And ironically, sitting right in front of me was Maddy's dermatologist, there to watch his son perform. And I thought: I owe this moment to him and the drug Accutane.

Six months ago there is no way Maddy would have been up on that stage.

Writing about one's teenage children is sensitive ground — particularly about their struggles, in Maddy's case her struggle with acne. But Maddy and I have talked about this column and I am writing it with her permission and approval. "I think other teens and their parents should know what we went through," she said. "It might help them make their decisions." (Plus she added: "And none of my friends read your blog, so I don't really care.")

I swear we did not make the decision to go on Accutane — Isotretinoin — lightly. It is a very powerful drug — some would say toxic drug — with the potential for serious side effects. It is hard on the liver, bones and gut. Lawsuits have linked it to depression, rages and suicide as well as Crohn's disease. If you went by what is prominently found on the Internet, you might never consider it at all. And that is one reason why I write this — to give a balanced version to those trying to decide.

By last fall we had tried everything to control her acne.

Maddy's acne story was typical. She first started having breakouts in Grade 8, around age 12. At first Proactive worked. Then we moved to topical prescription antibiotics (Clindasol) with a Rx drying agent (Differin). The doctor by the end of Grade 9 added oral antibiotics — Minocycline starting at 50 mg and rising to 150 mg daily. She was on antibiotics for more than 18 months, a long time and daily antibiotics can have very serious rare side effects, which fortunately Maddy never got. She also took Alesse for hormonal regulation. That complex mix of Rx lotions and pills worked fairly well until the spring of Grade 11.

Then it all stopped working. We had numerous trips to the doctor to try to adjust medications. While diet has longed been deemed unrelated to acne, we still stressed healthy eating and good sleep. I read in recent medical literature that a statistically significant link had emerged between heavier consumption of dairy products to kids with more severe acne. Maddy cut back on dairy to no avail. We tried health food supplements called `Perfect Skin` and other concoctions touted to naturally cure acne. All useless. We even bought a very expensive hand-held infrared light device, recommended in some studies, for which she need to wear special eye-protecting goggles. All it did was burn her face, making it bright red and painful. Her skin was inflamed with acne and scarring. She was miserable.

"There were days where I did not want to get out of bed," recalls Maddy, particularly of last September and October.

I had been avoiding Accutane for months. I had read in the blogosphere about alleged links to Crohn's and suicide. Maddy had read about a risk of losing her hair, another one of its reported side effects. We read a lot of scary stuff on the Internet. But in hindsight, perhaps we would have considered it sooner.  I know some Moms who refuse to allow their teens to go on Accutane but I now feel it is reasonable choice when you have tried all options. And that is why I am revealing some private details to tell the story. As a journalist I feel almost a duty to report our experience -- I always ask others to tell their personal stories to me. Now it is our turn. Maddy agrees with me.

When I finally decided we had to at least talk to the dermatologist about its pros and cons, I got an appointment date of almost three months hence. But I phoned them in desperation "I know you have cancers you are dealing with, " I said, "But I have a teenager who won't come out of her room, who is refusing to go to school. We must get in on the first cancellation."

We were in that week. The doctor examined her and said: "You are the perfect candidate for Accutane."

I voiced my fears, citing various studies. "Don't worry Mom," he said. "I have been using this for 30 years. We will follow her. By the time five months are done, she will likely never have another pimple in her life."

Maddy was sent for a blood test for liver function and when it was clear, she started the pills a week later. She had another set of blood tests a month later and when those, too, showed her liver was tolerating the drug, her dose was increased.

Like about 30 to 40 % of users, Maddy's skin got worse in the first two months. This was tremendously hard. I believe — and recent medical literature has proven this true — the links to depression on Accutane are for those kids who worsen upon starting it. Says Maddy, "You have tried everything and you have all your hopes riding on it — and it makes you feel terrible and still you get worse. That was not fun."

"Hang in there," said the dermatologist. "This is normal."

The drying side effects were tough. Her lips were constantly dry and cracked — but vaseline and Elizabeth Arden's 8-Hour Lip Protectant helped. She had nose bleeds almost every morning during the winter. In week six, she suddenly developed back pain that was so severe that I called the doctor's cellphone on the weekend.  He checked her out Monday morning. "Ease up on her gym class and workouts until the pain goes away," he said.

Her eyes got dry, red and scratchy. Visine worked for that. She developed patches of eczema on her legs and arms, treated with copious amounts of vaseline and 1% hydrocortisone. She couldn't drink alcohol on it and we stressed to her the danger to her liver if she did. "I know Mom, I am not like that," she said. But for some kids it could be a serious risk.

There was one unexpected benefit: instead of losing any hair, it thickened, and she only need to wash it once a week. "I actually loved my hair on Accutane," she said.

We decided, that if she got sick or developed food poisoning or a stomach flu, we would temporarily halt the pills until she got better. There is not a lot of medical evidence for this action but I figured it was such a strong drug that we would not add it to her system if her gut was at all compromised. There is evidence that inflammatory bowel disease can be first triggered by an intestinal infection alone. I reasoned, why add Accutane to the mix? But we never need to temporarily halt the drugs.

By the third month we started to notice an improvement. By the final, fifth month, her skin was clear, the results almost astonishing considering where she started. Now, about six weeks after taking the last pill, she hasn't had a pimple since early March. Her skin now looks almost flawless.

"I was really scared to go on it, but I am glad I did," she says.

We acknowledge that it is not for everyone. That you must investigate all options. You must have liver function tests and have a good dermatologist who sees you monthly.

But even Maddy agrees: "There is no way in the world I would have been up on that stage without it."

And when the concert was over and we were trouping out I smiled at her dermatologist and said, "Thank you."

In recent days, a conversation piece here on the West Coast, along with the Canucks, the election and the deplorably wet cold spring, is the question: "Are you going to get up and watch the Royal Wedding?"

Most of my friends and family respond: "Good God, No! 3 am? I'm not a monarchist. Are you?"

I'm not a monarchist. I care little about the Royal family, as attractive and rich as they are. To me, it is not a glamorous life. I think being one of them would be a sentence akin to life in prison with no chance of parole.

But I will watch the wedding. Maddy, my 17-year-old, and I have already decided we will set the alarm for 2 am,  bake fresh scones ( I will make the batter ahead) and eat them with strawberry jam, clotted cream and a good cup of tea, while no doubt remarking at the unfolding pageant - "Oh, look at that fascinator on Princess Beatrice's head!" or "Victoria Beckham is too skinny!"

For me, watching is not about the celebrities or the fashion ogling, although that is part of the fun, it is about sharing a collective "spot of time."

Poet William Wordsworth coined the term "spots of time" to denote those heightened moments of experience, when reflected upon later, bring trailing with them all sorts of other vivid memories. His poetry is full of descriptions of these spots, which resonate with readers 300 years hence.

Here is the exact stanza, from his poem The Prelude in which the term arises (Book XI, ls 258-278)

There are in our existence spots of time,

Which with distinct pre-eminence retain

A renovating Virtue, whence, ... our minds

Are nourished and invisibly repaired

A virtue, by which pleasure is enhanced,

That penetrates, enables us to mount,

When high, more high, and lifts us up when fallen.

Wordsworth experienced most of his "spots" in private contemplation while out in Nature and for me many of my spots of heightened present moment awareness come from intimate times with family and friends.

But some come from collective experiences that I witnessed on television, some disasters and tragedies, others of world celebrations and cultural catalysts. In recalling them, I can conjure a flood of details. The first for me was the assassination of  JFK, when I was 5. The next was the debut of the Beatles on Ed Sullivan a few months later. For the Beatles, I can remember being in my aunt Helen's basement, her floor tiles, the red wool dress I was wearing, the tomato aspic jelly mould we had at dinner ( yuck then,  yum now), my rambunctious somewhat scary cousin Billy. I can almost smell, hear and taste it all.

A whole list of TV events carry such shards of vivid memory — the space launches, and the first step on the moon, the Solidarity marches, 1982 Royal Wedding ( watched with girlfriends under a big duvet in one of my first apartments in Toronto with tea and scones), the Berlin Wall coming down, 9/11, the 2006 tsunami...

The events are like thumbtacks in the map of a life, that pin down a point in time, a date and place, to which we can go back with certainty about where and when and what we experienced. I have many other vivid memories of my life, but many float in a general mist of time, a feeling and fabric, but are not so anchored. 

So when Maddy and I make our tea and scones tonight and settle in to watch, it will be more about making our own memories together than it will be about Will and Kate. It is about us, not about them.

Perhaps years from now, when I am dead and gone, she will get pleasure from telling her grandchildren: "I watched the 2011 Royal wedding with my mother, under her big duvet. We made scones at 2 am. I can still taste the strawberry jam ..."

Or else we could sleep through it and have no memory at all.



In our modern times, though, "atopic" individuals (those prone to allergies)  find themselves fighting their own bodies or other otherwise harmless substances like peanuts, eggs, milk, nuts, fish, animal dander, dust, mould, grasses, pollens. Simple things can sometimes kill an allergic person. Those prone to allergies are often depicted as weak, mouth-breathing, nerdy, canary types whom others delight in kicking sand in their faces.

I come from a long line of allergic types. My grandfather on my father's side died of an asthma attack in 1926. My father is anaphylactic to flat fish. My sister is deathly allergic to scallops. I get asthmatic to cats, hay and dust, and my throat swells upon eating kiwi. All of us in my family have hay fevers to various grasses and pollens. ( One bonus, allergic individuals are much less likely to get cancer.)

I happened to marry an atopic man, who is allergic to walnuts, peaches, cherries and anaphylactic to bees, wasps and hornets. Our kids didn't stand a chance! Kate our oldest soon after birth developed severe allergies to dairy, eggs and peanuts and had to carry an Epipen wherever she went. When I was pregnant with Maddy, I drank goat's milk,  and ate sweet potato, lamb and ancient grains in an attempt to avoid sensitizing her to common allergens. So far, Maddy shows no allergies but I suspect, any day now, she will emerge allergic to something. She is genetically destined.

With this history, I wasn't surprised, therefore, when just after Christmas this year, I broke out in hives for no apparent reason. Hives are raised, itchy welts that afflict allergic individuals. My hives seemed to arise in the midst of a hot yoga class. Exercise and heat are two known triggers to hives for allergic types. It also happened at a pretty stressful time in my life ( and stress is a known trigger). Plus it arose just after Christmas, which is a time when many foods are consumed that are high in histamines ( chemicals involved in the immune response.) Shrimp, cheese, alcohol ( especially red wine and port), chocolate, spinach, nuts, and celery are all foods with high histamine levels and indeed the day before my outbreak I had eaten almost everyone of those items.

But for almost a month I was miserable. My eyes were swollen and inflamed, I had hives around my hairline, back of ears, down my neck, on my chest, down my belly and down my legs. They ebbed and bloomed almost every day. Spicy food, exercise, and exertion all made them worse. I looked a red splotchy sight, but I felt even worse - itchy, irritable and perplexed. What had caused my hives and what did I need to do to make them go away? Some people live with hives for years. I was damned if I was going to be one of them. I had to get to the bottom of it.

I saw my family doctor three times in three weeks, each time being told I had "chronic idiopathic urticaria" ( meaning she had no idea why I had hives but they didn't seem to be going away.) She gave me different formulations of corticosteroid creams, but they didn't seem to work. I was taking a double dose of Benadryl at night and downing a Reactin every morning. By week three I even went for acupuncture -- weirdly cool but it didn't remove the hives, although I did feel much less itchy for 24 hours.  I researched chronic idiopathic urticaria extensively on the web. All the sites said you must be a sleuth and eliminate all possibilities both internal ( foods, drugs) and external ( products) and then add them back to see what happens. If not, you may fight hives for five, ten and fifteen years.

By week four, I finally got into the dermatologist. His examination lasted, I swear, less than 1 minute, in which he said :  "Seems to be no pattern to the distribution, so must be internal" and wrote me a prescription for an even stronger corticosteroid.

But his words stuck in my head: perhaps there was a hidden pattern to the distribution? I started at the top - if the hives were around my face and head, what was I using on my hair that might be triggering it?

In the shower later that day, I noticed how the water traced a path flowing down from my face over my eyes and body. It was a direct path of my hives! It was something I was using in my shower. The first thing I eliminated was my Herbal Essence Hello Hydration coconut and orchid hair conditioner. My kids and I love this stuff and have used it for at least five years with great results.

I stepped out of the shower and for the first time in a month was not newly itchy and sporting a fresh bloom of hives ( my doctor and I thought it was the heat of the water that was triggering it in the previous weeks.) In a day I was not itchy, within three days, normal. I had somehow become sensitized to a product I had used hundreds upon hundreds of times with wonderful results.

So here is a tip for you allergic types. If you get hives, something you have been using for years may suddenly trigger them. You, and your doctors, may not think there is a pattern, but start at the highest point on your body. If it starts at your head, think of something you use on your face or hair.  Look for a distribution.  If I had really looked I would have seen it weeks earlier.

Suddenly in the shower, the light went on for me, and then four weeks of misery was halted in 24 hours.

But now I am in the market for a good, hypo-allergic hair conditioner. Any suggestions?



 Every Christmas Eve, for as long as there has been TV or video or DVD's,  one of my most revered Christmas traditions has been watching "A Christmas Carol," on Christmas Eve — the fantastic 1951 movie of the Dickens' classic with Alastair Sim as Scrooge. The family tradition started in the 1960s when the movie  began appearing as special programming in the week before Christmas, often scheduled on Christmas Eve.

My father would say: "The Alastair Sim one is on the TV!" ( the only one really worth watching, but Bill Murray's Scrooged  does come close )  and the whole family would gather around our RCA Zenith console in the living room to see the dour, grasping, bitter Scrooge go through his ordeal of past and future compression to become redeemed at the end.

The final scenes were worth it all. The giddy, ecstatic, wonderfully-enlightened Sims stands on his head, fluffs his hair, hails the boy in the street to buy a goose ( looks for a label, label, label!) and alarms his housemaid with his utterly changed persona. His portrayal is so infectious with true joy of redemption, of transformation from a grasping miser to a generous enlightened soul,  that one cannot watch it without being a tiny bit redeemed oneself.

Of course, as I had a family of my own, watching A Christmas Carol became part of our tradition every Christmas Eve with my own children. I truly love that film and have seen it likely 40 times, if not 50. I can recite whole passages of dialogue ( "Are there no prisons? Are there no workhouses?" "I don't deserve to be so happy.") You know, as he strides of with Tiny Tim at the end, Scrooge is truly changed for life, and he and the world are better for it.

But I don't feel the same way, at all, about It's a Wonderful Life.  Everyone in the whole world seems to love It's a Wonderful Life  and with this blog post I risk exposing myself to flames of criticism and condemnation for my confession that it irks me.

Let me explain: ( Every Christmas I have tried to explain, to anyone who would listen, why I don't like It's a Wonderful Life, ( IWL) but I it is reduced to jokes now in my household: "Mom, your favourite movie is on, har, har.")

Let's go back a bit, first, to how I first came to see IWL.  I grew up in a classic movie-loving household. My father loved good films. I was exposed to multiple viewings of The Treasure of the Sierra Madre,  Bridge on the River Kwai, All About Eve, The Wages of Fear and more  —  great character-driven films, all before my 10th birthday. But I never saw IWL. My Dad said he didn't like it , but never said why.  I was almost 30 when I first saw it.

I wanted to like it —I had heard so much about it for years and as a movie buff was eager to add this to my film lexicon. I knew the  plot line, of course. I love redemption films ( Central Station, the Argentine film is another terrific redemption flic) IWL sounded like a great redemption flic of a fallible human character who eventually sees the light.

When I finally saw it, I watched with open mind but I remember being distinctly uncomfortable as it unfolded. At first, I didn't know why it did not fill me with joy. Now that I have seen it many times, I understand why: it is not true redemption. The main character George Bailey is ego-driven throughout and rather than being redeemed at the end, his earlier self is validated.  

Let me deconstruct, if I may. In early scenes George delights in humiliating his future wife Mary when she is naked in the bush ( any young man treating me in that disrespectful way would be dispatched forever with no chance of reprieve! And I hope any young girl, like my daughters,  would say likewise.)  He repeatedly states that he is better than his small town and is going to build bridges and airports and basically "blow this pop stand."  He is increasingly bitter that unlike his medal-winning brother he is stuck in his small town running the Savings & Loan. When the money is lost at the bank he yells ``Where's that money, you silly stupid old fool?" to his doddering uncle and then later, as everything is unravelling, yells abusive threats at the innocent school teacher about ignoring his daughter's sore throat. Worst of all, his proposal to his lovely wife Mary as he is on the phone, is frankly horrible -  a man incapable of declaring true intimate feelings, but instead with his own inability to to be real negates her and his feelings for her. (Why she said yes to him is beyond me, after he left her naked in the bush.  'Come back when you can say you love me to my face, and treat me with respect,' I would have told him!!)

 He is, to me, in the early parts of the film, a good man but an inauthentic man who has leading an inauthentic life of role-identity that he resents and rails against yet does not have the courage or gumption to change.  Of course, as this persona he does do a great deal of good in the world -- he saves his brother's life, he saves a woman from prostitution, he builds houses for the poor and gives them self respect. He contributes to the greater good. He is a good man at heart doing good work. (This is what we all latch onto.)  He hates what he is doing. He thinks his life is worthless because he has not won medals or built monuments ( been acclaimed in other's estimation.)  He is full of inner conflict. Resentment, bitterness, regret define him.

And then his crisis hits, the money is lost, and when he is unable to face the consequences of that loss of face, loss of role and status, he decides to commit suicide - an ego-driven act of someone whose self-identity is completely constructed of what others think of him and what he thinks of himself.

Of course these revealing scenes of self-worth and identity completely tied to external validation would be fine if through angel Clarence he sees his fallibility and becomes truly enlightened about a better way to be and live. But NO! He is shown how, as that inauthentic, ego-driven self all these years, his actions and self-sacrifice have changed the town for the better and how many lives would have been ruined or lost but for his forfeit of his true ( perhaps ego-driven) needs. His inauthentic self is celebrated!

Okay, I admit, that now in my 50s,  that message of "your sacrifice has been worth it" hits a chord. Like most, I have seen some cherished dreams turn to dust, things I held dear that have never come to pass and now likely never will, and so part of IWL  does reaffirm that need we all have to know that our giving up on our dreams, they way our life has unfolded,  has been worth it for the greater good of our children or our society.

But still, at the end when he comes home to friends, they are re-affirming that old, ego-driven self, not a new enlightened one. They don't know he has spent hours with the angel. They don't see the new him and he does not show a changed persona to them. If the husband of the teacher he bitterly scolded only a few hours earlier came through the door, he would still beat him up! And worse, Old Mr. Potter has gotten away with stealing thousands of dollars; Wrongness prevails.

Yes, his sacrifice is acknowledged and it is valued by his community and his friends, but he has not distanced himself from his earlier acts. He is frankly unchanged except for seeing that his sacrifice has had purpose and done good in the eyes of others. ( I believe true good is doing the right thing when no one is watching and no one will ever see. Then your self-belief is internally driven and imutable to the winds of societal approval.)

And as an uplifting Christmas fair,  it rings hollow to me.  I think given six months or a year, or as soon as his world does not validate him yet again, George would be in crisis once more and unlike dear old Scrooge, will not be skippingoff into the future as a truly joyous, liberated, authentic self who does not need things or other people's views of him to make him happy or make him do good for good's sake. Scrooge of course started off a very bad, evil man who becomes good. George is a good flawed man at the start and a still good flawed man at the end, with the only change that he has been recognized by others -- for now.  This is not redemption, it is ego validation.

But I am open to discussion. What do you think?



"A problem has been detected and Windows has shutdown to protect your computer. ....Modifications of a system code or critical data structure was detected.... Stop code 0x00000109."

The first time, I was startled. The second time perplexed. The third time, hyperventilating. The fourth time (before I could even update my status on Facebook: Anne is hyperventilating) I was a quivering mass of nail-chewing hysteria. The fifth time - ya don't wanna go there.

I had just bought the system three weeks earlier, dropping $1300 plus on the top of the line monster with 8 GB of RAM, a hard drive with enough computing capacity that would have taken up 6 city blocks of IBM mainframes in the 1970s, and an enormous flat screen monitor capable of having three documents full size, all viewed at once for editing and multitasking.

 I had a day of writing and editing to do in a busy week and a nutso month. This could not be happening.  I have all my data obsessively backed up, but I need a functional computer just to get work done.  Telling editors, clients, and art directors that you are late on a deadline because of computer problems sounds as convincing as "the dog ate my homework."

But five blue screens! This was not a computer problem, this was a meltdown. My keening moans of woe  shook the quiet 1940s Victoria apartment block where have my office.

Calm down. Rending garments does nothing. This is obviously a hardware fault on a new system. It is all under warranty. Call Future Shop.

"What is the make and model of your computer?" the clerk asked between my sobs.

“Gateway MS Pro.” 

 “Let me see… oh here. Gateway has a chat forum and email tech support on their website. Just go to www.gateway.com”

 “Calm down ma’am. You are right, email is not much use if your system is not working.  I’ll see if I can find a phone number. Hmmm. I don’t see a phone number. I will transfer you to our tech support.”

I waited while Michael Buble played. Eventually a man came on whose voice sounded completely bored and flat -- to counteract no doubt the hysterical calls he gets all day.

I could hear him sigh as he listened to my problem: “That needs to be dealt with by Gateway, Ma'am.  You are still under warranty. They have online email support and a tech support chat room….”

“Okay. Calm down ma’am. Yes I guess that is no use if you can't get online. Yes, I do have a tech support phone number but we can’t give out that phone number as that is the one we use..."

My frustration was sky high. I tried to keep my voice as even as his. What did he suggest I do with a three-week old malfunctioning system?

"Well the best thing to do is pack up your computer and bring it in here. Blue screens are hard to determine. We will run diagnostic tests. That takes four or five  business days, depending on the problem. If it is not a software problem or a virus, but a manufacturer's hardware problem -- and it sounds like hardware -- then we ship it back to Gateway. It is all under warranty.

And if it was hardware ( I knew it was hardware) how long would my computer be gone?

"One or two months at the most...

 “Well no, we don’t give a loaner…” he said.

Eventually the bored-voice man - to get the hysterical me off the phone --  found a phone number for me to call – that of Acer, the manufacturer of Gateway.

I called the 1-800 number and a pleasant, computer generated woman’s voice answered.

“Welcome to Acer. Please say as clearly as possible the issue you are calling about. You can say sales or tech support or..“

“Tech Support” I yelled.

“Okay. Tech support. What is the technical issue you are calling about?”

“Blue Screen!”

“Okay, blue screen. For operating system issues we need your 11-digit SNID number. You will find this number underneath the bar code on the side of computer. If you do not have this number handy, this automated system will wait until you find it. Say halt to look for the SNID and then say continue when you are ready to proceed.”

(Oh dang!) HALT!

I pulled the computer tower out from my desk, disentangling wires and cords. The bar code was a tiny patch and the SNID an even tinier number underneath it. It looked like this: 00083383712.

I got out my reading glasses and rummaged for a pen light. On my hands and knees under my desk I still could barely make it out. I wrote it down as best I could and then climbed  back up to the phone.

Continue! I yelled.

“Please type in or say the 11-digit SNID number.”

I typed in the number, trying to get the zeroes, 8s and 3s in the right order.

“To confirm, the SNID you provided is: zero, zero, zero, eight, three, three, eight, three, seven, one, two.

That was what I had written down.

“Yes! ” I said.

“This is not an Acer Product. Please call the company who made your computer. Goodbye,” said the voice. The phone clicked dead.  The computerized woman hung up on me.

Shit! I pulled the computer back out, got out a magnifying glass and got back on my hands and knees. Dang!! I had an 8 and a 3 reversed.

I dialled the 1-800 number again.

“Hello,’ said the pleasant computer female. “Is this the same problem you recently called about?”

Okay, at least she is efficient. We can get right back to entering the correct SNID.

“Yes,” I said.

“This is not an Acer Product. Goodbye."

I called my husband Keith, frantic. "Find me another number for Gateway or Acer. I am being blocked by a cyber control freak." He searched websites and got a different number for customer support. I called this one. The same computerized woman's voice answered.

“Is this the same problem you recently called about?” the computer voice said.

“No!” I lied.

“Are you sure? Is this the operating system problem you called about at 10:05 am June 9, 2010,” she tested, almost HAL-like in her menacing, overly-calm tone.

“No!” I lied.

“Okay ( I could tell she didn’t believe me.)  To go any further we need your 11-digit SNID number. You will find this number underneath the bar code on the side of computer. If you do not have this number, the system will wait until you find it. Say halt to look for the SNID and then say continue when you are ready to proceed.”

I entered in the number, holding my breath that this time I would do it correctly.

"You are being transferred," the system said. Muzak played.

A human voice finally came on.

“Hello, this is Raminder, how may I help you?.”

He was in a data call centre on the outskirts of Mumbai, India.

I sputtered out my blue screen problems, the three-week old system, the whole sorry tale.

I could tell Raminder was reading from a binder. He was a lovely caring man ( I couldn't understand half of what he said, but he mumbled it in a very caring kind way.) But he was no use what-so-ever. Ultimately, his only advice: pack up computer in its box -- it was all under warranty -- and either ship it or deliver it by hand to the Gateway office in Burnaby or Toronto. It would be back in one to two months, all covered. But no, they do not give a loaner.

I was on my own.  

 (PS. Thank God for Darryl Gittins, tech writer for Boulevard and computer whiz extraordinaire. He took away my new system, hooked up an old lap top of his to let me survive for three days.  Running my new system through a series of diagnostic tests he discovered  my blue screen woes were coming from a 2GB module of RAM that had a manufacturing glitch. He pulled the RAM -- I still have 20 times more RAM than my last system. Now I am going to see if Future Shop or Gateway will reimburse the cost. I have a feeling, no, because I did not pack up the computer and send it back.)



The story of that spooky 1919 call and the death that Ella foretold is family legend. It goes like this: Six-year-old Gerald ( my father’s older brother in a family of 10 siblings)  cut his foot on an ice skate. It became infected, and, in the age before antibiotics, gangrenous. He was to have his leg amputated in hospital the next day. The family, all worried about the fate of the sweet young child, had finally gotten to sleep when the phone rang. It was midnight ( of course.)  My grandmother, who usually never answered this new fangled contraption, did not want everyone to awaken again.

“Mary,” the voice said. “This is Ella in Heaven. Don’t let Gerald have the operation.”

My grandmother screamed and fainted, so the story goes, and the rest of the family found her on the hallway floor,  the earpiece dangling off the hook. Stopping the operation was not an option, the leg was too far gone. But Gerald died during the procedure.

 Ghost stories like this abound in my paternal lineage, but only one of the visitations occurred via phone.

 Naturally Grandma thereafter refused all late night calls, saying nothing good can come from them.

I think she was onto something: I’ve been bedevilled by phones for at least two decades.

In my 20s my cat, Fauve, loved to chew through telephone cords. I’d be cut off in mid-sentence. I’d rub Bitter Apple repellent or spray her with a water gun, but it remained a game for her to wrap herself in the cord and gnaw as fast as she could whenever I talked.  Once I waited on hold for 45 minutes, motionless, to seek out training tips from the vet on a CBC call-in show. “We could be cut off at any minute. What do I do?” I asked. 

“Get a cordless phone,” he said.

But cordless phones are worse, at least in my house where no one EVER puts them back on their base. “Where’s the $#@ phone!!!?” we yell, frantically lifting couch cushions, newspapers and sports gear as we can hear it ring — somewhere.

I bought two identical phones so that one, at least, might make it back to a base. We soon learned they wouldn’t charge unless coupled with their true mate. But which went where?  It took weeks to figure it out and when we finally did I painted bright pink nail polish blazes on the upstairs set and pearly white ones on the downstairs set.  So now its: “Who put the pink phone on the pearly base!!!?”

Of course, if it stays off the base long enough the batteries die completely. We once lost the dead downstairs phone for a good four months. I scoured the house repeatedly, finally resorting to Grandma Mary’s remedy: praying to St. Anthony, Saint of lost items. (And I am not even a Catholic since my father left the fold. ) “Guess what was in the pullout couch?”  Kate announced after a sleep over. (Wow, good work St. Ant!)

I won’t tell you how many trips I’ve made to London Drugs to buy new batteries for phones so dead they won’t recharge.

Being prudent, we also got tethered phones on both floors – but they root you in place. We were a host family for a guide dog in training, a black lab puppy named Piper,  who soon learned we couldn’t move and discipline him when on a fixed phone. During the year we had Piper we put everything possible chest high or higher. Like Pavlov’s dog, Piper would hear the ring, and if he saw I was immobile, take off to find a leather shoe, washcloth, kid sock,  butter dish, hair brush, or Barbie doll to devour. “Can’t talk now,” I’d say, slamming down the phone to run after him shaking rocks in a tennis ball can, a training tip to control his ravenous appetite that failed miserably. He gnawed everything, including a telephone.

While dogs can figure out tethered phones, some modern youth can’t. My sister called a friend and got her young daughter: “Can you get your Mommy for me?” my sister asked. “Oh no,” said the girl. “This phone is attached to the wall.”

Now we hardly ever use the house phones at all. Messages left on the home answering machine can sit there for days, everyone else assuming another person in the family has lifted the receiver to listen for them.  "You have ten new messages" the computerized voice almost nags when one finally remembers to check. "What is wrong with you people?!" our former friend Michael greeted us one day this past month when we bumped into him at the Moss St. Market. Three of his messages that week had still not been heard.

These days of course each of us in the family has our own cell  phone.

But OMG, I could go on and on about the bane of cell phones: the mafia-like contracts, the frustration of companies that seductively court newbies with sweet deals but jack the prices on long-time customers; the umpteen ones lost by teens that even St. Anthony can’t help find;  the one destroyed after it was dropped in a puddle;  the exorbitant bills; the overheard irritating conversations in public venues; the tyranny of never being unavailable.

In rebellion, I refuse to use my cell phone for all but the most urgent calls. ( I do rather like texting; I am a writer after all.)

But I will take a call anytime, from Ella. There is one thing I have to know: “Ella, how did you make that call? "

Because in my heaven, there are no phones.



The situation that prompted this discussion is that last week my 19 year old daughter used my office computer to write and print out resumes. Today, the first time in a week, I typed in www.facebook.com and instead of having my login pop up I was taken directly to her home page. At first I was confused. The first name I saw, in bold print, was a young man, a friend of Kate's whom I happen to have strong feelings against for a few egregious infractions I witnessed or was recipient of  during those awkward teen years. I have heard he has since grown up and become a decent young man, but when I saw his name front and centre on what I thought was my home page I went: WHAT? He IS NOT my Friend!!??# He's in JUVIE!!

That name shocked me into the recognition that this was not my homepage but in fact my daughter's that she had neglected to exit. I wanted my page,  so I logged her out. But in the time it took to sign on to my profile I thought: Oh dang! Wasn't that just the perfect opportunity to explore ( some might say "spy") on the life of the flesh I gave birth to? 

The role of parent is a weird one in the teen years. It is like parenting toddlers who have access to alcohol and car keys. I  believe Mother Nature has designed the relationship between teens and parents to be increasingly distant so that around age 19 both sides say: all right, time to get out and explore the world. If our children stayed as sweet and lovely as they are at 10, holding our hand as we walk to the grocery store, we would never want them to grow up and get on with their own lives.  "Live with us forever darling, no need to find a job, mate and produce a family of your own." If our children continued to look at us with those eyes of adoration and dependency that gazed at us as we tucked them into bed at age 5, they, too,  would never want to go.

And then no new generation would have babies and everything would collapse. So Mother Nature makes sure teens and parents spar and separate. The survival of the species is at stake!

So by 19, when the kid has all the answers and roles her eyes you both know: time to get some experience of your own, dearie dee.

But I miss knowing the details of their lives, their ups and downs they used to share so readily, the who- said-what-to-whom. It is natural for teens to withdraw into grunts upon being asked "how was your day?" And I am luckier than many in that my girls are still rather open with me. 

 But while both my daughters ( and many of their friends) have friended me on Facebook, both have put me on "extreme limited profile" to curb my intrusion on their space. Both have made it clear that if I should somehow get access to their unguarded face book page and read it, it would be akin to reading their diary.

I know all about diaries. I was an obsessive diary keeper from the age of about 11 to the age of about 32. I have 13 large volumes in a box in my attic. My early jotting years are largely juvenalia: " "Jennifer likes Scott, but I like him, too. And he smiled at me yesterday and I smiled back and said Hi. But Jennifer saw it and then we got in a big fight in the girls'washroom and she said she wasn't my friend anymore."

Once in my late 20s,  I read out loud my diaries from those early teen years  to my mother and a sister and we laughed so hard we had tears streaming down our faces. My excruciating recording of those awkward angst-filled years hit a chord of hilarity with  of us  -- every woman has been there in her teen years.

Though much in my 13 tomes is fogettable drek that I would happily now burn at no loss to the world of literature and letters, within those pages are hints of the writer I was to become - Holden Caulfield-like observations of hypocrisy, Thoreau-like ruminations on nature, Leacock-like ( well at least I like to think so ) riffs on life's absurdities. And there are sketches and paintings, concert stubs and snapshots,  and heart-felt revelations and honesty that still move me to read to this day. There is also some pretty racy bits -- I was single to age 30 after all -- and that content in my 20s is rather akin to the "I like Scott"  material of the early years but with way, way more at stake. 

But here is the thing. They are nothing like facebook. They are my most private and intimate thoughts on life. There is no way, in the world, I would have ever have posted my entries to share with 500 so-called friends. I would have been humilated and  mortified to have anyone -- my mother, my sisters, my friends -- read about my insecurities and bravado, my loves and likes, my insights and worries, my pratfalls and pontificating.

Now I have the dilemma: what to do with my diaries? I still am not keen to have anyone read them (i.e racy bits) least of all my husband and children who have a certain image of me. (Note to family: I will notice if anyone goes up to the attic and touches them!! Thank goodness the attic is only accessible by a long ladder hauled up from the basement and a trap door.)  And I still cringe with the thought that after I am dead, someone will read them. But I cannot burn them yet-- they still contain too much of me even though I have not read them in years.

But as I said on my Facebook profile, a daughter's face book page is not really like a diary at all, it is like a teen party with no adult supervision in which there is no expectation among friends of privacy. All is shared -- every last camera angle and thought. It is life lived as if on stage, knowing, hoping, all are watching.

I do hope they are finding a quiet time for pause,reflection and rumination somewhere, somehow. I think it is good for the soul and for the maturation of an adult.  Facebook does not provide it.

But I will give them their privacy on FB, because like a closed door in teenage years, they seem to really want and need it.

But it ain't no diary.

Before we get into the details let me make two things perfectly clear:

• Screening versus diagnostic mammograms: the general public often doesn't understand the difference between screening and diagnostic mammograms. Screening takes a healthy population of women with absolutely no symptoms and tests them with regular mammograms. A diagnostic mammogram, on the other hand, is done when there is a detectable lump, a discharge,  a change or puckering in the skin or when a woman is found or suspected by family history to carry BRCA-1 or BRCA-2 genes. The debate about mammograms is around screening healthy women with no symptoms or genetic risk and its value in saving lives. If you or a loved one at any time has any symptoms  or carry the gene for breast cancer, get a diagnostic mammogram as fast as you can. In the same way, screening breast self exams -- which means teaching healthy symptomless women how to check their breasts in a routine way at the same time ever month -- has not been found to help. That is completely different from the need for all women to simply know her breasts and notice any change -- a lump, a puckering, a discharge or thickening of the skin. As soon as you have a symptom, get into the doctor right away.
• The need for clear informed consent and personal decision-making:  A woman  must be the master of her own body. If, with her family doctor, a woman at any age is fully aware of the pros and cons of mammograms and decides she needs one or wants one, and the doctor agrees, she should be able to get one. But as I will detail below, there has been a lack of clear informed consent around mammograms. Only the benefits, and none of the downsides, are widely promoted in the invitations to screening programs. But, if a woman knows the pros and cons and decides to get one, I absolutely support that right. I personally know many women who chose screening and had early cancers, mostly DCIS,  found. They firmly believe this saved their lives and I support their right to believe that and make that choice. More informed consent is needed.

Now that those two things are clear, let me tell you a story. Back in 1987, when I was medical reporter at the Vancouver Sun, I got a call from the BC Cancer Agency that the Canadian National Breast Cancer Screening Study was comparing the outcomes of women screened to women not screened in huge numbers -- more than 90,000 Canadian women. But there was a problem - not enough women knew about the study and so not enough were signing up to take part. I wrote a story about a woman whose breast cancer was found on a screening mammogram, and how grateful she was. And I urged women to take part in this important study. The Cancer Agency had so many calls in the week after my story ran -- more than 3,000 -- that they had to put in extra phone lines. The BC arm made its target number for the study in part based on my promotion of it. I firmly believed early detection was the way to go.

But then, around 1988/89, I began to hear concerning rumors among my sources that results of the study were astonishing and confounding. In the 40 to 49 age group, more women were dying in the screened group than were dying in the control group. This did not make sense. We all believed so firmly that early detection would save lives, and that the earlier that screening was started, and a cancer detected, the better. No one wanted to believe that finding it earlier might in fact be harmful.  Canadian lead researcher Dr. Cornelia Baines says the data about worse outcomes in screening in younger women started showing as early as 1983, but by the early 1990s, with more than 90,000 women studied,  it was clear - the young mammography group had more deaths, more false positives and more overdiagnosis ( treatment of harmless cancers) than the control group. When Baines et al published the results in 1992 they were roundly criticized, their study methods were faulted (there was nothing wrong with the study) and the Canadian team's credibility was assaulted. It was shocking to see how ideology trumped the research. The message was ignored and the messengers shot instead.

But two otherr large European controlled studies found exactly the same result -- women under 50 had more deaths.  UK surgeon and breast cancer expert Dr. Michael Baum, who in in the 1980s was the strongest proponent in that country for mammography and set up its national screening program, has become one of its strongest and most vocal critics. Baum is particularly concerned by the huge increase in ductal carcinoma in situ ( DCIS) found in women under 50 who have mammograms.

Here is what Dr. Baum has said widely in various interviews, including to me in an article I did on DCIS in spring 2008 Best Health, about his theory about what is occurring:

" Ductal carcinoma in situ is probably not a good word, and we should call it latent cancer. These latent cancers, particularly in premenopausal women, are grossly over-represented in women given mammograms--something like five times more, compared to what you would expect. This suggests that if left to their own devices, these latent cancers might never trouble a woman. But if you identify these latent cancers and biopsy them, you have traumatized the area. You immediately trigger the natural healing mechanisms, and natural healing mechanisms involve angiogenesis ( formation of new blood vessels.) So, effectively, the biopsy could be considered an angiogenic switch. You take a latent cancer that would never hurt a woman, biopsy it, turn on the angiogenic switch, and it ceases to be latent. A latent disease becomes an aggressive disease."

This theory of angiogenesis is highly controversial and you won't hear it discussed much, but it is strongly supported Michael Retsky, PhD, a researcher at Harvard Medial School and the late, famed researcher Judah Folkman, also of Harvard, who is credited as the father of angiogenesis research in many disease processes including cancer. Another interesting finding that might support the theory that mammography may somehow help turn on a switch making some breast cancers more aggressive. For years researchers have known about "interval cancers"  -- breast cancer that shows up, suddenly between the screening as a felt lump in women who have been having mammograms every year or two.  There is no evidence of a cancer at all on the screen, but then one suddenly grows rapidly before the next scheduled mammogram. Interval cancers are usally more aggressive than those found at the time of screening or those found in women who have never undergone screening. They don't know why interval cancers are particularly nasty, but Baum theorizes that perhaps radiation or the intense squeezing of the breast during the screen may switch on the healing response of angiogenisis that also spurs a cancer growth.

Baum resigned from the UK screening program in the 1990s when it refused to share the pros and cons with all women taking part in screening as a necessary discussion about informed consent. He believes that fully informed women over the age of 50 should choose for themselves as there is evidence past age 50 it saves lives, but he is on the record saying: "To promote screening mammography to women under the age of 50 is absolutely unethical."

But let's take a closer look at that age of 50 -- that age is chosen because the median age of menopause in western women is around 49.  Onset of menopause ranges from the early 40s to the late 50s. Some women do not experience menopause ( a full year without a menstrual period) until age 58 or 59. The evidence is that it is likely menopause not age, that is the defining factor of whether screening mammograms are helpful.  ( It could again be angiogenesis and the menstrual cycle, some theorize.) The evidence is convincing enough for me that I have decided I will not undergo a screening mammogram until I have had one full year of cessation of menstruation. The best results for screening is among women aged 60 to 69, likely because all women by that age are menopausal.

Here is another fact that more women should know. The huge drop in the use of hormone replacement therapy corresponds exactly, with a lag time, with a significant drop in breast cancer incidence. In fact, more lives may be saved by not doing HRT than from screening.  There was a 13 per cent drop in hormone receptor positive breast cancer between 2001 and 2004 and an 8 per cent drop in a single year ( 2002/2003) that tracks exactly to the sudden stop of HRT by millions of women following the 2001 results of the Women's Health Initiative, that found HRT was harming women.

Look at these two graphs from the New England Journal of Medicine and note the  drop  corresponds to the sudden decline in prescriptions for HRT. Although the issue is still being debated, a similar decline was seen in Canada, Spain and the UK, and a special study by regions in California also showed the same result. Click to enlarge the thumbnail to better read the graph, from New England Journal, Berry et al, April 19, 2007 

For those of you wanting more references, here are a few ones to start. The literature is huge. Just google pubmed and go to the National Library of Medicine data base. You could be reading for hours. I am citing the British Medical Journal and European journals primarily because there seems to be a more open discussion of the pros and cons over the last decade in Europe than in North America,  which may be interesting to Canadian women. Here in North America we still shoot the messenger, as has been seen by the coverage of the past week. Thus, I am wearing my flak jacket.

H Gilbert Welch. Overdiagnosis and mammography screening.

BMJ 2009 339: b1425. [Extract] [Full Text]

Zackrisson S, Andersson I, Janzon L, Manjer J, Garne JP. Rate of over-diagnosis of breast cancer 15 years after end of Malmö mammographic screening trial: follow-up study. BMJ 2006;332: 689-91.[Abstract/Free Full Text]

Duffy SW. Some current issues in breast cancer screening. J Med Screen 2005;12: 128-33.[Medline]

Moller B, Weedon-Fekjaer H, Hakulinen T, Tryggvadottir L, Storm HH, Talback M, et al. The influence of mammographic screening on national trends in breast cancer incidence. Eur J Cancer Prev 2005;14: 117-28.[CrossRef][ISI][Medline]

H Gilbert Welch, Lisa M Schwartz, and Steven Woloshin. Ramifications of screening for breast cancer: 1 in 4 cancers detected by mammography are pseudocancers
BMJ 2006 332: 727. [Extract] [Full Text]

 Michael Baum. Ramifications of screening for breast cancer: Consent for screening BMJ 2006 332: 728. [Extract] [Full Text]

As the mother of a peanut allergic child I have a unique perspective. Both sides are right: allergies must be taken seriously, but parents of allergic children often do blindly promote peanut bans without reflection. I support a sensible third way: risk management.

 Early in Kate’s school years we learned peanut bans were actually dangerous to her.  Their effectiveness relied completely on all the school's parents, staff and children honouring the ban. Twice peanut bans were broken around Kate by parents whose children would only eat peanut butter sandwiches. One parent at our tiny preschool told the child to quietly eat his lunch out in the play area. He did so on the swing set and he put his hands all over the swing's chain. Kate touched the chain later that day and there was enough residue that her face swelled up to twice its size and her eyes closed shut. She was taken to hospital where we tried to figure out how in the world she had come in contact with peanuts. Fortunately she did not put her hands into her mouth or she might have died. In search for the reasons for her reaction, we were told other children had seen the child eating his sandwich on the swing. The parent confessed that she had encouraged him because he would eat nothing else. She didn't want him to starve. The ban forced her to act surreptitiously and that put Kate in danger. A second incident occurred when a grandparent made a peanut butter sandwich and it came into Kate's Grade 1 classroom without anyone knowing. The fumes caused a serious asthma attack for Kate.

Those two incidents convinced me that peanut bans are quietly breached all the time leaving no protection in place. In fact Kate's safety was in the hands of some 600 people we did not know.  I wanted the control in our hands, and ultimately in Kate's hands. She is the one who must move through the world with her allergy. She must learn how to manage risk to keep herself safe.

 Here is how risk management deals with food allergies at schools and is applied to all children with or without allergies:

• All food is eaten at children’s desks or the cafeteria ( no food in school yards, halls or playgrounds – this reduces risk of choking too.)
• All desks or eating surfaces are wiped clean and hands washed before and after all food consumption. In particular, kids are charged with keeping their desktop and their hands clean and free of food residue ( This reduces transmission of viruses, too.)
• The serious allergies in each classroom are noted and posted – nuts, peanuts, fish, egg, etc. If another child has a food that contains an allergen, it is announced. In Kate’s classroom, the kids would say: “I have peanut butter today, Kate” and arrangements would be made to put the two of them far apart and be extra careful with the clean up. Most of Kate’s friends decided they would not eat peanuts around her. But she always knew who had what.  It promoted communication and understanding. And the child with the shrimp allergy was safe, too.
• We stressed to Kate, “If you don’t eat it, it won’t kill you.” She might get hives or wheezy, but she would be okay. She was calm around other people's food. She didn't freak out if she saw peanuts, she just kept herself away or washed her hands really well. She always carried her epi pen, asthma meds and antihistamines.
• We also stressed: “Don’t eat what you don’t know” which meant no experimentation or food sharing. She learned to assess the risks of each situation and judge the places where peanuts traces might be hiding ( chocolate, ice cream, a jam or honey jar at a friend’s house, cross contamination at a Thai or Vietnamese restaurant.) She would avoid those situations.

These simple clear techniques not only kept her safe and in control of her own health – she had no further peanut reactions despite peanuts being all around her  – but kept other kids safe, too, no matter what their allergies. While I agree peanuts must not be eaten in closed air environments like airplanes – the risks are too high – I strongly encourage all parents of allergic children to lobby for the adoption of risk management rather than peanut bans. Then we can stop the ridiculous name calling and truly reduce the chance that an allergic child will come to harm.