This Christmas, cherish your greatest gift

holding-handsA slim, fake Christmas tree stands close against a set of chairs in front of the nurses’ station at Missouri Baptist Hospital’s Cancer and Infusion Center outside St. Louis. Oversized gold and silver ornaments and tinsel cling to the tree’s nylon branches, which sway as the nurses, treatment counselors, and orderlies hurry to serve their patients.

A few feet away, a string of red and green letters spelling “Merry Christmas” dangles in a low curve from the ceiling. Air blowing from the heating vents causes the letters to dance and twinkle in the fluorescent light.

Beneath the string of letters, I listened to Martha, mother of four and grandmother of nine. She was in a treatment lounge chair near mine. We were not introduced. However, I turned my head when a woman sitting next to her commented on Martha’s wig.

“This one is much better,” the woman said to Martha. “Almost looks lifelike.”

Martha smiled and reached up to touch her new hair. “Yes, it does. I think it’s a real improvement, don’t you?”

Small things matter now, such as how Martha’s bangs frame her forehead and curl over her ears. These are the elements of her life she can control. Everything else depends on how her body responds to the pint bag of clear fluid hanging from a metal rod by her head. As she touched her wig, the fluid trickled down a tube toward a pump sewn into her shoulder.

Martha was worried. Thanksgiving was in two days, and she was expecting 30 house guests – family and friends from across the country. She wanted to feel well enough to see them, enjoy them. The last time she was here for treatment, three days of nausea followed. She vomited so hard a blood vessel burst in her eye.

“I can’t be sick this time,” she told her friend. “Every moment this week has to count, you know?”

The Infusion Center is a broad, open room subdivided into small, curtained cubicles. This is where cancer patients receive chemotherapy treatments. Each cubicle contains a reclining chair, a pump to dispense intravenous fluids, and a small flat-screen TV.

Treatments can last hours depending on the dosages and immediate side-effects. The nurses do what they can to make patients comfortable: warm blankets, cool drinks, conversation. One walks around with a guitar and offers to sing the patients’ favorite songs.

On the day Martha and I were there, all 35 cubicles were occupied.

Three weeks later, a young woman named Karen was in the recliner nearest mine. The curtain was drawn between us; she requested privacy. A nurse pulled up a rolling chair next to Karen, and they began chatting.

In August, Karen received her master’s of Business Administration. She already had two job interviews scheduled in New York when she walked onstage at Washington University to accept her diploma. Karen blamed the summer-long exhaustion that came with her across the stage on too much studying. Her parents insisted she get a checkup to be sure.

The nurse listened as she prepared Karen’s first chemotherapy treatment.

“I wish I could plan. I wish I knew what was next,” Karen said, “I feel I was just getting started. Now, I don’t know.”

The nurse’s voice was calm, reassuring.

“You should go ahead and plan. It sounds like you’ve got a lot going on. And it’s always good to be optimistic. Helps with the recovery more than you know.”

Karen said she was trying to keep an open mind, but it was difficult. “Nobody hires someone with cancer.”

The pair turned quiet as the metallic clicking and snapping sounds of chemo treatment preparation continued. Then:

“Is there someone here waiting for you?” the nurse asked.

“No,” Karen mumbled. “I don’t want anyone seeing me this way.”

On my third visit, I was sitting near the Christmas tree awaiting an open cubicle. Across from me, also waiting, were two women with Kyle, 8, a slight pale boy in flannel pajamas, SpongeBob slippers, a blue knit cap and a big smile. Kyle squirmed in his seat. The women – his mother and aunt – were tickling him. He giggled. He charmed the nurses, the orderly pushing a mop bucket, the woman with the guitar.

“Looking good, Kyle. Like the hat,” said Amy, the social services counselor, whose white smock fluttered against Kyle’s ears as she breezed past.

“My sister made it for me,” he said happily. “She’s 13, you know.”

Kyle’s initial leukemia diagnosis had come before he turned 5, which means his lifetime of memories is framed by the disease. He knows everyone’s names at the Infusion Center, including the volunteers who work without name tags. He sparkled like the Christmas ornaments. They bounced and clanked as his chair nudged the tree.

It occurred to me at that moment: the ornaments were oversized because everything else here is, too – the love and the loss, the plans and dreams, the joy and pain, and the laugh of a little boy awaiting his next dose of hope.

Each of us carries around a gift too great for the space in our hearts. Yet we take that gift for granted because it fits neatly within the container of our lives. This holiday season, pay special attention to those great gifts. For millions like Martha, Karen, and Kyle, they are the most precious any of us ever possess.

Everybody’s already made up their mind

Illustration by Jeff Crosby for Salon.com

Illustration by Jeff Crosby for Salon.com

The sound of vomiting awakened me. The smell of it assured no return to sleep.

My roommate was coming out of his coma.

“That’s OK, that’s OK,” a woman told the gently groaning man who had just emptied his stomach and, I noticed a moment later, his bowels. “We’ll take care of that. You don’t worry.”

I heard but did not see any of this. A gauzy, cornflower blue curtain on a metal rod trembled from the activity behind it. Between gulps, the man apologized, his words wavering in the air.

“No problem, no problem at all,” said another woman. The pair sounded much younger than the man they were addressing. “Here, just roll over a little this way so we can get – there, that’s it.”

The whisper of changing bedsheets filled the room. The thud of something wet and heavy landed in a plastic bucket, followed by another thud.

My attention span rippled like water in a breeze. The drugs administered to arouse me from surgery were prying me out of a deathly slumber, but a mild grip continued. The analog wall clock said 3 a.m.

As I noticed this, the women emerged from behind the curtain wearing purple smocks, latex gloves, and their frosted hair bound up in small buns. Each clutched a bulging plastic trash bag and a facial expression wrought from a hard night. The air improved when they left.

My roommate coughed and cleared his throat a few minutes, then was silent. When next I heard him, the hands on the wall clock had spun around three times and sunlight dribbled through the window blinds.

I needed to pee – I could not remember the last time that happened – and so began focusing on how to do it. I had come out of surgery without a catheter and without the use of my shoulders. Long, raw, S-shaped scars curved beneath my arms. A tube jutted from the bottom of each scar. Beneath each tube, a plastic bulb collected orange fluid. Concentrating on how to squirm out of bed unaided softened the edge on my urge.

But in fumbling to stand, I brushed the room dividing curtain, causing one side to slide back on the rod. And that is when I met Clarence from Anna, Illinois. His drooping, swollen eyes stared at a muted TV on his side of the room. He had long white and red tubes running the length of his black arms.

“Hey, hi. Sorry about that,” I said as I grabbed at my loose gown with one hand and my rolling intravenous fluid pump with the other. Pain coursed from my shoulders to my ribs. The half-filled bulbs pulled on my scars.

“No, that’s fine,” he replied and waved to me with thick fingers. “Hope I’m not disturbing you. I guess I got a little noisy last night.”

“Nah. I wasn’t really asleep anyway. They kept waking me every hour to ask a question or poke me with something. How are you doing?”

“Better, I think. They tell me I was out awhile, so I’m not sure,” he said, groggily.

“You mind if I asked what happened?”

“Car crash. I was making a delivery and a woman plowed into my side at a stoplight.”

“You remember that?”

“I remember that much, then I woke up here.”

“So, you feeling better?”

“Yeah. I think one of these tubes is morphine.”

As the last syllable dribbled from his mouth, two other women slid past me, nodded acknowledgment, then positioned themselves on either side of Clarence’s bed. He greeted one as Mom.

“Ohh, baby, how’re you feeling?” She knitted the words together in a long, soft musical note.

“Mmm. ‘K,” he mumbled.

At that, I regathered my gown and rolling IV stand to address the business that forced me upright. When I finished and returned to bed in a way as innovative and as painful as I had left it, the conversation behind the re-extended curtain had changed from a lovely tune to legal matters.

“Police say she’s already got a lawyer …” the woman called Mom said.

“… and he’s already talked to them,” the other woman added. Clarence called her a word like “Sulee.”

“She was the one who didn’t stop,” he told her. “I was stopped and moved out a little to see past the car and then she was slamming into the side of me.”

“I know, honey,” Mom said. “And they know it. But she’s got this lawyer now.”

Piece by piece, the puzzle came together before me. Clarence was working his second job, floral delivery, and had pulled up to a flashing stoplight two blocks from his destination. Cars parked close to the intersection interfered with his view, so he stopped then inched and stopped then inched forward to see better.

He remembered flashing lights, a siren, and someone shouting questions at him. That was four days ago.

“Mmm, yes,” Mom hummed.

“But now you gotta get a lawyer, too,” Sulee said. “You gotta talk to somebody at the college. Got a lot of friends there, right? You’ve worked there a long time. Somebody there knows someone who can help, right?”

“Dunno,” Clarence said. “Maybe.”

“Oh, we gotta try,” Sulee said.

“Dunno,” Clarence repeated. “I mean, look at me, look at that town. Everybody’s already made up their mind.”

Smoking clouds your financial judgment, researchers find

Smoking was once a major part of my life even though I never lit up.

My parents did, however, and often. So often that I remember clearly how long, brown nicotine streaks stretched down our bathroom walls after each steamy shower; how the burn marks on our furniture multiplied until my mother figured how to hide them with throws and pillows – until those were burned through, too; how the school dean once told me to change clothes because they smelled strong of second-hand smoke.

You’d think all that exposure would carve a similar habit into my behavior; after all, we tend to pick up many of the same habits our parents do. Instead, the constant exposure to cigarettes and their noxious or ashy effluent did just the opposite; I grew up repelled by cigarette smoke and tended to steer clear of its sources.

Over time, however, I wasn’t the one who modified my behavior to meet social demands; the marketplace did. Smoking’s cachet fell away, driven largely by repeated health warnings, to be replaced with a stigma that attached to it like barnacles and pushed persistent smokers outside and away from workplace centers of decision-making.

Now, add a new discouragement to smoking: Research led by the University of Wisconsin-Milwaukee says habitual smokers tend to make worse decisions regarding their personal finances than people who smoke infrequently or not at all.

The research, buttressed by other economic analysis of smokers and led by Scott Adams, a professor of economics at UWM, surveyed more than 1,000 smokers over a two-year period and found that people who retreat into a cigarette break seeking instant gratification are likely to bridle when their attempts at fiscal gratification do not similarly yield immediate benefits.

The outcomes are reflected in credit scores, Adams says. Among the economic analyses, 41 percent of smokers were denied credit, 30 percent routinely missed credit card payments, and 27 percent had filed at least once for bankruptcy. Across the board, these percentages were twice as high as those for non-smokers. (These experiences were common among the survey group.)

In general, smokers accept the risk of poor health to pursue their habit, Adams stipulated. That risk-taking can be considered reflective of an overall willingness to take chances – an appealing quality in business.

But risking a smoke is met with the immediate gratification nicotine provides. Rewards gleaned from taking financial risks are neither readily apparent nor readily available, and hurrying toward those perceived rewards tends toward recklessness, Adams said.

“(A) smoking habit has an important and independent ability to predict behavior even after we control for variables that might be considered the true source of the poor performance in personal finances,” he wrote. “… We find that there is residual information in smoking status that can help predict credit score, and the size of this residual information is substantial.”

Adams acknowledges that other factors not measured by this study may clarify the relationship between smoking and personal finance but gave no indication that his research group would investigate them.