Musings on memory and specialness

I've been meaning to write this post for several weeks now and am finally getting around to it. Some of you know that one of my favorite shows is House. On most Saturday nights, my date is House, ie watching the reruns. Occasionally, there will be a quote or scenario that really makes me think. (see "control" and organ transplantation, "let them eat cake," "life is a series of rooms," and "the greater good.") Or better yet, I tell myself, "this will make a good blog post!"

The show was entitled "You must remember this." It was about about a waitress, Nadia, who came in with paralysis of her legs after she falls suddenly. There is nothing different about this woman except for one thing--she has an impeccable memory. She can remember anything from any date. Everyone is impressed, including House.

Later, we find out that the waitress and her sister have been estranged for a long time. The sister comes to be with Nadia. She tries to share memories with Nadia, but Nadia only lashes out at her sister, always finding a reason why that was not a good memory. After several times of this, Nadia's sister leaves. That is, until she learns that Nadia needs a kidney and is persuaded to donate hers.

Nadia's case has yet to be solved, but House wonders whether Nadia will thank her sister. "She claims that she objectively sees reality. Weighing the good and bad in people. If that's true, I don't care how many times her sister borrowed her scrunchy without asking, a free kidney ought to trump all the bad stuff."

Well, it didn't, and Nadia still could not thank her sister.

As the show nears the end, we learn that Nadia also likes jigsaw puzzles and would never leave one unfinished--it would drive her crazy. Houses reasons she has OCD, and that she has McLeod's syndrome, a rare genetic neurological disease in which anxiety and OCD can be a symptom. House tells her, "Best case scenario, you can live another twenty years." Then, he says one of his famous lines, "If it's any solace, everybody dies alone."

Chase comes back into Nadia's room with a bottle of SSRIs, telling her it will help with the OCD. Nadia is only concerned that it would affect her memory. Chase tries to explain that her memory would be like everyone else's. Nadia goes on to say, "My memory is the only thing that has ever made me special." Chase replies with "if you want to be special then it means being alone."

So this episode is a twofold one--the idea that we filter out our memories, rehashing or remembering only the bad stuff and the idea of "specialness."

Lots of us, ED'd or not will at times dwell on things in our lives which may not be the most healthy for us. Take in point last week when I was talking to my dad about work. He felt I kept bringing up my former boss, and he just couldn't understand why I was not able to drop the subject already. I think had I gone on for days and weeks and weeks about it, yes, then, it would be considered dwelling. Or dwelling if I could just not stop talking about it completely, like an obsession. But it's not. I have talked about it extensively with close family and friends--heck I even had a recent dream about it, but I have moved on from it. Will I still wonder, yep. Will I ever get answers? Likely not.

That was the thing for Nadia, she was not able to let go or forgive people. She saw her memory as objective, but it was far from it. Instead, she filtered everything good out from her memories and only remembered the bad stuff. And continuously obsessed on it. And that became what she felt was her true memory.

This is similar to the scenarios of therapists who continuously want to rehash the past My feeling is that there is a time and place for it, and in early recovery, it can help understand why you feel the way you do or how someone else may have felt. Then, when there is a point of acceptance about it, that is when you must move forward and learn what you can do now.

Secondly, a lot of us want to feel special. Truly, we all are--we just never see it at the time. We want a special quality that no one else can do. For many with eating disorders, it is the idea of starvation and thinness. (For me personally, it was the superwoman complex which equated to great grades, functioning on very little sleep and food, and being a part of lot of extracurricular activities and excelling at them.)

Though I don't completely agree with Chase's statement if we relate it to eating disorders--really we aren't alone, there are millions starving, purging, bingeing everyday. But we do feel alone. We feel alone for being different, for having no one else to talk to who relates, for our isolation/our imprisonment in our own minds. And that's truly not a way to live a life.

It's kind of weird when I think about the whole "special" thing. For so long, I've been told I was special. I never believed it though. I mean, it just doesn't count when it is from your parents. But other people would say it too, and would they lie really? Still though, here's what I do know. I don't want to be special for my outward appearances (well okay, being called attractive is kind of nice at times--a recent date told me this), but rather for my inner qualities. I know that sounds hugely clichèish, but it is true. I'd rather be considered kind, compassionate, generous, reliable, hard working, etc. than just pretty.

Did anyone else see this episode? What were your thoughts? How do you view memories? How do you want others to see you?

Change is in the air

The last few days have truly been a whirlwind. I have so many big decisions to make/do that it is all terrifying to me. I've learned that no matter whether a transition will be positive or negative, I will still feel stressed and overwhelmed. Up until this point, there was still a feeling of "well, you can always change your mind." Now, there is no turning back, this is really real and going to happen. True, I know there is always the possibility to change my mind, but I really have to force myself to think this way. Otherwise, I will only have self doubts and second guess my decisions.

What I have to remember is this: “The only wrong thing is to do nothing.” This was a quote from the "Greater Good" 100th episode of House said by Dana Miller, a patient who had come to the hospital after collapsing. We find out later that Dana was actually a prominent cancer researcher now turned chef.

When Wilson, House's best friend and an oncology doctor, asks her how she could have left her renowned position as a researcher to be a chef, her simple answer was that she wanted to be happy, that she needed a change in her life. This episode revolves around this theme as all the cast members have to re-evaluate what makes them happy.

For Wilson, his happiness had been swept away by the death of his girlfriend, Amber. He remained stuck, not moving on, keeping the apartment just as it had been from the time she had died, including never washing a mug of hers. By the end of the episode, he decides to make a change and wash the mug.

This is just the condensed version, but it's a good episode, looking at this idea of happiness.

In my own life, I think about happiness quite a lot. It's always been a concept that has just felt out of reach due to my own sabotage and self-esteem. I somehow have this fear that my happiness will never be real, that it will be jinxed if I think I am happy. (illogical thinking I know) I wonder if this change will bring about happiness?

Change is so scary. Everything is new, different, the familiarity gone. Sometimes, I think of my life (or I should say others might describe it this way) as the decision-making process to move a piece on a chess board. There I am waiting, waiting, waiting to make a move, the best move, the right time, the move with the maximum security, the maximum chance at winning, thinking, thinking. But no move at all. I remain stuck there--too afraid, too fearful which way is the right way, the best way, the least scary way, the least disappointing way if something should fail. But at some point, I have to move my chess piece. I have to keep making those decisions to get to the other side of the board and reach "check mate." Because otherwise, I will forever just be sitting there like that chess piece.

Note--*At some point, I'd really like to give more background history. I cannot at this time but have thought in the next several months to make the blog private for a few days. I'd switch back to private and delete those posts. Does this make sense or does that seem stupid?

Recap of House episode

Life is a series of rooms

image: stock.xchng

So I was watching another repeat episode of House which made me think about life and its meaning. This is the episode, "One day, one room." about the girl who is raped and only wants to talk to House. The episode itself is full of philosophical debate about pain and life. One of the most poignant dialogues between the patient, Eve, the girl who was raped and House, is about life:

Dr. House: They’re out there, doctors, lawyers, postal workers, some of them doing great, some of them doing lousy. Are you going to base your whole life on who you’re stuck in a room with?

Eve: I‘m gonna base this moment on who I am stuck in a room with! It’s what life is, it’s a series of rooms, and who we get stuck in those rooms with, adds up to what our lives are.

I think this is certainly true, but it also makes me wonder, "what if the only person you're stuck in a room with is yourself?" What then? We all say we can't run away from ourselves, so therefore we must learn to be stuck with ourselves. Why is that so hard though?

This episode also gives me the mental imagery of unlocking rooms or trying to figure out what is behind door numbers 1, 2, 3, and so on. What does each room mean to us and which one are we in in any given time?

Related post on this episode: Greythinking wrote about this episode several months ago, looking at the aspect of the promise (or not) of therapy.

"Let them eat cake"

Since I am unable to watch House during the week, I like to watch the reruns on the weekends. Some of the cases are quite fascinating. The one I watched last night was from a few weeks ago, titled "Let them eat cake."

In this episode, a personal trainer comes in after she has collapsed from a fitness infomercial shoot. As usual, House and his assistants go through a battery of tests to figure out the right diagnosis. They wound up scanning her for a tumor and realized that she had gastric bypass surgery since her stomach was stapled. Some of the assistants ask her about the ethics of her career choice as a fitness trainer yet having medical intervention. She replies with that she is helping her clients to get healthy as she did once she had the surgery.

Anyway, this post isn't geared towards the contradiction of her career choice and previous lifestyle. This post is about what happens at the end of the show. After many tests, House finally makes a diagnosis of hereditary coproporphyia, a condition in which the liver lacks an enzyme that interrupts heme production. There is no cure for the condition, however, the treatment protocol is to reverse the gastric bypass surgery and implement a diet high in carbohydrate and sugar.

When House tells the patient, there is a look of mortification with her pleading for another way. The only other thing was medications for pain control. In the end, she chose the medication, and refused the surgery. House's final statement is, "Most people don't have the guts to admit they'd rather be pretty than healthy."

Now, I think that statement is slightly shallow, but I do get the point he is making. For this patient, having the bypass surgery helped transform her life so that she wound up living a healthier lifestyle. Therefore, I'm sure she felt like if she reversed the surgery, it would all be for nothing, or there was a fear she would regain all the weight lost, or simply unsure she could trust herself.

If I was in that position, I'm not sure what I would have done. I'd like to think that the "healthy" rationale would win out, but would it really? If you were placed in a medical situation of being thin or healthy (excluding weight restoration), which would you choose? What if your diet had to drastically change to all your fear foods, how would you react?

Transcript for episode

"House"

image: National Library Medicine

Normally, I don't talk about ethics much on this blog, but occasionally I find something that makes me ponder and want to know how others feel/think. So I guess I'm just putting this disclaimer that this post is about ethics and it's your choice to read or not. And if commenting, please be considerate.

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The USA Network is running a "House" marathon this weekend. This is a show I like but often don't watch since it conflicts with another program. That, and I rarely ever watch much of the Fox station. Occasionally, I watch a few episodes of "American Idol," but that's about it.

Although I like House, his sarcastic, dry wit, and think Hugh Laurie does a great job in the role, I'm not sure I could actually stand him as a doctor. The one thing going for him is that he is an excellent diagnostician. That's a good thing, because his bedside manner sucks. I'm sure if this was a real hospital (and there's bound to be a few in the US--egos and all), I'd probably be like one of his assistants in always worrying about getting fired or not doing the right thing. But if I was really dying or needed an answer, I do think I would maximize the situation and want him as a doctor.

Anyway, yesterday, I caught most of an episode from the first season, titled "Control." In this show, Carly, a 30+ year old comes in with what looks like paralysis of the left leg and pain in her right quadricep. She undergoes an angiogram for any clots as well as a virtual scope for colon cancer. During the second angiogram (the first one got botched), Carly's lungs fill with fluid which must be drained. Later, House examines her leg while she's sleeping and sees marks on her thigh, implicating she is a cutter. I'm not sure how he went from cutting to eating disorder and that she needed a new heart. Somehow that jump was made in his mind despite the fact that tests suggesting she had congestive heart failure had not come back yet. Of course, that's House for you.

Now, House, knowing she needs an immediate heart transplant and figuring out she has an eating disorder, must decide what to tell the committee. He sees Carly first, exchanging the details of the facts he knows about her. The ipecac syrup she had been using destroyed her heart and caused muscle damage. Then he says how he has an emergency meeting with the committee to rank how high in need her case is. Normally, her case would be ranked high since she has little time to live. However, due to her psychiatric history, the eating disorder can be an exclusionary factor, much like a suicide risk or substance/chemical dependency case.

I can't remember the exact dialogue between House and Carly, but one essential issue Carly felt was whether she was worth it or not. Really, House wanted to know whether she wanted to live. At the end, Carly said she didn't want to die.

House, then lied to the committe saying she had no exclusionary criteria for an immediate heart trasnplant. He fought hard for her and she got the heart. After the transplant, he visited her and basically told her not to screw it up. And then talks about how she would be on a strict diet and hands her some chicken or something. Okay, that wasa bit ironic, but I could see the point being made.

So, I think this episode brings up some interesting ethical type questions. If you were in the same situation as Carly, ie, needing an organ transplant due to your eating disorder, how would you feel? Would you feel worthy of a transplant or that you should even be considered or ranked high? Would you want your Dr. to be proactive for you and perhaps lie to the committee? How would you feel if your Dr. was truthful about the eating disorder, and you were ranked low on the list for an organ transplant? Would you then feel like you were not worth saving? Or, if you did receive an organ, would it be enough for you to adhere towards recovery?

I'm not sure how I'd feel honestly. If I knew someone was "ranked" the same as me, had a congenital heart defect, and there was only one heart...well, I'd feel that that person should get the heart over me. I'm not sure if I'd feel it was more of a worthiness issue or rather a fair issue. After all, some people wait months and years to receive an organ which is in high demand. And unfortunately, some die waiting.

On the flip side to this, if I did receive a heart over someone else, would I feel guilty?

I also wonder if eating disorders were looked at as more on a biological basis, thus taking out the assumed idea of "choice" which most people believe, would the exclusionary criteria be different? I know suicide and other psychiatric illnesses not being treated are also on the exclusionary list, as well as your lifestyle choices, like smoking and alcohol. BMI is also considered with those over 40 or 100 pounds overweight not recommended for transplant unless brought down to BMI of 30. Other factors are considered as well in terms of health and psychosocial aspects with some criteria recently broadened like age, having cancer, and other illnesses. I should note that any organ transplant case is looked at on an individual basis by each transplant/treatment team, so these guidelines are only suggestions.

Anyway, I just thought this was an interesting case and makes you realize the importance of well...your organs and how eating disorders can affect them. Personally, I do not know of anyone who has had to have an organ transplant due to their eating disorder (sadly, my feeling is that their organs might shut down before organ donation would be considered or they would have already passed away), though I have heard of people having organs like their gall bladder removed due to malnutrition. The point being is that this could happen. Maybe for some, it would be the impetus for change and recovery, while for others maybe not. But in the end, why do we even really want to take that chance?

Heart transplant criteria broadened
Transcript of show "Control"