A little bit of peace

Thursday was a nightmare, one of the pop's worst days yet. He got his longest dialysis so far, and after that was transferred to the new facility - a lot of stress in one day. The doctor who accompanied him in the ambulance during the transfer came forth with some very dire prognoses, and Ritesh was so upset when I talked to him yesterday morning that I bailed out of work early and skipped dinner to get there as soon as possible. With bloody Friday rush hour traffic, it still took me 2 1/2 hours for the 45 mile trip but just as the mom said, it was so worth it.
When I got there at 7.30pm, his eyes were still wide open, as they have been for these last days that he's been unresponsive. When I told him that I was there, he managed to frown, which at least is a reaction. I did some acupressure on the kidney points on his feet until Ritesh and the mom arrived, and then when the frown came back, stroked his forehead very gently from the root of the frown between the eyelids up to what they call the 6th chakra or 3rd eye. This is super-relaxing as you'll know if you've ever done an ayurvedic treatment, and the frown disappeared, his breathing relaxed, his eyelids started getting a little droopy and a little while later, he had this eyes closed and was asleep. What a relief! He looked so peaceful, for the first time in days. Not that I'm trying to take credit for that, I think he is just in much better hands here and can hopefully finally make some progress. Just the reduction in the bacterial load that he's exposed to must help - it was striking how lax the other hospital was about hygiene. Here, you have to put on a gown, gloves and mouth protection if you want to see him - in the other place you could just walk in, as did everyone else, too, notably the hospital staff. No wonder he ended up with a hospital-borne bacterial infection (MRSA) that they're still trying to get under control.

Meanwhile in Germany...

...my one and only goddaughter is in hospital as well, due to a ruptured appendix. Poor little thing got emergency surgery on Saturday morning and a second operation on Sunday - ruptured appendices are NASTY! - and is still in a lot of pain. But she's a trooper and being really brave and we're all really proud of her. Here she's even attempting a little smile...

The pompous flowers in front are from us, ordered online from LA and hand-delivered by a local florist the next morning - fabulous how that works, and I'm glad they did a nice job on the bouquet.

Poor little girl will have to stay in hospital a full week, but if all goes well she can go home on Saturday, which is just as well as Sunday is her birthday! (the 12th, if I'm counting right...). Hopefully, she won't have too bad of a time until then. At least the nurses all adore her and it seems like she's in really good hands - not something you can take for granted! I happen to have been born in this very same hospital, and my mother can tell you a story or two about how horribly they treated her at the time. But then again, that was a long time ago, and I'm happy to hear that things have changed.

SO, NAMIMAUS, LIEBES SCHNUCKELCHEN,
GANZ VIELEN HERZLICHEN DANK FUER DIE FOTOS - WIR HABEN UNS RIESIG GEFREUT! WIR WUENSCHEN DIR WEITERHIN GUTE UND SCHNELLE BESSERUNG UND DASS DU ZU DEINEM GEBURTSTAG WIEDER ZUHAUSE SEIN UND FEIERN KANNST!
BIS DAHIN SEI GANZ FEST UMARMT UND GEDRUECKT
VON DEINER
PEDI

WIR HABEN DICH LIEB!!

New hospital, new hope

The pops just arrived at the new medical facility he got transferred to. It is further away from the mom's house (20 min vs. around the corner) so it's less convenient but hopefully will make a difference in the quality of care as well as the kind of treatment they can give him.

Agonizing Choices

We are thinking it may best to finally take the risk to move the pops to a better medical facility. One of Ritesh's coworkers, a doctor herself, recommended that right from the beginning. So far, we have been hesitant because he just didn't seem well enough to be moved, and we knew from the insurance company that he would be moved anyway as soon as he was out of the woods. Plus we trusted the doctors, based on the miracle work the cardiologist performed at the beginning, and were of course hoping for his condition to improve. As this doesn't seem to be happening, we are growing more and more concerned. It seems the doctors here have reached the end of their wisdom. They keep repeating the same drill, dialysis and blood transfusion, and it doesn’t seem to be working. Nor have they been able to find the source of his recurring infection. Also, it might be good if he was in bigger facility that has the full-time staff to take care of him and do the necessary procedures without having to rely on outside contractors that don’t seem to be very committed to the place or the patients. No wonder he keeps getting infections if you can't trust the medical personnel to change their gloves after taking calls on their personal cell phones.

Today is Day 19 since the heart attack. He has been in critical care and on a respirator ever since, suffering from a string of complications that have culminated in kidney failure. He has had dialysis three times, number 4 due tomorrow, and three blood transfusions, but the uric acid level in his blood just isn’t going down (at the very least, we need to consult a more experienced kidney specialist...). And the most disturbing effect of the hyper-uricemia is that it affects the brain and that as a result, dad is basically comatose. This is supposed to be temporary, but it’s been several days now and it is very hard to live with. Today, they finally did a tracheotomy to help him breathe. But having him lie there unresponsive, eyes open but unseeing, is just heartbreaking.

Reading List

I have a recurring fantasy of spending a vacation reading. I buy a stack of books whenever I go on a trip, assuming I'll have plenty of free time to lounge in some foreign street cafe and immerse myself into the fiction I never get to during the drudgery of my work weeks. Of course, this rarely happens. Wherever I go, I'm generally too busy getting to know the place to read anything beyond my Lonely Planet guide - with the exception maybe of Italy, where I did make it through a fabulous Sicilian classic (Di Lampedusa's Il Gattopardo) on those long train rides from Rome to Naples and Positano and then back up to Tuscany.

There are no long train rides planned for our trip to Mumbai, but there are some godawful long plane journeys involved, so I did compile a reading list, and my bestest friend Roger went out and got me all the books on my list for my birthday - thanks so much, Rogie! And thanks also for the great card that came in the mail yesterday :)

I already made it through The Elegance of the Hedgehog during my sick days this week, and loved it. Kindred spirits - balm on my wounded soul, predictably. It's all I can do to stop myself from packing up and moving back to Paris, to eat madeleines while discussing Ozu and lamenting the latest excesses of post-structuralism.

B-Day kindness

It was my birthday on Monday, and people have been inordinately kind to me all week. First, I got flowers from my love, who also took me out for a lovely dinner at Sasaya - thanks, babe!

Then there was a birthday lunch with the nice guys from work - Cecy, Caroline, Kimberly, Frank and Beatrice, and at Cafe Brasil, no less. Thanks everyone for coming out and putting up with me in my in my worn-out stupor, and thanks, Cecy, for getting us all organized and out the door!

And thanks, Kimberly, for the special dessert! This is Cafe Brazil's apple tart, kind of like a Brazilian version of what a tarte tatin should look like, and with real whipped cream - a real treat!

Then there were some heartwarming voice mails from Laurence and Jacob, singing French b-day songs, and from my goddaughter and her family in Germany, singing Happy Birthday, AND a lovely little package from my goddaughter including letters and drawings and all kinds of little goodies....

And to top it off, a nurturing and soul-comforting girls' night at Laura's on Saturday, with Katherine and Susan (Kathleen was home sick), with chocolate cake and lovely kids who really lifted my weary spirit - thanks so much, everyone! I feel really blessed to have you all in my life.

Chalard

Don't think for a moment that dialysis is a walk in the park. You may be tempted to assume from having seen pictures of people who get dialysis thrice weekly that it's not a big deal - patients seem to just sit there, conscious and comfortable, and relax while a machine does their kidney's work for them. Not so. It's quite a shock to the system, especially the first time, to have the blood circulating outside the body and in touch with foreign substances. Dad did not have the easiest of times going through it today, but he did it and is resting, and we're very hopeful that tomorrow is going to be a much better day. "Nothing is going to be fast for him", the nurse said tonight when I checked in one last time before driving back up to LA, but a small improvement is really all we're looking for now. Small but steady, please, God, if you're listening.

The nurse who has been taking care of him the last couple of nights, Chalard, left a profound impression on me. To say that she is my favorite amongst the nurses I've met so far wouldn't begin to sum up the impact she's had on me. She is Thai (chalard means smart/intelligent in Thai) , probably in her 50ies, and looks like a Buddhist nun, with short cropped hair and the kindliest of smiles - plus a set of funky, artsy glasses. She is indeed a Buddhist, as Ritesh's mom assures me, and radiates a kind of goodness that permeates you through and through, makes the world appear less stupid and vile, and makes you want to be a better person. I've known my share of Buddhists, both Asians who were raised that way and Western converts, and no one has ever struck me that way. I hope she'll be around to take care of dad as much as possible.

Unfortunately, I have no picture of Chalard to share, but I do have one of the impressively moody sky today. You may think it's a little somber, but when you live in a place where the sky is relentlessly blue 320 days out of the year, you come to really appreciate a little texture...

Dialysis today

Saw dad last night and he didn't look quite as bad as I expected. His breathing is very laborious but that is at least partly due to accumulated toxins in the lungs, so we have a lot of hope that the dialysis is going to make a world of difference...

Mumbai

We were supposed to leave for Mumbai this Wednesday, but have pushed our trip back by one week to March 4. By then, it will have been a month since Ritesh's dad's heart attack, and we hope that he will be at least stable, if not a whole lot better. It took an hour on the phone with Virgin Airways to get it all sorted out, and will require the faxing of an official letter from the hospital on Monday, but all in all, they were reasonably helpful and ended up not charging us the exorbitant change fee of $200 and GBP100 per person that they at first tried to slap on us.

Glimmers of Hope

I'm not sure this is an appropriate title for this post. It seems like when someone has been in intensive care for a while, procedures and interventions that would otherwise seem disastrous don't really seem quite that bad anymore. If the overall picture is sufficiently grim, anything that might keep it from getting any grimmer is welcome, no questions asked.

The good news is, the pop's heart is doing better. The aortic balloon pump was removed without much ado, and his heart has been beating miraculously well its own, indicating it may indeed have fully recovered from the attack, as the pulmonologist had declared. However, he is still on the respirator and heavily sedated due to the respiratory distress syndrome which had me so freaked out last Sunday. Reading about it online is a terrifying experience when you have someone near affected by it, what with a 50-60% mortality rate, possible infection leading to septicemia, possible spreading to other organs and causing organ failure etc. So when the first news came that water was building up in his extremities because his kidney's weren't working sufficiently, we were beyond worried. And when it that situation came the announcement that he would be given a blood transfusion because his platelet count was low and he was running a fever, sign of an infection, the thought of a blood transfusion didn't cause nearly as much panic as you'd think, but was instead welcomed as a possible source of strength and healing. Which it kind of turned out to be - the fever went down as a result, as did the swelling, somewhat. The kidneys, however, are still not working that well, and the toxic load in his blood is in turn affecting the lungs that need to heal so badly, so tomorrow, apparently, they have him scheduled for dialysis. Another intervention that would seem massive in any other situation, whereas here it is just another pocedure that's necessary on the way back to health and that'll hopefully give him a good boost.

He has lost a lot of weight, and he wasn't heavy to begin with, so I'm a little scared of what I'll find when I see him tonight. I haven't been down all week as I've been sick myself, nothing serious, but I'm on antibiotics and feeling dazed, achy and exhausted. This whole experience has been hard on everyone, and the longer it goes on the more daunting the long-term prospects seem. At first, this seemed a very scary but finite interlude, and we expected a reasonably swift return to normality. We wanted him off the respirator and back home recovering as soon as possible. We thought there would be some minor changes in his diet (he's already eating pretty well, and exercising) and a regime of medications for him to follow, but really, we expected that life would continue more or less the way it had been going. How naive we were. It was Ritesh's mom who pointed out the other night that our lives have changed completely. And she didn't just mean the short term, hopefully temporary changes, the fact that Ritesh has pretty much moved in with her to be close to the hospital, that he has been to work no more than a couple of days in the last two weeks, the fact that everyone's schedule pretty much revolves around trips to the hospital etc. I'm fairly sure the long-term changes are dawning on her as they are on all of us, the fact that even if he makes it through this, it may take a long time, and it may take even longer for him to recover fully. He will need a lot of taking care of, and this, along with a lot of the management of family affairs will land on her shoulders, and ours.

It doesn't help to think about this yet, as all our resources are required in the present. I for one need to find a better way to manage my energies, as I'm getting to my limits and am feeling spent and depleted. It doesn't help that the stress at work is insane. The boss has finally admitted that I am completely overburdened and allowed me to delegate part of a project to someone else - about 5% of my workload this week, but better than nothing. And I did get a decent night's sleep last night, for once, which must be a good sign. But I still feel I'm running on empty, and really need to find more ways to recharge my batteries.

Sometimes, just being present to something beautiful can help - like this sky, taken the other night, on my drive from work to UCLA to pick up Ritesh:

Rollercoaster

Ritesh's dad is still in the hospital, still in intensive/cardiac care. There was some improvement last week - in fact, on Thursday, things looked great. He had been weaned of most of the medications and could communicate by nodding his head yes or no and by blinking his eyes in response to letters of the alphabet, thus creating words. He wanted to know what had happened to him and where he was. He was emotional but lucid and seemed to progress well. Doctors were confident they would be able to remove the respirator. "A no brainer" the pulmonologist said, "we'll take him off". They would remove the aortic balloon pump that helps his heart the day after the ventilator, and then move him out of the ICU straight into cardiac rehab. He would be able to talk and walk and come home soon. Our relief was palpable - this ordeal was finally going to be over, and a huge weight was lifted. We joked with dad in the ICU, and giddily told jokes and made plans and giggled in the waiting room. I bailed out of work early that day and spent a small fortune on thank you cards and chocolates and macarons for the 7 nurses and 4 doctors who had been taking care of him, and we felt so celebratory that we polished off a whole box of macarons ourselves, right there in the hospital waiting room.

The next day, Friday, he was indeed taken off the respirator and seemed to be doing well. I decided to make cupcakes to celebrate. Valentine's Day was coming up on Saturday, and while I resent the marketing/retail onslaught of that day as much as the next person, I felt sentimental this year. Ritesh had been spending the night down in Anaheim pretty much every night since the heart attack and although I commuted down there on most days, it was hard on us and I missed him very much. With everything he's gone through this week, I figured the least I could do was to finally make him some banana dessert. So I made banana custard cupcakes, with a chocolate-coffee-liqueur glaze and some salted caramel and extra fleur-de-sel on top:

They were good and Ritesh was happy. However, by the time I got down to Anaheim, pops was already not breathing very well. He was struggling to get enough oxygen, and it got worse throughout the evening in spite of an assortment of oxygen masks they tried on him. In the end, he went into respiratory distress and had to be put back on the respirator around midnight, along with the heavy sedation (to help him stand that tube down his throat) and the blood pressure meds. "We're back to square one", the nurse said.

The weekend has been one of waiting and stressing out over the new diagnosis of Acute Respiratory Distress Syndrome, which sounds very frightening if you look it up on wikipedia. We won't know until later today what the doctors have to say and what the prognosis is, if there is one.

Call for prayers and good thoughts...

We've had some sad and difficult news. Ritesh's dad had a heart attack on Saturday morning. He has been in intensive care ever since, more or less stable, but in critical condition, heavily sedated and connected to a dozen machines and IV tubes, including a ventilator. Today is day 3 since the attack, and his heart seems to be slowly recovering, but unfortunately there is some water in his lungs that's just not going away and that's making it hard for him to breathe on his own. He also contracted a lung infection and has been running a fever since lunch time. He was supposed to be off the respirator by now, so we're very concerned and not sure what to think. We're trying to remain positive but we're all exhausted. Hopefully his temperature will be down tomorrow. It's hard to see him in this much pain.

Cute things falling asleep...

Our adorable godson, he of the gorgeously abundant (abundantly gorgeous?) cheeks!
cuteness: 5*
sleepiness: 4*

(*rated on a scale of 1-5, with 5 being the cutest/sleepiest)

Laura's handsome Jasper, jetlagged and out cold after returning from a trip to India

cuteness: 5
sleepiness: 5

If you haven't seen the original ... "Cute things falling asleep"

Nady to the rescue!

Having witnessed us failing to resolve our banana pie issues, Nady took pity on us and stepped in and saved the day with her fabulous Banana Dream Pie! This is the stuff of legend: a subtly salty crust, a delicious chocolate-banana filling, all topped not by cholesterol-laden whipped cream, but by a perfect, fluffy and crunchy layer of meringue! This was really supposed to be Ritesh's treat, but I think I loved it even more than he did :) - thanks so much Nady!

Nady also made yummy lasagna...

...and we had both wine AND champagne...
... much merriment ensued...such as Nady and I self-referentially taking pictures of each other taking pictures of each other...
and Ritesh getting his hair sorted out...

It was a very special night, lots of fun and love and hugs- thanks, N&D, for letting us be a part of your family!

Amazing Black Bean Brownies

I’ve never been particularly fond of brownies, they’re too heavy and sweet for my taste and always seem to put me into some digestive coma. But as I really love Japanese red bean cakes, I couldn't help but be intrigued by the idea of using black beans to make a more wholesome sort of brownie - and lo and behold, this is one great recipe. You can't really taste the beans as such, but they add a nice fudgy texture (apart from protein and fiber) and make it possible to dispense with flour altogether, yay. Also, there is no sugar in these, as they are sweetened with wonderful organic agave nectar (and a whole bottle of it) - sweetener of millionaires as my vegan cupcake cookbook calls it, but great stuff, nice flavor, all natural, no sugar high – perfect.

I splurged on the other ingredients, too – Scharffenberger chocolate, the best European butter (with that extra butterfat!), organic Omega-3 eggs, organic low-sodium black beans and some of that fabulous fresh vanilla bean that Suzanne and Prashant had brought from Hawaii (thanks!). Cecy, gracious as ever, agreed to invest ¼ cup of her instant coffee, which she keeps at work, for that extra kick, and seemed to be fairly pleased with the return on her investment. So I for one am a convert – I think I like these better than my French Flourless Chocolate Cake…

Home-Cooked Meals

French toast made w/ brioche buns and caramelized apples

lemon-coconut French toast, again made w/ brioche buns but encrusted w/ whole wheat flakes, plus some fresh orange slices

my ginger-turmeric-garlic soup w/ butternut squash, shitake mushrooms and kale

my spinach eggflower soup made with Thai lemongrass-ginger broth, and a broccoli slaw w/ a homemade Thai peanut-chili dressing

and Ritesh's fabulous Indian beans w/ garlic bread and salad

Recession Dining - Pellkartoffeln

You may not know it from reading this blog, but I LOVE potatoes, and not just French fries and Bavarian dumplings and extravagant Indian potato dishes, but also the glorious simplicity of plain boiled potatoes with butter (granted, really good butter) and salt.

This is the kind of potato dish I was raised on, and it always brings back fond memories. It is also the kind of dish that got my grandparents through two world wars and some hard times as refugees, so if it's good enough for them, it's definitely good enough for me...

Not quite good enough for Ritesh, though, who thinks of this as a side dish and keeps wondering where his dinner is. Sorry hons... :(

England in the Snow

You must have heard about the snow in England these days – pretty impressive the havoc an unexpected four inches can wreak in a major metropolis! Our London office was pretty much shut down because there was no way people could get to work. Per the BBC, this was the biggest snow storm since Feb 1991, and while I was reading this and calculating that this was 18 years ago, it dawned on me that I was actually there at the time! I was an undergrad then, and I actually remember that snowfall – it was just magical, coming out of the library to find everything covered in white, and then slipping and gliding on the cobblestones on my way home. I didn't have a camera with me back then, and the only pictures I found online are copyright protected, but this is what it looked like on my way home past the Radcliffe, only that, of course, there was way more snow back then.

This was during Hilary term of my second year at Oxford (the academic year there is divided into three terms, Michaelmas, Hilary and Trinity), and Hilary was a hard one that year as I struggled through Medieval Spanish and the complete writings of ole Jean-Paul Sartre, who even at the time struck me as particularly un-wholesome and depressing. February 1991 was also the time of the First Gulf War, so there was lots of upset and demos all around. And on top of that, I had been signed up since the previous fall to go to Israel in early March as a kibbutz volunteer, and now due to the war saw more and more people from the group I was supposed to go with drop out. In the end, the war ended a few days before I flew out to Israel, but by then everyone had canceled and as anyone will tell you, I was the only international volunteer reporting for work in Tel Aviv in the first week of March 1991. All this to say, these were not particularly cheerful times, and I remember that snowfall as one of the few moments of quiet happiness and pure joy during those weeks. The dreamlike silence of snow falling, the muffled sounds and absent traffic - it felt unreal, like time stood still. Just beautiful.

Stuart Jeffries had a great piece in the Guardian today about this sentiment. Sorry about the long quote, but I just love this article and didn't want to post just the link for fear it'll become inactive at some point. It's so right on target - talk about swooning souls!

Other cities - Winnipeg, say, Moscow or Bergen - cope with snow, subdue it and go to work through impeccably gritted roads. London isn't like that: it rarely copes with anything; these days, it masters nothing. Equipped with a loveably tragi-comic public transport system, our capital fails on a daily basis. The poor suckers who live here get - at best - inured to this hopelessness. Yesterday London was so hobbled by the snow that the situation was even worse than hopeless: usually six million Londoners get to work by bus; yesterday there were no buses; the tube was even more spectacularly unreliable than usual. Even gnarly cyclists in all kinds of crypto-pervy winterwear were laid low. Just for a day Londoners got hit by something special.

For a day at least, Londoners returned to a forgotten innocence. Yesterday the headlines howled about how £2bn would be lost yesterday thanks to public transport disruption. Two words: So. What. We're in the middle of a credit crunch and £2bn is the sort of money a hedge-fund trader might find in the lining of his Armani suit. Yesterday we stopped measuring our lives in coffee spoons, overdrafts and balance of payments deficits. It felt good.

We needed the snow to remind us of that innocence. We needed it to remind us of who we are. We are not just homo-economicus, we can't be defined by the size of our negative equity, the burden of our personal debt, or numbers of en-suites. We need something more this winter than cowering at home noting down how many times Gordon Ramsay swears on Channel 4. Our new year resolutions are broken, our jobs insecure, our pensions worthless, our spirits crushed by January's post-Christmas gloom. We needed something to lift our spirits, to give us the excuse to play to no discernible economic benefit.

And yesterday here it came, free as air, falling on to my bare head as I walked down the canal towpath. I was doing what a human being should do now and again: stare. A Spanish man and I watched a heron dive from the ice into water that is starless and bible black. Would it ever resurface? What could it find down there to eat? We did what London hardly ever allows: exchanged the conspiratorial glances and then resumed the satisfyingly economically unproductive business of staring.

In London, this doesn't happen often. We trust our dour reflexive, self-poisoning moaning as a lifestyle philosophy instead. We like it that way: strangers are strange and Britain, damn everything about it, doesn't work. Why don't the buses run on time? Why are we so hopeless? Why can't something be done (usually by someone else who we can blame for their shortcomings)? And this chorus of self-immolation is taken up countrywide: why, non-Londoners ask, is the capital brought to a standstill by a little snow? Why can't you southern ponces get your act together? And the cry is international too: as I walk through the St Pancras Eurostar terminal, a French couple consulting the warnings about the tube, roll their eyes as one. He said: "Typiquement anglais. Rien ne va plus!" They both laugh, as if to say their Gallic expectations had been confirmed.

And so we surrendered to delight. We found better questions to ask: how do you roll a snowman? Where the devil are my galoshes? What have you done with my sledge? Can one get to work by sleigh? Doesn't Prokofiev sound lovely when it's snowing outside? After leaving the canal, I walked down through virgin snow in quiet back streets nestling right next to the Eurostar train line. A snowy bucolic idyll at the heart of the metropolis. I looked from Camley Street through the snow to the gothic tower of St Pancras - a Caspar David Friedrich painting had suddenly leapt before my eyes.

As I walked towards Hampstead Heath, I heard whoops and cheers. The heath was like Narnia (though with none of CS Lewis's unwonted Christian allegorising). My God, I told myself as I walked through a heavenly avenue with snow-laden branches bejewelling my steps, this is the most beautiful city in the world! (I was delirious, high on pheromones, snow bonkers, and in need of a good slap).

I stand on Kite Hill, looking across the London panorama below and remember the ending of Joyce's The Dead. "His soul swooned slowly as he heard the snow falling faintly through the universe and faintly falling, like the descent of their last end, upon all the living and the dead." My soul was swooning (there, I admit it) yesterday as I stood and saw the snow falling, not on Joyce's Ireland, but on dirty old London, reborn as a thing of beauty. It was snowing from Epping Forest to Heathrow, Upminster to Uxbridge, on duke and dustman in a way that it hasn't for ages and probably won't for a good while. Savour it, I told myself.

http://www.guardian.co.uk/uk/2009/feb/03/london-snow-weather