Putting a "Face" on Brain Damage

Back in December my turn finally came for a long awaited Neuro-Psychological test to assess if I had lost any brain functioning over the course of my treatments. I was on a waiting list for 10 months, with the dim knowledge that, when my turn finally came, I would be subjected to two days of cognitive tests. A walk in the park!

As you can imagine, as my turn approached, I began to wonder exactly what kinds of tests I would have to perform (for two full days), and was also quite curious as to what they would have to say about me. I simultaneously felt quite smug in my personal knowledge that I felt that I had not lost anything, (save for a few cubic centimeters of brain matter), but also a little nervous that they would rock my boat and tell me something I didn't want to hear.

I imagined that there would be a fair amount of spacial and memory testing. With dread, I remembered how much I hated these types of tests back in Gr.5. Flipping and rotating 3D images in my head or recognizing and extrapolating complex patterns and then filling in my final choice on a bubble sheet are not my idea of fun. My short term memory has always been lacking, but even I have noticed an increased deficiency since my tumor treatments.

I also didn't know how much of these two days might involve sitting on a psychiatrist's couch and being prompted to spill my guts so that they could probe into my psyche.

Well, my predictions were not to far from what actually happened (which surprised me; I often make mental predictions to myself, but expect to be surprised). The first "day", which only turned out to be a few hours, was spent first talking to the psychiatrist, then filling out bubble sheets. The psychiatrist asked me deep probing questions about my adjustments, my mental processes, my relationships to others, my views on life, etc. (no couches!  Boo!). Then I was turned over to the bubble sheet questionnaire to answer more questions of the same variety worded in different ways. Did I feel understood by those around me? Did I ever have overwhelming urges that I couldn't contain?  And so on. I tried not to blow through the questions, reminding myself that I would only benefit from examining myself and being honest.

The second day, I spent many hours in a room with the psychiatrist's assistant, who performed numerous other tests on me. Every test started off very simple, then got harder until you could no longer perform the task that was required. Lists of words to remember (read only once). Word associations to remember (seeing them only once). Patterns to solve. Mental math problems. Social/common knowledge questions. Reading ability. Building patterns with colored blocks. Categorization abilities. You name it! A timer counted all my response times.

At the beginning of each one, I had to remind myself that they used these tests to establish ALL levels of mental ability. Even a child would have found some of them to be very simple. But as they progressed in difficulty, I got slower in my answers until eventually I had to say that I didn't know the answer. The assistant reassured me that this is how it was supposed to happen. Here are some of the more memorable tests (no pun intended):

1) I was given 30 seconds to study a nonsensical line drawing, then asked to reproduce it from memory. Several tests later, I was asked to reproduce the same drawing (much harder given the shift in concentration!).

2) After being read a list of twenty or so objects, I was asked to repeat them back and to categorize them. I was given several tries at this one as I have always been very bad at remembering lists.

3) Given a letter of the alphabet, I was told to rattle off as many words beginning with that letter as I could before the timer stopped. At first I thought this would be a breeze... until I got going. I quickly realized that my pitfall was that I would get stuck on themes. For example, the letter S got me stuck on two themes. Out came "scientific, sarcoplasm, sarcomere, salicylic acid..." Realizing how dumb the words were that came out of me, I couldn't help but start laughing! And with the laughter came a new theme, this one far more creepy! "Sad, sadistic, Satan..." (more laughter and thinking to myself "why can't I think of more simple words than this, like... silly?") This train of thought brought out "silly and stupid". The end result was that I spent a lot of the time laughing at myself, and didn't get a lot of words out. The human anatomy theme continued to dog the rest of the letters they gave me. "Anatomy, anabolic, anaplastic, anemia..." The researcher's inevitable question was to ask what my undergraduate degree was in.

4) Given number and letter combinations, I was asked to repeat them back and/or reorder them. The researcher read them to me once. When it started with 4E this wasn't too hard. But getting up to something like 5j9pu7, it was a little harder. List the letters in ascending order first, then the letters in alphabetical order: 5j9pu7 became 579jpu. You can imagine that hearing it only once, this was quite difficult. I managed to get up to combinations of 8 before I had to say that I couldn't go any further.

5) Given similar number combinations I was told to remember that combination while verbally subtracting three from a number they would give. For example, I was told to remember A9T6, then starting with 76 talk out loud subtracting three. ...76, 73, 70, 67, 64, 61, 58, 55... then STOP! and tell the researcher the number that I was supposed to remember. The number I had to remember increased by one digit when I showed that I could continue. I think I got up to 7 digits before I had to stop.

6) Questions of general knowledge or educational level. Who is the President of the United States? What year did Canada become a country? What is the distance from the earth to the moon? What is the circumference of the earth? Who wrote Alice in Wonderland? Etc. I was pleased with myself for only missing two of these questions. But seriously now, is the circumference of the earth really considered general knowledge? I was, however, quite bummed out at forgetting that Sir Arthur Conan Doyle wrote Sherlock Holmes.

I walked away feeling very good about myself... which made the results a little shocking to me! While the analysis determined that I am functioning at a high level of cognitive ability (relatively), and that I am well-adjusted considering the life changes I've had, it also revealed some other things. Apparently, it is because of my pre-existing higher level of cognition that I have been able to cover up certain deficiencies that have come about from receiving brain damage.

Brain damaged. Of course they didn't say it like that, but that's essentially what it means. It felt like a fist in my stomach to read that in the Neuro-psychiatrist's report. Even though the vast majority of the report reinforced my smarts, my superior emotional adjustment and my positive attitude, it shook my confidence to read that I have used my intelligence to cover up my areas of weakness. As though I were some kind of con artist, fooling everyone around me. But even more shocking was when I found myself thinking, "How did they know?". It is true that I have been using my brains to figure out ways to cover my weaknesses, not in a deceptive way, but more as a kind of coping mechanism and technique to "save face."

There is a trace of irony in me trying to "save face", however, as recognizing faces in particular is one of the ways that my mental abilities have changed.  To some degree, I have lost is the ability to recognize new faces!  It now takes a few interactions and significant associations before I can remember a person's face. Until I recognize their face, I will only recognize someone by what they are wearing, or by the conversation I had with them. But if they change their clothes (something people tend to do) or don't give me any indication of prior interactions (as in, "Hi, I'm the guy who talked with you yesterday about rubber plantations in pre-Independence Malaya"), I have no idea who they are.  (This shouldn't be read as a request to always wear a colour-coded jumpsuit and begin all conversations with a long preamble.)

This makes it interesting to work at a coffee shop where people are constantly streaming past me. There are people who come in every day and order the same thing, but as far as I am concerned they are a new person every day. I need to have meaningful interactions with someone (sometimes several) before I will remember their face (unless it is outstanding in some way: monstrously ugly people get remembered). This doesn't apply to people I already know.  If there is something exceptionally striking about a person, I will remember their face.  I am often able to remember people if I pick out facial features on them that look like someone else that I already know.

A few weeks ago, I read a BBC article which talks about the area of the brain that helps to recall faces. Lo and behold, above and behind the right ear (right where my hole now lies) is where the brain stores memory of faces. Here is the link to the article: http://www.bbc.com/future/story/20120209-why-names-and-faces-are-so-vexing

It was very enlightening to see that for all of my feelings of stupidity, there is a justifiable reason for it.  So I have figured out other ways to either determine if I know people or, if all else fails, to hide my ignorance.  By far the most embarrassing situation is if I have had a meaningful interaction with someone (especially if I've had multiple meaningful interactions), but still forget their face and greet them as a total stranger (or, worse than that, not greet them at all).  Imagine yourself saying "Hi, welcome to Starbucks, Stranger," when you just saw that person an hour ago.  During my interactions now, I find myself watching and listening carefully for an indicator of who the person is.  Often it is something very subtle that clues me in (good old body language to the rescue), and if I am successful, that person has no idea of what has been going on in my head.

Its never boring being me!

Riddle me this: What's the Deel?

James here. I am intruding on what has, in effect, become Jessica's blog to say that I have completed the coat that Jess mentioned in a recent post. It was designed to be Mongolian in style, but sort of turned out as a hybrid between a Mongolian deel and an Edwardian driving coat.

Here are a few photos for your viewing pleasure:

Women MY age

That's right, women MY age. You know... menopausal. You heard me right, but I'll pause to say it again. Menopausal. Age 28 and menopausal. Clinically proven by blood tests, and verified by my doctor, menopausal. Actually, peri-menopausal. Now there's a word I didn't know before being launched into this stage of life (20+ years ahead of my time). It turns out that there are stages to menopause (who knew?). And from what I have read, peri-menopause is the more unpleasant of the three stages. Perhaps other women would refute that statement from their own experience.

So why am I there? Why do I keep repeating this word over and over again (probably making you cringe in your seat)? Because I still find it so hard to believe, and because I am living daily with a considerably less comfortable existence. Fourteen months of chemotherapy have left me with a few not-so-great byproducts. My body's reaction (among others) has been to start premature menopause.

In case you hadn't guessed, I feel a slight repulsion to this idea. I'm not overly devastated at the idea of not having any more babies. James and I had already determined that we were done with that before we went to China. I am more than happy with the two boys I already have. I'm also not terribly concerned about "losing femininity." (yet)

I have, on a side not, noticed a definite slowing of my metabolism. For the second half of my chemotherapy regimen, getting drinks at Starbucks was my main source of caloric intake. It was easier for me to down a drink then to eat a meal that I had no appetite for and made me feel sick, regardless of how much I needed it. However, there has been a swift reprisal for keeping my energy up that way, in the form of some unwanted weight gain. Its been a rollar coaster. After months of steroidal weight gain during my radiation treatments, followed by chemotherapy induced weight loss, and now menopausal weight gain, I'm left feeling quite uncertain about what my weight "should" be. Needless to say, with the warmer weather, I am VERY happy to be biking to work again. Now that my appetite is back we are also trying to get back to a the vegetarian based diet we had pre-diagnosis.

Back to the main topic. I don't really know how to explain why I have a sort of disturbed feeling when I think about menopause. I've never had any reason to consider at any great length what it must be like for the older women in my life to experience this change. Part of my young attitude was to roll my eyes a little at the drama that is attached societally to menopause. Maybe I secretly thought that hot flashes were silly and that women just needed to "get over it". Go ahead and laugh at my naivety! But you have to admit, some of the headlines on women's magazines (touting it as some kind of Sexual Renaissance) do make you want to roll your eyes and say, "Gross! Just keep it to yourself would you!" Assuming that many of you still feel that way, I'll spare you the details.

But in a way, its like being told that I have to experience the hormonal roller coaster of reverse puberty, except that this time I am old enough to understand things a little better. Old enough to understand, but still too young to be legitimate (like a pregnant preteen!). Frankly, its a little embarrassing.

I've known about this new development since early last summer, but it took me awhile to put two an two together and go see my doctor about it. The connection happened sometime in June when, in the middle of a sudden onset of sweating bullets, heavy panting and an inability to think beyond the overwhelming sensation of HOT!!!, I thought to myself, "Maybe this is what a hot flash feels like." When I began having these episodes several times an hour, I decided to get it checked out.

Let me just describe this to you. As a person not prone to exaggeration (well, sometimes) and not particularly inclined to draw attention to myself (especially my body), let me assure you that hot flashes are not overrated!!!

Picture this: Comfortably reclining in your pleasantly air conditioned home (even a little chilly, perhaps), you find yourself, in a time span of 0-5 seconds, encased in an astronaut suit of pure heat that radiates from your body in waves that leave you gasping for air! Your sweat glands open, and out comes Niagara Falls! You quickly stand up, in a desperate attempt to minimize your skin contact with anything that will either reflect or intensify your heat. If your child was on your lap, you roughly shove them off (this is a moment of self-preservation after all). If you were having a conversation 5 seconds ago, you can forget about it now! The most important thing to concentrate on right now is breathing (gasping really) and exclaiming (possibly swearing). Chances are you'll try to apologize to whoever you were talking to, but it will likely come out sounding non sequitur and crazy. It feels as though you've been working hard in the hot sun in high humidity all day and and some idiot just zipped you into a heavy wool sleeping bag! You feel certain that for three minutes time you could probably single handedly power New York City.

Then comes the slow decline, which leaves you in cold sweat and shivering. For several weeks near the beginning, it was my pleasure to have this experience several times an hour. When I asked others such as my Mom (aka. my new comrade-at-arms), how often it happened to them, I discovered that it isn't especially common to have them THAT often. But from what I have read, medically induced menopause is often more intense and quick than nature intended. Thankfully, things have slowed down a little, and I don't have to endure it quite like that any more.

Nevertheless, many of the other joys of this change remain my daily companions, which brings us to our next item on the agenda - hormonal mood swings! This is where I really feel like an adolescent. Again, the very quickness itself of the mood change is maybe the most alarming part. Jessica may be very happy one moment, and five minutes later is found going to James for a hug and saying, "I feel like crying!"

It feels like the floor just dropped out from under me. The house feels too small. The boys are too loud. Suddenly the world feels like a very insecure place. Strangely enough, the default emotion to this state is to feel guilty. Just generically guilty. This is not the time for me to go to my Bible and glean some comfort, because whatever I read will make me feel like I'm not measuring up. Words of love suddenly sound like words of judgement.

I have never been this way. I've never had crazy PMS. And although James claims that I can be a little more cranky at a certain time of the month, I'm usually still rational.

Actually, one of the best things for me to do has been to learn about the science behind menopause. A wonderful book for this is called The Female Brain. Being a lover of science and human anatomy and physiology, it has been a life saver to find out what is happening in my brain, which hormones are dipping and dropping, and what parts of my brain that affects. It helps to know that I haven't ACTUALLY become a terrible human being in the last five minutes. What HAS happened is that I'm going through estrogen withdrawal (and other responsive hormones such as oxytocin, progesterone, and even testosterone).

Four years of science courses taught me to think like a scientist, and I can't describe what a relief it was to see that this book was a conglomeration of years of scientifically legitimate studies, fMRI's to watch brain activity in response to hormones, blood tests and much more. However, if on my recommendation, you go out and look for this book, be forewarned that the author attempts to explain the evolution behind these hormonal responses, leading to far flung conclusions from the caveman era! Very over the top in some sections. My appreciation for the book is purely limited to the proven science, and not the theories that develop from the data.

In practice, I am trying to figure out ways to minimize the effect of my altered state on my family. When I quickly become sullen, it is usually better for me to withdraw to my room. Before all this, I used to take comfort from the sound of the boys playing, or the closeness of family. But now I'm quicker to snap at the boys, or to feel irritation at the people around me. A better practice for me is often "Least said, soonest mended". (I may have just stumbled upon another reason for why I am more introverted these days!) In a sense, I am fundamentally more selfish than I used to be.

All that being said about hormones, what I don't want to do is blame everything on my brain. The tendency to blame hormones and relinquish all responsibility for one's actions is another reason I find Women's magazines annoying. I don't want to use being on a hormonal roller coaster as a trump card for every situation. I don't want to be selfish. I don't want to be short tempered. I want to enjoy the people around me. When I see myself failing in these areas, that's when the guilt sets in. This is also when I feel a little annoyed at God for creating me with these basic flaws. When the basic instincts to be selfish, angry, and irrational already exist in me, and I am constantly subject to an ebb and flow of hormones that I can't control, it's almost irrelevant whether I make the choice to do wrong in the other areas of my life. At my core, before I even wake up in the morning, I have already failed to be the person that I want to be.

I know that sounds harsh and self-condemning, but in reality it is in recognizing my weakness that I can accept redemption. Blaming my hormones for everything would provide ample justification for lying in bed and doing nothing except feeling sorry for myself. If I truly have no control over my hormones, I might as well submit to them. But there is a Truth that exists outside the realm of my emotions. Truth is not subject to my hormones, even if my perception of Truth changes.

I suppose I am talking in circles which is probably a good example of the whirlpool of emotions. Thankfully it is not my ability to hold on to Jesus (aka Truth) that saves me. It is that He reaches into my whirlpool and holds on to Me. Even if I can't see Jesus clearly when I am in my whirlpool, I can still thank him for holding on to me.

So I thank him. I thank him that having a dirty house means that I have an active family. I thank him that having loud children means they are entertaining themselves instead of being planted in front of the TV. I thank him that my boys WANT to talk to me and ask questions because they want to learn. I thank him that James is here with me instead of being in Bali. I thank him that there is so much food available that I need to watch my intake. I thank him for the fact that HE IS, and that he remains unchanged by my changing world.

Strangely enough, in being thankful, the storm usually passes, and I can see the sun coming out again.

All in a Day's Work

Well I have a few hours before I have to head out to a doctor's appointment this afternoon (another routine MRI), and I find myself faced with the tantalizing question of what to do with my spare time. It has to be spent sitting (as Jude has insisted upon doing his coughing and recovering on my lap), so that means cleaning is out. Shoot! I had my heart set upon cleaning and watching it get messed up in a matter of mere minutes! Other options include quilting on my current project of a baby quilt for my lifelong friend Char, or reading. But I choose blogging, because my tongue has been loosened, and rather that stifle the flow for the sake of some kind of posterity (after all its only been one day since my last blog), I'll just float along.

As a side note, as I write this, James has decided to take a break from his thesis writing to sew himself a mongolian deel. See picture. I'm married to a certified weirdo, and I love it!

I told James last week that one of the most interesting challenges of working at Starbucks has been that I always have to be prepared to meet anyone, at any time, from any stage of life. You know how there are days when you just don't feel like talking to people? I can't have those days. If there were signs pointing to Historical Points of Interest in Jessica Frey's Life pinpointed in and around Winnipeg, you couldn't choose a more central geographical location for me to work. Here is the list of obscure people that I might converse with on a weekly basis. From listening to these conversations, you'd think that I am intimately acquainted with all of these people, but really its me pulling out that extroverted side that we talked about yesterday.

1) People I went to school with and have not seen in 10 years (usually quite fun)

2) Parents of people I went to school with (informative)

3) People I knew from random Youth Group gatherings way back when (could be from any number of churches from Winnipeg, Steinbach or rural Manitoba). These interactions usually start with, "I have the feeling that I know you..." and we proceed to play an elimination game of how our paths may have intersected.

4) Old neighbors that moved away to the Yukon when I was seven years old (this happened last week, and I was truly at a loss for how to make conversation without sounding like an idiot. Nodding and saying "Wow...!" with great emotion made the basis of that conversation). Don't get me wrong, I did enjoy seeing them again.

5) People that I went to camp with (usually pretty fun). Thankfully, we are usually able to recognize each other and there is none of this "Should I identify myself?" question.

6) People I played sports against. Growing up in a small town, we always played sports against the same people, so we were able to watch our "rivals" grow up at the same time we did.

7) People from my small town who were younger than me that I unfortunately did not pay attention to. They recognize me, and I usually don't recognize them because I never stopped thinking of them as being in Gr.5, 6, 7, (fill in the blank). When I complimented one girl on her memory, she graciously said, "Oh its okay, you know how you always remember the people you looked up to!" A very kind thing to say, mostly serving to make me feel bad for not being able to place her!

8) Teachers. I saw my science teacher a few weeks ago and was astonished to see that he looked younger now than he had when I was in Gr.10. Maybe it was the loss of the beard, or maybe my idea of what looks "old" has changed. Whatever the case, I promptly stuck my foot in my mouth by saying "You might be interested to know that despite how much I hated Science class I actually went on to get a Bachelor of Science!". Realizing what had come out of my mouth, I blushed heavily. But being a good sport, he laughed and said "Its okay, I probably deserved that!"

9) University classmates. Awkward. They know what I trained for and don't really know what to say to me when they find that I am working to make the world a healthier place by making such "nutritious" beverages for people. Sidenote: I actually had a woman on the Atkins Diet come and order a Venti latte with sugar free syrup made with 35% milk fat whipping cream (liquid form). Biologically, the Atkins Diet makes for a very interesting study. I can theoretically see its use to lose large amounts of weight quickly (not healthily). But if I imagine drinking that drink... shudder! I registered enough shock on my face at her order that I had to cover up somehow. "...that must be... um, thick".

Before I go on to number 10, here is a related story. I had an athlete training for the Olympics come in and ask for nutritional information about her drink. Making conversation, I mentioned that I studied nutrition. Her eyes widened and she proceeded to lecture me on how I should go about seizing control of my life and knock on government doors to personally fund me in the fight to obtain Registered Dietitian status. When I tried to explain that things were a little more complicated than they seem, her harsh reply was that I wasn't allowed to give her that load of #@$! My manager was furious. A few days later when she came back, she saw me behind the counter and looked shocked. "YOU'RE STILL HERE???" I suppose she honestly thought that she had inspired me to instantly quit my job.

10) University professors. Slightly less awkward. Despite large class sizes, they do remember me, but thankfully, they have a larger perspective of the obstacles life can throw onto one's path to fame and glory.

11) James' classmates. Based on the fact that you know you know each other and you are face-to-face, you have to make conversation. But since the relationship is entirely vicarious, there is very little to say. Best to keep those short and sweet.

12) People from jobs I used to work at. A while ago I recognized someone I used to work with there. I sat there desperately hoping that she wouldn't recognize me. Close, but no cigar... out came the dreaded words. "You used to work at Tim Hortons in Steinbach didn't you?" I debated with myself if it was worthwhile to state that contrary to how it seems, I haven't actually been working at coffee shops for the last 10 years. Blatant self-promotion, or humility? Blatant self promotion won out!

13) People from the various churches I attended. Usually quite pleasant.

14) People who read this blog during the Krang Dynasty (aka. tumor treatments) and were concerned for my well being. My coworkers were quite astonished one day when a girl I hadn't seen in years came in and said "Jessica! I never see you, I just read about you!" Is Jessica on the front cover of tabloids?

15) People who I have chatted with over the counter and gotten to know. Unfortunately, I never remember faces, and I can't tell you how embarrassing it is to have a "new" conversation with someone, only to realize that they already know me. This frequently happens with Chinese customers. I'll often chat in Mandarin with Chinese customers, but unfortunately, I am more concentrated on their drinks than I am on their faces.

All these, of course, are in addition to people like my family who frequently visit me. For the most part, I quite enjoy seeing people, and I try my best to put them at ease with the unexpected interaction. It's one thing to see someone across the aisle at the grocery store that you know, and decide that you don't feel like bumping into them (we've all done it!). Its another to stand in line at Starbucks, looking forward to your drink, and instead seeing good old Jessica. She's standing there right in front of you and you suddenly feel like you need to come up with something to say to her. No escape routes!

If you should find yourself in this intimidating situation, never fear, I will do my best to make you comfortable! As far as I'm concerned, its part of my job description! All in a day's work...

Speaking of Emerging Icemen...

James recently reemerged on Facebook after a two and a half year hiatus, and I quipped on my status that the Iceman had emerged. But if he's a Facebook iceman, then I suppose that makes me a blogger Icewoman. Encino Man style!

If I even get started trying to make excuses for why I haven't blogged for the past ten months, I'll never actually blog. Besides, to make excuses is to assume that there is someone out there holding me responsible or even watching this blog anymore (which I highly doubt). However I have recently begun to restore my view of blogs as being a tool to write giant letters about yourself to the people who are around you and care about you, but whom you may have a hard time keeping in contact with. I am awful at emailing (as many of you can attest to), and chance encounters with me are more and more likely to happen at Starbucks while I make your Decaf Triple Tall in a Grande Nonfat Half Sweet, No Whip, Extra Foam, 190 degree, Pumpkin Spice Latte, which of course is a recipe for highly in-depth conversation. (breath, that was a run-on sentence!)

Another good reason for me to blog is that over the last year and a half, I have largely become an introvert. This is definitely a new development for me and I am often surprised to realize that I have become more comfortable to not say anything at all than to aimlessly chatter. I used to feel uncomfortable around people who were quiet. I thought that it was my responsibility to fill the silence with whatever came to my head, and that if I didn't, things would feel awkward. Then one day, I had this startling realization: "Wait a second, this quiet person is not feeling awkward... they just don't have anything to say!" While that was a mind blowing realization in and of itself, an even greater extension was to realize that if THEY were comfortable being quiet, I should feel comfortable being quiet too.

So I began to practice feeling comfortable with silence. But that is what it remained, a practice. Not a natural inclination.

Not so anymore. I have tried to analyze why this sudden change has occurred, but every analysis takes me on meandering rabbit trails and leaves me dangling. The best one I can come up with is that over the year of being sick and the internal processing that followed, my words usually felt inadequate to express my thoughts, so I just stopped trying. Often that is still the case. Whatever the cause, the outcome is that my introvert/extrovert side has done a complete 180, and its been a strange thing to observe. I've always considered myself to be an extrovert. I can still pull it out on a moment's whim (usually at Starbucks), but it is no longer my default setting.

So what has happened in the last 10 months? Plenty! I will make a short list here without offering explanations for any of them. I have tried to start blogs with explanations and they all come out sounding like I am very disappointed with the world, which is definitely not true!

1) In July James left for four months of research for his Master's degree in... Bali! James' stepmother gave four months of her life and devoted it to caring for the boys and helping me on the home front. Although I've tried to say it many times... thank you to that wonderful and loving woman, Theresa Frey! You will receive your honorary Master's Degree sometime in the next few months.

2) Three days after James left, I started working as a shift supervisor at Starbucks. Not the job I dreamed of or trained for, but God provided nonetheless. Rather cry about the doors that closed in my own field, I'd rather be grateful and do my best at the job that has been given to me. Besides, after a year of being "sick" I just needed something to make me feel useful and alive. However after living in China, dealing with my health, questioning God and just being a parent and wife in the midst of it all, it was a bit of a shock to my system to return to the world.

3) Working where I do has taught me a lesson in humility. Even though I was "groomed for bigger things", it turns out that our working world doesn't consider me to be such a hot commodity. Thus, I've learned that I am no better than anyone else. But there is a bonus to this. The flip side to not being superior to anyone else, is that no one else is superior me. I used to feel intimidated by those with "better credentials" than I, but my lesson in humility has taught me to look for the human being in everyone, instead of looking at their credentials. The outcome is that I feel a lot more confident around a myriad of people, and less concerned about what their opinion of me may be. I find myself to be far more interested in people's LIVES and their HEARTS.

The funny thing is, I can't count the number of incredulous looks I've received to hear that I have a Bachelor's Degree in Nutrition, I speak Chinese, worked with an NGO, come through a cancer battle... and yet work at Starbucks. But the truth is that I don't owe an explanation to anyone. My mantra has become "And whatever you do, in word or deed, do it all unto the Lord Jesus Christ whom you are serving." I used to hate it when people said that because I thought that it was just a Christian-ese way of making mundane tasks seem holy. But the way I see it now is that God is the only one who truly sees my heart as I go about my work. So whatever it is that I find myself doing, my goal is that he would find my heart to be pure.

4) While James was in Bali, we were limited to email contact. His access to internet in poor rural fishing villages couldn't support anything nearly so sophisticated as Skype (or even Google chat) and the phone was inconceivably expensive, so other than my visit to see him in September, we went without hearing each other's voices for four months. Only in retrospect do I realize how crazy this sounds. Right after a year of fairly traumatic and life changing events for us, we were essentially cut off from each other. Our only communication was through email.

But guess what! Letter writing turns out to be quite a therapeutic measure for recovering from trauma. Everyday, James and I wrote letters to each other. He would describe the people he was meeting, the places he was going, the scenery, the work, his motorbike rides etc. I, in turn, would write about the people I met at Starbucks, the garden, and the boys. And of course, we wrote about our thoughts. Through our emails we conducted our own sort of Couple's Therapy for Couples Recovering from Traumatic Events. It was amazing how honest and open we could be in our letters. We've always been very communicative, but sometimes in a marriage it is just hard to have a conversation without interruptions, misunderstandings and offense, especially when you are on opposite sides of the same coin. When you write a letter, however, you have all the time in the world to express yourself the right way (as opposed to whatever pops out of your mouth). When you read the letter that comes in return, you have time to process what was in that letter instead of having to respond immediately, or risk hurting the other person.

I went to visit him for two week in Bali, and it was a very good time. I rode around on the back of his motorbike, hugging him for all I was worth, and he took me to beaches with beautiful black sand, high terraced mountains, and tiny poor villages.

By the time he came back in the beginning of November we were more than ready for a family life again, where Mom isn't sick, and Dad isn't far away in Bali. However, for all the trials of that time, I truly believe it was a good thing, at a good time. Since he has been home, we have coveted our family time, feeling protective of our quiet evenings at home and savoring our new family dynamic.

And it definitely is a new family dynamic. Its funny. At times I have felt like I fell asleep on the day of my seizure in Beijing and only just woken up recently. During the time that I was sleeping (aka dealing with stuff), the boys changed dramatically. When I "fell asleep", Ari and Jude were still significantly dependent on us and not very good at expressing themselves. Now they have well developed personalities, and a great sense of humor. They know how to contribute intelligently to the dinner table discussion and they make us laugh all the time with their jokes. Ari is reading and writing stories (both in French and in English!). They don't wake up crying during the night anymore. They can clean up after themselves (not that they always do!) They play board games together!

For now, James is the primary caregiver, since he is at home writing his thesis and I am still working. But I have been amazed at how well it is working out. James missed the boys so much while he was gone, that he seems to have gained a limitless ability to enjoy them. They in turn think he is the funniest man alive. (the real secret is that James can finally indulge in his little boy humor!)

And that brings us to today (sort of, by way of numerous short cuts), where I have a day off, the boys are recovering from some kind of flu, and James is off guest lecturing at both Providence College and the University of Manitoba. I'm hoping that writing this blog entry will break my reticence to write. After maintaining a "cancer blog", its easy to forget that this blog was never started for that purpose.

We'll see how it goes from here!