Sunday, 27 July 2014

Top surgery 1: pre-op and op

I had top surgery on Monday 21st July 2014. This is a record for me, and for anyone who would find an account of the process useful.

Consultation, pre-op assessment and surgery

I had my surgery with Andrew Yelland at the Brighton Nuffield Health Centre. I met him on July 1st for my consultation and pre-op assessment. He was really nice and relaxed: chatty, informative, unfazed by questions and concerns. In fact, according to my mum (who attended the pre-op with me), he was a little too blasé - but my mum is a worrier and his casual attitude didn't worry me or put me off. He had a look at my chest and told me I'd need double incision (which I had already assumed) and showed me how it would be done. He drew pictures and took me through a list of facts, risks etc.

At my pre-op assessment I had my blood pressure taken, was weighed and measured, swabbed for MRSA, and told how to prepare myself for surgery: remove nail polish and jewellery, wash with a special sponge they gave me, don't wear deodorant  / moisturiser / makeup etc. The nurses were lovely. Oh, something I wasn't told in advance was that they'd need to take a urine sample. So save some up for that!

My admission letter told me that I'd be admitted at 7:15 on the morning of my surgery, but when I spoke to Ginny (Andrew Yelland's secretary) the week before, she told me I was last on the list for the day, so could actually check in at 11. That made for less of an early morning, but also meant that the 6 hours of nil-by-mouth occurred over a much less convenient time. I didn't have anything between 9pm on the 20th and 5pm on the 21st (when I came out of surgery). I was starving!

When I was admitted, I was immediately asked to choose my menu for the stay. It made me even hungrier, but at least I could look forward to my tea - pasta primavera and a cheeseboard. Then I was seen by a nurse (she had a student nurse with her as well) who took another set of "obs" as they called them (observations: blood pressure, pulse etc) and measured me for my sexy surgery stockings. She took me through a pile of questions about when I'd last eaten, if I had any allergies, had I washed, had I followed all my pre-op instructions, did I have my binders, etc, and then supplied me with a wristband with my details on it. 

After that, I changed into my gown and delightful paper knickers and stockings, and hung out until Andrew Yelland arrived to draw on my chest. Soon after, my anaesthetist (Martin Street) arrived to say hello, check again that I wasn't allergic to anything, and it wasn't long after that that two porters arrived to wheel me off down the corridor. Nothing makes you feel sillier than being wheeled down a corridor under a duvet on a hot day, when there's nothing wrong with you. 

I was fitted with a cannula and then given the anaesthetic, which felt exactly as the anaesthetist said it would: cold in my arm, then a strange taste in my mouth, then nothing. I was a bit disappointed I wasn't asked to count back from 10. I guess that's just in the movies.

When I came round I was pretty panicky. There was a mask on my face and I couldn't breathe very well - I was very cold and uncomfortable, and I think I was thrashing around a bit. I asked if I could sit up, which made me feel a bit better, and then they gave me a bunch of morphine, which helped me calm down pretty fast. The nurses there were very kind and attentive, giving me little sips of water and chatting gently about music and weather and the like. It seemed like no time at all before they wheeled me back to my room.

The time after that is a bit of a blur. I know I was pretty woozy for quite a few hours - my mum and partner were there and apparently I was quite incoherent and fell asleep a lot. I also told them about four times (allegedly) that I intended to have a pedicure when I was better. They suggested I skip dinner (which was to come round at 6) as it might make me sick, but I wasn't having that! They brought it as promised, and it was the most enormous portion of pasta I've ever seen, and I slowly ate about a third of it. It was the best meal. After that I was allowed a pot of tea, and I managed to not spill any of it on myself, which was amazing. During this time I had a lot of care and attention from various nurses who took more 'obs' and kept my temperature sensible (I was freezing, then too hot, and generally just a pain in the arse). I had an automatic blood pressure check every ten minutes or so, thinning out as time went on. 

My visitors left around 8:30, and I spent the evening listening to the Proms on the radio, slowly eating my way through the cheese and biscuits, reading my book (well, looking at my book) and watching something with Trevor Eve in it on ITV3. I was given some antibiotics at around 10pm, and some time after that I called a nurse (as I had been told) to help me get out of bed for the first time. I was dizzy but it was ok - totally failed to pee though. I tried to change into my own clothes for sleeping, but eventually decided that the gown was probably more comfortable. I had been told - and this surprised me - that I should stay fairly upright for the duration. It wasn't as uncomfortable as I thought - and it meant that I never strained myself trying to get out of bed or reach for things on my table. 

I fell asleep easily enough, and was woken at about 1:30 for pain relief and more obs - after that, I slept straight through until about 6:30, when I had more obs, pain relief and the final shot of antibiotics. Then breakfast at 8, followed by a revolving door of visitors: Andrew Yelland came to see me, told me it had gone well, and undid my binder - blessed relief! He had a look at my dressings, poked around a bit, and told me I could leave it open until the nurse came to fit my post-op binder. It was nice being able to breathe for a bit. The anaesthetist popped in, checked I was ok, and left again; a physiotherapist came and walked me through some exercises to do once I was home. The nurse who had admitted me came to fit my binder, give me my prescriptions and talk me through my post-op care. I wish I could remember her name, because she was particularly great - although absolutely everyone I met at the Nuffield was lovely and helpful and reassuring and friendly. 

I had a nurse carry my bag downstairs, and sat on the terrace with a glass of water, enjoying the sun, until my dad arrived to pick me up. The drive home was appalling. DO NOT ignore the advice to bring a pillow to protect your chest from the seatbelt. I had one, also a very comfortable seat and a very good and considerate driver, and I was still in quite a bit of pain (my journey took about 2 hours). I dozed most of the day when I got home. 

I want to flag up the benefits of using absorbent lint to line the rough edges of the binders (you can buy these from the Nuffield for £10, but they're cheaper from Sports Direct). If I wear the binder as tightly as I feel I should, the edges chafe painfully, especially around the top (I'm very broad-shouldered, so your mileage may vary). If I'd known to do this before the journey home, I would have been in far less pain that day!

Saturday, 29 March 2014

Review: Big Brother

I read We need to talk about Kevin when it was published, along with everybody else I saw on trains, beaches, and benches, at coffee shops, hospitals and dentists. I was fascinated by it, and unsure how I felt about it. My Auntie J asked us "So, what do you think? Was it the boy, or his mother?" She herself was entirely unsympathetic to the mother, and used some uncharacteristically unfeminist language to condemn her. But then, Auntie J was (is) a mother herself. Maybe it's more tempting, from that position, to believe that a mother's character can influence her child's one way or the other. Maybe it's even true; how would I know? (I mean, my mother is the best person in the world, and I'm ... me.) But I know that I never had the conviction that Auntie J did to damn Eva unreservedly. It was more complicated than that.

If you haven't seen the film with Tilda Swinton and Ezra Miller, you should. It's bleak and horrible and you won't want to see it again, but it's worth a watch. 

Anyway, the things I really loved about Kevin were the writing and the complexity. Something about Lionel Shriver's prose is deeply compelling, and I love to read even her books whose contrivances leave me cold (the story of The post-birthday world, for example, is complete nonsense, and I still enjoy reading it). But I was disappointed to learn that her most recent novel is called Big brother and centres around a woman whose brother Edison, once a "slim, hip pianist" turns up for a visit weighing roughly 386 pounds. To us Brits, that's 27.5 stone. 

Let me get this out of the way right now: I couldn't care less about all the handwringing regarding obesity epidemics and national averages and plane seats and fatties-cost-the-NHS-millions-of-pounds-a-year. Everyone has the right to be whatever weight they want, or whatever weight they happen to be, and in the UK, you additionally have as much right to be treated for any conditions arising from that as you do to be treated for sexual health, lung cancer, liver damage, gender confirmation, and a million other things. I have no patience for fatness-as-a-moral-failure narratives, nor for conniving arguments that try to make that statement without seeming to make it (see I'm only concerned for your health, I just want you to live a full life, I don't want people to be mean to you, wouldn't you rather have more choice in clothes, etc).

So that's why I was disappointed in Shriver's subject matter. The best thing about Shriver's novels is how deeply she examines complicated situations; how much nuance she reads into people and their lives. It's impossible to say that it's all Eva or all Kevin, or even how much blame should be assigned to Franklin. The novel twists and turns on itself with such dedication that you're constantly wrongfooted as a reader, and that kind of satisfying moral ambiguity is not something I want to see applied to (as the blurb says) "why we overeat". 

I'm going to spoil the entire plot of Big brother, including the twist at the end, so read on at your own risk.

The narrator, Pandora Halfdanarson, has grown up under the shadow of a famous father and a huge personality of a brother, but by the time we meet her, she is outranking both in personal and professional success. When Edison arrives for a visit having gained hundreds of pounds and lost friends, work, pride and possessions, she and her family struggle to ignore what they call "the elephant in the room". As he prepares to leave on a fictional jazz tour of Europe, she proposes that they get a house together for a year, where he will be put on a strict diet until he loses the weight. He succeeds, but when he realises that she will now go back to her family, he deliberately binges until he regains all the weight.

At this point it is revealed that the whole weight-loss story line has been Pandora's invention, and that Edison instead returned to New York, foundered further, gained more and more weight, and died at 49 of "complications of congestive heart failure". 

This feels like such a cop out. I'm not saying I was happy with the 'I love my bro so much I'm gonna force him to crash diet for his own good, bravely risking my own health and marriage in the process' story, but this 'and then I woke up and it was all a dream' thing? How has that been allowed in a successful writer's fourteenth novel? It's not that it isn't subject to similar complexities as Shriver's usual narratives - I would be far angrier if her 'dream' had ended successfully rather than with a reversion to eating-as-emotional-weapon - but it does have the effect of declawing everything about the preceding 200 pages. In those pages Pandora gets to know Edison, and herself, and other characters develop alongside them. Employing the silly 'it was all a dream' contrivance cheapens the development that has occurred throughout the novel, leaving you with a crushing sense of anticlimax. "Oh yeah, this didn't happen and could never have happened, and he's dead now anyway." It's just poor form. 

This book has all of Shriver's signatures: complicated, often unlikeable characters with unusual names and esoteric occupations; multi-faceted musings on place, identity and fame; an obsession with food and eating; a focus on familial ties and responsibility. The complexities are great, and her fascination with the strive for satisfaction, challenge and meaning in life is as compelling here as it is in Kevin. There's a really interesting discussion to be had about their portrayals of 'normal' life: ambition, achievement, stability, adventure - what 'normal' means and if it's worth it. But I feel so let down by the subject matter, and even more so by the cowardly ending.

Reading the notes at the back reveals that Shriver's older brother died in the same circumstances as Edison. So that pretty much explains why this novel feels more like a vehicle than fictional craft. It also gives us this gem from Shriver herself: 
I faced a range of obvious end points, none satisfying: a) Edison stays fat (static, not a story); b) Edison loses the weight and lives happily ever after (didn't sound like a Shriver novel to me); c) Edison loses the weight only to gain it all back again. Now, the latter structure would engender an appealing pathos. Yet as a matter of principle I could not publish a novel with the implicit message that in the long run it's impossible to lose weight, and thus it's pointless to even try.
So I chose d). 
I mean, this could take days to unpack, and I'm trying to practise brevity. (But I have to say this: a character getting really fat and then living their life is not "static". That is frankly insulting.) Shriver's anti-fat bias is summed up in the closing point: she thinks losing weight is so desirable that it would be morally wrong to publish a piece of fiction suggesting that losing weight is impossible. And that's disappointing from someone who wrestles with moral ambiguities the way that Shriver normally does. To be clear, I'm not advocating for a debate about the rights and wrongs of weight loss, fat-hatred, obesity scaremongering and the like. I think I've made my own views clear. But this moral high-handedness is not what I expected from Lionel Shriver, and it's not what I wanted.

Sunday, 23 March 2014


I had wanted to see S Bear Bergman speak at Bar Wotever, where I was sure he would be far queerer and less 'family friendly' than he would be at JW3, a Jewish community centre in North West London. But I was away for that event, so off to JW3 I went, along with another queer Jew of my acquaintance who was in a similar position, although more worried than I about drinking the tea of the occupation. (It was Oscars night at JW3, and my friend and I were surrounded by opulently dressed, exquisitely-groomed Jews who politely skimmed their eyes over us, the raggedy queers drinking g&t and peppermint tea in their midst. Apparently there was a real Oscar statue there, but I didn't see it.)

There were maybe 40 people in attendance, and I assumed that people had taken the write-up seriously, and brought their parents and grandparents to the event. It was nice, I thought. Bear's storytelling was marvellous, of course, and there was a lovely jumble of queerness, Jewishness and family in every story. 

It wasn't until the q&a at the end that things went awry. The very first question was "So ... you mentioned the word 'transsexual'. What ... er ... can you ... say more about that?" Bear answered that he is transsexual, and apologised (in a gloriously polite 'sorry not sorry' way) for not including the information as part of his introduction. Then he quipped that the line about his grandma asking him, as a youth, if he had a boyfriend yet, would have made a lot more sense with this information, and something about the amount of head-nodding in the room must have given the game away.

On going round the room, Bear discovered that there were 3 separate groups of people who had had no idea what they were coming to: about half the audience in total. At least one of the groups was a work outing. And in another group, one man explained their presence thusly: "Well, it was this or Wolf of Wall Street."

Another man, sitting right at the back, tried very hard to be polite as he explained that queer means homosexual, and that we don't really use the word here, as it's derogatory. (Outraged gestures no it doesn't! yes we bloody do! from the queers in attendance.)

Bear, to his credit, handled the whole thing tremendously. He was nothing but polite and sympathetic to the confused and they, for their part, were mostly respectful and seemed genuinely interested. There were some awkward questions ("So how long ago were you a woman?") but Bear handled them all with aplomb, and at the end, while the queer side of the audience huddled together to recuperate, it was wonderful to see that the other half of the audience had gathered around Bear. I was in the other half, of course, but I hope they were being nice to him. Maybe apologising a bit, or asking more questions, or just getting to know him.

On our side of the room, we were conducting shaky post-match analysis. I don't think I was alone in finding the q&a quite traumatic: for much of it I was near hysterical with a laughter which wasn't always happy, and others were acting similarly; I can't know their feelings, of course, but my companion confessed afterwards that she had felt the same. After things had calmed down, I found myself so shaky and short of breath that I recognised the sensation of an anxiety attack. Texting each other afterwards, S and I discussed the strange feeling of 'coming down' that we were both experiencing; S said her immediate response had been to want to get drunk, and that she knew she'd feel very tired soon. That's not how I processed it, but it certainly feels familiar! In the immediate aftermath, there was a feeling of euphoria amongst the leftover queers - we were laughing and talking, greeting old and new friends, bonding in a way that reflected the strange intimacy of what had just happened. I'm not overstating the post-traumatic feeling, for myself at least. It felt like we'd survived something together.

The leftover queers
And that brings me to machatunim. Properly, this Yiddish word means 'the parents of your child's spouse', but in his book Blood, marriage, wine and glitter, Bear expands it to refer to a kind of 'chosen family' which resonates particularly with his queerness: whilst queers might not have uncomplicated access to the traditional family framework that most people operate within, in its place we can access a different kind of family - a deliberate family. Bear's most recent book is all about this kind of family: mixed in with tales of his parents and grandparents and brother are stories about people tied to him not by blood but by love and kindness and choosing - wine and glitter, in fact. I've written before about the homo head nod, the sense of safety and support that can come out of being similarly marginalised, and this is what machatunim means to me. 

It means silent, fleeting recognition on the street, and heartfelt welcome in a hug. It means webs of connectivity across facebook and tumblr and gay bars and queer book readings. It means the shaky, euphoric release felt as we exchanged with one another broken fragments of the strange thing that we'd experienced. The ease with which we opened up. Becoming more than a handful of strangers in an anonymous room. Becoming, just for a moment, family.

Sunday, 2 March 2014

Review: The Goldfinch

I fell in love with Donna Tartt's The Secret History when I was 15 or 16, in France with my family,  and my aunt lent me the copy she had brought with her as holiday reading. (I discovered We need to talk about Kevin in the same way: thanks Auntie J!)

Although I knew even as I was reading it that it was angsty, pretentious nonsense, I couldn't help myself - I was an angsty, pretentious, teenager and it spoke to me. It was about college, about people only slightly older than myself who seemed worlds away. They wear knee-sprung trousers and long woollen skirts and "unexpectedly beautiful" jackets: "old Brooks Brothers, unlined silk, ivory with stripes of peacock green." They have "off campus apartments" where they invite each other for dinner, bringing bottles of wine and champagne, about which they know a great deal. They buy each other books and cufflinks and go on holiday to somebody's enormous house "in the country". Their conversation is erudite and full of obscure quotations which they all recognise - a truly secret language. 

For a geeky, sensitive teenager, full of love for language and learning and literature, resenting the hell out of people who didn't love these worthy things but seemed to be far happier than I was, it was like a hand reached out to me from far away. There are people like this, it said. Places where these people are. Bring to me your freaks. And despite the fact that these are mostly terrible people - arrogant, snobbish, unkind - there is something awfully seductive about the whole deal. And that, I always thought, was one of Tartt's underlying messages: hateful things can be tempting; fatally so. It's the worst kind of cliquishness, making you want to be on the inside not solely because the inside looks so lovely, but because being on the outside is so cold. The students are sneeringly indifferent to what they see as the lesser lives of the people around them; people who don't study Greek or wear suits and who prefer house parties to dinner parties. Being on the inside of that is shamefully tempting, especially for someone who has never fitted in - like Richard.

Richard, the narrator, is a kind of everyman interloper to this rarefied world, desperate to fit in, constantly terrified of being discovered to be fraudulent, masking his inadequacies with drugs and alcohol and Ancient Greek. It feels unfair to make generalisations about Tartt's writing based on only two books (I didn't read The Little Friend), but having just finished her most recent offering, The Goldfinch, I find the similarities uncanny. Both have young male protagonists cut adrift from family and stability (Richard and Theo); both have an esoteric but richly detailed and narratively important background subject (Ancient cultures and art/antiques); both are full of alcohol and drug use both as an escape from life and a cleaving to it - a desire to experience things more fully, to "wade straight through it, right into the cesspool, while keeping eyes and hearts open" (Goldfinch); both feature beautiful, mysterious, unobtainable women (these women are "quirky", have unusual and passionate interests, and are generally loved and wanted by every male character (Pippa, Camilla, Theo's mother)), alongside women that the protagonist must settle for (who are beautiful, cold, tasteful, shallow (Kitsey, Mrs Barbour, Judy, Sophie)); both feature wild, destructive forces in friends (Boris, Henry) and absent and inadequate fathers replaced by cool, wise, sexless father figures (Julian Morrow, Hobie) who draw the innocent, wildly grasping protagonist into an elevated world in which they flail about desperately, in way over their heads, courting trouble that the detached elder finds both horrifying and secretly compelling. 

They also share Tartt's idiosyncratic prose style, which I love and could pick out of a line up (there's an idea: a quiz on style, matching the writer with the writing!), as well as of course the deeper themes of her work: beauty, madness, lust, the death drive, timelessness, love.

Her characters, if not always likeable or the littlest bit realistic, are always so well-drawn that you want to know them, and her characters' descriptions are always at once trivial and vivid ("lovely, dusty-soled boy feet"). 

She also does that wonderfully silly thing of cameoing a character from one book in another for no apparent reason: in this case, Boston-born Francis Abernathy, one of the main characters in The Secret History, is mentioned in passing at Theo's engagement party in The Goldfinch (" ... Harry's cousin Francis - the Longstreets and the Abernathys are related on the father's side, Boston branch of the family ... "). Although this slightly saddens me by putting The Secret History into a time frame, when the novel itself works hard to keep even the smallest contextual reference hidden, I love it when characters cross worlds. It's the geek in me, probably - it's satisfying to realise how well you know a work, when the smallest reference in another place seems made just for you. 

Quite apart from all these details, what Tartt's novels share above anything else is a sense of intensity. Her characters feel things compellingly deeply and that, I guess, is what keeps me coming back to them. Both protagonists feel the same sense of connection to (although also isolation from) the world, one which, when they achieve it bridges continents and centuries. They talk of the light that suffuses a page of Greek prose, a light than exists in no other language and that they feel bonded together by understanding. They talk of the brushstrokes which capture the goldfinch, bringing a centuries-old bird into the contemporary in a way that seems personal to each viewer. They talk of the timelessness of art, the essentialness of it when compared with brief, pointless human life. It is at once a nihilistic and joyful worldview, and one which the most compelling of Tartt's characters (Henry, Boris) share and her hapless interlopers (Richard and Theo) ceaselessly aspire to. The death wish and the life wish together. 

For whatever reason, however pretentious or sentimental, I love The Secret History and will always love it. I really enjoyed The Goldfinch, and I will give The Little Friend another try, but for me, The Secret History is that book. I hope Donna Tartt doesn't leave it another 10 years before publishing again.

Sunday, 16 February 2014

Context Is(n't) Everything

Just found this in the Draft folder. Many moons out of date, and clearly unfinished, but I actually didn't mind my own voice in it, which is rare enough that I'm going to publish it anyway.

So, that Suzanne Moore, eh? She wrote a little article in the New Statesman, and all hell has broken loose. There are accusations of Islamophobia and language policing, there is sympathy from Caitlin Moran and Frankie Boyle, and there are defensive responses from Moore herself as well as the Julies Burchill and  Bindel (two people that everyone wants on their team). There are also a lot of responses from within the blogosphere; some are thoughtful, and some, like this one, are less so.

I think we can all agree that the attempts by Burchill and Bindel are nothing more than disgusting hate speech doubling down on Moore's own exposed hatred of transsexuality. For me, though, it's the subtler support that is the most upsetting.

I don't want to pick on Stella Duffy, but her argument seems to boil down to her feeling sad that she is now scared to say "trans", even though she ought to be exempt from criticism because 20 years ago she wrote a "lovely, loving, sympathetic trans character". She seems to be proud of the fact that she, a professional LGBT-focussed writer (by which I mean LG-focussed), wrote a trans character twenty years ago. Is this like the I-have-black-friends approach? Or its lesser-know cousin, the my-best-friend-in-nursery-school-was-black? As if the longer-ago something happened, the better your claim to progressiveness is. I see where Duffy's trying to go with this, but really she's just highlighting the vast disconnect between how much insight she has into transgender issues and how much insight she thinks she has. That in itself speaks volumes, and doesn't even take into account the fact that Duffy claims to be "the only person [she] know[s]" who has written such a character. I don't even know where to start with that. Suffice to say, Duffy is not the expert that she thinks she is. And perhaps she ought to hesitate before speaking on trans issues, particularly when "speaking on trans issues" means "coming to the defence of an unapologetic transphobe".

Now, for a more nuanced take on the issue, take a look at Pissers vs Wankers: The state of left-wing feminist debate?. I'm going to throw myself into the quoted circle jerk here, and to hell with the consequences. Here's a quote from glosswitch's worryingly relevant post:

"I wouldn’t have known the word “transsexual” alone could offend. I might have used it – I probably have – in a different context. Now I won’t. But if I were called out on it, I might have thrown a strop."

I think the point about this is that although the word 'transsexual' alone is often used in a purely descriptive (although outdated) manner, one's use of it can be something of a red flag, pointing to worrying attitudes towards trans people (almost always, and not at all coincidentally, trans women).

Partly this is because of the fact that it's outdated: generally, if one has engaged with trans issues at all over the past decade, one knows that the word "transsexual" now has a much more specific meaning and isn't used as a catch-all, having been replaced (ish) by transgender. So I generally assume that if someone uses "transsexual" as a catch-all or a punchline, they haven't bothered to engage with current trans issues and debates, which can be (although isn't always) a red flag.

Secondly, Moore's use of it ("a Brazilian transsexual") is indicative of some nasty attitudes behind the flippancy. For me, using "a transsexual" is unpleasant (like calling people "gays" or "blacks"), and the word "Brazilian" simply reinforces the idea that Moore has only one stock image of transgender people, and it just happens to be the most outdated, racist one of them all (bar perhaps going with the Thai version of the same 'joke').

And the point about context is important. The word "transsexual" is innocently descriptive in certain contexts, and is wildly offensive in others. An article about gender and feminism and the beauty myth and anger is not an innocent context for a throwaway one-liner about "a Brazilian transsexual". 

In my opinion, people's ears pricked up when they caught that usage of a word that isn't always on its own offensive, but can be when used in a certain way. Those of us who have to be alert to transphobia may have picked up on those little signals, and prodded a little, and unhappily discovered the seething pit of anger and disgust and condescension that lies beneath. That, sadly, isn't uncommon. It's like hearing the word "homosexual": inoffensive in itself, but often indicative of offensive attitudes.

Context is everything, but some words create their own context, and use of them can be a handy warning that someone is about to blow your mind with their factually inaccurate, morally indefensible "opnions". They'll probably also be quick to tell you that everyone is entitled to their opinion, and that haven't you heard of free speech?