FATBACK

Nine month before my third liver-first kidney transplant, I visited my eldest son on the University of Virginia campus at Charlottesville. I was overjoyed to spend time with him, even though this trip had more to do with a costly shopping spree at Ikea than him missing me.

I booked a last minute flight on Jet Blue, the Kmart of the air: a bus that flies, offering cable TV so you don’t focus on how uncomfortable you are. I always choose an isle seat when I fly, because anything other feels slightly claustrophobic, especially on Jet Blue. Luckily, I got my seat. The plane was packed; everything was taken, except for the window and middle seat next to me. I looked up the isle just as the flight attendant announced that the door would close shortly. I couldn’t believe my luck! Only two empty seats on the entire plane, and they were mine!

And then it happened. Twiddle Dee and Twiddle Dum (the two fat characters in Alice In Wonderland) came waddling down the isle barely clearing the sitting passengers. They were heading straight for my empty seats. Oh shit! I thought. First the son squeezed in close to the window, shifting his body as best he could. As he sat, his fat spread onto his mother’s seat. I watched in horror, fully aware of what this meant for me. Then the mother shifted and squeezed her way into the middle seat…and mine.

The son couldn’t put down his armrest because he was too fat. The mother couldn’t put down the armrest between us, because well…you get the picture. The woman glared at me as I took what was left of my seat. I managed to accommodate a little over half of my buttocks. The rest of me hung over the isle. The Gargantuan couple beside me dwarfed my one-hundred-and-five-pound build. I felt like Alice In Wonderland, the shrunken one, shadowed by six hundred pounds of Dee and Dum. I strapped myself in, while the flight attendant handed them extenders. I’d never heard of such things until then. It’s for people who can’t fit in a regular seat belt and need an extension.

The flight took off. The woman was unpleasant. She couldn’t put her arm down and held it in a sort of self-embrace position. If she had lowered it, I would’ve fallen into the isle. To put it simply, the sacred distance strangers enjoy, the space we take for granted even on a Jet Blue flight, was gone. She and I rubbed against each other like lovers. Thank goodness for Jeans and long sleeves. I turned towards the isle to create some semblance of private space, only to encounter the gaze of the passengers around me. They all sported the same “Oh, do we feel sorry for you,” look. And I replied with a beaten puppy face. I didn’t know it yet at the time, but I was already quite weak and sick, and had no energy to deal with this situation.

As unfamiliar as I am with the plight of fat people, I’m sure they’re not all as unpleasant as this woman and her son were. She glared at me every time she maneuvered her arm, as if all of this were my fault. Then, the snack cart came by. Suddenly her arm darted straight out with a wobble as she said, “Four barbecue chips and four Doritos.” Her son asked for the same. Once the attendant silently handed them half the snacks on the cart, Fat lady mouthed something under her breath. She couldn’t get drinks because the tray wouldn’t go down and her hands were already full. But her son insisted on a coke. The mother continued to mumble as she struggled to bring the Doritos to her mouth without knocking me over. Leary of this whole state of affairs, I left them both to their junk food feast to go to the bathroom, and to complain. After all, I had paid for a whole seat, and I wanted it.

The flight attendant agreed with me. A few minutes after I had returned to my seat, she came over and told my sticky neighbor, “Ma’m the armrest has to be down. Please lower the armrest. The lady looked at her and replied, “I never heard of such a thing. No one has ever asked me that,” meaning this wasn’t her first flight, nor was it the first time she inconvenienced a passenger. The stewardess grabbed the armrest, and began pulling it down with all her might, claiming with each jolt, “this…has…to…be…down.”

Not exactly what I had wished for. Fat bulged from my neighbor’s torso and rump to compensate for the space taken over by the armrest; and my sitting surface shrank even more; one buttocks cheek, and more personal contact. As soon as the well-meaning flight attendant left, I raised the armrest again, quickly scooting into the space it had just freed. I sat sideways facing the isle, and stared out the opposite window, hoping for…land, please? In the meantime mother and son munched on their fourth bag of barbecue chips. I sipped my water, exhausted, and drained, but did what I do best. If there’s one thing I’m good at, it’s making an intolerable situation better. I’d done it pretty much my entire life with illness; I certainly could do it with some obnoxious woman invading my physical and air space…in a plane. Mind over matter. I zoned out the fat squad and meditated on seeing my son, meeting his friends, and wondering what we would do besides spend money at Ikea.

We arrived at Dulles. Twiddle Dee and Twiddle Dum stayed seated while the rest of the passengers deplaned.
A couple of months later, back at UVa I met a Jet Blue executive whose daughter also went to school there. I told him the story. He suggested I write the airline a letter. So I did. The reply shocked me: ‘we’re very sorry for your inconvenience, but we can’t discriminate against obese people. We hope you’ll understand our position and continue to take advantage of our many destinations all over the country.’ Seriously? And what about the rights of regular folks? I thought. I tore up the letter and never flew Jet Blue again.

DIE

I decided to write this in honor of Troy Davis who was executed after three different stays of execution. The case was flawed from the very beginning. As time passed and his defense team changed, it became clearer that many mistakes had been made by the police, the witnesses and his lawyers.

Troy Davis has been all over the news so here his story in big strokes: Troy’s friend, Redd Coles was arguing with a homeless man over a beer. Redd Coles pistol-whipped the homeless man. A security guard, by night and a police officer by day, Mark McPhail came over to break up the argument. Suddenly, he lay dead from two gunshots. The very next day, Redd Coles and a lawyer arrived at the police department in Savannah, Georgia and accused Troy Davis of murdering the off-duty cop. Here some words in poetry instead of prose.

DIE

Die a useless death for those who come after you

Die like a junky, justified with a needle in your arm

Justify his death through eyewitnesses

Witness his demise as if you’ve done no harm

Today the law stands accused

Of killing a man they say killed another

Today power has been abused

For refusing to investigate further

He’s not your man, his lawyer said,

Here, take a look at what we’ve found

Sorry, is what the judge replied,

This case is closed, review denied

How can you throw a man under the axe

When all we want to do is crack

This case and discover the real facts

Which could give him his life back?

He is a murderer, this is a fact

He’s had his day in court way back

Twenty years since then have past

He’s guilty as hell. And that’s that

Twenty years since then have past

And still I swear I’m innocent

Twenty years is time I’ve spent

Breathing sweat from the cement

In this jail, which is my home

I’ve checked out long ago

I’ll never leave but in a box

Even though this debt I don’t owe

I’ve killed no one, not then not now

I’ve done no wrong, of this I swear

Twenty years since then have past

I’ve killed no one, law doesn’t care

Let this man live, the whole world cried

Desmond Tutu, Jimmy Carter

Millions of people were on his side.

Save his life! Make no martyr!

The judge, the governor, the Supreme Court

Watched as the Board made up of five

Turned a blind eye on Troy’s case

Any more time spent was a waste

This is it, no more appeals

This is it, you’re going to die

They won’t make any more deals

Because the system's gone awry

It’s all good, it’s all okay

I’ve made my peace, I’ll feel no pain

I’ll close my eyes and drift away

But don’t you worry, we’ll meet again

Die a senseless death for those who’ve come and gone

Die like a junky, justified with a needle in your arm

Justify his death through eyewitnesses

Witness his demise as if you’ve done no wrong

CHAPTER 41. NOW OR NEVER

Death doesn’t become me

I spent the next day as I had the previous one, crying and drawing blood as I tore at my feet with a key. Every so often I dozed and awoke, my delusional mind hoping for a miracle. Around nine that evening, Uli called.

“I’m in so much pain,” I cried. “I’m so scared!”

“Schatz, Schatz, Ich komme bald.” (Dear, I’m coming soon.)

“Hurry, please come. I can’t stand it anymore!”

Uli heard the panic in my voice. I should have gone with her, shouldn’t have let her fly to Miami by herself, he thought. “Call an ambulance! Go to the hospital right away,” Uli said.  “I’ll call the lobby for you. You must go to the hospital immediately.”

“But Gloria F’s coming. She’s already on the plane. She called and said she’s on her way. I’ll wait for her.”

“Don’t wait! Just go. I’ll call an ambulance.”

“It’s okay, I can catch a taxi in front of the hotel. I’m going.”

Jackson Memorial hospital is in a seedy part of downtown Miami. Crowds of people, mostly Cuban and Haitian, loitered outside the emergency entrance. They smoked and shouted in a cacophony of Cuban Spanish and Patois. I immediately perked up at the sound of foreign languages, but I was too weak to listen to everybody’s conversation the way I usually did. Not this time. Not now.

The emergency room was packed with people slouched in chairs. I’m not waiting. I can’t wait. I walked towards the information desk where a heavy-set African-American lady sat behind a tall counter.

“Where’s hospital admissions please? I’m Dr. Tzakis’ patient,” I said, barely holding it together. My feet didn’t itch anymore. Instead they were on fire.

“What did you say your name was?”

“Gloria Edel.”

A quick glance at the computer screen. The clerk immediately went into action. She looked around and said, “George, come over here with that wheelchair.” She looked back at me. “Someone’ll be right with you,” she said, calmly and emotionless, like someone who’s seen it all.

Within minutes a suited woman wheeled me through a door at the far end of the emergency room. A déjà vu moment. I was checking into Jackson Memorial the same way I had checked myself into Presby almost fifteen years ago. Back then, I was achy and bloated, my ankles were on fire, pretty much the same as now. The suited woman asked me the usual pre-hospitalization questions while handling papers. Tears poured down my cheeks. Someone handed me a tissue, and then discretely placed an entire box in my lap as I sobbed, hiccupped and blew my nose through the Q and A session. The process took longer than expected. The woman often had to repeat herself. I couldn’t always hear her. I felt like I was in a tunnel, far away from her although she sat right across from me. My mind was distracted, sinking into black holes and then re-emerging to hand her my insurance card, or spell out my address. Once formalities were finished, I waited a few minutes, or perhaps it was an hour, I wasn’t sure, for a volunteer to wheel me to a room.

I want to pause for a moment, and talk about luck. Carl Gustav Jung called it ‘synchronicity’ or ‘acausal connection of two or more psycho-physic phenomena.’ He believed that there are no coincidences, no serendipitous moments in life. Relying heavily on his psychoanalyses, Jung concluded that synchronicity begins in the dream state and materializes through the connection in the mind with the outside world. Certain people might find this sacrilegious, but a part of Jung’s theory has been watered down, or perhaps a better word is bastardized, in the book, The Secret. If you think it, it can happen.

On the other end of the spectrum, luck is seen as divine intervention. We say “good luck” when taking leave of someone, as if luck were something that falls from the heavens. Or perhaps it’s a moment in time when the stars, moon, earth, and universe are aligned with your consciousness to conjure up the phenomena called luck. However you perceive it, we know luck or synchronicity to be intangible, unpredictable and only appreciated in hindsight.

I was in a fog, my mind fading and blacking out. In this scariest moment, luck was about to materialize. The volunteer and I left the emergency room and approached the large overhang, shadowing the hospital’s main entrance. Suddenly, I became lucid, as if the tears, dazed state, and blackouts had never existed. Two men standing against a column carrying on a conversation zoomed into focus. One of them held my attention.

 “Andreas!” I called. “What are you doing here?!”

“Gloria! I should be asking you that! When did you arrive?”

“I’m so sick, Andreas! I’m in so much pain I can’t take it any more…the day before yesterday…I just checked into the hospital.” I was sobbing, and took advantage of the box of tissues still on my lap.

“That’s okay,” he said to the volunteer, “I’ll take it from here.”

It was eleven o’clock at night on a Sunday. What were the odds of running into my doctor right at that moment? Less plausible is that I would experience a moment of lucidity just then. He didn’t know I was in Miami, or that I was checking myself into the hospital. Had he known I was in town, I’m certain he wouldn’t have expected to see me on a Sunday night in front of Jackson Memorial. On my way to the emergency room, I had daydreamed about Dr. Tzakis. I had hoped I would run into him, that he miraculously would cross my path. This Jungian ‘synchronicity’ born from my mind and my environment had come to fruition, and it meant more than I could even fathom at the time.

Time was of the essence. I can’t say for sure, but if I had waited until the next day for my doctor to see me, if matters had been delayed just by a couple more hours, there’s a very good chance that I wouldn’t have survived. Dr. Tzakis immediately started the ball rolling. There’s no doubt in my mind, I   was   lucky.

Dr. Tzakis grabbed the handles of the wheelchair and took control of the situation. A waterfall of meaningless words poured out of my mouth while I cried. Dr. Tzakis listened to my senseless gibberish on the way to the room. He knew what this behavior meant. My system was on the verge of shutting down permanently. 

Once I was settled in bed, my mind began to completely fade. I was still coherent at times, but the moments of lucidity were few and far between. No medication could fix my condition; it was the precursor to death. At some point, Gloria F. stood by my bed and rubbed my temples. I suffered from a migraine headache. Most of the time, I was out of it. She spent the night in the room with me. Early the next morning, she left to freshen up at the Doubletree.

Back in Los Angeles, Uli rushed to tie up loose ends with the producers of his next project before catching the red-eye to Miami. He arrived a day later after a grueling trip, and headed straight for Jackson Memorial. He was holding my hand when I regained consciousness.

“They have a liver for her,” Uli whispered.

“How soon are they going to operate?” Gloria F. whispered back.

“Stop whispering. I want to know what you’re talking about,” I called out, the feisty side of me emerging from my confusions. “Uli you better not go with a younger woman. It better be someone older.”

“Schatz, open your eyes,” Uli commanded gently as he stood by the bed and stroked my face.

“Don’t ask …I can’t.” 

At that moment, as I uttered those words, Uli became frightened. This seemingly harmless remark took him aback. For the first time since we were married, he finally realized how close to death I really was. A few weeks earlier I had spent hours in the gym. In what state was I, if I didn’t have the strength to perform the simplest of tasks, and open my eyes?

   Later that day, Dr. Tzakis stood at the entrance of my room.

   I gestured for him to approach.

        “I don’t need to get any closer to see how sick you are,” he said.

The last time we had met, I was strong and looked relatively healthy. At that time, I wasn’t convinced I even needed a transplant. He knew better than anyone that I could die before making it to the operating room. In fact, I was going to die if a liver didn’t become available in the next few hours. The irony was, the liver and the papers were in another building of the Jackson Memorial complex. The fax machine on the other end was broken, and took six hours to repair. You would think someone could’ve simply walked over and collected the authorization forms and the organ. However, protocol can’t be breached when it comes to organ donation. Finally, the fax arrived. At five in the evening, Dr. Tzakis ordered the nurses to prep me immediately. I was placed on a gurney. Uli and Gloria F. walked along side. We took the elevator down to the operating room.

“Don’t cry,” I said to Uli “I’m going to do this.” I turned to Dr. Tzakis, “Andreas, could you give me a tummy-tuck while you’re at it?”

Little did I know that those would be my last words for the next two months.

GENDER BENDER

I was intrigued a couple of days ago, watching a Nightline special on transgender kids. Lately, sexuality in the United States, a historically taboo topic, has taken the cow by its implanted testicles and put a face on the many shades of preferences. Well, it’s about time.

I enjoyed the piece about the mother who wrote a children’s book called My Princess Boy in honor of her five-year-old son, who, ever since he was a toddler, loved or rather demanded to wear dresses. This beautiful, brown-skinned child, with big, witty eyes feels much more at ease in a sequenced dress, and playing with Barbie, than in pants…and playing with Barbie. It took just a few words from his not much older brother for his mom to realize her son was going to vogue to his own techno. “Mom,” her older son said, “just let him be happy…” Out of the mouth of babes…

For someone who grew up in Germany, when it comes to sexuality, I’m amazed how the ‘Old World’ (that would be Western Europe) is more understanding than the ‘New World’ (more specifically the United States). In Germany, and in most of Europe, sexuality is a matter of fact. In Holland, gay marriage is a given. Italy, (yes, the country where the pope resides) has more porn channels than regular ones. France always praised and admired their transgender artists. In Germany sexuality isn’t a topic. It just is. A nude body on the cover of Spiegel, (German Times magazine) just is. The popular model/singer/talk show host Romy Hag, a transvestite, just was. Homosexual kids and adults, just are. Totally naked people in the English Gardens, (a park in the middle of the city of Munich) playing frizz bee, just are. The only reason why I bring this up is because we, here in the New World, are supposed to be the open-minded ones.

After all, this is the country that embraces innovation like no other. We make millionaires overnight; we come up with new vocabulary and new expression to match the mood of the moment. We make a family of five girls whose names all begin with ‘K’ famous for…absolutely nothing. We’re a creative, ‘go for it’ people that thrive on new ideas. But when it comes to sexuality, suddenly, it’s all over.

I blame our puritan forefathers for this. As ground-breaking as we are, somehow we can’t shake our, firmly planted in austerity, history. Nudity is nasty, masturbation, the devil’s work. Although these views have evolved (it sure took its damn time!) we aren’t ready to embrace all sexuality. Today, we still grapple with total equality for gay people. Transgender is wrongly considered a choice, just as homosexuality was years ago, and still is in some places. Anything beyond the archaic and prehistoric definition, man is man - woman is woman, man loves woman - woman loves man, is labeled ‘sexual deviancy.’ This expression from our ever-evolving language is supposed to refer to any sexuality other than the archaic definition. However, I’ve decided that sexual deviancy has become synonymous with ‘priest.’ And no, I’m not going there.

The man who feels he’s female, or the woman who ‘s convinced she’s male knows from an early age. Princess Boy, and Kim Petras, knew who they really are. In they’re minds, there’s no gender confusion. They might need some adjustments to make the body and mind match, but there    is    no    doubt.

Kim Petras, the budding teenage pop star from Cologne, is the youngest person to undergo a sex change. I wasn’t at all surprise that Germany is the place where the surgery was performed. The psychologists and doctors evaluating the sixteen-year-old agreed that waiting two more years for her to turn eighteen, thus adult, was unnecessary. Several conversations with Kim, who used to be Tim, convinced them that, although she was only sixteen, she was ready to make the cut. Now, a popular, beautiful and complete young lady, Kim said it best. She wants her fans to know that it’s all right to be who you are. Wise words indeed.

In the meantime, there’s been an outcry in this country because the producers of Dancing With The Stars have invited Chaz Bono to participate in the show. Some have vowed never to watch it again because a man they don’t approve of is in it. Deep-seated fear and the need to point a finger are ingredients for hatred. Princess Boy and Kim Petras have families that encourage their children to become the person they were intended to be. For every transgender child with a positive support system, there are thousands of others who suffer daily. They’re forced to live on the fringe, shunned by society and their family. They often end up selling their bodies to pay for the medication that allows them to maintain their identity.

There is no conclusion to this topic, but I’ll end on a positive note. Never before has there been a generation of young Americans more open and inclusive than now. They don’t care what your sexual orientation is or what you wear. Gay marriage is a right, it    just    is. Fortunately, that right continues to gain ground, and included in this conversation are the rights of transgender people.   

BLOODLINE

As I was preparing dinner a few evenings ago, a friend of ours dropped in for a visit. I was particularly happy he’d stopped by because the last time I’d seen him was in a hospital bed. Several months ago, his future was very uncertain at best. Diagnosis: MDS.

Myelodisplasty Syndrome a.k.a. pre-leukemia is nothing to laugh about. This very serious condition is as sneaky as it gets. MDS is a mutation of the bone marrow stem cells. They become discombobulated and ineffective, often without the person knowing it, depending on how severe or mild it is. My friend visited his doctor in Berlin, for no other reason than some slight aches in his joints. Although it doesn’t run in his family, he thought he might have rheumatoid arthritis. He’d gone to a yoga class and had felt that his downward facing dog wasn’t as soothing a pose as it used to be. His doctor took some blood tests. They revealed abnormalities. She referred my friend to an oncologist who diagnosed MDS.

After the initial shock, my friend consulted with the best doctors he could find in Berlin and in Los Angeles. He educated himself on MDS, weighed his options, and then decided against the only cure available. Why would he do that? Because those of us who’ve been diagnosed with deadly diseases grab at straws. I call it distorted hope. When facing an almost incurable illness, you hope for a miracle. Hope of finding a less invasive solution; hope for a potion from an alternative medicine man that’ll fix you thanks to natures wonders. You’re convinced the cure is out there, and that it’s just a matter of you happening upon it. Take my…yada yada yada. The key word here is almost in ‘almost incurable.’

Acupuncture and stem cell therapy helped my friend for a while. It did some good but didn’t free him from frequent blood transfusions. Fresh blood on a regular basis was the only way to keep him relatively active. Without the transfusions, A) he was two weak to function, B) he would die. Thankfully, it’s hard to keep a good man down. And certainly not one with such a strong will to live. He opted for the almost in ‘almost incurable’, a 25% chance of beating this thing.

Approximately 13,000 people are diagnosed with MDS every year, and many more don’t know they have it until it’s too late. They’re more likely to die from symptoms (infection, anemia) than MDS. It’s a progressive illness, which can lead to complete bone marrow failure, and in 1/3 of the cases, leukemia. It usually occurs in the sixty and older age group, and is more prevalent in men than in women. It hardly ever affects children.

The cure: chemotherapy, then bone marrow transplant. Chemo is a bitch. No two ways about it. It’s meant to kill everything good and bad in your body and that’s what it did to my friend. I visited him in the hospital right after he’d completed chemo. He was weak and drugged, but also a man on a mission. Step one accomplished. On to step two: my friend has a brother. Bone marrow stem cell compatibility with a family member or a sibling is not at all guaranteed. Certain criteria must be met and they can be present or not. The closer the match, the better the chances. His brother didn’t have the same blood type, but he turned out to be a 99.9% match. With no stem cells of his own left in him after chemo, my friend received those of his brother.

And this is where I’d like to make a point. Most of us cringe at the thought of a bone marrow transplant, because we envision some invasive, painful procedure for both donor and recipient. This used to be the case. Newsflash: donating bone marrow is as easy as donating blood. My friend’s brother sat for four hours with an IV in his arm. His blood was processed through machines that separated stem cells and T-cells, (which went to my friend) and then was fed back into his body. Done!

Today, my friend is back to his energetic self. His brother, who lives in New York, enjoyed a three-week vacation in L.A., while saving a dear life. My friend has been given a clean bill of health from MDS. If ever any of you are in need of a good deed, I would strongly suggest thinking about donating bone marrow. The need is great, and the act, saving a life, is exponentially greater.

OUCH!

I opened the tamper-proof bottle, poured the two white tablets in the palm of my hand and stared at them. Flashback to the gym. In the morning, my body had said, “I’m not anywhere near twenty years old, so go easy on me,” and my mind had replied, “fuck you, I’ve got energy, and I’ll do what I want.” So, I pumped too much iron, burned up the spin bike, and now, I was paying for it big time. If I didn’t want to walk like a zombie for the rest of the week, I’d have to swallow those two pills. I should take them, I thought hesitating. I need to get rid of this pain. In the past, before my third liver/kidney transplant, I’d relied on painkillers to make it through the day. That didn’t work out too well for me. One must learn from ones mistakes at some point in time…at least one would hope one does...

20 million Americans take prescription painkillers daily. Every year, 70 billion over-the-counter painkillers are sold. Advil, Aleve, Anaprox, Aspirin, Anacin, Ecotrin, Excedrin, Motrin, Nuprin, Voltaren, Celebrex, to name a few, are all NSAIDs or Non-Steroidal Anti-Inflammatory Drugs. There are more commercials for painkillers in the United State than in any other country in the world. Unless you live under a rock, you’ve heard of these drugs and have probably taken one or the other. Here’s what’s going on in your body when you do.  

First, what’s pain? Pain is the result of chemical messengers (prostaglandins), which alter the make up of your cells wherever you hurt yourself, have physical damage, or develop a headache. This change in your cells alerts the nerves and spinal cord and they send an electrical signal to the brain. Voila! You’re in pain! Chances are, according to statistics, you’ll grab one of the above-mentioned pills, just like I had.  

Meet COX 1 and COX 2 (cyclooxygenase). These enzymes promote fever, inflammation and pain, which is a good thing because they’re our primary alert and defense systems. COX 1 can be found in most of our tissue. Besides bringing about the things we dread, this enzyme helps make mucus, which protects our digestive tract from its own (battery acid) juices, thus making sure the flora and fauna, so to speak, in our stomach and gut is healthy. COX 1 also manages blood flow in our kidneys, which keeps them working properly. COX 2 is responsible for inflammation (arthritis, menstrual cramps), but also manages our platelets so that they don’t clump together and cause high blood pressure or put us at risk of a stroke or heart attack.  

NSAIDs are COX blockers. Well, not exactly, but pretty close. They’re COX inhibitors. When you take a couple of Advil, it impairs all of the COX 1 functions. Much like bringing your little sister on a date, it stops you from having…pain. It also diminishes kidney function and mucus formation in your digestive tract. When you take Celebrex, currently the only COX 2 inhibitor still on the market (Vioxx and Bextra are no longer available), you’re targeting inflammation without impacting kidneys, stomach or gut. However, there is a potential for high blood pressure, stroke or heart attack because your platelet protection is suppressed right along with inflammation.

But fear not. If you only take NSAIDs when you really need them, none of the side effects matter. The astounding machine, which is our human body, bounces back. It continually seeks balance because that’s what it’s programmed to do. Take it from a pro that has unbalanced her body more often than I care to remember. Hell, I’m well acquainted with both my digestive tract juices and the effects of too many NSAIDs, but you’ll have to read the book (coming in September) for those stories. I’m not alone though, because every year over 100,000 people are hospitalized for NSAIDs related gastrointestinal problems.

Like all NSAIDs, Aspirin is harsh on the stomach, but it has stood the test of time. Probably one of the oldest medications ever, It’s been around since 400 BC. Hippocrates (you know, the one from the doctors’ oath) gave women willow leaf tea, a plant that carries the pain-killing component, after childbirth. Aspirin later became folk’s medicine, and then evolved to be a painkiller. In 1897 the German pharmaceutical company Bayer patented the current form of Aspirin (they added the component, which makes it less harsh on the stomach). Aspirin, among all NSAIDs, is unique because it’s the only one that keeps platelets nice and loose and prevents them from clumping together and causing a heart attack.

Back to the two pills in the palm of my hand. Tylenol (Acetaminophen). The only over-the-counter painkiller I can take. A wonder drug. No really, scientists wonder how it works. This one-of-a-kind pill isn’t a NSAID. It’s not a COX inhibitor either, and it doesn’t impact the kidneys or the stomach. They think it works with the central nervous system but the debate is ongoing. Tylenol has one drawback: it’s quite toxic for the liver.

I stood there, weighing the pros and cons of swallowing the pills in the palm of my hand. Yes, I’ll feel a lot better, but if I don’t absolutely need it, why bother? Then I realized: one had learned something after all. One had learned that one mustn’t turn to pills for ones own fault by overdoing workouts. I placed the pills back in the bottle, and walked over to my computer…like a zombie.  

SHADY SHADY

Dominique Strauss-Kahn. Like a tree in the forest, he’s fallen from very high. The case, the handling of it, and its players leave us with more questions than answers.

First, there’s the man. DSK was Professor of Economy at Science Po in Paris, the prestigious Political Science university, and sister school to Harvard. He became Minister of Economy when Lionel Jospin of the Socialist Party was president of France. Oddly enough for a socialist, during that time DSK privatized, among other things, France Télécom, the main telecommunications company.

He sought but lost the Socialist nomination for the presidency to an unwed mother of four, who believes in women’s rights, abortion, condom use, gay marriage, equal pay for women and plenty of other things that should be taken for granted (Ségolène Royal, you rock in that respect).

In 2007, the 27 European Union countries voted him managing directors of the International Monetary Fund. Not that there were any other candidates (Russia pushed for some Czech guy but he didn’t really have a chance).

With respect to the Guinean chambermaid, things aren’t as clear. My feeling is she’s done no more or no less than the average immigrant, to get that all mighty green card. Whatever it is she wrote on her application, it can’t be that bad. I know many people who ‘marry’ for the green card. Every time they go with their ‘spouse’ for an interview, they’re lying. If she claimed refugee status but really wasn’t, well it seems to have worked, that’s what counts. I neither advocate nor disavow the practice of lying on any application, but to point the finger at her when it’s commonplace, seems hypocritical.

Telling her incarcerated boyfriend that “she knows what she’s doing” and that “he (DSK) has money,” well, surely both statements are true. Does this mean she wasn’t raped? I wasn’t in the room so I don’t know.

And now the Perp Walk. There’s a history, especially in New York, for such dramatic action. Apparently, J. Edgar Hoover began the practice. It’s meant to be a proud moment for the boys in blue, an expression of triumph for catching the bad guy. The police let reporters know when the ‘perp’ (short for perpetrator) is going to be led in or out of a location. Once the reporters are all gathered, the police proudly parade the person through a crowd of flashing cameras. These perp walks haven’t always ended well. One gentleman who was led out of his office in handcuffs and in tears, allegedly for insider trading was eventually let go for lack of evidence, and therefore lack of a case against him. His life was ruined. We all know what happened to Lee Harvey Oswald when he was taken handcuffed from the garage. Jack Ruby shot him.

DSK in handcuffs surrounded by law enforcement, appeared guilty before proven innocent to many, which is the very opposite of our justice system, or so they say. The French, more than the Americans, were appalled at the way DSK was disrespected. The sight of one of Frances, and indeed one of the world’s most powerful men being humiliated in this fashion, was more than the French could bear. Especially since it’s an unproven accusation.

So we have the accused, the accuser, and the police department. In my opinion, three shady sides to a shady case; the perfect example of a bad human tragicomedy. It’s fair to say that DSK isn’t without fault. He fits right into the formula: Male+Power+Female=I can do whatever I want i.e. Arnold Schwarzenegger, J.F. Kennedy, Robert Kennedy, to name a few. Should the case here in the States fall appart, a likely scenario as things stand, DSK’s troubles aren’t over by a long shot. Tristane Banon, another woman, has come forward and accused him of attempted rape. The French prosecutor is investigating.

As for the Guinean woman, the way I see it, she hasn't got a chance. She’s black, poor and a foreigner...who lies. Need I say more? Perhaps she was raped. At this point in time, after being discredited, it makes no difference. Whatever she says from now on will be viewed with suspicion. And then there’s the part about DSK forcing her to give him a blowjob. I’ve been pondering the logistics of such an act, and somehow I feel the woman has the upper hand (no pun intended) in this situation. Clenched teeth would have had him meowing like a cat.

Speaking of cats, if the New York police department needs a pat on the back, recognition for the ‘amazing’ job they do, they should go rescue a cat. They shouldn’t parade someone around like some trophy. And why would anyone gloat in someone else's misfortune? Oh, I forgot, it's the NYPD. After the incident with Dominique Strauss-Kahn, the practice called perp walk is in serious jeopardy. (Yeah…right).

All parties involved in this affaire are suspicious.

Where is Shakespeare when you need him? He would have had a field day writing a contrived, over the top drama called Who Rapeth Whom? Thee the Rich, Powerful, White Frenchman, Thee, The Poor, Black, Foreign, Chambermaiden Or Thee, The Fucketh Up, New York Police Department? 

RIDING HIGH

June 5^th, 2011, the AidsLifeCycle ride took place once again. Since doing the ‘Ride’ last year with my brave son Adam, I’ve found new appreciation for professional cyclists.

The Tour de France is the Olympics of cycling although there are other such feats. The Vuelta a España and Giro d’Italia are just two of the many mind-boggling, super-strenuous, physically excruciatingly demanding cycling competitions. Like most extreme sports, cycling hasn’t been spared its problems.

Just this year, Floyd Landis, a former fellow cyclist from Lance Armstrong’s team Radio Shack admitted taking performance-enhancing drugs. Because of this admission, he was stripped of his title for winning the Tour de France in 2006. He seemed sincere in his interview on 60 Minutes, when he said all cyclists who want to rank among the best take these drugs. He went on to say that if you’re part of the Peloton (the group of cyclists from the various teams that ride together), or just one of the regular cyclists, you don’t have access to these drugs. But if you stand out for your talent and lead the pack, then the drugs, the way to take them and avoid detection, can be your ticket to a Maillot Jaune.

I’m a big fan of Lance Armstrong. I feel a kindred spirit with him. He battled prostate and brain cancer to come back and win not once or twice, but seven times the Maillot Jaune (Yellow Jersey) of the Tour De France, the coveted overall winning jersey that comes with prize money in the amount of 450,000 Euro or $700,000 and tons of glory. We all love someone who rises above the worst imaginable scenario, only to soars to the highest of all heights by winning over and over again the most prestigious ride among all rides.

I wasn’t surprised when Landis accused Armstrong of doping. While this hasn’t been proven, I tend to believe Floyd’s got a point. I have no doubt that all of the top riders including the stage winners who adorn the green or polka dot jerseys are doing so as well.

Illness sets you back tremendously. It took me three years to fully recover from liver transplant #2. But illness is also a powerful motivator. For someone like Lance, a competitive and ambitious cyclist who had just cheated death, the choice was clear. Do whatever it takes to prove to himself and the world that no deadly disease can get the best of him.

Personally, I’m convinced that the Tour de France can’t be undertaken without performance-enhancing drugs. Not at the speeds they go, not at that level of competitiveness and athleticism. I believe that all involved in the sport know this. The occasional victimization of a champion such as Floyd Landis serves no other purpose than to send the message that the cycling authorities are doing their best to keep the sport clean. Floyd became the sacrificial lamb for the sake of the public.

It reminds me of the war on drugs. Every now and then, a big fish gets caught, and the public at large is relieved to know that something is being done about drug trafficking. Never mind the fact that this multi billion dollar industry is alive and well, and will continue to thrive as long as people take drugs.

In cycling it’s pretty much the same. The committee, cycling official, managers and cyclists know that drugs are an integral part of their sport. Doping is alive and well among riders and will remain so as long as it’s a multi million dollar televised event, with tons of sponsors and scores of tourists.

I enjoy watching the Tour de France. I love that it’s a grueling feat. My muscles tense every time the cyclists tackle a ridiculously long and steep hill labeled ‘hors categorie’ or ‘out of category’. These hills, harder than the hardest category 4 hills, demand more than just performance-enhancing drugs. In fact, I say let all cyclists take the drugs and thus even out the playing field. I firmly believe that regardless how many drugs one might take, they won’t make you win. The race to the finish line, the title of best accomplishment will go to the cyclist who wins the mental challenge. More than any drugs, it’s determination, willpower, inner drive and a ‘mind over matter’ matter.

In my opinion, Floyd Landis deserved to keep the Maillot Jaune. He deserved to be rewarded for his mental tenacity, which is the real stuff that allowed him to win in 2006.The fact that the cyclists are doping didn’t and won’t stop me from watching the Tour.

Among all of today’s extreme sports, cycling requires the most endurance. I have respect for any athlete that crosses 2,263 miles (3,643km), up hills and over cobble stones through three countries (Netherlands, Belgium, France) in 23 days, drugged or not.

Having said all of the above, none of this applies to any other sport.

 As for the AidsLifeCycle ride, there were times when I wished I had some performance-enhancing drugs; especially when tackling the hills called Evil Twins and Quad-busters. They might not have been ‘out of category’ hills for anyone else, but they certainly were for me. 

3RD WORLD TRAFFIC

I got in my car and switched on the radio as I always do when driving back home from the gym. As usual, Larry Mantel was on, and his guest was Scott Carney. I’d never heard his name before but you can be sure my ears perked up when he said, ‘…organ trafficking.’

Scott Carney is a contributing editor for Wired magazine and an investigative reporter who used to live in India. He became interest in organ trafficking after a friend of his died there. The vultures immediately began to circle (not literally). Before his friend was dead, organ brokers came out of the woodwork, asking Scott what he intended to do with his friend’s body parts.

India is a growing economy, but there are still plenty of Third World characteristic in the way the country functions. One of these is a lack of basic, essential, well-organized, regulatory mechanisms i.e. laws on the books that are actually enforced. In this case (and countless others), it means supervised and controlled organ donation, retrieval and transfer laws. According to Carney, ever since organ transplants have become commonplace, life expectancy has risen around the world by thirty years. The problem is the means by which this life expectancy has been attained.

China is pretty much in the same boat when it comes to organ trafficking, but India seems to have the most blatant problem. On one hand, consider the 25 billionaires who have emerged from India’s steadily growing economy. On the other hand, consider over 51% of the Indian population don’t have a toilet. It would be presumptuous of me to say “don’t have a toilet in their home” because stacked cardboard boxes hardly qualify as a ‘home.’ 51% of India’s population means twice the population of the United States uses a toilet outside of their dwelling or, a plastic bags...if it’s available. Add lack of social standards, rampant corruption and mismanaged, inefficient bureaucracy to this equation and you have a recipe for exploitation.

I can tell you in all certainty that the 25 billionaires don’t become targets of organ trade rings. However I’m not so sure about the five hundred million who don’t have toilets. Everybody from broker, to doctor, authorities, hospital and donor are in on the scam. Scott Carney went on to mention a group of eighty women post tsunami so desperate to feed their family they sold their kidney for less than $2,000. When you don’t have a toilet, it sounds like a lot of money. But it isn’t. It was quickly spent, and the families ended up in even worse situations than before (is that even possible?), especially in those much too often cases where the organ retrieval hadn’t been done properly.

Speaking of retrieving an organ properly…most recently, a seventeen-year-old boy in China really wanted an iPad 2. So much so that he was willing to do anything to get one, even sell his kidney. And it was much too easy for him to do this. A broker contacted the teen on the Internet. The teen ended up following the broker’s instructions, and going to hospital #198 in Chenzhou without notifying his parents, and having his kidney removed.

This story is disturbing on so many levels. It turns out, hospital #198 wasn’t qualified to perform such a surgery. You’d ask yourself, why would they accept to do the job? As a result, the boy is having serious health complications due to…a poorly retrieved organ. China, the up and coming economy just like India, has plenty of corruption to go around. No matter how illegal, everyone is a willing participant if it means a payday. Organ trafficking has become a very lucrative way to compensate for low paying jobs, joblessness and poverty.

Now about the boy; this is an example of the increasing consumerism among Chinese youth. There’s a strong likelihood peer pressure from friends or classmates pushed the teen to these extreme measures. Perhaps he wanted to fit in. Or he fell pray to the ‘keeping up with the Jones’ mentality now rampant in the newly materialistic China. The boy received $3,400 for his organ, got an iPad 2, but might die because no one ever stopped him along the way.

No system is perfect. Here in the United States, some doctors have slipped through the cracks. In 2005, St. Vincent hospital in Los Angeles had to shut down the liver transplant department. Doctors gave a Saudi national who was #52 on the list, a liver that was meant for a near-death person. He ended up passing away. While it’s sad such an unethical decision was made, it’s also true that the checks and balances worked. A thorough investigation shed light on the fraud. Dr. Lopez, head of the transplant department, had to resign.

What is the conclusion if you live in India or China and need an organ? Best case scenario is that you’re somehow related to one of the 25 billionaires. Short of that, you’re pretty much on your own. 

EIGHT FOR EIGHT

What a wonderful article in the New York Times, this past Tuesday, May 17.  The Science Times section brought a story about Julio and Mirtala Garcia. The couple, naturalized Americans originally from Guatemala, saved the lives of seven people and restored the vision of an eighth. Theoretically speaking, instead of 110,000 people waiting for organs in the United States, there are now 103,000.

Mr. Garcia was at his plumbing job one day, when he felt ill. He was suffering from one of his much too frequent migraine headaches. This one was different than the others, because besides being in terrible pain, he also felt numb all over. He called his wife and asked her to come pick him up. Mrs. Garcia wanted to call an ambulance. Her husband, Julio, thought it unnecessary. They drove to the hospital where doctors diagnosed Julio with massive brain hemorrhaging. They were able to stabilize him; then they had him transported to another hospital better equipped to deal with his problem. By the time the ambulance dropped him off at the new facility, he was in a coma. A few hours later, and several attempts to drain the blood from his brain, he was declared brain dead. After the obligatory verification from two independent doctors, Mirtala was given the news. In this profound moment of grief, a hospital official asked her if she would donate his organs.

At first Mirtala hoped Julio would awake. But the doctor explained that this wasn’t possible because, essentially, he had already passed away. Machines were keeping his organs oxygenated. The next day, once again, she was asked if she would donate his organs. Julio had been a deeply religious man. He was the pastor at his church. Mirtala thought of her two friends from church suffering from kidney failure, and whose time was running out.

And she thought about the comments her husband had made after watching the movie Seven Pounds, starring Will Smith and Rosario Dawson. In the movie, Will Smith plays a man (Ben Thomas) filled with remorse for what he had done. He drove and was on his cell phone when he caused an accident that killed six people in a van and his passenger. Ben decides to ‘give back’ by donating his organs and thus saving seven people, the same number of lives he had taken. Personally, I don’t go for movies full of transplant flaws. You can’t transplant eyes (only cornea), and you can’t take organs from a dead man, even if he’s lying in a tub of ice water, waiting for his pet jellyfish to sting him (Helloooo!!). I don’t know how many times Hollywood has gotten this wrong, and will continue to do so as long as it makes for good drama, and, more importantly, good box office (the movie made 168 million worldwide. It cost 55 million to make. In Hollywood terms, including P&A coast, I’d say it barely broke even.) But I digress.

After seeing this movie, Julio had told his wife that he’d be happy to give life after his death. He said that if anyone got his heart, she should meet the recipient. Recalling that conversation, Mirtala knew she had to donate Julio’s organs. The article went on to say that she met five of the seven recipients: the heart, lung, two kidney and adult partial liver recipients. One, the pancreas recipient, chose to remain anonymous, the other, a one-year-old baby who received a portion of Julio’s liver, well, it’s pretty obvious. The cornea recipient was never at death’s doorstep and doesn’t count among the 103,000 remaining on the organ transplant waiting list.

The five recipients and Mirtala met at the New York headquarters of the liver distribution center. Such a gathering had never happened before. Perhaps one donor a year gets to meet his/her recipient. For five of them to come together with their single donor is highly unusual, as is one donor giving seven of his organs.  

I found this story quite touching for several reasons. A Guatemalan man who could barely speak English (Mirtala spoke through a translator) donated his organs to save American lives. This alone is praiseworthy. As much as we would like to think of ourselves as ‘color blind,’ there’s still plenty of racism in the United States. Does race affect organ donation? This is a question I can’t answer, but it is something to think about.

If all donors gave up to seven organs, perhaps the list would shrink a little. Why the average organ donation is only three I don’t know, but it’s something to think about.

I commend Mirtala Garcia for quickly deciding to donate. Her husband passed on Thursday, by Friday she had made up her mind. When you’ve just lost your loved one, it can’t be easy to think rationally. Time is of the essence when it comes to donors and recipients.

Let me end this story the way I began it. For a moment, there were 103,000 people on the waiting list thanks to Julio and Mirtala Garcia. By the time I finish this post, or probably even before, the number will have jumped right back where it was to 110,000. I wish no one the tragedy Mirtala and thousands of others experience when a loved one passes of brain death. Optimist that I am, the upside of such a death is giving life to others. We recipients welcome many, many more Mirtala Garcias. 

TRANSPLANTS

We all know what the word ‘transplant’ means, but what exactly does it entail? I’ll try to explain the process without putting you to sleep.

Dr. Christiaan Barnard performed a successful transplant on a black woman in South Africa in 1969. She lived twelve years and six months with her new heart. In 1967, Dr. Barnard had first tried several heart transplants but the patients died. For many years the effectiveness of transplants was debated. Then, in 1981, Dr. Starzl (my hero who transplanted me in 1984) championed the anti-rejection drug Cyclosporine. Prior to then, rejection occurred almost 100% of the time. The way to stop rejection was high levels of steroids, which ended up killing the patient. Once Dr. Starzl found the solution to keeping patients alive (Whew! Am I glad…), other transplant centers came into being, and with it a need for regulation (1984).

All transplant candidates have been evaluated and suffer from confirmed end-stage organ failure. At that point they are placed on ‘the list.’

The list, that mysterious word every transplant patient pronounces with pathos, becomes the first step on the long road to an operating room. The list is kept in Richmond, VA at a place called the United Network of Organ Sharing (UNOS), a complex national bank of organ data, which it collects and manages. UNOS operates twenty-four/seven, continually updating and changing the list as information becomes available.

Being on the list is not a linear thing. One doesn’t get a number and wait in line. The list is actually a pool functioning according to patient data. This patient data is regularly modified to ascertain placing on the list. A score called Model for End-stage Liver Disease or MELD score is one of the many criteria used. It’s based on certain levels in a candidate’s blood test: the worse the levels, the higher the score. This information and other such as organ, blood type, tissue, size and match will determine the candidate’s position.

But wait…there’s more. UNOS, the headquarters of the list located in Richmond has tentacles. They’re called OPOs or Organ Procurement Organizations, to be precise eleven of them scattered throughout the United States. These organizations see to it that donated organs from their specific region get used at their transplant centers first. If an organ cannot be used in their region, then it goes to the next closest OPO region. Should it not be needed, the organ will be free for distribution to any other transplant centers in the country. The reality though, is that the majority of organs are used in their OPO region. Because the list is a pool, patients’ waiting time varies. All things being equal, it’s the patient with the greatest need that will be transplanted first.

Are you still with me?

The average waiting time for a heart is from three to eight months, a liver eight to fifteen months, a lung fifteen months to two years, a kidney three to five years. Currently there are between 80,000 and 100,000 people waiting for an organ. On average, eighteen people die every day waiting. 15,000 people are added to the list yearly.

There are plenty of horror stories out there with respect to organ retrieval. I should know. My husband was offered a script about steeling kidneys in India. I’m glad he didn’t make that movie. To be fair, the script was exciting: the topic lends itself to an action flick. But when I read it, the flaws were too obvious, which, for someone like me, is unacceptable.

Transplant myth A: “If you die, your organs will be taken without your consent.” You cannot take an organ from a dead person. If the heart has stopped beating and oxygenation of the body has ceased, so has oxygenation of the organs. Organs can only be retrieved from the certified brain-dead. That person has zero or very little brain activity, and therefore, is a corpse with blood flow and oxygenation of the organs. There is no recovery from brain death. Period.

More recently ‘non heart-beating organ donation,’ is experiencing resurgence. If you’re in the hospital and have a directive to become an organ donor, after your heart stops and you are proven dead (checks and balances) your organs are retrieved before they deteriorate. This practice has helped narrow the gap between donors and recipient.

Transplant myth B: “There’s a black market out there for organs.” The United States does not have an organ black market. There are no hidden, fully equipped, sterile, state-of-the-art operating rooms floating about where people are kidnapped and anesthetized to harvest their insides. Everything regarding transplants of any kind, be it living donor, tissue or organ is regulated and verifiable.

Transplant myth C: “If I say I’m a donor and I’m in the hospital they might let me die.” The person who came up with this conspiracy theory has obviously never been in a hospital. Need I elaborate more than to say that doctors, nurses, orderlies, more nurses and more doctors pass through your room at all times? The likelihood of something getting past them is as unrealistic as a mother committing suicide to give her remaining kidney to her daughter. The script definitely needs a rewrite.

But, forget the myths and the regulations. None of it would mean a damn thing if not for the most important component to organ transplants, which is…(drum roll…) organ donation. And here the scariest statistic of all: practically every American adult (98%) has heard of organ donation, however, only 30% take the trouble of becoming donors. All you healthy people out there, this is your chance for greatness. The gift of an organ is a purely altruistic and trusting act. It comes from a place of generosity and caring for your fellow human. Whether you are a living donor, or a deceased one, the decision to donate organs is by far the kindest and humblest accomplishment in your life. 

THE RIDE

Just about a year ago, around this time, I decided to participate in something I had always wanted to do, but had never been healthy enough to undertake. It was the AIDSLifeCycle ride departing from San Francisco and arriving in Los Angeles six nights and seven days later. Normally, this journey on a bike isn't something you jump into a couple of months before it takes place.

But, leave it to me to decide spontaneously. Fortunately, I’m not the only spontaneous person in my family. When I asked both my sons if they would join me, my oldest didn’t hesitate. “Sure, I’ll do it,” he casually responded. Neither he nor I knew what we were getting ourselves into. And, it was probably better that way.

So here we were, mid-March, joining another 1800 HIV/AIDS advocates. The AIDSLifeCycle ride raises money to provide critical services for the afflicted. The fact that it’s a fundraiser and a ride makes it appealing. On one hand, you’re supporting a worthy cause: in order to participate in the ride, you must raise at least $3,000. On the other hand, you’re in for the experience of a lifetime, which, for my son and me began with a practice ride of 75 miles from Santa Monica to Palos Verdes and back.

Prior to tackling the Palos Verdes ride, we were advised to try out our new equipment. New bikes, shoes with cleats, helmets, biking shorts, gloves, and jackets. My son and I had never ridden a road bike with cleats, but we certainly looked the part. (Move over Lance Armstrong, my outfit is cooler than yours.) In fact, I had not ridden a road bike since I was twelve! First, I started out mastering cleats on flat surfaces. Then it was time to try something more challenging.

A very patient and generous friend took my son and me to Malibu for our first hill along Pacific Coast Highway. Ten feet up the hill I fell on my side. Ten feet further, I fell again. Ten more feet…fall. Always on the same right side, always because I couldn’t get out of my cleats fast enough. After about eight falls (I love my helmet!), I “quickly” realized that if your road bike isn't moving, you'll fall. I knew this, but my muscles didn’t. They weren’t cooperating. In fact, every ten feet, my muscles went on strike.

 

Black and blue lesson #1: build muscle before you plan on climbing a hill.

The day of the Palos Verdes ride, AIDSLifeCycle management, highly organized and made up of the nicest, most helpful people I’ve ever met, gathered the riders around for a pep talk. They said, ”Whatever you do, respect the rules of the road. The police will stop you if they catch you running a stop sign.”

From the moment riders hit the road, they jockeyed for position. They zoomed by my son and me, an endless stream of, “On your left!” shouts as they passed. We ended up somewhere in the middle, among the ‘laid back’ group of riders. When I reached Manhattan Beach, I saw a stop sign before me and stopped. Suddenly, flashing lights in the sun, a black and white car. I released my cleat in time, just before falling over from exhaustion.

“Do you know you ran a stop sign?” the officer asks. I stared at him. Answering ‘yes’ wouldn’t have been honest. I had been much too focused on making it to the next lamppost to notice a stop sign. Answering ‘no’ wouldn’t have been honest either, because I had seen the stop sign right before considering a mirage of the road buckling before my eyes.

The very helpful “Roadies” rushed to my defense. Instead of answering the officer, I stared at him and…burst into tears. He stepped back, “That’s never happened before, that someone cry when I give them a warning,” the officer said, which only made me sob more. What had I gotten myself into? How the hell was I going to ride 575 miles if I flaked after 45? How was I going to get to Palos Verdes?

I stood next to my bike in tears holding the warning from the officer who had quickly left. The roadies kept asking, “should we drive you to the next pit stop? Do you need someone to ride with you? Is there anything else you need besides tissues?” I blew my nose, shook my head and thanked them.

I knew what I had to do. Two words, three max. Keep going or…you’ve got this or…just do it or…you and me or…try harder (take your pick). I got back on the bike, clipped into the pedals and moved forward. Just to that next garbage can…just to that next tree…just passed that little hill up ahead…Five miles later, I saw my son sitting on the pavement next to his bike sipping water, waiting. We continued on our way together, my son slowing down every time I fell too far behind (damn you twenty-year-olds!) The roadies drove by in intervals and shouted from the car, “Are you all right?!” I gave them thumbs up and continued riding.

Harsh lesson #2: if you think you’re in shape, think again.

The Palos Verdes ride was an eye opener for things to come. Thankfully, we did get in several more rides before the big event. Still, it’s only on the last day of our major journey from San Fran to LA that I got it. After a week of putting my fake hips and knees through long hills and deep valleys, smooth surfaces and bumpy ones, I finally felt confident on my bike. I had built up my muscles, including the one in my head. Tenacity.

Joyous lesson #3: never underestimate your abilities. You’ll be surprised how much you really can do.

The time has come for another AIDSLifeCycle ride. If you know anyone who is participating, open your wallets so that some unsuspecting person like I was has a chance to develop his/her Tenacity.