Sunday, November 8, 2009
When Liza found out I had lost 85 pounds over the last two years without knowing it, certainly without trying to, she instantly said "No wonder you write about food all the time.' Indeed.
I have been starving in many ways. Fat people are as often malnourished as thin folks in our culture, especially if they are lower income and urban. Post surgery, my electrolytes were persistently abnormal, and they began giving me daily potassium and magnesium sulfate. The surgeon put me on a 2200 calorie diabetic diet -- I don't have diabetes but good insulin control promotes wound healing. I listened to my own cravings and for the first few days of eating solid food I stuck to veggies, cranberry and orange juice, and potatoes plus bananas with every meal. I couldn't get whole grains or avocados, the other items I was jonesing for. The kitchen dutifully limited my carbs but I never reaxhed my calorie limit.
After a week, when I began hard-assed physical therapy, my craving switched to protein and milk, and I ordered accordingly: I was starting to replace muscle. I asked for a comsultation with the hospital dietitian. When she arrived, I told her I wanted to know how to best address the specific malnutrition I had been living with for more than a year, assuming I could afford to buy fresh produce and seriously complete grains as I prefer in my diet. I also asked for a print-out of what I'd ordered through the meal service the past week with nutritional breakdowns I could study.
She had no idea what to do with me. She agreed that living as I had been on a poor person's diet, I should have gained rather than lost weight (my saving habit, I bet, is my inisitence on brown rixe/whole grains). She kept trying to turn our discussion toward calories instead of nutrition. Turns out the kitchen did not keep or report patients' daily meam records, and in the end, she urged me to go on an 1800 calorie a day diet, even after I flatly reminded her that 95% of all weight-loss diets fail and I had only become fat after I began dieting as a young adult.
I told her I loved my body, and after how it had just pulled through for me, ill-conceived calorie counting was not going to be how I rewarded myself for living. She left after giving me a print-out of a diet that relied heavily on white flour and caffeine as "snacks".
Fortunately, just as she was leaving, the Good Doctor came in. He recognized her and asked me how the visit had come about. I explained I'd requested it and gave him a thumbnail of what she'd said. A very nondemonstrative young man, he leaned over me and touched my arm to say "For countless reasons I'd ile to see you thin but PLEASE don't consider dieting, not for months until you are healed." Yet another reason why we call him The Good Doctor.
I stopped dieting during the same general stage of my life when I stopped hurting others via sexual messes. My weight plateaued for a decade, until my orthopedic disabilities drastically altered my mobility and I began living in pain. I gained to another plateau -- partly because in the advice of every expert I consulted, I returned dairy products to my diet. (Kinda need that calcium and minerals when bones are going whackamole.) I'd been the same size for a decade until this recent change.
The second oncologist who saw me this hospitalization, the one called in when pathology of my removed appendix revealed an occult carcinoid tumor, was wise enough to do an exam and take a thorough history of me despite the tumot's clean margins and staging indicating that carcinoma was neither a metastasis nor had it metastasized itself. She understood my level of weight loss, unintentional though probably the result of bowel strangulation and malnutrition, still warranted investigation to consider the idea of cancer elsewhere. In the end, she reassured me that as far as she could see, I had totally sidestepped death. Her face was so delighted: I bet she doesn't get to say that very often.
In contrast, I still remember the sneer on the face of the white gay male physician I saw at the free clinic in San Francisco in 1981 after having been flattened by fever and severe shortness of breath for a week. I was 25, unemployed, and broke, but my roommate Renee finally got me dressed and walked me two blocks to the nearest clinic in the Mission, paying the $12 office visit demand herself rather than let me waste precious oxygen answering their income questions. She also came into the exam room with me, thank g*d, because before even taking my temperature or listening to my chest, that doctor said "So, how long have you been overweight?"
I gaped at him, wheezing audibly. Renee said "She's not here for her weight, she's here because she's burning up with fever."
He turned on her. "Clearly her main problem is obesity, that's what we always see in here." At that point I was at most 25 pounds above the "ideal average" for my height, thick with muscle from walking everywhere.
Renee was slight but a working class Jew who was well-versed in fat liberation. In fact, she was who introduced me to the theory, and I'll love her forever for that fact alone. We shared our household food and she regularly ate circles around me. She stood up and raised her voice to demand that I be examined and treated for what was wrong with me, not given a lecture about obesity. An x-ray revealed advanced pneumonia, and a sputum culture eventually diagnosed me with Valley Fever. Antibiotics cured me and I avoided doctors for a long time after that, until I got insurance and searched until I found physicians I trusted.
Renee and I were in the habit that year of putting Alix Dobkin's latest album XX Alix on the turntable every evening when we got home from our respective jobs or meetings. One of my favorites was the haunting "Separation '78", which begins
Liza, you look more like your mother every day
Counting your calories, my how your body's changed
(Yes it's the same Liza as in my opening paragraph. We were not yet friends, although it's hard to see how we missed connecting back then it seems to have been an inevitability.)
Alix and Liza were lovers who became founding figures in lesbian-feminism, and because Alix's songwriting was frequently autobiographical, Liza's life was very public even when it wasn't through her own art and publshing. Liza was zaftig, buzzed her hair, defied fashion constraints -- including those dictated by dykes -- and had been a role model to me for years by 1981. I understood damned well that if Liza was paying attention to how she ate, it was in no way an attempt to be the kind of slender sex object dictated by heterosexual norms.
I also knew -- all of us who followed Alix's music knew -- that a couple of years earlier, Liza's beloved parents had been killed together in a freak accident. My own mother was still alive, but I felt keenly the poignancy of Alix telling Liza she looked like her mother. Our generation was mother obsessed, positively and negatively. Even more evocative was the fact that "Separation '78" is a love song written about their break-up, again very public. I wept the frst time I heard Alix sing the chorus, with melancholy and hope interlaced:
Going our separate ways
We're on our own
Trusting that only love will come between us
Thus, you can perhaps imagine my shock when I attended a live concert by Alix that year and from the all-lesbian audience came a chorus of boos when she sang her opening lines above about Liza. Alix was visibly startled but far too professional to drop a note, even when boos broke out again at the next verse
Everyone's noticed your new grey hair
Clearly, my darling, I put some there
And my head is carrying its own share
We're an aging pair
After the concert, I talked with one of the women who had booed (not a friend of mine) who said any reference to weight loss was fat oppressive and the grey hair lines were age oppressive. I argued vehemently that noticing changing bodies is not inherently oppressive, and in particular we had every reason to trust the process of Alix and Liza as individuals. Or, to quote a remark Maria Limon made last week when she visited me in the hospital, "Can we just put down the pitchforks?"
I don't know anybody who thinks completely rationally about eating. Or money. Or sex. Do you?
I'm in mid-stream here. I'm hungry for protein as I write this but probably won't go make the tuna sandwich I really want because my pain pills didn't come and that trip to the kitchen might as well be a hike up Bernal Hill used to be. I'll nurse my cranberry juice and wai till morning. At least Ihave this link to you all, typed in my bed on a netbook Liza bought for me and arranged for Maria to bring me in my isolation. Some empty spaces do get filled with just what we need, sometimes people listen and stick up for you and tumors get found in time and love lasts. Let's keep talking. As they say in the crip community, "Not dead yet."
> (Publicity photo for Dyke: A Quarterly, circa 1976; editors were Liza Cowan, left rear, and Penny House, front second from right; also in right front is Alix Dobkin; photo courtesy of Liza Cowan)