years ago. He was reciting Devices of Detachment.
It was poetry. Spare and searing, the words suggested that the bombs and bullets, the “suspect incendiary devices” all too familiar in the 1980s Northern Ireland were far less deadly than the “devices of detachment, as dangerous as bombs” its people used to distance themselves from the violence, to cope. Aware of it, yet so removed. We were, all of us, very good at “detachment.”
We know how to cope, how to turn a phrase, a word, a hint, around and around until we have successfully distanced ourselves from the subject.
We have coped too well, the heart is numb,
~ Damian Gorman
Through social media, I have come to know Damian Gorman, and when I need words, he somehow finds the right ones at the right time. It was on his Facebook page in this harrowing, heartbreaking week on the Gaza strip, that Damian posted this:
For too many Palestinian and Israeli Parents (and for sharing)
July 23, 2014
Today I bury my child,
stop
And it was you who killed my child,
stop
I know that he wasn’t the target,
stop
But that doesn’t make him any less killed.
I know that “these things have contexts,”
stop
I have walked all around the contexts,
stop
I have tried unfamiliar angles,
stop
But they don’t make him any less killed.
You ask, “what should we do – tell me?”
stop
And I say, “don’t murder my child”
stop
“Walk as far away from that as you can'”
stop
“Move forward, away from that thing.”
stop
And you say you are “just like” me,
stop
That we feel and we do the same things.
stop
I know what you mean, but we’re not
stop
For today you don’t bury your child
stop.
Breast cancer forever changed the connotations of certain words for me – “staging” I no longer immediately associate with the theater; “fog” I am more apt to attach to a state of cognitive loss instead of the stuff of Van Morrison’s misty mornings or the cloud that can obscure parts of Pacific Coast Highway as we head north in the summertime; “cure” no longer the idiomatic “hair of the dog that bit you” but a confounding and elusive thing all wrapped up in a pink ribbon; “Mets” no longer the other New York baseball team, but a tragic abbreviation for metastatic breast cancer from which no one survives yet of all the millions of dollars raised for breast cancer research in this country, only 2% of it is directed to metastatic breast cancer.” Until cancer came to call, “infusion” was something done to transform olive oil into a gourmet gift, and I freely associated with “sentinel,” the cormorant.
What would I know of the sentinel node, the first lymph node to which cancer cells are most likely to spread from a primary tumor?
Watchful and still, a cormorant was sometimes the only point of distinction on a foggy morning in Morro Bay, perched on its post in the shallow water where the eucalyptus grove touches the South Bay. And I would think of poet, Dermot Healy. As long as the cormorant was there, surveying the bay, all was right in the world – a bit like Healy himself, on the edge of the ocean. Ever-watchful.
Cormorants
They fly over like flagships of the devil
with messages between the dead.
Fighting to keep a straight line
they bring news to Ulysses,
then back again to Lethe
with his letters for the boatman.
Only the cormorant is allowed into hell.
That’s why he stands with his wings out
on an unsheltered rock
imploring the heavens
to forgive him for all
that he’s seen and heard.
by Dermot Healy, writer and poet, (9 November 1947 – 29 June 2014)
I found out that Dermot Healy died, not from a newspaper headline or a phone call from Ireland, but from the beautiful tribute to him and to his craft, from County Down poet, Damian Gorman. Ironically, I first heard Damian talking about how my people had grown complacent – immune, even – to the violence in Northern Ireland on a TV in my American living room in the early 1990s. He was reading his Devices of Detachment “as dangerous as bombs,” and he stopped me in my tracks. He knew me and from whence I came. He knows all of us.
Since then I have come to believe that Damian always finds the right words at the right time:
Because writing is such a construct it is always (properly) open to particular scrutiny around its tone and truthfulness. “Does this piece ring true?”we ask, and “has it anything to do with me?”
In relation to Dermot Healy’s work there was never any question; never any question about authenticity. This was, undeniably, the real thing.
I think there is a way of writing in which you make a shape inside yourself so that the writing emerges but rarely touches the sides of you on the way out. This was not Dermot Healy’s way. His was the opposite. In truthfulness, giftedness and craft he has few equals. And,though we have the work, this is a very big loss.
it is the first Sunday in June, a day set aside to celebrate cancer survivorship. Did you know this “treasured worldwide celebration of life” has been on the calendar for twenty-six years? I wonder would I have been any the wiser had I not been diagnosed myself. So who is a survivor, and who do I think I am? At best, I am ambivalent.
According to the National Cancer Survivors Day website:
… a ‘survivor’ as anyone living with a history of cancer – from the moment of diagnosis through the remainder of life. National Cancer Survivors Day affords your community an opportunity to demonstrate that it has an active, productive cancer survivor population.
Was I surviving before I discovered the lump myself? Is that how we would describe my living – my life – before it was officially declared “surviving?” Is that the label we would ascribe to it, after pronouncing as cancer, the disease that flourished, undetected for as long as a decade, defying three mammograms, hiding in tissue no one had bothered to advise me was dense? Or is there another word for my pre-diagnosis living? A better word? Had I been a more active and productive member of the population before diagnosis and after surgery or during treatment? Is there something about the Arimidex I take every night at nine o’clock that makes me a survivor, or am I just an obedient patient?
On this day last year, I took an interminable trek through the internet, searching for the right word, and encountered a jarring Times of India headline: “National Cancer Survivors’ Day: Gutsy fighters took on cancer, and won.” Took on? Took on Cancer? Won? Those who have been killed by cancer, are they “less gutsy” than the rest of us? Those with metastatic breast cancer, what of them? As a country, we do a great job ignoring them altogether. Is it because they are losers in this breast cancer lottery? Is that what we would call them? Would we?
Of all the words that no longer connote for me what they once did, “survivor” is the one that leaves me entirely flummoxed. As I have mused previously, the diagnosis has forever changed certain words for me – “staging” I no longer immediately associate with the theater; “fog” I am more apt to attach to a state of cognitive loss than Van Morrison’s misty morning fog or the cloud that can obscure parts of Pacific Coast Highway as we head north in the summertime; and, “cure” is no longer the idiomatic “hair of the dog that bit you,” rather a confounding and elusive thing all wrapped up in a pink ribbon. “Mets” no longer the other New York baseball team, but a tragic abbreviation for metastatic breast cancer from which no one survives yet of all the millions of dollars raised for breast cancer research in this country, only 2% of it is directed to metastatic breast cancer.
Even “sentinel,” which was reserved, until cancer came calling, for a lonely cormorant perched on a post in the shallow waters of sleepy Morro Bay, I now associate with the first node to which cancer cells are most likely to spread from a primary tumor. Until one afternoon at the oncologist’s office, “infusion” had been something done to transform olive oil into a gourmet gift. But because I had turned left instead of right upon leaving, I missed the exit and instead found myself on the threshold of the infusion suite, a room I didn’t even know was there. Feeling as though I had intruded, I fled. But not before I had registered a row of faces of people sicker than I. In one microscopic moment, I made eye contact with a young bald woman and wondered if perhaps she was cold because, as I turned away, I noted a quilt on her lap. I turned away and thought of Shakespeare’s “enter fleeing” stage direction. Ashamed. Guilty.
Ironically, there was a moment last year, in response to a poignant and provocative piece of writing at Nancy’s Point, when I felt compelled to remark that somehow I was beginning to make some kind of order out of my life since cancer. Or my life with cancer. Or my surviving cancer. I wrote that I was learning to make room for it, to make sense of it no less. Well, that was a bit premature, wasn’t it? Cancer makes no sense at all.
So the headline from The Times of India troubled me. I do not feel gutsy. Nor do I feel like a winner. Nor am I comfortable with being described a survivor. What then? I am a cancer patient. I am in treatment. I am aware that my treatment, currently, does not impinge on my life to the extent that it would were the disease more advanced. If it progresses, that is.
A profound sense of guilt accompanies this awareness. Why? It confounds me and reminds me of growing up in Antrim, a small town in Northern Ireland. At a safe distance. Except the times our kitchen window shook because a bomb had exploded somewhere. Or the time when the bomb exploded outside Halls Hotel. Or coming back to her brother’s house in Belfast after a great Saturday night out with Sk’Boo playing at The Errigle Inn in Belfast, to find my friend Ruth’s car had been stolen and set ablaze as a barricade somewhere on the other side of Belfast. Or the time my brother, as a young journalist, was sent to conduct a harrowing interview with the heartbroken grandmother of three little boys who had been murdered
In May the Lord in HIs Mercy be Kind to Belfast, based on his interviews with the people who lived there, Tony Parker makes an unsettling but astute observation that those born and brought up in Northern Ireland have a mutual need to know, from the start, about a person’s background, so they can proceed in the dialogue, the longer relationship, without saying the wrong thing, “the wrong word.” The schools we attended, our last names, the way we pronounce an “H” all became clues to help establish “who we are,” and if we are to be feared. “Derry” or “Londonderry?” “The Troubles,” “the struggle, or “The Irish Question?” “Ulster” or “The Six Counties?” Between the turmoil in the country of my birth and cancer country, I find that myth features prominently, in particular the myth that victims have in some way, brought it upon themselves. Breast cancer? Didn’t you go for mammograms or do your monthly self-exams? Lung cancer? Oh, you must have been a smoker? Skin cancer? Didn’t you wear your sunscreen? It is a curious mix of sympathy and blame that engenders detachment.
The calendar takes on a new significance, too. The people of Northern Ireland could fill a calendar with anniversaries, those of Bloody Sunday, the bombing of Omagh and Enniskillen, Internment, the Twelfth of July. Most of us physically untouched by these, but changed nonetheless. Survived. The images are indelible. Iconic. Father Edward Daly waving a blood-stained handkerchief on a Derry street on Bloody Sunday, the carnage on Market Street in the heart of Omagh, orange sashes, bowler hats, Lambeg drums, and The Guildford Four. While I have personally passed just one “cancer anniversary”, I have already penciled in my two-year appointment in November. In the end, I suppose every day marks an anniversary of something.
On the question of language, there is no easy answer. Within terrorism, within cancer, and the respective wars waged against both, are words and phrases that sanitize and even glamorize the suffering and pain, that hide the horror and heartbreak visited upon ordinary people going about their daily lives.
I first fell upon the words of writer, Damian Gorman, some twenty years ago. I was channel-surfing in my living room in America and stopped on Channel 8 when I heard a voice from home, narrating Devices of Detachment, a “verse film” about the role of ordinary people like me during The Troubles. It has stayed with me for all these years, and resonates deeply through these ruminations on the complexities of cancer, the politics of its lexicon, its races and pink ribbons, the platitudes we use to keep the ugliness and horror of it – the mets – as far away as possible. He describes the bombs, bullets, the “suspect incendiary devices” all too familiar in 1980s Northern Ireland as far less deadly than the “devices of detachment” its people used to distance themselves from the violence. Aware of it, yet so removed.
We are, all of us, very good at “detachment,” aren’t we?
“I’ve come to point the fingerI’m rounding on my ownThe decent cagey peopleI count myself amongWe are like rows of idle handsWe are like lost or mislaid plansWe’re working under coverWe’re making in our homesDevices of detachmentAs dangerous as bombs.”
~ Damian Gorman
This post includes a 1930 video of the Radical Amputation of A Left Breast. Viewer Discretion Advised.
I discovered the elegance of Lois Hjelmstad‘s poetry and prose in March 2012. Tentatively broaching the subject of my return to work, having undergone a mastectomy just 47 days earlier, I wrote in Resuming Old Ways of the final pre-operative surgical procedure – the administration of the nuclear medicine for a sentinel node biopsy to be performed the next day at some point between the removal and reconstruction of my right breast.
The pre-op procedure had been conveniently reduced to a specious “X” next to “Nuclear medicine” on the Surgery Scheduling Information sheet in my Cancer 101 notebook that is always at hand. Highly probable that my surgeon had already discussed the procedure with me and answered all my questions, but even at this late hour, I had not moved much farther beyond “You. Have. Cancer.” Thus, I showed up. Obedient and vaguely prepared with a stack of paperwork and disclaimers and a half-understanding that this nuclear medicine, a blue dye, would enable my surgeon to see if there was any cancer in the lymph nodes. If so, she would remove them all. Just like that.
Following the obligatory mix-up with the out-patient registration department, I proceeded into Nuclear Medicine, pausing to wonder about those who had preceded me through those double doors. A cheery nurse, diagnosed with breast cancer some years ago, told me it would be all over before I knew it. Encouraged and unaware that she had omitted the part about the procedure necessitating three injections of radioactive dye directly into and around the nipple of my right breast, I settled in. How I wince, even now, as I write of it. But more powerful than the sting of his injections, was the kindness of the radiologist who, right before he administered the medicine, said my name and told me:
I am so sorry you’re here.
I will never forget him for making enough time to make that connection with me as a human being who did not deserve to be there. No one does.
I published the post and was subsequently introduced to Lois J. Hjelmstad, who remarked:
“Along those same lines, I’d like to share a journal entry from my book, Fine Black Lines: April 19, 1991 – The doctor was gentle and thorough as he put the needle into my nipple, threaded in the tiny tubing and took x-rays. …The nurse kept her eyes on my breast. She said she couldn’t bear to look at my face. The ductogram was excruciating–but it was not conclusive. We will have to repeat the procedure next Friday.
And even though I haven’t had nipples for over twenty years, they still hurt when I typed that. I’m sorry you had to go through that procedure.
The irony is: that nurse has since died of breast cancer and I’m still here.”
Since then, it has been my privilege to learn more about Lois through her evocative prose and poetry. Finally, I bought her book, Fine Black Lines, yesterday. Another gift of poetry to myself. This 50th birthday celebration may just go on indefinitely.
In November, I asked Lois if she would write a guest post for my blog. She agreed. In breast cancer culture and in the medical community, there is a collective willingness to use language designed to soften the blow and a preference for words that sanitize and trivialize. Made-up words and euphemisms are flung around in myriad ways to minimize the savagery of the disease. “Mastectomy” is code for “amputation.” The latter makes me shudder.
Why are euphemisms so acceptable in the cancer conversation? Medical euphemisms, like “lumpectomy” I used to toss around as though it were like lancing an inconsequential wart, instead of what it really is – a partial amputation. The surgery to remove my breast and reconstruct would be trickier than the “simple” lumpectomy I had anticipated. In fact, as her meticulous notes would later confirm, “dissection was very difficult given the very small circumareolar incision used for the skin-sparing mastectomy.” Because it required additional time and effort, not to mention skill and patience, my surgeon recommended (and I nodded sagely as though I knew what she was talking about) a skin-sparing mastectomy which entailed removing only the skin of the nipple, areola, and the original biopsy scar to create an opening through which she would remove the breast tissue. Duly spared – spared, no less – the skin would then accomodate a reconstruction using my own tissue. Simple.
Reading through the details of my surgery, you’d never know cancer and its treatment could be ugly, savage, or even that it might hurt. At times it sounds downright regal, befitting a fanfare of trumpets, especially that climactic moment when my breast tissue is “elevated off the pectoralis and delivered from the wound.” Amputated.
******
GUEST POST: DAY 14 WEGO HEALTH ACTIVIST MONTHLY WRITING CHALLENGE
“Well, yes, Lois Hjelmstad had written an occasional poem when life got intense, but she planned to continue teaching piano until she was 96. And she definitely planned to reach 96.
Life changed her plans. The night before her first mastectomy, Lois wept as she wrote the poem, “Goodbye, Beloved Breast.” She did not know, of course, that the poem would lead to an award-winning book, Fine Black Lines, or that the book would lead to a national and international speaking career and to two other award-winning books.”
Perspective of a Double Amputee
There seems to be renewed discussion in the blogosphere about the language of breast cancer, specifically comparing “mastectomy” with “amputation.” The recent Sarcastic Boob blogand comments are especially succinct.
At the end of this blog, Scorchy posts a black and white film from the UK in 1930 depicting a breast removal surgery.
Viewer Discretion Advised: “Radical Amputation of the Left Breast.”
P
As I was born in 1930, it particularly caught my eye. Scorchy did advise viewer discretion, but, curious as I am, I decided to watch it anyway. I made it to the end, past the stitches, but I could not eat dinner.
My editor looked at me over her reading glasses and said, “I sense your feelings about all of this might be deeper than you are expressing. ‘Second Surgery?’ This poem should be called ‘Double Amputee.’”
Double amputee?! I was shocked. It had never occurred to me that my mastectomies were actually amputations. I didn’t feel comfortable with the word. It sounded way more serious than what I perceived I had endured, although I have to admit that my perception changed when I watched that damn film yesterday.
I rushed to the dictionary to learn that amputate means to cut or lop off, but that amputee means one who has had a limb amputated. In discussing the definitions, my editor and I thought about the historical reasons such a distinction might exist. Amputee seemed to reflect men’s experiences.
Undoubtedly, men have suffered more loss of limbs than women, if for no other reason than men have been involved more directly in war. [That has changed, of course.] And men have had more accidents because they have been allowed and expected to be more active. But the restriction of the termamputee to limbs belies not only the broader use of amputate but also the psychological truth of cutting off a breast.
I took the idea to my breast cancer support group for discussion. Most of the women were horrified to even consider that their mastectomies were amputations.
Then we talked about how our culture has viewed breasts and how form has replaced function in much of Western Civilization. And even as we argued that losing a breast could not be compared to losing an arm or a leg, some interesting questions arose:
How long did women have to fight for the right to choose a modified radical mastectomy over a complete radical mastectomy, let alone a lumpectomy over either of those?
How many women walked around disfigured or with a falsie on the loose before an adequate prosthesis was invented, let alone breast reconstruction?
How important is it to have our bountiful bosoms restored?
There are obviously different levels of amputation. Losing an arm or a leg generally has far greater consequences than losing a finger. But an amputated limb can be replaced with a prosthesis that allows some functioning. In fact, people have been fitted with artificial limbs that allow them to ski, bicycle, or even climb rocks. [And there is much more sophistication now in 2013.]
A breast, of course, can also be replaced with a prosthesis or reconstruction. However, neither of these simulates any natural functioning. If you are young when you lose a breast, you lose the ability to nurse a child. [If indeed you are lucky enough to have a child after breast cancer.] If you are past menopause, you lose the artifact of that experience. In either case, you lose the contentment of cradling a child to your bosom and the pleasure a breast brings to you and your mate during sex.
A prosthesis or reconstruction is only superficial. It looks good—score one for beauty pageants—and fills a void in your clothes.
If I had to choose between losing a breast and losing an arm or a leg, I would sacrifice the breast. But that awareness does not contradict the fact that I am an amputee.
I wrote that passage TWENTY YEARS AGO and people are still using the term “mastectomy” to cover up the truth. Everyone should watch the old black and white film from the UK.
*********
Lois Hjelmstad is an international speaker and the author of three award-winning books:
Lois has spoken more than 600 times in all fifty states, England, and Canada, in many venues including CEU and CME for healthcare professionals.
Hjelmstad was featured in the October 2001 issue of Rosie Magazine and appeared on The Rosie O’Donnell Show.
She and her husband of sixty-four-plus years, Les, live in Englewood, Colorado, where she taught music for forty years. They have four grown children, eleven grandchildren, and eight great-grandchildren.