Breast Cancer

This poem is a homage to every brave woman I have ever known.

 

 

 

 

 

 

 

 

 

 

 

 

Youthful temptress, aging oracle,

Nymph-like debacle, Gorgon spectacle,

Retreat from retribution’s precipice,

And a transient victory wrought by avarice,

To listen to a parable

Devoid of the empirical.

 

Several centuries ago in the land of the Saracen,

You were born to a tribe called the Bedouin.

Clad in hijab to protect you from knowledge that is carnal or ecstatic,

Your elders were quite emphatic

In their desire to imbue you with virtue

In languages derived from Aramaic.

Rules were enforced by the prevailing patriarchy,

Who were keenly aware of lust in the presence of your budding sexuality.

 

Nature’s sculpting of your cherubic form

Into a Circe with Djim-curved breasts

Straining against material meant to cocoon a figure otherwise ethereal,

Did little to maintain the moral norm.

Codes of the West and codes of the East,

Dictated restriction or punishment for unleashing a Beast

Called unrestrained passion, robbing Man of reason,

Paralyzing Zeus with snake-like tendrils spewing poison and hissin’,

Only the strength of family kept you safe from the abyss

And the sword of Perseus,

Albeit temporarily.

 

In the ensuing years

Your inevitable rebellion as an uncontrollable hellion,

Sent you scurrying in a soulless desert from the puritanical to the heretical,

Falling for a secular encyclical

Promoting the hype of the perfect male archetype.

The rush of intellect combined with tingling nerves and tissue erect,

Anesthetized your senses

And blinded you to fragile mental fences,

Especially your own…

 

Now, in your twilight years,

Forced to face your deepest fears,

You gaze into a mirror,

To inspect Aphrodite with a wrinkled body all-a-quiver,

Sagging breasts with shriveled aureoles publicly wrapped in fashionable frills-

Fatty tissue feted by paramours over whom you once held sway,

Rose-tinted nipples electrically bonded to Venus’ mound in her heyday,

Now drooped untouched below a proud visage lined with pain

And experience in surviving life’s interference.

 

As you caress your naked loneliness,

And pause to touch a cancerous mass,

In life-giving organs soon to be disfigured by modern medicine,

In its quest to heal every lesion,

Your heart yearns for a cloak to shield your fading womanhood.

But inevitably you muster the strength,

To find your own identity and carry on the fight,

To any length, even to death’s finality,

For you are now fearless

And ready to show your true beauty and grace in the face of adversity.

 

The Heroine Next Door: Status Update

HIVAIDS_infographicTuberculosis_2016 Diabetes_infographicIt has been a few years since I first thought about a series of books about Islam and chronic diseases. What would such disparate topics have in common, one might ask? Part of the impetus has been to try and interpret complex events that hog the news headlines and impact my life in a direct and indirect way. As someone who experienced apartheid in South Africa and the 9/11 aftermath, my writing journey started as another twist on familiar themes. The start of the project was simple. Join some Muslims together in a loosely-fitting collage of immigrant experiences and show that a positive spirit can endure all manner of problems to solve, in one instance, the burgeoning triple epidemic of HIV/TB/diabetes epidemic in South Africa. Combine those books with some non-fiction tips and poems about the diseases, relationships, and life.

Since “The Heroine Next Door” and subsequent books appeared in print over the last 24 months, I have realized how difficult it is to transmit the message that good people can help one another if they choose to apply themselves to solutions. My naïveté has been tempered, but I have also been heartened by the positive responses from fans and the fact that some people have expressed that their eyes have been opened to new ways of doing things.

So, in the spirit of continuing to spread positive energy and basic information of the top infectious killers and the diabetes epidemic, I have put together some infographics. Please feel free to visit Amazon to check out the books and Facebook/LinkedIn for the infographics (high-res versions are available upon request).

The children are watching

The children are watching

The conflagration of fact and fiction,

And wandering without comprehending,

About the dereliction of truth’s benediction.

 

In a world with no secrets,

Why are adults filled with so many regrets?

Why is nothing as it appears

And success built on lies and smears?

Why does every catechism

Bear little resemblance to realism?

Is perpetual pretense

The price adults exact for lost innocence?

 

The children are watching.

What do they see?

Hollow imitations of you or me?

Do they long for what is in the neighbor’s yard,

Even as the world tears itself apart?

Do they yearn for gold faintly gleaming,

On the fifth-tier of a video game?

At least avatars with scimitars

Can forego a world where people hate and maim,

For a cyber-Eden where they can find treasure and fame.

Being poor and sick in America

This apocryphal story about a cancer patient was written prior to Obamacare (appeared in the Norwalk Patch).

I will never forget the first time I heard her voice in the university hallways. “Are you from Cape Town?,” she asked. I stopped momentarily, because that familiar-sounding accent brought back a flood of memories about South Africa. When I turned around, I saw a tall, middle-aged lady with a smile, reminiscent of the African sunshine in my former homeland, beaming at me. This was the beginning of a decade-long friendship between two lost souls in the heart of Manhattan. I quickly learned that Lady M., as I will call her, had been through a lot of ups and downs in her life. She had been diagnosed with an insidious oral cancer that eventually required surgical removal of part of her tongue, rendering her sounding like a female version of Scrooge McDuck. Lady M. did not let her condition get the better of her. She became a mother figure, who dispensed advice along with recipes for how to make tarts and stews based on the produce on offer at Jack’s World and other cheap emporiums in Manhattan. Visits at Lady M’s place were filled with laughter, stories and trips to the local bodegas to search for the Hispanic equivalent of South African staples such as Marie biscuits (a cookie with a hint of vanilla, best consumed with tea) and Milo (a Nestlé chocolate and malt powder product that we liked). She showed me tokens of her youth as a South African lass born to Scottish parents. I learned about the influence of friends on her formative years and about how she had cared for her aging parents before emigrating here.

While her cancer was in remission, we could both ignore the elephant in the room. In many respects, Lady M’s story was similar to those of others in households all over New York; however, she faced the added burden of being poor and without health insurance in a country that regards this item as a benefit and not a necessity. The first sign that her cancer had returned was marked by slurred speech and pain in her jaw. After finally securing insurance and consolidating her medical records from various institutions, experts confirmed her worst fears. The cancer had spread and this time it would be fatal. It was ironic that she was the one that ended up comforting the few people that knew her. Lady M quietly started preparing for her own death. She withdrew from the few friends that still kept in contact with her. Gradually her speech became incomprehensible. People would automatically assume that she had a mental disability when she spoke to them. So she learned to get by with a pen and paper.

And then she died, not registering a blip on the radar of thousands of passers-by in the busy city. In reality, dying of cancer is not as sanguine as euphemistically portrayed on television. People are not always fortunate to be surrounded by loving families or live in fancy houses. Sometimes people fight, because they want to live or they have someone waiting for them. Sometimes people are poor, they have no one and in the end the fight against bureaucracy and to improve the quality of their lives prove be overwhelming. I salute those people. May their struggles remind us of the human component of the financial equation in the search for effective, affordable healthcare for all citizens.

Maria (First appeared in the Norwalk Patch in 2012)

Happy Cinco de Mayo. The bars in Norwalk carry signs beckoning customers to partake in liquid celebrations of Mexican heritage and pride. It is sometimes difficult to remember amidst all the fun that Mexico has also become the symbolic source of all undocumented workers entering the USA. The San Francisco Museum of Modern Art has an ongoing exhibit containing “Freeloaders,” the provocative title of a photo by Lola Alvarez Bravo, that may be interpreted as a visual encapsulation of some views on migration here from Latin America.

If one gets lost in artistic interpretations or vigorous political debates about the issue, Nancy Capelle’s moving post about helps one to focus on the plight of individuals. Her post also reminded me of another individual who “fell through the cracks.” Call her Maria. Maria caught the train from Stamford to Southport every day. I remember her as plump, with a sad smile and eyes with dark circles that belied her otherwise youthful appearance. Maria was an “illegal” immigrant. Once upon a time she and many others, seduced by the prospect of a living wage, crossed the border into the USA. The escape from an abusive marriage and monies she could send back home to her family kept her going day after day.

We only saw each other occasionally on the train platform. Sometimes she would show me photos of her three children. She had been in this country for several years with no imminent prospects to return home. Her children in the meantime were growing up and her only contact with them came via the help of others. She was a cook at a local restaurant and would take leftovers with her in the evening for dinner. She had nothing, but felt compelled to share some of her leftover burritos. I declined, silently embarrassed that I had just wasted twenty dollars on lunch with friends.

A couple of months ago her restaurant, like so many others in the neighborhood, closed. I don’t see Maria anymore. Currently, the path from “illegal” immigration to citizenship resembles a labyrinth, especially for someone like her who does not speak English as a first language.

I will never forget her eyes. The regrets of having made that fateful decision to come here several years ago were unspoken, but one could see it in her eyes. For every “rags to riches” Latin immigrant story celebrated in the press, there are a thousand Marias.

The great jobless economic recovery

In May 2016 the American unemployment rate was 4.7% and the consumer price index rose by 0.2%, building on an increase noted in April. This would be cause for celebration if one overlooks another number, the proportion of Americans participating in the labor force, which stands at 62.6%. According to The Economic Policy Institute’s flagship publication, “The State of Working America,” this country’s low- and middle-income families have suffered a lost decade, in which the median family income was 6% lower in 2010 compared with 2000. Despite a 22% increase in productivity, typical wage-earners made about the same amount per hour as in 2000. While the bottom 60% suffered a decline in wealth, almost three-quarters of the wealth went to the top 5% between 1983–2010. In fact, if one looks back over a span of more than a decade, productivity grew 69% and wages grew just 7%.
Once upon a time, if you went to college, worked hard and paid your dues you were virtually guaranteed the American Dream. There was an inextricable link between hard work, economic growth and falling poverty. Today that is no longer true. Over 46 million Americans live in poverty, according to 2010 statistics. More than half of them were African-American or Hispanic. Nearly half of black children under the age of 6 years old lived in poverty compared to 14.5% of white children. Digging deeper into the numbers, 44.3% of poor people are in deep poverty (living on half or less of the official poverty line; this deep-poverty threshold stood at $11,057 in 2010 for a family of four). This number could in fact be higher, since experts think that the official estimates understate the number of actual people living in poverty. In their book, “$2.00 a Day: Living on Almost Nothing in America,” Kathryn Edin and Luke Shaefer, noted that nearly 1.5 million Americans lived on $2 a day, including about 3 million children.
Changing racial compositions, code words for immigration or instability in some political quarters, account for only a 0.9 percentage-point increase in poverty rates, according to the Economic Policy Institute study spanning the 1979–2007 period. The most significant contributor, income inequality, contributed 5.5 percentage points to increased poverty rates. The Pew Research Center’s recent analysis on the shrinking middle class builds on this theme, while a brief from the UC Berkeley Labor Center fills in the details on declining manufacturing wages and the proliferation of temporary staffing agencies in this document: Producing Poverty: The Public Cost of Low-Wage Production Jobs in Manufacturing. When a day’s wages can no longer feed your family, the default action is to rely on government programs such as Medicaid and food stamps, to survive.

In addition, the 2009 median age of an American was 36.8 years old, with researchers agreeing that the country is becoming a nation of older people. In an evolving job market, where sought-after skills in green energy and engineering may be the prerogative of a select group of highly-educated younger people and, yes, immigrants, room will have to be found at the table for these older Americans. This means foregoing the piece-meal block grant approach, dreaming of transforming everyone into entrepeneurs and facilitating a long overdue inter-generational conversation on what it would take to match existing skills to available/new jobs and ultimately steer the economic ship back into clear waters of progress.

So the systemic economic issues plus or minus security/nationalism/radicalism/jihadism/-fill in any other -ism are here to stay and will not disappear through rhetoric alone. Is anyone listening?

Why names matter in the wake of Orlando

Omar Mir Seddique Mateen was a 29 year-old US citizen of Afghan descent living in Orlando, Florida. Because of his actions, 49 people are dead and 53 were wounded.

Centuries ago, his namesake and companion to the prophet shepherding the world’s youngest Abrahamic religion, Islam, lived an ascetic life in Saudi Arabia. Omar, also spelled Umar Ibn Al-khaṭtāb, was a fierce leader widely respected for his justice and authority (read more about him here).  Some of his thinking, steeped in religious belief is worth revisiting. Here are some examples culled from different sources on the Internet:

“May Allah show mercy on the man who shows me my faults.”

“Fear your sins more than you fear the enemy as your sins are more dangerous to you than your enemy.”

“Let not your love become attachment, nor your hate become destruction.”

As we try to make sense of the unthinkable, it is worth wondering what may have happened had the Omar of Orlando truly understood the meaning behind the words of the Omar of yesteryear.

Nuclear relationships

Commuters from Connecticut to Cape Town have usually gained impromptu insights into different cultures by reading books written by brilliant wordsmiths. For example, the Russian writer, Nikolai Vasilievich Gogol, was masterful at translating everyday life in the Ukraine in a manner understood beyond the borders of the former Soviet Union. His work was also used as a literary device by the Pulitzer-Prize-winning author, Jhumpa Lahiri, in her novel, The Namesake—a tale that focused on identity and the complexities of cultural assimilation into America.

Gogol’s childhood, filled with the Cossack traditions and rich folklore of his Ukrainian home, provided creative impetus for short stories that would form “the foundations of the great 19th-century tradition of Russian realism.” Using humor and a beekeeper as a narrator, Gogol introduced the reader to Ukrainian customs and folklore in Evenings on a Farm Near Dykanka. In another book,Diary of a Madman, the hero is an office drudge who ultimately ends up in a lunatic asylum. Such stories may also have resonated with the Indian-American author, Lahiri, in crafting a pivotal train scene in The Namesake.

However, the young woman on the train from Stellenbosch to Cape Town had no pretensions of seeking literary or cinematic fame by invoking Gogol’s name. She was far too caught up in her daydreams about a fellow commuter. If one could imagine a cross between the Hollywood actors, Joaquin Phoenix and Vin Diesel, the sensitive-looking soul with the biceps of a football player was her dream man. He usually sat across from her on the lengthy journey from South Africa’s wine heartland to the University of Cape Town. His nose was often buried in fictional books (mainly Gogol) or incomprehensible scientific texts. When she finally summoned the courage to talk to him, he told her that he was a physicist. The young woman, a humble secretary, was star-struck and tongue-tied at the same time. She did not wish to pester the young man with tales about her boring life where the only recent thrill was watching the formation of a new bee hive on the family farm. Besides, how could occasional intellectual spurts such as listening to the South African opera tenor,Gérard Korsten, compare with the sophistication of this smart man?

As it turned out, the pair shared a fascination for Korsten. The physicist analyzed the tenor’s performance as Canio in Ruggero Leoncavallo‘s Pagliacci and she told him about her love for Korsten’s role as a family patriarch in the long-running South African soap opera, Egoli: Place of Gold. Over time the physicist told her about his admiration for Sergey Korolyov (1907-1966, head Soviet rocket engineer and designer during the Space Race between the United States and the Soviet Union in the 1950s and 1960s). She listened to his scientific tales and reciprocated with gossip stories she had read about famed South African heart surgeon, Christiaan Barnard, in the Afrikaans tabloids.

Finally he revealed the top-secret research he was conducting at a local nuclear power plant (Koeberg, 30 km north of Cape Town). In addition, he confirmed reports about negotiations with the South African government to supplement the country’s growing demand for electricity by building more nuclear power plants. He explained that Russia has about 10% of the world’s reasonably assured uranium resources and considerable expertise in the generation of nuclear power (employing 200,000 people in this industry). Furthermore, the export of nuclear power and expertise were major economic objectives. To him it seemed like a match made in heaven. While a decision was still being weighed by the South African government, the physicist was excited at the idea of having more nuclear power plants on the continent and elsewhere. He viewed nuclear power as a “clean,” energy source and a means to offset the interminable energy blackouts that had become the bane of South African consumers’ existence.

Unfortunately the young woman did not share his feelings. Koeberg had opened in 1984, two years before the disaster at the Ukrainian power plant, Chernobyl. Radioactive fallout had spread several thousand square miles, driving more than a quarter of a million people permanently from their homes and causing numerous deaths. Her pessimism increased after reading reports about a faltering cleanup following a subsequent Fukushima Daiichi nuclear power plant disaster in Japan.

It would be up to the physicist to convince her that the Russian government had learned lessons from the disaster. He would wax lyrical about improved crisis-management practices, cost-effective and safer nuclear reactor designs (citing innovations by TerraPower as an example), and also mention the possibility of using different reactors in the future. Although real-world applications were still decades away, he felt reasonably confident that he could assuage her fears and change her mind.

The next morning the ardent suitor decided to hedge his bets by presenting her with a list of alternative, climate-friendly energy sources which he knew would be more suited to her beliefs. Armed with both plans of action, he boarded the train and mentally rehearsed his request to resolve their debate over dinner later that night. He suppressed his excitement by feigning indifference, looking down at his briefcase, before settling into his usual seat near the window. He looked up expecting to see her face. Her seat was empty.

 

Are we doing enough to prevent treatable tumors?

Bob-MarleyAs we enter the season of sun-kissed and beach-ready bodies, it is hard to concentrate on the “buzz-kill” words “skin cancer,” especially not the rare, but frequently-fatal form of the disease called melanoma. Sure, one has heard that Senator John McCain has had to battle the illness, but we are lulled into a false sense of security that early diagnosis and the wonders of modern medicine is a cure for everything. After all, everyone can tell a story of dermatologist’s removing other, treatable skin cancers with simple, in-office procedures. Surely, all skin cancers are alike.

In the case of melanoma, the answer is “no” and sometimes it takes a mother’s heart-wrenching quest to remind us of that fact. Claire Marie Wagonhurst, the apple of her mother’s eye, died from melanoma at the tender age of 17 years old. Sometimes it takes stories to inspire action. A mole was present on the bony part of her ankle for the longest time and it was never thought to be worrisome, until it turned out to have dire consequences. Reggae superstar, Bob Marley, had a dark spot on his toenail. Nothing to worry about. Right? The spot turned out to be a rare form of melanoma.

What does the theme of aggressive skin cancer in a white girl and a black man have in common? Delayed diagnosis. The question then becomes if we can do more to catch a disease in its early stages when the relative 5-year survival is more than 90%. The answer is “yes.” The next question becomes “how does one tell the difference between a mole and melanoma”? Check out the American Academy of Dermatology’s mole map for their “Spot Skin Cancer” resources, including a step-by-step guide on skin self-examination. Depending on race and the type of melanin in your skin, the pattern of a spot may differ, but it serves as a useful starting point for discussions with a doctor. Clinicians may also take the opportunity to enlighten patients about services offered on a community-wide basis, as suggested by the CDC, with their “Let’s Start Now” program on the prevention of melanoma and other skin cancers. Bob Marley’s disease and premature death at the age of 36-years old serves as a lesson that darker-skinned races are not immune from melanoma.
Your doctor may also take the time to explain that UV rays from the sun or tanning beds are not the only ways to get melanoma. Race, genetics and environment or combinations of these risk factors play important roles.
Melanoma is also not just confined to the skin. Melanoma of the eyes and mucosal surfaces eg, nasal passages, oral cavity, vagina and anal area has also been reported in the literature. Check out the CDC’s June 2015 issue of Vital Signs for an easy-to-understand infographic on what can be done to prevent the disease.
What happens if you arrive in the doctor’s office and hear the dreaded words that the beauty spot that made you feel like a Cindy Crawford-wannabe has morphed into cancerous cells? All may still not be lost, as the National Comprehensive Cancer Network points out in their 2016 update of the melanoma guidelines for healthcare professionals. Interestingly, research breakthroughs harnessing the body’s immune system to fight cancer has been very encouraging in advanced melanoma among other solid tumors – a fact not lost on President Obama, as he announced his National Cancer Moonshot initiative spearheaded by Vice-President Joe Biden. It took 8 years between President Kennedy’s 1961 speech and Neil Armstrong’s first steps on the moon. Given the exponential progress that has been made between 2011 and 2015 in applying cancer immunotherapies as single agents or in combination with other treatments, we may get closer to tailored answers for patients with advanced melanoma over the next decade. The research arc is finally bending upwards.

Take home message: What you know about melanoma may help keep you alive, especially in the summer. Even if you do get bad news, it may not necessarily be dire, as research developments are ongoing and knowledge of people that responded very well in the advanced stages of the disease gives us all “clarity and hope,” to quote the Claire Marie Foundation.

Of Nehru and Norwalk

The sweltering heat can shorten anyone’s temper. Ask Mr. Singh (a fictional name). His temper tantrums when people dared park longer than fifteen minutes in front of his Norwalk store were legendary, and vagrants decided that they were better off rummaging through the garbage of the Chinese restaurant next door. His attitude towards customers veered from cloyingly sweet, if you were a curvaceous young girl, to patronizing, if you were a homeless person trying to buy batteries for a CD-player you found in the dumpster next door. Yet once upon a time he had been a bright-eyed and bushy-tailed youngster fresh off the plane from India with his wife and young sons. America was the land of opportunity and, armed with stories of relatives who had struck it rich in Connecticut, he came searching for his dream. An Indian community would be waiting to welcome him and his family into their temples and homes.

The years passed in the blink of an eye and the vigor of youth faded. Mr. Singh invested in the stock market and paid the price. The tax man put a lien on his business and he had to figure out creative ways to pay for the college education of his sons. Mr. Singh kept going, in part because of his delusions.You see, dear reader, everyone else was always to blame for every calamity in his life. The fact that he did not fill out the proper paperwork to have a lottery ticket machine in his shop became the fault of the government. The fact that dear Mrs. Singh’s samoosas landed me in bed with a serious case of food poisoning was the fault of the dough he had purchased at Costco. For a second I found myself more annoyed at the fact that she had not made everything from scratch, before arguing with Mr. Singh about his irresponsibility.

However, Mr. Singh always managed to wiggle his ample girth out of tight corners. When his belligerent explanation that office workers who had purchased the same savory delicacies seemed just fine fell on deaf ears, he tried a different tactic. The heat outside was merciless and he swept away my defenses and a potential lawsuit with peace offerings of Haagen Dasz ice cream and the latest copy of the National Enquirer. Having honed in on my vices, Mr. Singh felt secure that he would not be losing a customer. I could not let him off that easily.

“So,” I interrupted sweetly (as he railed about the indiscretions of American stars discussed in theEnquirer),”Is it true that the first Indian prime minister (Jawaharlal Nehru), had been in love with the last British viceroy’s wife (Lady Edwina Mountbatten)?”

Mr. Singh was thunderstruck. He demanded to know if I had read it in the free copy of “that dirty rag” he had just handed me. No. My source was impeccable. I had googled the information and if anything appears on Google it has to be true. Mr. Singh was quick to set me straight. Nehru was revered in India and, according to Mr. Singh (who had it on good authority from an uncle who had been Nehru’s personal photographer), nothing happened. His opinion that revered men were obliged to have no flaws was not that far removed from our pre-Clinton (or was that pre-Kennedy?) view of charismatic leaders.

The conversation eventually drifted to more neutral terrain. One of his sons was getting married. The kid had been a straight A-student. Thanks to Mr. Singh’s sweat equity, or perhaps in spite of it, the younger Singh had graduated top of his class at Yale University and now held a prominent position at a local investment firm. Mr. Singh informed me that there would be two weddings. One would be held in India and then all the relatives would be shipped over here for a mega-festival that would last a couple of days. Mr. Singh had taken out a loan to foot the bill. I kept my opinion about a son allowing his parents to take on an added financial burden to myself. My ice cream was beginning to melt and there was no need to anger Mr. Singh again.

Summer means vacation time. So I did not see Mr. Singh for a few months. When I returned to Norwalk, I was surprised to see that Mr. Singh’s store had closed. I heard via the grapevine that he was broke and had decided to return to India with his wife. A part of me was sorry to see the old rascal leave and the other part felt happy. Hopefully he found that mythical retirement sanctuary that we all long for, aka the Marigold Hotel. Hopefully he will at long last feel at home.