Feather-weight Words

The Visual Analogue Scale (VAS) for pain is one of the first things they teach us when start clinical rotations in med school. You ask the patient to grade their pain on a scale of 1 to 10, 10 being the worst pain imaginable. More often than not, the responses varied between 6 & 8 with the oddball 9 or 10 dropping by like a diagnostic mystery for the fresh Dr.Houses to toy with. We were naive then, & took what was told to us at face value. When we started narrating the VAS scores to our residents, they asked if we really thought their pain was as severe. It seemed a stupid question - the patient is in pain, hence with us. Why would the patient lie? The resident explained - no patient lies, they merely embellish & it is your job to take into account their dramatic exuberance. They then showed us what they meant with a thirty something mother who lay in a bed nearby. I was first asked to obtain a VAS score like I normally do, by asking, "If 10 is the worst pain imaginable, how would you rate yours?". I got a 7. The resident then asked, "If 10 was the pain during your first childbirth, how is the pain now?". He got a 3. 

Being stubborn as I was, I argued that the logic couldn't hold true for all patients and the question posed was only applicable to women who had undergone childbirth. I continued to make my case stating that a patient's memory of past pain may fade. But, in hindsight, their dramatic skills also improve with time to compensate. A few years wiser, I find not all patients embellish, but that doesn't mean the physicians let down their guard. The ones that do exaggerate have various reasons for doing so - want more time with the doctor, think they'll get better treatment, if a little medicine is good then a lot must be better, & then we had the occasional  psych references. But, you'll find there is a deeply ingrained tendency to aggrandize in all of us. And it extends beyond the confines of the examination room. 

I'm not a grand old man, I'm still going through my one third life crisis. But, I still remember a time when the spoken word was taken at face value, when hyperbole was just a figure of speech, not a way of life. Since when did we collectively decide that grandiosity is a must to be heard? How often do you hear - You HAVE TO try this place, it's got the best [fill in some obscure dish here] in town!?, She looks like a million bucks, The dog that bit me was built like a wolf, I couldn't be more depressed, God hates me & my personal favorite - I love it.

To quote the ever-articulate Snow Patrol, "Those three words are said too much, but not enough". 'Love' it seems, is a word that's thrown around the most and meant the least, which puts me in a dire predicament. How does one actually profess love without being lost in a sea of hollow superlatives? Should I take the extra effort narrating the depths of my emotion, or should I in true romantic manner, hope she loves me back enough to comprehend it easily? Ok, that sounded corny. But, I'm still in a constant state of confusion - Did I make myself clear enough? When is it ok to stop? Bearded man in the sky forbid I offer an average review of [enter anything here], I'm met with bewildered looks. Since when did calling something average become an insult? And why do women take it personally when I don't agree with their choice of restaurants? Makes me wonder if there's some women-centric restaurant mafia I don't know about.

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There's an acute shortage of words in the English language. Well, that may not entirely be true, but there's definitely a paucity of words being used. "Whatever", "like" & "you know" may not be as dramatic as the ten biblical plagues, but they're definitely heralding the death of language. Add to that this incessant need to mess with the degrees of comparison, where superlative is the new comparative, comparative the new positive & positive is a long forgotten remnant of what the truth used to be. 

Speak your mind, but make sure you mean every word you say, even if it means you speak less.

We must never forget that the highest appreciation is not to utter words, but to live by them. 

- JFK 

Averagely yours,

SS

Apathetic Spectator Syndrome (ASS) - Do you have it?

I was a wrestling fan in my formative years and like most kids, I tried out those outlandish moves with my brothers & buddies. This was in spite of the repetitive "Don't try this at home" messages, which have recently been changed to, "Don't try this at home, school or anywhere else". Like those additions would make a LOT of difference convincing kids that didn't care in the first place! Now, you can either blame the kids for being stupid enough to imitate wrestlers, the parents for not monitoring them well enough or try to bring down the root cause - wrestling! And try they did. There were awareness campaigns, discussions by NGOs and people who had time to burn. For a while there, these nervous Nellies won - wrestling deserted the airwaves for some time. Us kids though, we carried on with our play, until one day, someone got hurt bad. No child was wheeled into the ICU, no police complaints were filed, but damn that hurt! One episode of pain & hurt is a better teacher than a thousand hours of lectures & awareness campaigns. 

TV is a powerful medium. We watch, assimilate, emulate and subconsciously draw knowledge from what we see. That is exactly the reason behind the aggressive anti-smoking campaign going on in India right now. You can't watch a movie or TV show without the statutory warning gliding across the screen. A lot of people argue that it takes away from the experience, that the immersive illusion is shattered when someone tries to blur out a cigarette or an "annoying" message flashes on screen. Directors and actors have criticized the policy saying that smokers will smoke, irrespective of whether the stars they adore do so. But, they underestimate the power of the very medium which they exploit. If even one person is disgusted enough by the cancer ridden lung images to quit, the campaign is a successful one & the ministry is justified. We take home a million messages from TV & movies - what is the difference between right & wrong, I need to work out to look as good, those clothes are in right now, I want to accomplished larger goals - So, what's the harm if one walks away knowing that smoking kills, even if the message is buried deep deep within his subconscious?

We watch, remember, & therefore we do. It's a simple concept that eludes Indian movie & TV writers when they portray doctors and medicine. I spoke of the immersive illusion of television earlier. I was watching a show where a neurosurgeon was attempting removal of a Meningioma with one of his arms in a cast & shoulder sling. Single handed Meningioma surgery aside, that idiot had the shoulder sling ON TOP of his sterile surgical gown! And then the illusion goes POOF! Indian TV shows have horrific production values most of the time & I don't see a lot of viewers complaining, or even realizing this dreadful oversight. So, it's understandable that they don't show ventilators, heart lung bypass machines, & have Casualty departments with just needles for equipment. But, it's how they portray the practice of medicine & doctors that irks me most. 

A world renowned neurosurgeon (Indian shows are fascinated by brain surgeons, I think) is called in to operate on a girl with a gunshot to the head. He flies in with much enthusiasm, but when the girl starts sinking, all he does is order the nurse to up fluids & starts massaging her palms and soles in an effort to revive her. Yes, that's what 12 years of neurosurgical training teaches us - something that grandmothers do when kids faint in the sun. Then there's the ubiquitous and classic, "The condition of the pregnant woman is very serious. We can either save the mother of the child. The family must decide soon". This is followed by a never ending ethical & philosophical discussion within the family about whom to save. I doubt there is a single obstetric condition which turns into an "either-mother-or-child" survival situation so dramatically. And even if there is, no doctor can ever ask that question! We are compelled by our ethical code & the law to save the mother irrespective of the risk to the fetus, having liberty to sacrifice the latter if required. Myth debunked! 

A man is shot while walking on the street and collapses in a pool of blood. As if out of thin air, a crowd surrounds him, but nobody moves closer than a few feet to help the man. As luck would have it, a medical intern was close by and she pleads with the crowd to help her take the victim to a hospital. The response was another archetypal Indian TV dialogue, "He's been shot, it'll be a police case. We can't move him until the police gets here." The intern then proceeded to reprimand the crowd, calling them - for lack of a better term - Pussies. And so the gunshot victim got taken to a hospital. This, I thought, is a great show. For those not residing in India, the scene I've described is a common occurrence in real life. The reason behind someone collapsing isn't always as dramatic as a gunshot, but the common man is hesitant to get involved in somebody else's crap. And their apprehension is partly understandable. Government hospitals lack manpower, so the onus of admitting and transporting the patient within the hospital often falls upon the person who brought them. The police is only just becoming more sensitive to these cases, & instances of good samaritans who have been made to needlessly wait and sign declarations by the police are common too. There is an acute need to let the common man know that their good deed will not be punished. There are of course, lives at stake here. But, while thoughts of Indian television having matured were only just forming in my head, the very next scene had a police officer admonishing the hospital dean saying, "It was obviously a police case. The intern must be punished. She should have waited for us to get there before moving him". Sigh. 

I think back to us kids imitating what we saw on TV & how we all got away with a few scratches, bruises & cuts. All seems well with our approach of mimicking what we saw on the telly & figuring out our limits. But, what of the boy who faces a life in prison after accidentally killing a girl while imitating a wrestling move? Or the boy who died imitating his favorite wrestler by diving off the roof?

There may not be any statistics to report  the number of people who died because bystanders didn't offer any help - let's term their affliction 'Apathetic Spectator Syndrome' or ASS, from watching too much TV. There are numerous stories which make me wish that TV would stop with these deceitful portrayals of what happens within hospitals or events leading up to an emergency admission. I shudder to think of the number of people who would apply what they see in these shows, in a very real time of emergency. It's about time TV woke up and realized its responsibility to create awareness extends beyond a puff of cancerous smoke. 

I'll leave you with one last story. A young doctor was riding his bike to college one morning, when for reasons unknown, he lost control and fell off at a busy intersection. Nobody came forward to help this man. The police brought him to the hospital where he worked and studied, estimating he lay on the asphalt for a good 20 minutes before they found him. An hour of relentless resuscitation attempts couldn't undo the damage of twenty minutes lying on the road alone. I wish more than ever, someone would have come forward to help that morning. 

The Evolution Of Fat People

For students of medicine and biology, this is a lesson in evolution and anthropology. For anyone with a BMI over 25, this is a factual, motivational tool. 

It all started with Balpreet Kaur, a Sikh girl going about her business at the airport. She wore a turban and as per her religious beliefs, did not rid herself of any facial or body hair. As luck would have it, someone with a cameraphone found her appearance humorous and decided to share the joke with others on Reddit. He posted the picture under the 'funny' category with the tagline, "I'm not sure what to conclude from this". It wasn't long before she knew that she was the subject of discussion, often ridicule, on the social network. Her response to her detractors & critics is nothing short of a modern example of poise & dignity - "By not focusing on the physical beauty, I have time to cultivate those inner virtues, and hopefully focus my life on creating change & progress for this world". You can read more here. 

Just a few weeks later, I read about Stella Boonshoft. Stella is a girl of voluptuous proportions, who has been ridiculed by her fellow students, trainers and men of interest, because of being overweight. She shared a semi-nude picture on Facebook to show the world how proud and comfortable she was with her over-weight body. It was her emotional outburst that accompanied the picture which caught my eye. My first response, one I'm sure a lot of you would have, was - More power to you! But, then I thought of Balpreet. The similarities between the two women at first glance are great. Both are strong women with character, both have been ridiculed or questioned for their external appearance, both used social media to their strengths and were lauded for it. That is where the similarities end.

It took a moment before I started wondering - Stella isn't that great after all. She's been over-weight, & from her account, since quite some time. While she's had ample opportunity to change her lifestyle, she's chosen to  chide society for setting unreasonable ideas of beauty. She's lashing out because she's had a rough childhood. I felt for Stella, nobody deserves to be ridiculed or made to feel inferior while growing up. Adolescence is a tough age for most of us, and it's especially tough when you're made out to be an easy target because of your appearance. But, as a smart, informed adult, she missed the point by a mile. While Balpreet is a strong woman of conviction, whose religious beliefs are exactly that - HER beliefs; Stella is just another person struggling with her weight. She's adamant about her body being only her concern, but the medical mind in me refuses to accept that. Somewhere down the line, her weight will be someone else's concern too - her doctor's. 

Society's norms of beauty keep changing. They follow cyclical trends & are fairly predictable. There was once a time in Victorian England where a woman's ankles were considered far too private to be exposed, her bosom though, was let free to feel the wind. Caucasians are obsessed with tanning to get that perfect golden brown skin tone, and the already golden brown Asians are obsessed with fairness creams. Society is way tougher on women - waxing, bleaching, hair removal are all painful procedures without much merit, and a woman's life is a continual struggle to please that handsome man in the commercials. Are fashion houses and beauty product labels being unreasonable? Most times. Each time the billboards are plastered with a woman who is excessively thin to begin with and then photoshopped to look like Aphrodite, they're being idiotic. But, their idiocy is matched only by their financial success, because we lap up these perverse standard of beauty. This is the problem that Stella was addressing.

Some standards though, have withstood the test of time. A sculpted, muscular body, toned physique, smooth, supple skin, flowing hair have never been out of style. There is but one universal standard of beauty in the world that hasn't changed in thousands of years - Athleticism. The pinnacle of human endurance, agility, strength and skill, these athletes represent all that is good about the human design. They represent health in all its glory, & are universally desirable. Desirability - that's all it comes down to eventually, desirability as a sexual partner. 

One of my professors often said, "The fact that Isaac Newton's sperm never met an egg is one of the greatest crimes against humanity!". He wasn't wrong. To paraphrase Tom Cruise from Jerry Maguire - Show me the GENES! We choose our partners, on the basis of so many factors - their looks, success, wealth, potential for growth. But, that's now. Far back when we were just scavengers in the forest, we chose on basis of strength and speed. One's external appearance mattered a lot then, as it does now, because it is a sensitive indicator of someone's health & their genetic quality. Scour through medical textbooks, and there're hundreds of signs visible externally that signify internal disease. So flawless skin, hair, ripped muscles are all desirable. Its all about having the best possible mix of genes. The desire to find a suitable sexual partner, procreate and have offspring that represent everything that's good about us, is universal. So, the next time you're questioning ideas of beauty, ask yourself how much of it has been created by corporate propaganda, and just how much are we all born with.

In a lot of ways, the reason we're fat is the same reason we orgasm. A lot of people thought that the orgasm was a fortunate blip, a physiological event that didn't serve much purpose. They couldn't have been more wrong. Just imagine if we didn't orgasm at all. Would we all still be having sex if it wasn't pleasurable? Somewhere down the line, we would give up on sex & the entire human race would be wiped out, being replaced by a species that enjoys sex. So, sex is enjoyable for a purpose. It is nature's way of telling us that we must survive as a species. We may all struggle to philosophically describe the purpose of life, but a biologist knows it already - Survival. Life exists - in strictly biological terms - to continue and perpetuate.

Getting back to my original statement - we're fat for the same reason we orgasm. Fat is the most efficient form of energy storage in the human body. Carbohydrate stores last us only for a few days and protein is far too essential to our body, therefore utilized for energy as a last resort. Back when we were evolving and food was scarce, we developed a taste for fatty foods. Evolution was smart that way, it made us love fattier meals so we would seek out and completely consume them. Energy storage was of paramount importance; one never knew how far the next meal would be. Those individuals that developed this rich taste, survived more easily than those that didn't. Move into the 21st century, and we've inherited the same fondness for fatty meals from our ancestors. Except food isn't as scarce anymore, but our appetites are just as insatiable. A quality that was meant to ensure our survival, is exactly the reason for millions of untimely deaths. Maybe, just maybe, evolution screwed up.

Obesity has been rampant since the past 50 odd years, and has mirrored our growth as a species.  This progress has brought an abundance of food, technological progress, medical innovation; But, it is exactly this progress which is the cause of our collective "growth".

Medicine has finally come of age. It wasn't until 1964 that we knew the link between smoking and lung cancer. Chemotherapy didn't give results until the 1970's. And AIDS was discovered only in 1981. The questions in medicine have shifted from 'What's causing this?', to a more reassuring, 'How can we treat it?'. We live in a spectacular time because important associations between diseases and causative factors have already been made. While we improve patient care with each passing day, there arises a greater drive and focus to reduce the number of patients altogether. Preventive medicine isn't a new buzzword, its the most important one. But, a culture of instant gratification means patients are more likely to demand a magic pill when ill, rather than take steps to prevent the illness in the first place.

Almost every obese patient I've counseled has said, "I just don't know what to do". As their doctor, one tries hard to make them see reason, to make them see the trouble that awaits. As their doctor, it's my job to tell them what to do. But, more often that not, the next time I see them - still just as obese - I listen to, "I just don't know what to do". Obesity is primarily a problem of the developed world, of the affluent classes. I do not say the problem lies with a lack of intelligence or information. That clearly isn't the case, most are extremely capable of assimilating the information we provide and acting on it. The problem is, they're careless and indifferent. Having foresight is what doctors are paid for,  but we cannot force it upon our patients; we can advocate, support, counsel and fight for our beliefs, but we cannot force them.

The age when patients religiously adhered to their physician's advice are long gone. The internet has disseminated information, both factual & fictional, in a way none of us anticipated. It is every patient's right to gather information about their health concerns and question their physicians about the same. It keeps us doctors on our toes. But, when your interpretation of the statistics does not match with ours, we urge you to trust our judgement. A figure of 1% risk seems trivial, until you become the statistic itself. I will not debate the prominence of environmental versus genetic factors in the surge of obesity, they both have an important role to play. Understanding the problem isn't enough, we need to acknowledge the magnitude of change required to overcome it and go about our business doing just that! Don't tell me that you don't know what to do. Such ignorance cannot be tolerated, your life depends on it.

Evolution doesn't ensure the survival of every being. 'Survival of the fittest' - As a high school student, I was perplexed with the choice of word - fittest. Darwin explained that survival isn't guaranteed to the largest, the strongest or fastest, but the one that is best suited to the present circumstances. He who adapts best, survives longest. The grandiose, seemingly indestructible dinosaurs were wiped out after the meteor hit because their large, inefficient, hungry bodies couldn't adapt to the scarcity of food that followed. Those that did survive, were the unlikeliest of creatures - mammals, which until then were a small, insignificant part of the ecosystem. And they rewrote the history of this little planet. Just as the dinosaurs, we're at the precipice of an enormous environmental change, that of relative abundance. Those that fail to change, fall prey to evolution ensuring only the fittest survive, in a literal sense. We need to stop dragging our feet because failing to adapt, means adding another chapter to the history textbooks. Except we don't need meteors anymore, when we've got McDonald's.

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Respected Dear Doctor Dean Sir

Still cringing at the title? Yup, that was me for five years of medical college. Every damn time the dean came up on stage or had to address a gathering larger than two people, there'd be one person who introduced him as, "Respected Dear Dr. Dean Sir",and the rest (often just one) vociferously clapped. As if just calling him the Dean (which he is) or Dr.ABC (which he is), or Sir (which he is not, the Queen never called), wasn't enough. Ass licking of Grade A quality.  And every time they did that, or I'd read letters to the Dean starting off with, 'Respected sir', I'd hear the distinct high pitched voice of my ninth standard school teacher chiding us because that's grammatically wrong! Thanks ma'am, you've made me anal retentive for life. 

You'd think that after a few years, I'd begin to ignore this blasphemy of grammar, but it only got worse. And with time, I noticed that this ass licking extended to anyone in power. Not that these people ever noticed, but the minions tried anyway. I still hate the fact that so many fellow students one year my junior would call me 'Sir', because that's the established practice. It starts off in first year of med school when the freshers are "supposed" to respect the seniors, or face social purgatory. Dramatic, isn't it? In reality, not so much. The seniors may just rag on the juniors a little or refuse them help. All for what? False respect? For being born a year earlier? Yikes. Then there was our education department, where students regularly and loyally buttered up the clerks so that work may get done that tiny bit faster. Yes, ass lickers galore! If there is any difference between politeness & lunacy, the students failed to see it. 

"Hello Uncle, Aunty, how're you doing?". As a kid, this would be uttered multiple times a day. Everyone in our country is our uncle and aunt, and there isn't a damn thing you can do about it. Calling out to someone as Mister or Miss, is considered alienating them. But, the dynamics of Indian society heavily revolve around emotional blackmail and mental torture; so perhaps familiarizing yourself as family helps. We have problems with boundaries. I always felt that by giving relative unknowns more than their due respect, I was somehow belittling the relationships I already had. Having realized this, the supply of temporary aunts and uncles soon ceased in my life. 

While all these "respected" individuals and part-time uncles lead to a lot of awkwardness in our humdrum lives, it seems ridiculous when these principles start to spill over into the professional realm. From my personal experiences, relationships for the most part are extremely strained when they are between individuals working at different levels. Bosses feel superior in unjustifiable ways, and the workers, they help maintain the delusion. One knows all is not well at the office, when respect is commanded rather than earned.

While I was interning, I found I worked best under those residents who spoke freely, those who made me feel I was working with them, rather than for them. These are the sort of leaders you want at work, ones who you can speak to without fear of critical remarks, or being reminded of your place in the pecking order. I was lucky to met a few great seniors. Residents who wouldn't ever order dinner without asking where the interns were and when they'd get free; Professors who would call me into the OT just for kicks and then ask for coffee after; And people who were mostly just great guys looking for company, not an ego boost.

At the workplace, there needs to be some balance between hierarchy and equality. There isn't a building in the world that doesn't have its own version of a Power Pyramid. It is up to the people at the top to make those clutching at their trousers feel at ease. It is extremely difficult to work our way up when we are continually reminding ourselves of our place in the hierarchy, constantly projecting power to the person behind the bigger desk. We are just as much to blame for this as the person at the top. The line between respect and ass-licking is fairly large (Think large like elephants, football pitches, endless farms, Jupiter. You get the picture), and one that we continually ignore. 

One needs to be extra careful in our country, where promotions are decided more on basis of seniority & years served, than experience & expertise. Building camaraderie, not hierarchy, is important to working well together. How else will you promote competition and innovation not just within strata but between them? Make me feel like my excellence at work is foremost when it comes to rewarding and noticing me, then sit back and watch the magic happen. 

- (Just) Dr.SS

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Men Had It Coming To Them

There has been a lot of discussion in the past few months about the safety of women in India. A great offshoot, and one that has gained momentum in the past month, deals with discussing the status of women in our society. While I haven't yet come across any great article by a cultural anthropologist, this one is worth your time (Link).

While the chatter online has been positive, household & workplace discussions for the most part, are still archaic and disheartening. Why are these people still questioning why the Delhi rape victim was out with her boyfriend at night? Why are politicians still asking for skirts to be outlawed to "save" women from the fiendish eyes of men? Why must we question the integrity and morality of those women for doing that, which would be considered normal & acceptable for their male counterparts?

So in conclusion, the many recent news stories of female victims who are out drinking or traveling alone at night or showing too much leg or cleavage, have merited sympathy accompanied by that very idiotic afterthought, "What were they doing out there in the first place?"

If people think the blame for getting raped and murdered lies partially with the victim, they'll love my plan. Women, pick up your pepper sprays and batons and wait in groups outside nightclubs, pubs & descend upon any man who walks out alone, seems too inebriated waiting to be taken advantage of, or just has an extra shirt button open. Beat the crap out of him, & don't worry about the morality of it all. He had it coming to him. Why was he out in the night so late? Why was he out drinking? Obviously, men from "good" houses do not drink. How dare he walk out alone and without someone to protect him? Does he not know it's dangerous being out so late in our country? Is he not afraid of being raped or being killed? And why is he showing off so much of his chest? Yeah, he meets all the "had it coming to him" criteria that the Indian society seems to have deemed acceptable for women. 

Godspeed

Ambition

Aaaaaaaand I'm back

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In-a-body experience

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You lean against the wall, thoughts straying,
Until you can't remember how you got here.
You look across the room... & feel nothing,
The sight of your hand seems unfamiliar;
That it obeys your command, surreal.
You wonder if this body will take the punishment, this sense of freedom,
& then a familiar sense of carelessness, it comes flooding back.
Amazing how the right song and a pair of earphones
make you the loneliest philosopher in a crowded room

To Do List

Someone recently shared a picture with a To-Do List on Whatsapp that had me splitting with laughter! I take no credit for it, but thought I should share it with you!

Personal favorite: No.6!!

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Easy Living

There's been so much happening recently, I've been giving a lot of thought to what my 'life philosophy' actually is. Is everything I do as random as I think it is? The answer's so hilariously beyond me, it reminds me of the Roadrunner & Wile-E-Coyote; but here's what I think makes my days tick:

1. "That's what she said!"
   These glorious words should only be used for that spiritually enlightening game of sexual innuendo & double entendre. Using it to bitch about someone is just depriving someone of a good laugh! Not familiar with the game? You'll find the light here
   
   
2. Tell your friends just how amazing they are
   Why? Because they are! Boss making you miserable? Girlfriend won't give you head? Marks slipping? Rubbed your local mob the wrong way? There's always at least one person to help you out. If not, at least find a friend who bakes. Yumm, the sweet taste of misery
   
   
3. Go hug your mom at least twice a day
   There's an acute shortage of mothers in the world. Everyone has just one. Tells yours she's special.
   
   
4. Question everything
   What's the reason I'm here? How can I win her over? What can I do to succeed professionally? How can I make the world a better place? Why won't this itch go away? Figuring out the right question is half the battle won. 
   
   
5. Make Love, Not War
   Stop spending so much time fighting or arguing with people; & especially stop investing energy in avoiding 'mortal enemies'. Unless you have a Batcave or come from the planet Krypton, you can't afford to have mortal enemies! Stop sulking & skirmishing. Move on. And oh yeah, have sex. No particular reason. Well, you know what I mean. 

I'm sure I've missed a few important points, but you couldn't possibly handle anything longer. 

THAT'S WHAT SHE SAID!

You Chose Already, Now My Turn

Someday when you're unlucky, I'll kill you with my words. Start running away right now.

- A wise wise woman

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Dear friend with the beautiful back, 'cause that's all I see now,

I chose to write to you. The convolution of the situation was scalding me & I chose to walk away. No, I didn't admit defeat, I didn't cower, I chose to do the sane thing, I wrote. I wrote because I can always erase the hurtful words I write, before they reach the person they're meant for, I can vent without being angry. I wrote because I can't really take back the things I angrily say, that which I don't think through, mean or don't believe in. I wrote because it's difficult to be angry at a letter, because when we're at war, seeing you makes me want to sit down with you; seeing me, makes you want to run away.

If you thought I was wrong, why didn't you just say so. I would've let you shout, scream, moan, throw your arms & legs up in the air. I would've gone through it all because you were more hurt than I. Why'd you choose to walk away instead? It aches to think years together have whittled down to nothing more than distance. Before you left, you used the choicest of words. You tore the flesh from my bones, clinically dissected my mental faculty & still had some left to share with others around you. You told me of your bitterness I wasn't aware of, of problems that I thought were long gone. You chose to bring them up, because when there's that much blood spilled already, some more would surely help you vent. What's worse is you committed yourself to your words. You stood by your decisions. I'd salute your steadfastness, if only I could justify it. 

Isn't there just the slightest chance we're both at fault here? Had we deteriorated without notice? Yes, you're the judge, jury & executioner. You based our relationship on your account of that one day. You're impervious to my pleas, ignorant of the truth, & in denial of what I meant to you. You may say you're angry enough, but you're not, unless you're going to punch me. Unless you're eager to land a right-hook, there's still hope. Because when the smoke blows over, there isn't any nuclear winter, just a few people getting on with their lives. 

Its more a game of time than words right now, & too much has passed. I'm tired of writing. I'm wiser because, I finally realize that letting go has its own charm. I have many friends, none better, but I chose to fight for you. And now, I choose to walk away from you. 

Maybe someday, you'll look back at what happened & a doubt will creep in. You'll wish you'd chosen your words wisely. Maybe, someday you'll move on, not walk away; you'll remember how intimately I loved you, our time together. 

Maybe someday, I'll turn & there won't be any time for letters; I'll tear you apart with my words, except I won't be there to stitch you up again. Would you fight for me then?