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In the late 1960s, an ugly little rhyme circulated in Britain’s declining industrial towns. At the time, seemingly unstoppable mass migration from Britain’s former colonies had triggered a succession of new laws aimed at restricting entry to Britain, followed by a new political emphasis on ‘race relations’ intended to quell international dismay and reduce internal racial tensions.

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Here is a list of 11 books that address a wide range and variety of emotions that young readers may experience when faced with serious illness, loss, grief or trauma.

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By Richard D. Griffiths

Over the last half century, critical care has made great advances towards preventing the premature deaths of many severely ill patients. The urgency, immediacy, and involved intimacy of the critical care team striving to correct acutely disturbed organ dysfunction meant that, for many years, physiological correction and ultimate patient survival alone was considered the unique measure of success. However, over the last quarter century, our survivor patients and their relatives have told us much more about what it means to have a critical illness. We work in an area of medicine where survival is a battle determined by tissue resilience, frailty, and the ability to recover, but this comes at a price. As our focus has moved beyond the immediate, we have learned about the ‘legacy of critical care’ and how having a critical illness impacts life after ICU through its consequential effects on physical and psychological function and the social landscape.

This fundamental cultural change in how we perceive critical care as a specialty and where our measure of a successful outcome includes the quality of life restored has come about through the sound medical approach of listening to our patients and families, defining the problems, and carefully testing through research hypotheses as to causation and possible therapeutic benefit. It not only has changed how patients are considered and cared for after intensive care, but, through the detailed knowledge of how patients are affected by the consequences of the critical illness, it has fostered fundamental research to improve the care and therapies we use during their stay. As with all sound clinical advances, it has helped shed light and ill-informed dogma and helped re-focus the research agenda to ensure that the long-term legacies of a critical illness are equally considered. Immobility, oft considered of little consequence, is now recognized to be a significant pathological participant and contributor to disability. Amnesia, in short-term anaesthesia considered a benefit, now has defined pathological significance, along with previously poorly recognized cognitive deficits and delusional experiences, all consequences of acute brain dysfunction. The family, often in the past merely a repository of information, is now recognized to play a much greater role in how patients recover and are themselves traumatized by the experience, so meriting help and support if they are to assist in rehabilitation.

Perhaps the purest achievement has been the bringing together of contributions not just from patients and their families, but form the wide breadth of professionals deeply involved in the care of the critically ill from across many continents. Not only have the doors of the intensive care unit been thrown open, but so too have the minds of those working for the best care of our patients. The reward of a visit some months later of a patient brought back from the brink of death is cherished by a critical care team. Added to this, the knowledge that our patients are now understanding what happened to them and they and their families are being given the help to recover their lives following the legacy of critical care is something of which our specialty should be justly proud. We cannot ignore the lessons we have learned.

Richard D. Griffiths is Emeritus Professor of Medicine (Intensive Care) and Honorary Consultant at the Institute of Aging and Chronic Disease, University of Liverpool. He is a contributor to Textbook of Post-ICU Medicine: The Legacy of Critical Care.

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Image: Doctor consults with patient by National Cancer Institute. Public domain via Wikimedia Commons.

The post The legacy of critical care appeared first on OUPblog.

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We owe the same kind of hilarious grace to our characters and our young readers. We ask so much of them and it’s only right to give them every emotion in equal measure.

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Short Stories of Heaven is a wonderful resource for children and their families who are dealing with loss and terminal illness, as well as people who are looking for a way to explain the afterlife to children.

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The editors of the Oxford African American Studies Center spoke to Professor Jim Downs, author of Sick From Freedom: African-American Illness and Suffering during the Civil War and Reconstruction, about the legacy of the Emancipation Proclamation 150 years after it was first issued. We discuss the health crisis that affected so many freedpeople after emancipation, current views of the Emancipation Proclamation, and insights into the public health crises of today.

Emancipation was problematic, indeed disastrous, for so many freedpeople, particularly in terms of their health. What was the connection between newfound freedom and health?

I would not say that emancipation was problematic; it was a critical and necessary step in ending slavery. I would first argue that emancipation was not an ending point but part of a protracted process that began with the collapse of slavery. By examining freedpeople’s health conditions, we can see how that process unfolded—we can see how enslaved people liberated themselves from the shackles of Southern plantations but then were confronted with a number of questions: How would they survive? Where would they get their next meal? Where were they to live? How would they survive in a country torn apart by war and disease?

Due to the fact that freedpeople lacked many of these basic necessities, hundreds of thousands of former slaves became sick and died.

The traditional narrative of emancipation begins with liberation from slavery in 1862-63 and follows freedpeople returning to Southern plantations after the war for employment in 1865 and then culminates with grassroots political mobilization that led to the Reconstruction Amendments in the late 1860s. This story places formal politics as the central organizing principle in the destruction of slavery and the movement toward citizenship without considering the realities of freedpeople’s lives during this seven- to eight- year period. By investigating freedpeople’s health conditions, we first notice that many formerly enslaved people died during this period and did not live to see the amendments that granted citizenship and suffrage. They survived slavery but perished during emancipation—a fact that few historians have considered. Additionally, for those that did survive both slavery and emancipation, it was not such a triumphant story; without food, clothing, shelter, and medicine, emancipation unleashed a number of insurmountable challenges for the newly freed.

Was the health crisis that befell freedpeople after emancipation any person, government, or organization’s fault? Was the lack of a sufficient social support system a product of ignorance or, rather, a lack of concern?

The health crises that befell freedpeople after emancipation resulted largely from the mere fact that no one considered how freedpeople would survive the war and emancipation; no one was prepared for the human realities of emancipation. Congress and the President focused on the political question that emancipation raised: what was the status of formerly enslaved people in the Republic?

When the federal government did consider freedpeople’s condition in the final years of the war, they thought the solution was to simply return freedpeople to Southern plantations as laborers. Yet, no one in Washington thought through the process of agricultural production: Where was the fertile land? (Much of it was destroyed during the war; and countless acres were depleted before the war, which was why Southern planters wanted to move west.) How long would crops grow? How would freedpeople survive in the meantime?

Meanwhile, a drought erupted in the immediate aftermath of the war that thwarted even the most earnest attempts to develop a free labor economy in the South. Therefore, as a historian, I am less invested in arguing that someone is at fault, and more committed to understanding the various economic and political forces that led to the outbreak of sickness and suffering. Creating a new economic system in the South required time and planning; it could not be accomplished simply by sending freedpeople back to Southern plantations and farms. And in the interim of this process, which seemed like a good plan by federal leaders in Washington, a different reality unfolded on the ground in the postwar South. Land and labor did not offer an immediate panacea to the war’s destruction, the process of emancipation, and the ultimate rebuilding of the South. Consequently, freedpeople suffered during this period.

When the federal government did establish the Medical Division of the Freedmen’s Bureau – an agency that established over 40 hospitals in the South, employed over 120 physicians, and treated an estimated one million freedpeople — the institution often lacked the finances, personnel, and resources to stop the spread of disease. In sum, the government did not create this division with a humanitarian — or to use 19^th century parlance, “benevolence” — mission, but rather designed this institution with the hope of creating a healthy labor force.

So, if an epidemic broke out, the Bureau would do its best to stop its spread. Yet, as soon as the number of patients declined, the Bureau shut down the hospital. The Bureau relied on a system of statistical reporting that dictated the lifespan of a hospital.  When a physician reported a declining number of patients treated, admitted, or died in the hospital, Washington officials would order the hospital to be closed. However, the statistical report failed to capture the actual behavior of a virus, like smallpox. Just because the numbers declined in a given period did not mean that the virus stopped spreading among susceptible freedpeople.  Often, it continued to infect formerly enslaved people, but because the initial symptoms of smallpox got confused with other illnesses it was overlooked. Or, as was often the case, the Bureau doctor in an isolated region noticed a decline among a handful of patients, but not too far away in a neighboring plantation or town, where the Bureau doctor did not visit, smallpox spread and remained unreported. Yet, according to the documentation at a particular moment the virus seemed to dissipate, which was not the case. So, even when the government, in the shape of Bureau doctors, tried to do its best to halt the spread of the disease, there were not enough doctors stationed throughout the South to monitor the virus, and their methods of reporting on smallpox were problematic.

You draw an interesting distinction between the terms refugee and freedmen as they were applied to emancipated slaves at different times. What did the term refugee entail and how was it a problematic description?

I actually think that freedmen or freedpeople could be a somewhat misleading term, because it defines formerly enslaved people purely in terms of their political status—the term freed places a polish on their condition and glosses over their experience during the war in which the military and federal government defined them as both contraband and refugees. Often forced to live in “contraband camps,” which were makeshift camps that surrounded the perimeter of Union camps, former slaves’ experience resembled a condition more associated with that of refugees. More to the point, the term freed does not seem to jibe with what I uncovered in the records—the Union Army treats formerly enslaved people with contempt, they assign them to laborious work, they feed them scraps, they relegate them to muddy camps where they are lucky if they can use a discarded army tent to protect themselves against the cold and rain. The term freedpeople does not seem applicable to those conditions.

That said, I struggle with my usage of these terms, because on one level they are politically no longer enslaved, but they are not “freed” in the ways in which the prevailing history defines them as politically mobile and autonomous. And then on a simply rhetorical level, freedpeople is a less awkward and clumsy expression than constantly writing formerly enslaved people.

Finally, during the war abolitionists and federal officials argued over these terms and classifications and in the records.  During the war years, the Union army referred to the formerly enslaved as refugees, contraband, and even fugitives. When the war ended, the federal government classified formerly enslaved people as freedmen, and used the term refugee to refer to white Southerners displaced by the war. This is fascinating because it implies that white people can be dislocated and strung out but that formerly enslaved people can’t be—and if they are it does not matter, because they are “free.”

Based on your understanding of the historical record, what were Lincoln’s (and the federal government’s) goals in issuing the Emancipation Proclamation? Do you see any differences between these goals and the way in which the Emancipation Proclamation is popularly understood?

The Emancipation Proclamation was a military tactic to deplete the Southern labor force. This was Lincoln’s main goal—it invariably, according to many historians, shifted the focus of the war from a war for the Union to a war of emancipation. I never really understood what that meant, or why there was such a fuss over this distinction, largely because enslaved people had already begun to free themselves before the Emancipation Proclamation and many continued to do so after it without always knowing about the formal proclamation.

The implicit claim historians make when explaining how the motivation for the war shifted seems to imply that the Union soldiers thusly cared about emancipation so that the idea that it was a military tactic fades from view and instead we are placed in a position of imagining Union soldiers entering the Confederacy to destroy slavery—that they were somehow concerned about black people. Yet, what I continue to find in the record is case after case of Union officials making no distinction about the objective of the war and rounding up formerly enslaved people and shuffling them into former slave pens, barricading them in refugee camps, sending them on death marches to regions in need of laborers. I begin to lose my patience when various historians prop up the image of the Union army (or even Lincoln) as great emancipators when on the ground they literally turned their backs on children who starved to death; children who froze to death; children whose bodies were covered with smallpox. So, from where I stand, I see the Emancipation Proclamation as a central, important, and critical document that served a valuable purpose, but the sources quickly divert my attention to the suffering and sickness that defined freedpeople’s experience on the ground.

Do you see any parallels between the situation of post-Civil War freedpeople and the plights of currently distressed populations in the United States and abroad? What can we learn about public health crises, marginalized groups, etc.?

Yes, I do, but I would prefer to put this discussion on hold momentarily and simply say that we can see parallels today, right now. For example, there is a massive outbreak of the flu spreading across the country. Some are even referring to it as an epidemic. Yet in Harlem, New York, the pharmacies are currently operating with a policy that they cannot administer flu shots to children under the age of 17, which means that if a mother took time off from work and made it to Rite Aid, she can’t get her children their necessary shots. Given that all pharmacies in that region follow a particular policy, she and her children are stuck. In Connecticut, Kathy Lee Gifford of NBC’s Today Show relayed a similar problem, but she explained that she continued to travel throughout the state until she could find a pharmacy to administer her husband a flu shot. The mother in Harlem, who relies on the bus or subway, has to wait until Rite Aid revises its policy. Rite Aid is revising the policy now, as I write this response, but this means that everyday that it takes for a well-intentioned, well-meaning pharmacy to amend its rules, the mother in Harlem or mother in any other impoverished area must continue to send her children to school without the flu shot, where they remain susceptible to the virus.

In the Civil War records, I saw a similar health crisis unfold: people were not dying from complicated, unknown illnesses but rather from the failures of a bureaucracy, from the inability to provide basic medical relief to those in need, and from the fact that their economic status greatly determined their access to basic health care.

Tim Allen is an Assistant Editor for the Oxford African American Studies Center.

The Oxford African American Studies Center combines the authority of carefully edited reference works with sophisticated technology to create the most comprehensive collection of scholarship available online to focus on the lives and events which have shaped African American and African history and culture. It provides students, scholars and librarians with more than 10,000 articles by top scholars in the field.

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I've been reading a slew of serious books lately for the mock Newbery group, Newbery Blueberry Mockery Pie, so I took a slight detour between The Lions of Little Rock and Wonder, to read the latest in the "Stuff" series.


Holm, Jennifer L. 2012. Ginny Davis's Year in Stuff: Eighth Grade is Making me Sick. New York: Random House. (Ill. by Elicia Castaldi)

Using an updated version of the wonderful format that served the Klise Sisters so well in the Regarding the ... and 43 Old Cemetery Road series,

Jennifer Holm has crafted a winning series consisting of a collection of correspondence and realia.  While the aformentioned series rely heavily upon letters, newsletters, newspaper clippings and such - all rendered in black and white sketches, the Stuff series is illustrated by Elicia Castaldi and is a wonderfully fun and colorful combination of collages created from sketches, artfully chosen backgrounds, Post-it notes, screen shots, cell phone messages, scribbled notes, a brother's cartoons - virtually anything that might convey information to or about Ginny Davis, 8th grader at Woodland Central Middle School.

Changes are coming to Ginny's financially struggling family.  The biggest change? Mom's pregnant.  Didn't notice the positive pregnancy test stick in the garbage? No worries, just check the IM window running next to spider solitaire,

GinnyGirl
OMG mi mom is pregnant! I though she was just getting fat!
beckysooboo1
OMG! OMG! She's a grannymom!
GinnyGirl
What's a grannymom?
beckysooboo1
an old mom!
GinnyGirl
She iz pretty old. She's 39!
beckysooboo1
Do u think shez having twins? Or 3lets? I love all those shows with multiples!
GinnyGirl
omg.  I hope not.
 

In addition to mom's pregnancy, Ginny has to worry about making the cheer squad and earning some new privileges, specifically, permission to bike to school and join an online movie fan group, "Vampire Vixens Den." Hopefully, persistent stomach trouble and a troubling family financial situation won't keep her from completing

Ginny's big To-Do List

1. Try out for cheer
2. Convince Mom to let me bike to school
3. Fall in love
4. Work on art (sketch every day)
5. Save money
6. Look good in family Christmas photo
7. Join  Vampire Vixens Den
8. Teach Grampa Joe how to email
9. Have a cool Halloween costumer for once
10. Ignore horoscopes!

There are so many reasons to like this book. It tackles the very real problem of declining middle-class income. It embraces modern culture. It's fun. It's funny. It's artistic. Ginny is a likable young girl.  Kids (especially girls) will love it.  Do I sound like a Jennifer Holm fan?  I am.

Want to see more of Eighth Grade is Making Me Sick? 
Watch a "behind the scenes" video on the author's webpage.

Another review @ Kirkus Reviews

Note:
If you're a teacher who shies away from assigning any form of illustrated novel, here's an idea for you - with the current focus on cross-curricular instruction, pair up with the art teacher, if you're lucky enough to still have one! Let students tell their own stories in this appealing mix of text, art, and reality.


Note: This post had been edited to correct an incorrect attribution that I realized after posting.  My apologies, LT

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Queen of Hearts is an engaging YA novel set, for the most part, inside a tuberculosis sanatorium in Manitoba, Canada during the years 1940-1941.

Marie-Claire Côté, 15, lives on a small farm across a valley from the Pembina Hills Tuberculosis Sanatorium. The close proximity of the San makes everyone in the community very aware of this highly contagious disease. But so far, the Côté family have all been lucky enough not to have had TB touch their world.

Their luck changes, however, one cold spring evening in 1940 when Oncle Gérard returns to the farm. Gérard, only 25, has been riding the railroads for years, a happy go lucky vagabond. Then, in the fall of 1940, Gérard is diagnosed with TB. At first, he remains at home, but when a place opens at the San, he is taken there, where he dies in February, 1941.

But it doesn’t take long for symptoms of TB to start appear in the Côté children. First, in 11 year old Luc, then in Marie-Claire and finally in the youngest, Josée, 5. In December 1941, all three of the children are diagnosed and immediately admitted to the San. Angry and resentful, Marie-Claire doesn’t adjust well to San life – the food, the routines, even the constant cheerful friendliness of her very sick roommate, Signy.

Though not a willing patient, Marie-Claire does begin to adjust to the idea that she must change her attitude in order to help herself.  This attitude change is bolster by the loss of her brother and the recovery of little Josée. After a while, she even begins to slowly accept Signy’s offer of friendship and manages finds a boyfriend in the San.

The relationship between Marie-Claire and Signy is always strained and through it Brooks brings out an interesting phenomenon that often occurs when someone is faced with the possibility of a friend’s illness being terminal – avoiding them despite their genuinely good intentions. This happens a couple times in Queen of Hearts. Signy’s former roommate, Louise, is a good example. Louise had been moved to a cottage as she improved, but with promises of coming back to visit. The visit doesn’t happen until the day the now healthy Louise is leaving that San: “I always meant to come back and see you. It’s hard, you know to…see people. I mean, after you’re getting better and they’re…” (pg 104) Who knows why this happens – survivor guilt? Fear of getting sick again? Fear of death? It could be anything. It is just not something that is addressed in YA novels about illness very often, but maybe it should be.

I was very interested in this book, since my dear friend and neighbor, George Cassa, who passed away suddenly this spring, once told me about his own personal experience as a teenage TB patient in an upstate New York sanatorium, also during World War II. His experience mirrors much of was is described in Queen of Hearts, adding to the realistic feeling in the novel.

Brooks, who grew up living in a Canadian sanatorium where her father was the medical superintendent, is very familiar with the confined, often boring, lonely life of a TB patient. Her descriptions of the tedious daily routines that Marie-Claire experiences as she “chases the cure,” a rather ironic image given that TB patients are confined to a bed for a good part of their treatment, imparts a true sense of authenticity in the novel.

Queen of Hearts is a poignant, compelling coming of age story which will captivate the reader from beginning

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This colour version of my illustration for the theme Remedy would make a good get well illustration. I might turn it into a card yet. "We will tie the string to a door handle now , it won't hurt a bit" said mouse. Donkey wasn't so sure. I spent the day sketching for a toy design contract and this evening while kiddies were asleep and hubby out I had a digi play. It was a bit of a break from all

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This post is Part 5 in a 5-part series on Pain.

• Part 1: An Introduction to the Subject of Pain
• Part 2: My Personal Pain Story: The Pink Porcupine
• Part 3: Creativity in the Midst of Pain
• Part 4: What Others Have Written on Pain and Suffering
• Part 5: Resources Related to Pain Management

Thank you for going with me on this journey to learn more about how we can cope with pain, if and when it does appear in our lives. Here are some resources you might find helpful.

Pain Management Resources on the Web


The American Academy of Pain Management

American Academy of Pain Medicine

American Chronic Pain Association

Various conditions related to pain

American Pain Foundation

Pain: Chatrooms and Discussion Boards

American Pain Society

Guides for Persons with Pain

The Journal of Pain

Chronic Pain Information Page

Counseling / Pain Management Centers by State

International Association for the Study of Pain

Global Year Against Acute Pain: Oct. 2010 - Oct. 2011

Pain (Journal)

National Pain Foundation

National Institutes of Neurological Disorders and Stroke

How is pain treated?

Pain Connection: Helping People with Chronic Pain and Their Families

Pain Recovery Online

Partners against Pain (for Patients and Caregivers)

StopPain.org: Dept. of Pain Medicine and Palliative Care, Beth Israel Medical Center

Physical Medicine and Rehabilitation (Physiatry) is a specialty of medicine concerned with the diagnosis and treatment of aches and pains and other disabling conditions. Board-certified physiatrists complete four years of medical school as well as a four-year residency program, and many physiatrists also do fellowships in specialized areas of rehabilitation medicine. This training develops skills in the areas of orthopedics, neurology, and rheumatology. Physiatrists are therefore skilled in determining the cause of a patient's symptoms—nerve, muscle, joint, bone, ligament, etc.—and treating the patient’s condition. In addition to the conventional use of medications, physiatrists have expertise in the use of modalities (hydrotherapy, ultrasound, transcutaneous electrical nerve stimulation, etc.), exercise programs, manual techniques, equipment (splints, corsets, braces), and coordination of therapy programs. Source: http://www.rehabmed.net/patient_ed/physiatry1.html

Cond

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This post is Part 3 in a 5-part series on Pain.

• Part 1: An Introduction to the Subject of Pain
• Part 2: My Personal Pain Story: The Pink Porcupine

So many of my feelings and beliefs about creativity and how it relates to pain stem from the experience I had as a teenager over an eighteen-month period when I was ill with mono and then a benign tumor in my neck and three surgeries related to it. I would gather my sewing box, sketchbook, miniature poodle Suzi, and small b/w TV and, with Vernor's ginger ale close by to counteract the peroxide mixture I had to gargle with, I would retreate to my bed for the day, making tiny felt creatures and sketching farm scenes in pencil.

Perhaps it should be pointed out that I was a bit of an introvert, already enjoying creative pursuits, and I had the encouragement of my parents and the time to give to experimenting with arts and crafts. I also had a wonderful high school art teacher, Mrs. Catherine Lotze, who inspired me and even invited me into her home to show me the beautiful things she and her mother before her had made. So, though my love of making things did not begin with illness, the illness gave me time to nourish the tiny seed of creativity genetics or environment or parental guidance (or a mix of all three) gave to me.

In 2006 and 2007 when I was working on Open Your Heart with Pets: Mastering Life through Love of Animals, I solicited stories about people and their pets. Many of the stories I received concerned the manner in which the writer's pet had comforted and cared for them during illness. And, as I delved into the subject of pain this month, I am finding another commonality: many folks use creativity as an outlet to express or escape from pain.

When I am in discomfort or pain (in my layperson's terminology, I am using "discomfort" to indicate pain that only marginally interferes with undertaking one's usual activities and "pain" to indicate a level of feeling that does significantly impact one's normal activities), I can pick up the tools I'm using for the book illustration project of that month, work on my novel-in-progress, or grab some needlework and, perhaps like a person who has learned to meditate well, I mentally dive into the task at hand and my focus is on it and not on how I feel. Not on what hurts. Art takes me away the way nothing else can, or ever has.

When I put down the creative task and try to watch what for me is mindless TV—or talk on the phone, do laundry, or fuss in the kitchen—everything my body feels floods back. For me, creativity is truly

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Part 1, "An Introduction to the Subject of Pain"
Part 2, "The Pink Porcupine"
Part 3, "Creativity in the Midst of Pain" Part 3 (coming soon)
Part 4, "What Others Have Written on Pain and Suffering" (coming soon)
Part 5, "Resources Related to Pain Management" (coming soon)
Please bookmark Appalachian Morning or add it to your RSS Feed or Google Reader so that you can easily find all sections of this 5-part post.

Disclaimer: I am not a psychologist. physician, physiologist, or therapist. I have no medical or mental health training whatsoever. Therefore, no advice, medical or psychological, is intended or implied by any of the posts in this series on PAIN.

PAIN: The Pink Porcupine

"...we can let the circumstances of our lives harden us so that we become increasingly resentful and afraid, or we can let them soften us and make us kinder and more open to what scares us. We always have this choice." The Places that Scare You: A Guide to Fearlessness in Difficult Times by Pema Chodron

MY RELATIONSHIP TO THE HEATING PAD BEGINS
When was the first time you experienced pain? For me, it was in my ears, and this is curious as I grew up to give birth to a son who has struggled with a hearing disorder for nearly thirty years now and undergone two painful ear operations. I had horribly painful earaches (called "bealed ears") as a young girl (before age five). And, way back then there were no "tubes" to insert. The heating pad and late-night TV were my companions as I remember being up in the middle of the night, on the sofa, covered with a homemade afghan, the heating pad, and some long-forgotten program on the b/w television. To this day, I associate the smell of a heating pad with being a little girl.

The earaches felt like an ice pick, slowly pushing ever harder against my eardrum and radiating into my jaw, eye, and temple. The muffling of sound was accompanied by a thick, yellow liquid medicine (of which I can still remember the smell) that was not as gross as the liquid that stained my girlish pillowcase each morning when I awoke.

The earaches were the worst pain I'd felt in my young life and were, I realize now, an introduction to the pain that life can bring. When my parents loaded me in my flannel pajamas into the car for a ride to the hospital to have my tonsils out (as this was thought to perhaps help), I didn't worry about the surgery, I didn't know what surgery was. I kept my eyes focused on the shoebox on the front seat between my parents. In it was a surprise that I would get once settled in at the hospital: a Raggedy Ann doll. I can remember the anesthesiologist asking me what presents I received for Christmas and in the middle of my answer I fell into a deep sleep, had my tonsils removed and was never bothered by earaches again.

Just before my fourteenth birthday I came down with a nasty bout of mononeucleousis followed months later by a growth on the right side of my neck, between my jaw and collarbone. At Halloween that year I was in a semiprivate room having the abcess drained. I don't remember pain from this operation, but learn about pain I surely did, as the middle-aged woman sharing a room with my young self was underg

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Pain.
Aching
stabbing
throbbing
radiating
relentless
acute or chronic.
Pain.


I've been in a fair amount of acute physical pain over the last seven weeks. Thankfully, it has now skulked away, mumbling the brand name of my antibiotic and shaking its fist. I injured my back at the end of November, and it was just healing up and not constantly reminding me of the foolish move I'd made (trying to lift up an elderly friend), when I came down a week ago with an abcessed tooth. Overnight it progressed to facial cellulitis, a painful, serious infection that ebbed its way out of my jaw, chin and cheek thanks to the miracle of modern medicine.

I've had periods of both acute and chronic pain at other times in my life as well, and while I've written about my childhood, my children, surgeries, my business, my love of Ohio and art and crafts and books... I've never written about pain until now.

Outside of the medical community, pain seems to be a "hush-hush" subject. To talk about it, to admit to experiencing it, implies a degree of wimpishness, of self-centered attention-seeking impropriety even. For men, there are even more societal pressures to "put up and shut up" when it comes to pain and all sorts of cliches such as "take it like a man" and "Don't be a sissy." As children, when we said, "It hurts!" our parents may have countered with: "Now, don't make a big deal out of it. It's not that bad." Parents may be so afraid of raising a whiney child that their only course of action is to negate feelings and discourage further discussion.

Fortunately, although I spent a year and a half of my high school education ill and undergoing three surguries, my parents did everything right. Looking back now, as a mother myself, I marvel at how they offered to me the right mix of empathy and confidence in my ability to cope. They took my complaints and concerns seriously, yet never babied or spoiled me, though I'm sure at times it might have been tempting to do so, as I was the only child still at home and was introverted and sensitive by nature.

When bringing up my artistic leanings in conversations with others, my mother often mentioned how, when waiting for surgery at age fifteen, I asked for pen and paper and created a little chess set so I could play the game with my father and pass time while coping with pain and waiting for the operating room to free up so the surgeon could relieve pressure in my swollen neck (from a benign tumor). What Mom doesn't mention is that she and Dad were the sort of parents who encouraged my creativity and gave me the pen and paper and played the game with me as if these were good solutions to a stressful situation.

In the adult world, it seems we don't trust ourselves or others to mention, admit to, or discuss pain and illness for fear of giving into it entirely and letting its presence control our lives and keep us from the good health we all hope to experience. But perhaps that is the wrong approach. Perhaps silence only empowers pain; by trying so hard not to mention it, we end up screaming about it in less psychologically healthy ways. While no one but immediate family wants to listen to in-depth, descriptions of illness or medical procedures, that verbal faux pas is a far cry from stating the truth:

• "I'm in pain, but finding ways to cope."
• "I've been ill, but am on the mend..."
• "I am doing much better thank you; but it was pretty awful."

(Of course, in work environments there are reasons not to share health information, but I am talking about discussions between friends and those in one's social circle.)

Now, I'm not a psychologist. I'm not a doctor. I'm not a counselor. I have no mental health or medical training whatsoever. So, no advice, medical or psychological, is intended or implied by this post or the three parts that

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That´s beauty of being an illustrator. At one moment you can work on a project about importance of good sex life and than you move quickly to a very different subject, about old people in bad shape sent back from hospital home. Client: ESS newspaper.

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Oh yeah. Ever had one of those moments with your medical insurance company where the lady on the other end of the phone line is sweetly telling you how to fix a problem with your bill, but is making absolutely no sense to anyone other than herself? I’m sitting here scratching my head wondering what in the world this company was thinking when they made up some of these rules. Did you know some companies require the tax id number on the receipts before they’ll reimburse you for your expenses? Nope me either. And the kicker comes when the Doctor’s office doesn’t have a tax id number, won’t give it to you, or plain can’t find anyone who knows it. Someone, pinch me. Surely this is just a dream. . .

Now, most of you know I am the mother to four wonderful kids. Four children who go to school, activities, and church so illness is bound to happen. An insurance company isn’t a nicety it’s a “where’s the card, Cory’s bleeding again,” kind of thing. Try as I must, I am stuck with battling the insurance company on this fine fall day. I guess I should be grateful, I’m not out raking the leaves or pulling the dead underbrush (I don’t care for those chores much either:)).

On that note, Happy Friday!

What do you do when you’re stuck going around in circles with a company?

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In the midst of dystopia, vampire and violence stories emerges a refreshing story that definitely is my “feel good” novel of the year thus far.

Charlie is the freak. Gloria is the freak magnet. So both of them think! One day at a coffee shop Charlie spots the most glorious creature to grace the earth. You guessed it: Gloria. In his over-the-top, freakish way, he hits on her despite the warnings of his best buddy. Gloria disses him and heads off in her totally black persona way. Fate interweaves their lives and they continue to intersect. Gloria hates to admit it, but Charlie is hot, but still a freak. But her admissions to his endearing personality continue during their lucky encounters. This he said/she said format digs into her blackness, his love and fear for his family, and their growing affection. Charlie’s antics at his job with his quirky co-workers are laugh-out-loud funny. Gloria’s de-icing reveals the loss that she has felt the last year. This is a book that reminds us that love is in the world, if we only trust it.

ENDERS' Rating: *****

Andrew's Website

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A Sick Day for Amos McGee by Philip C. Stead, illustrated by Erin E. Stead.

I was utterly charmed by this book.  It has a gentle humor, a sweetness and an inherent loveliness that really makes it special.

Amos McGee got up early every morning, changed into his uniform, and headed to work at the City Zoo.  Even though he had a busy work schedule, he always had time to visit his friends.  He played chess with the elephant, ran races with the tortoise, sat quietly with the shy penguin, wiped the rhino’s runny nose, and read books to the owl who was afraid of the dark.  But one morning, Amos woke up and didn’t feel well enough to go to the zoo.  His friends waited for him, but when Amos didn’t come they set out to visit him instead.  The elephant played chess with him.  The turtle played hide and seek instead of running races.  The penguin kept Amos’ feet warm.  The rhino always had a handkerchief ready when Amos sneezed.  And at bedtime, the owl read them all a book.

The husband and wife team who created this book really worked well together.  Philip’s tone of writing has a gentle feel that matches his wife’s art perfectly.  Philip’s writing is very readable and works well aloud.  The small touches of detail make the world more convincing, including the elephant taking a lot of time to make his move in chess and the spoonfuls of sugar Amos uses at breakfast.  It is these little facts that really invite one to linger longer in the book.

Erin’s art is delightfully realistic for such a fantastical story.  The animals are very true to life except for their hobbies.  Her art uses delicate lines and subtle colors.  I especially enjoyed Erin’s two-page wordless spreads as the animals head to Amos’ home.  Again with her art, the small touches add so much: the elephant lining up his chess pieces while waiting for Amos and the socks on the feet of the penguin.  Small details but very important to the tone and feel of the book.

Highly recommended, this book will be embraced by all who read it.  Share it for units on zoos, colds or save it for a great bedtime read.  Now all I need to find is a shy penguin to keep my feet warm…

Appropriate for ages 3-6.

Reviewed from copy received from Roaring Brook Press.

Also reviewed by The Reading Tub.

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A wolf, a tiger and a pig congregate around a campfire one bizarre evening. One thing leads to another, and they inevitably begin to boast. The wolf says “every time I howl, the whole forest is scared”. The tiger says “that’s nothing. Every time I roar, the whole jungle is terrified!” The pig snorts (derisively) and says “Well every time I sneeze, the whole world craps itself.”

A global pandemic. A threat to modern civilisation. A hundred billion lives in danger (?) What will be reported next on Swine flu? As far as my number crunching has led me to believe, 4 of 100,000 cases have resulted in death unaided by any other illness. That’s 1 in 25,000. You have a better chance of being struck by lightning than dying if you get it. (1)

Does normal flu not result in a similar amount of deaths each year? Tell me if I’m missing something. Is an intolerable phobia of pig-flu the latest craze to sweep the globe ever since the constant threat of terrorism became auspiciously quiescent?

In a society becoming ever more bacteria-o-phobic (for lack of a knowledge of ancient greek), where will we get our immune systems from? Babies are sheltered from germs, kids aren’t going out and getting filthy and… well… teenagers I suppose are (allegedly) rife with STDs and fresher’s flu but that’s not the point.

Give your immune system some exercise- go outside without a facemask on! If you end up in bed for 2 weeks, sure, it’s crap but it’ll be character building or something…

I’d never heard that pigs could fly, until swine flu…

(1) - http://wiki.answers.com/Q/What_are_the_odds_of_being_struck_by_lightning

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So, my daughter’s fever turned into a nasty cold. An odd turn of illness in my book, but now I hear the same thing is going around. (“Oh, the one-day fever with the cough and sniffles! My husband had that!”) I love how we moms categorize these different illnesses and then spread the message far and wide, so that the next unsuspecting mom will have a clue. My girl felt decent over the weekend —

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From top to botom:
* Brenda fromCanada
* Arlene from Philippines
* Monika from Poland
This is my new project...my new blog. i do offer free sketch. its free for lo - res artwork. delivered to your mailbox! - i only charge USD5 for hi-res artwork A4 300dpi...:) come on all grab your free sketch today! just email me your pix!
Have a nice day!
myfreesketch

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