The Pecking Order of Disease

Take the right genetics, combine with the right triggers, a dose of family dynamics, add unattainable societal standards of beauty, the culture of "thin" and you have a recipe for an eating disorder. A lifestyle? The result of willful bad choices - that with a bit of pull-yourself-up-by-your-bootstraps tenacity would be snapped into submission? A disease? Believe me, nobody thinks that last one.

In all my years inside the health care system - what I learned is that every illness, every organ, has a pecking order. This is not a judgement - just a fact. Look where the majority of research dollars go and how the health care budget is divided. Cancer has more cache than syphilis - an extreme example and may I assure you I am not poo-pooing cancer research, I am simply saying that we prioritize our expenditures in certain ways - because there is always a judgement involved. And throwing money at people who you might rightly predict have a strong probability of relapse, compared to a "clean" investment where through a targeted screening program you could improve survival rates for say - prostate cancer - which would you choose? We are comfortable with the illnesses that we can manipulate with drugs, devices and procedures where parts are taken out or new parts put in. We are less enthusiastic with the big black hole that things like eating disorders represent. Nor do I suspect people fully appreciate the significant toll they take on the body and the associated costs, a toll which obviously grows more significant the longer they drag on. 

In the beginning I must admit I was focused not on the consequences. But it didn't take long after dipping my toe in the treatment pool and exposing myself to other patients before I was sure it would kill me, a feeling that would grow more deeply buried over time. If you look at websites with memorial pages for people with eating disorders, women and a growing number of men, you might be surprised to see how many names appear. I also don't suspect I imagined for a minute in the early stages that I might continue to function - not optimally of course - but live a life for 32 more years before the full consequences would reveal themselves. A life that was always clouded by the image I had in my mind of what I would have been, the risks I would taken, the mistakes I wouldn't have made, the professional mountains I would have conquered, the relationships I would have embraced more fully - had I been well. In so many ways it has felt like when I was 16 the life that I might have otherwise led, died, and while my body somehow soldiered on - I have had a 32 year dress rehearsal for the fate I now face.

Three Months Ago I Was...

I got a cheque in the mail yesterday for some consulting I'd done with some lovely people at the UBC Faculty of Medicine. I was in the early stages of what promised to be some significant work, when the call came about my failing kidneys and I had to reluctantly call them and tell them I'd have to stop as I was going into hospital and I frankly didn't know what might happen next. I don't know why looking at this cheque makes me so sad - maybe because there is a part of me that wonders whether the formal part of my working life is over or whether I'll have the strength to go back to what I love. It also made me think about how oblivious I'd been to any warning signs that my health was in serious jeopardy and how all it took was a single phone call from my doctor and nothing would ever be the same. Dial back to early March and I was:

- pouring my heart into my contract with UBC's Faculty of Medicine and contemplating taking on more work with them
- debating when or if I should return to a "real job"...and if so, where?
- realizing that from the frequent advice I was asked to give I'd learned more at the Ministry of Health than I gave myself credit for
- thinking that consulting and the interminable paperwork that comes with owning your own wee business was not my passion. Loved the work, hated what went with it
- still processing why I'd left my job and absorbing the lessons I'd learned through all of the difficult times; how would I do things differently in my next venture?
- missing my work colleagues more than I thought possible
- wondering what the upcoming provincial election might mean and what changes might happen in my profession
- thinking I should really go and reconnect with my doctor, after all, it had been six years

Of course, acting on that last point led me to where I am now - no longer blissfully ignorant about what my internal organs are up to - and thinking about the future with endless question marks.

The French Connection

When I was small, my Nana and Papa (my dad's parents) were incredibly close to me. Leopold and Antoinette Seguin were, as the names might imply, French Canadian and both hailed from huge families. Among her siblings my Nana had two sisters who were teachers and nuns (I didn't know you could be both) and a brother who was an MP. I'm told when my Nana arrived in Pine Falls to be a nurse at the local hospital, my Papa took one look at her and determined because she was also short in stature, she would make a fine wife. He was not wrong. My Papa was a book-keeper at the local mill and even in a tiny town like Pine Falls there was a social pecking order between people who worked in the office/administration and those who worked on the shop floor. My Nana had a cleaning lady (which I suspect was not really necessary) and in keeping with the times she would have her lunch alone in the formal dining room while the cleaning lady sat by herself at the kitchen table. That is simply how it was done.

Together they had three children, Rita, Bob (Bobby) and my dad, Ron. Because my mom's parents lived some distance away, Nana and Papa were the center of our universe. I would toddle down the street to their house frequently to pass the time and spend afternoons playing Go Fish with my Nana at the dining room table or poring over her costume jewelry which was kept in a box in their bedroom and held endless fascination for my sister and I. They were both the types to dress up every day, my Nana in a dress and pearls and my Papa in a suit and hat - winter or summer. My Nana was also popular because she stocked our favourite foods and both my brother Murray and I would stand patiently at the fridge waiting for the banana ice-cream to be pulled out. One time when my Nana asked me what I wanted for lunch I famously replied "nothing special, just a little turkey or a roast, but don't go to any trouble, Nana". (I loved her cooking). My visits often extended overnight and they would prepare the pull-out couch in their living room and we would watch TV together before I went to sleep, chuckling together at Laugh-In or whatever other comedy happened to be on. When they wanted to have a private conversation when I was around, they would lapse into French, which I didn't understand, as sadly it was a time when passing on that part of their culture wasn't encouraged.

When we moved to BC after my mom remarried, they flew out a few times to visit but my Nana sadly passed away when I was about twelve. Once in my late teens I went to visit my Papa who, suffering from early stages of dementia, had moved into a new senior's home in Pine Falls. I found him watching baseball on TV (one of his favourite pastimes). He had reached that stage of life where he could vividly recall the scores of games from 25 years ago but couldn't remember if he'd eaten lunch. At one point as we sat together he turned to me and said, with a pained look on his face, that he couldn't remember if he had been a good husband or not. My heart breaking, all I could do was hold his hand and reply that yes, he'd been a very good husband.

Who Precisely is Bess?

I confess, there is no Bess. I may have met a Bess in my lifetime and I am sure if I did you were a lovely person but I regret I have absolutely no recollection of you and I apologize. KISS had a song about someone named Bess and I think in a delusional moment in my youth I wrote away to join the KISS army, but I digress. When I started this blog I realized I had to call it something. For reasons I can't explain, I thought of the song "Bess, You is My Woman Now"...you know, from the musical. Then I thought, of course, I'll adapt that! So I did. All of this took about five seconds. Now I am stuck with this name and apparently no one but me understands this clever play on words. This is not uncommon. So in summary, the name of this blog means nothing and in retrospect I should have given it a bit more thought. Also, not uncommon.

Postscript: Someone infinitely wiser and with a better memory than me (Jody Paterson) has pointed out the KISS song was "Beth" not "Bess"...you see, I never was a very devoted fan!

Also, the musical in question was Porgy and Bess. Bess, not Beth!

Google is Not My Friend

I am coming to dread seeing a certain number pop up on my blackberry. It is the number of my specialist's office and it generally comes in the days after my latest bloodwork. Today's concern is my elevated calcium and phosphorus levels and a request that I stop one of my current medications to see if it helps. Being me, I can't stop myself from turning to Google to see what the Internet has to say about "elevated calcium levels in patients with end stage renal disease". Big mistake. Article I zero in on informs me of the highly elevated risk of death in patients with this issue. Of course I don't bother with the details...all I need is the first few lines to let my imagination go wild and convince myself I should have completed my advance care plan that I have been putting off, last week. There was a time when seeking this information might mean a trip to the library and hours in the reference section. Not so now, when one has instant access to information that makes you crazy, no car trip required. I know I shouldn't do it - nothing about these explorations makes me feel better. But like a car accident, I can't look away.

On the Radio

My journey into broadcast journalism may never have happened had my mom not rescued my BCIT application from the dresser drawer I had stuffed it in and mailed it off, unbeknownst to me. So it came as a complete shock when she informed me I had an interview. We drove down to Vancouver, with me protesting all the the way that I had zero hope of getting in - hundreds of people applied and there were few seats available and there was no way they would want me - a relative bumpkin in a sea of undoubtedly deeply talented naturals. It was a bit irritating to be told I was wrong.

I had grown up with a deep love affair with the radio - turning it on the minute I woke up and listening late into the night. It was the "theatre of the mind" in every way and I was deeply attached to the personalities I felt I knew intimately after years of faithful devotion. When I was a teenager I could listen to CFOX on the stereo in our basement where I heard Tracy Chapman's "Fast Car" for the first time long before my bible, Rolling Stone magazine, told me who she was.

When I graduated it was 1986, the year of Expo in Vancouver and I was among a small group of students selected to work at what was then known as BCTV while the fair was underway. But the risk of taking that position, not knowing what would transpire when Expo was over proved too much for my insecure self so I vaulted for the only radio job I could find on the "wanted" board at our school. It was at a station in Quesnel, an hour away from my parents and it fit within my comfort zone at the time. This was a station that offered "message time" an opportunity for people on reserve and in outlying areas who obviously didn't have phones to submit short messages to their friends and relatives that the DJ would read on-air. Messages like - and I quote - "Got beat up last night so can't meet you in town today." Being part of the "media elite" in a very small town was an eye-opener and I quickly learned when I covered a city council or hospital board meeting that the principals involved wouldn't hesitate to call the station (or drop by!) and offer their editorial comment on what I had just said. I wasn't there very long before my news director got a job overseeing the newsrooms within the Kootenay Broadcasting System and he asked me to go with him - so I was soon packing my bags for Trail, where Ken Georgetti was still ensconced as the head of the local Steelworker's union and news revolved around life at the smelter up the hill. Stations like KBS still carried large newsrooms at the time and our 8am and 5pm newscasts were marathon affairs with a full sports packages, farm news and unique to Trail, "news in Italian" read by an unpleasant local man who apparently spoke in a dialect of Italian no one in the largely Italian community understood. I often covered the court beat in neighbouring communities like Castlegar and Rossland, phoning in my updates from pay phones. I remember one incident when I was alarmed to find the accused waiting to use the phone while I filed my report and I passed him in my car hitch-hiking on my drive back to the station. He waved.

I stayed in radio for ten years - hosting talk shows, producing radio documentaries, on the beat and on the air. For the first couple of years away from it, I missed it terribly and dreamed of going back but it wasn't to be. The radio landscape has contracted since then and I don't suspect the same opportunities exist today that I enjoyed back then. Still there is something magical about the radio that will never be replicated in any other medium. Close your eyes and listen.

He Ain't Heavy...

I was very little when my brother Murray left our home for the special school in Portage la Prairie, Manitoba. My mom remembers that as he was being loaded into the car I told him, tearfully, "Nobody loves you Murray, but I do". Gut-wrenching to me, even now. It was not unusual back then for children with developmental disabilities like Down's Syndrome to be institutionalized and for my mom, having lost her husband and then her own mother to cancer, with two other children to care for and struggling to maintain her job as a nurse to support us, it seemed like the right if not the only choice.

I was probably as close to my baby brother as one could be and I suppose we bonded even more when our older sister Karen went off to kindergarten. So while I fight to remember my father's passing I have no difficulty vividly recalling the day Murray left. As confounding and upsetting as it was for me, I cannot begin to describe how it shattered my mom and after everything she had suffered, I have often wondered how she lived through it. Nothing that I am going through or have ever gone through comes close to what she had to endure. Over the years I know she experienced tremendous guilt over this decision which was magnified when we left Manitoba after she remarried. As for me, I often dreamed of rescuing him...we would live together forever and I would make sure he would never be vulnerable or alone. It was a lovely little dream.

And yet, somehow for Murray fate was kind. He bonded with his music teacher at his new school to such a degree that the teacher, his wife and children took Murray into their own home and he became a very treasured member of their family and remains close to them to this day. He lives now in a group home in Winnipeg, has a job and a daily routine that includes "reading" the paper each morning and fastidiously ensuring the coffee mugs are washed and put precisely where they are supposed to be. He has attained a level of independence that I think we all realize would likely never have been achieved had he remained with us...our forever baby...our precious wee boy.

Dear Shae Alosius Montgomery Greenfield

I have it on good authority that the following letter has just been received at your Mayor's office:

Dear Rob Ford,

On behalf of my client, a Somali drug lord (name withheld upon request) I am writing to inform you we quit. Our little joke with the video that may or may not exist, has come to an end. My client notes the human carnage in your office is becoming an embarrassment, even by Somali drug lord standards.  While he recognizes you informed the assembled media horde today that everything was "fine", he notes a slight twinge of hysteria in your voice which is not uncommon in his profession. As he also hails from a dysfunctional family, he has sympathy for your plight and notes (if he can be candid) your brother is doing you no favours and you should think seriously about whether anyone in the football community might better speak on your behalf. As your long-time friend and a member of an ethnic minority he understands the power of prejudice against those elected to be mavericks and defenders against the Toronto elite. The video that may or may not exist has been destroyed and you can carry on doing the people's business safe in the knowledge he has not forgotten where he put the other copies. Sincerely, Thomas J Maggot, Esquire.

Iguanas and the Sands of Time

When I first met Kirk, my partner of almost 15 years, we were down at the beach drinking coffee and watching the waves go by when a man wandered into view with his pet. This would not be unusual, except in this case the pet in question was an iguana. Cue a group of Japanese students, who giggling nervously came upon this sight and out came the cameras as they took endless photos while declining all offers of actually touching said lizard (more giggling). For months, maybe years, we would refer to this moment and at one point he bought me a stuffed iguana for Christmas. Ha Ha. I think of this memory because his daughter Miranda reminded me today that I was 33 then, which happens to be the age she is turning on her birthday in June. When I think about Miranda, it is hard to believe I could have been her age, when Kirk came into my life. She seems so young, and I thought of myself as so very old at that age.

It was a huge leap of faith on both our parts for Kirk and I to choose to share our lives, both being wounded in various ways and not inclined to trust. The prospect of actually moving in with someone, particularly someone with a teenage daughter still at home, was daunting for me on so many levels, not the least of which was the fact I would be sharing a small space with two people who did not know about my other life. Having Miranda and Kirk's son Aaron become a part of my family was something I never anticipated, nor did I ever imagine how much I would care about them, worry about them, feel joy when they were happy and gutted when they were worried or sad. Now the gap between our ages doesn't seem so large and Aaron has two little else boys of his own. Time marches on and our lives are somehow fused together in all of the ways a shared history brings.

Of all of the people in my life, there is no one who has had a more difficult few months than Kirk. He has no escape from it - from me - and I know the future that lies ahead weighs heavily - a far different future than the one we anticipated. He didn't sign up for this, nor any of the other revelations about my life that were revealed after it was too late to turn back. We have had many amazing moments, mixed with more difficult times and there were even times when we thought it might be easier to go our separate ways, coming very close to that breaking point. More than anything now, I am grateful I am not alone and while I wish I could spare Kirk the pain that comes along with this, we are the sum of all of our history and we can try to be strong for one another even when we can't be strong for ourselves.

Dear Shae Alosius Montgomery Greenfield

Apparently there is a marathon taking place in Stephen Harper's neighbourhood today. The sound of all those running feet must be disturbing to him and remind him too much of fleeing senators. But his wife is trying to remain supportive and cheer on the sweaty, less important people thundering by their mansion. She's gone all out, making a sign to inspire the passing herd. Oh, Canada. http://ow.ly/lpl5U

"Fun" With Numbers

Since my journey with kidney disease started, It feels like I've had more needles than a heroin addict. In the hospital it was a daily event, that switched to weekly when I went home. Tracking the delicate balance of levels in the blood that nature generally takes care of, but in my case tends to produce a series of red flags. Vaulting into the electronic age, I realized I didn't have to wait for a doctor's call, I could read these juicy reports myself on-line in real time. In all of my years at the Ministry of Health talking about the advent of electronic health records, now was the opportunity to experience this first hand. This development is both a blessing and a curse. While I suppose it is nice to know how things are progressing, it is also a depressing read and it is hard to look at it with anything akin to clinical detachment. Sadly at this point my reports show about half of the numbers on the page outside of the "normal" range - some by a long shot. No number fills me with more than anxiety than my "GFR" - the number that estimates your current kidney function. In a woman my age it would normally be in the 85-90 range. As of yesterday the number was 12 and because it is calculated based on averages, the specialist estimates that given my size it is likely a few points lower. The challenge is last week's report said 13 and so did the report before it. Intellectually I know it has stayed reasonably consistent for the past two months - and I shouldn't read too much into it and yet - a part of me can't help but do just that. I wonder when the gaps between testing stretch to a month - what that waiting will mean, where my mind will go and whether it will be better or worse to wait another 30 days before learning where things stand. They say knowledge is power - sometimes I'm not so sure.

Dear Shae Alosius Mongomery Greenfield

Well wee dumpling, a big day today as I finally got to see our Prime Minister's holiday snaps from Lima, Peru! It was just as exciting as you can imagine and he captured the very essence of the country - if it consists of military parades, hand-shaking and sitting in boardrooms looking earnest - I truly felt like I had been there myself! It was brave of him to take a trip courtesy of the taxpayers - when that kerfuffle about travel expenses hangs over the Upper Chamber! It sends a strong message - like anything they can do, I can do better - or suck it up, buttercup, I have a majority!
http://ow.ly/loxpl

Mr. Music Please!

I grew up in the age of the record player and finicky needles with pennies taped on to them to get the weight just right. I spent my weekends at Sam the Music Man, rifling through albums and 45's - coming home with a prized purchase and escaping to my room to play my favourites over and over again. When I was in grade four, our class was given the equivalent of a musical aptitude test - to determine, one supposes, who was tone deaf and who might display a modicum of talent to land in the school band. I knew I had an advantage as I'd already suffered through several years of piano lessons so I wasn't a complete novice. The result was exactly what I long suspected - I was some kind of musical genius, according to the teacher - some muse of the metronome, able to keep basic time and recognize a tune when I heard it. Understandably I was over-joyed that finally my talents were being recognized. Until I learned that my prize was being assigned the French Horn. That bulky, impossible swirl of metal that involved all kinds of complexities of hand placement and breath - that with the right master can sound like the angels from heaven and in my clumsy paws sounded like a car accident. While all the other girls seemed to be given the more feminine clarinet or flute...with a few trumpets thrown in for good measure, for some mystifying reason - I was rewarded with this monstrosity - that could not possibly be shoved in my locker on the weekend - but would have to be lugged in one mittened hand, with the other arm burdened by binders of homework - across the snowy field to my house. I loathed it to such a degree that I would do anything to "forget" it in the band room, thus leaving my weekend free to ignore it without the arm strain I normally experienced. In the end, reminiscent of a long history of quitting things I didn't care for including my one-day experiment as a Brownie, I let it go. I tried to move on to the flute momentarily, but it gave me a headache and that was the end of my illusions of a life on the stage - the death of yet another less than gifted musician.

A Very Public Un-Doing

What is the point of it? Dredging up ghosts, hanging them on the line in public - what possible purpose does it serve? To be honest, I didn't intend to go this far, to a place that stops feeling brave and twists into something less palatable, a peep show of misery that most people would store firmly behind closed doors. So why? I could stop this now and all it would be are a collection of titillating tidbits, fodder for gossip and speculation I would leave behind as a sign to people who know nothing about me that I was nothing more than a series of mistakes, bad judgement and perhaps, rotten luck. Of  course that is not the sum of my life. But if I'm not willing to be unflinchingly honest - if I can't describe how someone who seemingly had so many advantages, a good job she was lucky to have, people who loved and supported her - could land in this place now, then there really is no point. I am more than a label, a textbook definition of an illness, a case study of characteristics that are easily dismissed. On some level I am compelled to explain there were reasons why this transpired. Self-indulgence? Pity? I could spare you the gory details and take them with me when I go - spare my family from revelations that cause them pain - and perhaps you think I should. I could tell you to look away - stop reading these words - this uncomfortable unburdening that takes me places I too would prefer to leave behind. But that is the point, they never did go away and the more I tried to keep them in the more they literally ate me alive. I need to write because it is the only way for me to control the story, to say there was more to this than this flawed surface might suggest. I write to let the ghosts go...

A Message to my 16-year-old Self

Dear Michelle - this may be among the hardest truths to face. The summer when you were 15, you tell your mom you are going to a sleep-over at your best friend's house - but you know that is a lie. Instead you accompany her (she being your beautiful friend - who models in Vancouver from time to time) to the home of an older hockey player you are a wee bit in awe of, who's parents are away. You know you were invited only because you are bringing that friend with you and you are a raw bundle of self-hate and insecurity and so when you get there - you start drinking almost immediately. You are not a drinker and combined with the food that is not in your stomach (you starved yourself all day hoping to be stick-thin by the evening - it didn't work) you don't handle it well, not well at all. So when one of the boys marches you stumbling down the hall, where you pass out in someone's room - well you know what comes next. And in the early morning you wake up sick and sore, knowing what has happened and desperate to get out. You stumble home where you plaster a smile on your face and avoiding your mom's eyes tell her you had a nice time. The end of the story. You will speak of it to no one but you will decide in that moment it is time to disappear and by the next summer you will have launched that quest in earnest. You will not in any way fathom the consequences of that choice. How it split you in two...and how all of this truth would sink further and further into the abyss while your days of punishing yourself for that mistake...and so many others, would begin. Until at some point you will almost forget how it came to this - one bad choice after another - so many reasons to keep going until the reasons almost don't matter any more. It is so much a part of you that it has overtaken all of the reasons why. That weak, sorry girl who couldn't say no.

To Joke or Not To Joke

So if you think it hasn't escaped my razor-sharp grasp, you might wonder how I can alternatively be pouring my heart out about my eating disorder and denial issues, while poking fun at the saga facing Toronto's mayor - who may or may not be facing some denial of his own - believe me, I get it. Yes, it does seem incongruous for me to respond to this story with anything less than compassion. I guess it is because it is ingrained in my nature to make a joke - and it is distant enough from me that I suppose I feel I have license to do it. Perhaps this speaks to the fact that as a society we are very uncomfortable with seeing someone's demons play out in the public domain, particularly when those demons so closely resemble our own or someone we love. Then it is not so funny - not so funny at all. Something for me to ponder...

Dear Shae Alosius Montgomery Greenfield

Please note the following job opportunity conveniently located in downtown Toronto!

Wanted: One chief of staff. Position reports to an innovative maverick with an international reputation. If you want adventure and a new challenge every hour of the day, this job is for you! Learn new skills, like dodging cameras and planning parties for teenage athletes while building your reputation as a strategic forward-thinker. Must be comfortable in back stairwells, have a passion for football and be skeptical of rehabilitation of any kind. Those who don't appreciate the ease with which videos can be manipulated need not apply. Salary commensurate on ability to enable bad behaviour and avoid the obvious.

Apply - you can't af'FORD not to!

A Perpetual State of Good-bye

I find myself in a strange limbo - on the one hand hearing the ticking of an expiration clock continually in my head and on the other knowing this state could, optimistically, last for years. So every communication seems to carry a weight of significance and emotional pull - that is sometimes exhausting. In some ways it is like the slate of all of your sins and misdemeanours has been wiped clean and that very imperfect person you were and are is shrouded in a new cloak - and I find it hard to recognize who that person might be.

As much as I know other people are struggling with this new reality, I too am tempted by a running commentary that goes something like - if this is the last contact I have with this person how can I possibly convey my respect and affection or how sorry I am for every hurt I have caused. Every outing has to be filled with meaning and I need to find a place that feels like normal...find a way to walk in these new shoes. Fortunately, Samuel and Daisy find no such dilemma. They continue to love me and occasionally shun me - as they always have done. Dogs always get it right.

The Privilege of Public Service

It has been almost a year since I quit my job as director of communications with the Ministry of Health. It was a watershed moment, walking away from a job that for many years I had confused with my life. It was said that the job was 24/7 and I took that message seriously. You see, health care doesn't stop on the weekends - and more often than not I was chained (by my own choice) from the minute I awoke to late at night to the hundreds of emails and phone calls I'd receive every day describing a myriad of issues, mistakes and tragic patient stories. Pharmaceutical negotiations, labour issues, the black hole of senior's care, SARS and H1N1, excessive wait times, medical errors, and families who in their grief or guilt about the loss of a loved one would lash out at the system when there was no one left to blame - a complex system in which every occurrence seemed to be painted in black and white. A ministry that consumes about half of all government spending, where the needs are endless and the voices of the interest groups and naysayers drown out the vast majority of encounters where the system actually works. I recently listened to two of my former Ministers almost in unison declare on a cable program what a "grind" the health portfolio was - and I listened with particular sympathy. And yet, I was privileged in so many ways to be a part of that world and with the gift of hindsight understand with a new clarity how fortunate I was to have people, right up to the end, place their trust in me - and as a patient myself, have a new appreciation for the system I was a part of for so many years. I worked with some incredible, dynamic and passionate people, Ministers and their staff, executives, health authority leaders - no more so than in my own communications shop - where I was spoiled by a group of creative, funny and caring individuals who still remain in touch - and continue to exemplify public service in the best possible ways. However, I also spent a great deal of time and energy on the inside, railing against the system and challenging policy decisions that in retrospect were better left alone. More significantly, I used it as an excuse to ignore what was going on with my own health - which might explain how in the six years that elapsed between doctor visits, my kidneys went from functioning to almost dead. People say I was passionate about my job and that was true - but that can also be a kinder way of saying strident - and I know there were many moments where I crossed the line. Still being part of it - particularly in moments like the SARS crisis - when an entire system mobilized against an unknown enemy against a backdrop of incredible fear and uncertainty - is a privilege I will never forget. In part, this is why I am so conflicted over my own patient journey and why I believe in my heart pouring resources into people like me is not the answer - not because my life doesn't have value but because I know as with any chronic disease the best opportunity for healing - or at a minimum, a better outcome - comes at the beginning, not the end of the road.

My Hair: A History

Face it, one of the most distinctive things about me for better or worse is my hair. Like everything else about myself that I wanted to control, fix, change - those stubborn follicles refused to become the long and flowing or naturally curly masterpieces I saw in magazines. At some point I decided it had to be distinctive, had to express something that I could not verbalize - as mad as that may seem. Go to any salon and you will find young girls clutching pictures ripped from the pages of People or Vogue hoping in vain that they will be transformed - and I don't just mean their hair - I mean they truly want to walk out the door two hours later with a narrower face...a foot more or less in height, longer lashes, strutting like Beyonce with new-found confidence. I want to cry out to them, "Your stylist is not a wizard!" but I know it would be to no avail. The stylist will sigh when they see these crumpled and hopeless aspirations pulled out of an eager hand, and may gently suggest that Rihanna's hair extensions might not be possible. Even when they agree that with Picasso-like creativity they can duplicate the look on the shivering 12 year old sitting before them, you know at the end of the exercise that same young girl will stare in the mirror in dismay and realize she is no different than when she walked in (only now her hair is too short, she knows it). And so I offer a glimpse at my own journey.
The Bowl Cut: When I was little, haircuts were courtesy of my mother, who has many talents - but cutting hair would not be one of them. In every picture tufts of uneven bangs mock me. She explained that while my sister was allowed to have long hair, I looked "cute" with it short. I did not share that sentiment and on more than one occasion was greeted by "hello, little boy".
The Perm Years: Few pictures remain from this dark period that coincided with high school which was unfortunate. For hours I would sit with that foul-smelling solution on my head in an effort to attain the effortless curly locks that would somehow make me beautiful. When I emerged, my mom would try to cheer me up by saying it would look better in a few days. It never did.
Fun with Colour: Name a colour and I have tried it - anything to escape my natural born colour, mouse-brown.  This included several efforts to do it myself - only to be shipped to a salon for an emergency correction where the sighing stylist would strip the goth black from my head (that I was sure from the picture on the box was full of sunny highlights) and start again.
Hair Products - A Revolution: Hairspray, mousse, gel, styling foam...for women like me with poker-straight hair the volume solution had arrived. I could live with the stares and laughter, if it meant my hair would not be plastered to my head like Napoleon.
So if you ever wondered why I look this way, you will forgive me from offering to change at this late date. Like Popeye before me, "I am what I am".

Too Much Information?

I wonder sometimes about ripping off these bandages outside of the comfort of a journal's pages. So much of what I have shared represents not only a painful part of my past - but of my family who lived through it. A therapist might label it "attention-seeking behaviour" and perhaps there is a grain of truth in that. While I like to think about my motivation as altruistic, it has consequences for the people I love most. I guess I hope the fact we can share some of this more openly allows us all to let some of the hurt go...and remember that outside of all the trauma, there was and is great and abiding love. In so many ways Pine Falls was a magical place to me, filled with sadness, yes, but also with funny, happier moments - like my extended family's unsuccessful efforts to wean me off my soother and blanket obsession - capped off with my sister screaming "let her have it, let her have it" when someone dared to put the soother out of my reach - like she was tending some crazed junkie. My 1st attempt at a lemonade stand in Pine Falls that ended with three unkempt adults rolling on our grass and a police presence (it was my drunken customers who were responsible...not I...and I should clarify they were drunk before they had the lemonade and were hauled away in a police car). Buttons the kitten who we only recently learned did not run away as we believed (my sister led the long and unsuccessful search party) but was instead driven by my mom's aunt to a farm where presumably she led a happy and much quieter life (the cat, not Aunt Cora). My first confrontation with a lone bag-piper while innocently riding my tricycle - installing a life-long hatred I carry to this day. My Papa's dislike of his neighbour's small dog - which infected me like a virus - leaving me racing away from it's clutches when I would go on my daily visit. My sister at five years old firing Mrs. Dawson - the saintly woman who looked after us (for free) when our mom was at the hospital because she was always a wee bit bossy that way and clearly couldn't leave it up to my mother to manage the hired help. So all these moments and so many others make me smile and I hope Aunt Lynda, if you're reading, make you smile too.

Dear Shae Alosius Montgomery Greenfield

Dear Shae, it appears our Prime Minister has adopted the language of a first-grade teacher in responding to his senate woes, saying he is "not happy" and urging the trouble-makers to "leave the room" (what, no time out???). The fact the chamber of lameduckedness (is that a real word?) has invited its' appointees to behave like game show contestants, deserving of lavish trips and expensive appliances is truly not his fault. Besides, as his disgraced chief of staff pointed out, he didn't know the MEANS through which the cash found its way into Mike Duffy's over-size pockets. It could have been dropped by carrier pigeon for all we know. And I don't blame him for forgetting to mention the names of any of the offenders, as he is a busy man with a lot on his mind. The fact they have been dispatched to sit alone in the political out-house should surely be punishment enough? As a communications expert you should pay attention to this lesson in managing issues by not talking. Fortunately it will not require many notes!

A Message to my Three-Year-Old Self

Dear Michelle...right now you do not know that the man who is holding you tight in that wedding photo...your daddy - whose arms you cry out for in the night (never your mom's)...will be lying in a hospital bed where a doctor will cut his spinal cord when the pain from the cancer ravaging his body can no longer be controlled. He is 30-years old. How he will tell your mom not to bring you and your sister to the hospital any more because he doesn't want to scare you and perhaps, doesn't want you to remember him this way. Your sister, who is older, will remember this last visit...you - try as you might to find the memory - will not. You do not know that your baby brother, Murray, has been diagnosed with Down's Syndrome - and that when your mother heard those words in the doctor's office was afraid she would drop the baby. You also have no suspicion that Murray, whose wee body you would drag to the middle of the living room when he would press his nose against the screen of the television, will be sent away to a "special school" and you will only see him a handful of times in your adult life. You don't know that your Mother, having lost her husband, and with three little ones to look after, will go back to work as a nurse, but will need to curtail her hours when her middle child (you) suddenly starts wetting the bed repeatedly. You don't know your Nana, your father's mom, who lives a short tricycle ride away from your house in Pine Falls, Manitoba, will destroy almost every picture of your dad, because she can't stand the pain of losing her baby boy. You don't know that you will leave Pine Falls, and your treasured Nana and Papa, your beloved Uncle Bob and Aunt Lynda, your cousins - Stacy and Tim - and move to British Columbia when you mom gets remarried and that whole chapter of your life will all but close. You do not know these things...but they will shape so much of your adult life.

The 5th Season - Cruise Ship

And so it begins, the months of confused American tourists traipsing confused and with a hint of fear past our driveway searching elusively for something resembling downtown. Small and large groups dressed completely inappropriately for the weather, with their parkas in one hand and clutching their purses tight to their body in the other, ambling away from the mother-ship and wondering what the buffet might behold on their return. While I will go out of my way to avoid them, my partner, Kirk - while walking our dogs - often engages them in conversation to discover they are from places like South Carolina and Texas, bewildered that things like home ownership exist on our socialist shores. He patiently directs them on the path to something resembling an American retail outlet and has even accompanied several of them well past our street when the directions just don't seem enough. Needless to say the community of folk who choose cruise-ship travel, hardly sturdy Magellan-types in search of brave new worlds, are more apt to sigh deeply upon learning the walk to downtown could take 15 minutes OR MORE and look longingly back at their floating virus-trap, contemplating whether to carry on or catch the karaoke back on board. Studying them and their habits has become like my summer job - who will trip and curse the faulty Canadian infrastructure? Who will gaze upon the houses and declare them unfit by Dallas standards? Who will loudly condemn the wind as if it has blown in their path just to smite them? How many ants will die under their clumsy American feet? Summer is truly here.

Sometimes I Forget...

For minutes, even hours, that the reason I started this is because my kidneys are failing. My mind doesn't dwell on every twinge in my body and think "Is this a symptom?", is this the beginning of the end? Kidney disease, it would appear, is deceptive. Because there is no real pain, and the only symptom I felt was a period when I was terribly itchy (phosphorus builds up and your body can't get rid of it) it is even harder to wrap your head around the fact that there is something critically wrong. And according to the specialist (and the literature) it is not a painful way to go - most people start to sleep more, slip into a coma and pass. Once I'd read that, I went through a few weeks when I was afraid to close my eyes (for obvious reasons) and when I did fall asleep - would wake with a start every couple hours just to reassure myself that I was still here. While that has eased somewhat, I still understandably wonder when...will I be one of those patients who hangs on for five or six years with no treatment - or will I last through the summer? Questions no one can help me answer. For now my kidney function is said to be around 10 per cent. As the specialist says, if we see it go down by one point a month - we can make an educated guess. Indeed, even I - not a wizard in math - can make that calculation! So I try to distract myself which I suppose is a long way of explaining why writing has become so important - why I feel the need to explain how I got here and to translate some of what I am feeling into words. What I have been given as a result of this exercise, has been nothing short of miraculous. Deep connections with people that a few short months ago I could never have imagined would occur. So I will take the uncertainty, if it means I have some time to learn from this and to wrap my arm - figuratively or otherwise - around someone else who is suffering or has suffered. I will kiss my dogs and hug my partner and smell the flowers in the garden and write like my life depends on it.

A Dweller in the Land of Books...

I confess that when I was little I wanted to be one of two characters, Pippi Longstocking or Harriet the Spy. There were many strikes against these ambitions as I didn't own a monkey (though one of our neighbours had one - it wore diapers and had a bad temper) didn't have shocking red hair, my own house, or in Harriet's case a series of mysterious circumstances to investigate - though I did spend a great deal of time wandering through the school playground staring down at gum wrappers and looking for clues. Books, from my earliest memory have been my joy, my escape and my salvation. I have never been a traveller but I could go anywhere and be anyone in my imagination. Even now...there are treasured favourites I return to again and again when I need to find a place of comfort and certain authors who have made me forget - for hours at a time - any petty worries that confounded me. Anything by Kate Atkinson. Gerald Durrell, Sue Townsend, Alice Munro...give me five minutes with any one of the complete series of Adrian Mole and I am rolling on the floor. Human Croquet, a Kate Atkinson masterpiece, has some of the funniest and most poignant moments in any book I have ever read. So here is to books - and the gentle souls who find solace in their pages.

Dear Shae Alosius Montgomery Greenfield

Rihanna quote of the day..."B____es (rhymes with witches) be like...Get away from my BFF". This is why she is a role model, presumably. In other news, the Prime Minister's chief of staff resigned for stuffing $90 thousand in Mike Duffy's pockets for inappropriate housing expenses. Apparently he did this "in the public interest" which is understandable because I personally was worried sick about how Duffy would manage.

What Doesn't Kill You Makes You Stronger?

So the flood-gates have opened and what has emerged is a river of stories that I can only describe as revelatory from both men and women - people I thought I knew well and many I didn't - who have shared that on some level, my struggles have struck some chord within them. In private messages and emails, so many have come forward to send their support - but also to share their own truth about their struggles with body image, or that of someone they love, in confidences so intimate that I find it hard to breathe through it. From the beginning of my journey, as every birthday passed, I would foolishly pray for rock bottom - because I earnestly believed when that magic moment would come I would miraculously have the will to get better. Well I have found that place and while I may not be healed - something transformative is happening...truth begets truth...the masks are coming off and with every confession, every story, I am learning. We are all a collection of our stories and insecurities, our childhood hurts and the bodies that intersected with ours at some point on the road. The voices that destroyed us and those that lifted us up, scarred and scared on the inside and walking though the world as if none of this damage exists. We are the walking wounded...but still putting one foot in front of the other. Here's to us...

Dear Shae Alosius Montgomery Greenfield

So I understand you are in Calgary. From my research, it appears to be rainy there so I hope you brought the appropriate attire - slicker, rain boots, and of course, a large hat to protect your hair, I mean, head! (To fit in with the locals I believe this means a cowboy hat - but then again, I suspect this may not be the custom at all times of year.) You may run into an actual farmer there, as I understand they do take to the city from time to time for provisions and whatnot. If you do, don't hesitate to say "Howdy!" then comment on the weather. These small courtesies will be welcomed, I can assure you. Also, if you happen to run into a disgraced senator (or mayor) avert your eyes while shaking your head slightly. They will know immediately what this gesture implies. If they ask you for money, remember they have no self-control and will likely only throw it away on swanky condos in Toronto. Cheers, my dumpling!

When the Genie has Left the Bottle

So it is the day after my disclosure - and here another slice of truth. Several reporters have contacted me and kindly offered to "tell my story". I honestly did not contemplate this response - though as a former reporter and communications person - I perhaps should not be surprised. I have responded that for now I need to let my written words speak for me as I am simply too shaken to contemplate exposing myself any more than I already have (which I know is a lot!) They were incredibly kind and understanding which I appreciate more than they know. I may feel differently someday - but it was never my intent to malign the system or the professionals who work to support those with eating disorders every day - as the bulk of my interactions were long ago. Nor to draw attention to myself or be a poster child for the afflicted - though my compassion for anyone living with this knows no bounds. And before letting myself off the hook, I will share with you that my very first thought when TV was mentioned was that I wasn't thin enough - and maybe I should lose a few pounds - consider that an insight into the way this disease works. (And if you don't think that is legitimate - I remember reviewing a news story about an eating disorder patient when I worked in the Ministry of Health and the response of several of my colleagues to the patient profiled was "she doesn't look that sick" - and sadly I suspect I agreed - implying that had her bones been protruding through her clothes she would have earned our sympathy.) After decades trying to keep this secret - I need some time to sort out how I go forward. For now I continue to be grateful for everyone who has been in touch.

Not a Walk in the Snow

After his failed bid at provincial politics, a reflective Samuel L. Jackson (the dog, not the actor) rejects a 'walk in the snow' and instead chooses to quietly ponder where he went wrong and whether he will bow to the naysayers (primarily his sister, Miss Daisy) and resign.

Dear Shae Alosius Montgomery Greenfield

Hmmm, just when you thought you'd escaped wacky left coast politics, your illustrious mayor has allegedly switched from racing through parking lots writing Haikus with fridge magnets on parked cars to cavorting with Somali drug lords in crack dens. As your deputy mayor has sagely pointed out "drug dealers can not be trusted". (We might not have known this otherwise!) Meantime, Rob Ford himself has taken to Twitter and encouraged his subjects to escape to Toronto Island for a picnic this long weekend (presumably so he can be left in peace with his crack pipe). I'd suggest you not follow his example while in Toronto!

This is a love letter...

...to everyone - friends, family and those I have not met - who reached out to me today to send their support, their love or reassurance about my decision to share my story. As I have said, every word you wrote helped take a bit of the shame away and for that I am eternally grateful. But more than this, to the many people who wrote privately to share their own pain and struggles with eating disorders or the struggles of someone they love - I thank you for the gift of your honesty and your generosity in disclosing such personal anguish. For as much as I have struggled, for my family and the people who are close to me, this journey has cost them dearly - in so many ways. Many have described me today as "brave" and I have to say that is the last word I would use to describe myself...for it was cowardice, fear of facing the world in my own skin and incredible self-loathing that brought me here. More than anything, I am a cautionary tale - the embodiment of the real consequences of this abuse and how the weight of your own secrets can slowly drain the life out of your body. Perhaps it is the looming presence of my mortality that filled me with a sense of urgency not to let this pass without confession or maybe just a way of helping you to understand what my family in particular, has had to contend with. If I could spare them just a minute of this, erase every fear, false hope and disappointment, I would in a heartbeat. With love...

Desperately Seeking Skinny

They say the truth shall set you free, so now, borrowing Stephen Colbert, a touch of  'truthiness'. Few who are aware of my failing kidneys, understand how this could have happened - how one could suddenly discover - seemingly out of the blue - that vital organs were shutting down. The truth is that this is the result of a 32 year unrelenting and painful quest to be thin. Anorexic, bulimic - name a label - I've had them all. Words that represent to me profound shame - and worse, a lifetime of lost energy and opportunity that can never be reclaimed. In an ironic twist, "managing" issues related to adults with chronic eating disorders was one of my responsibilities as communications director with the Ministry of Health - where I would staunchly defend what little is offered to support those struggling individuals - never letting on, I was one myself. In the beginning long ago, age 16, I was referred to the leading "expert" at BC Children's Hospital who suggested that if I had sex it would get better. (He was later driven out of the profession.) This began a cycle of unsuccessful efforts to be rid of it, while living, in essence, a double life. This included time as an in-patient at St. Paul's where I escaped from days of force-feeding to emerge bruised and bloated, worse than before. Every few years, the threshold of what I would allow myself to weigh would drop a little lower, and the denial a little deeper. In the meantime, any reference to my size would leave me anxious and panicked - if the scale read one pound heavier at the end of the day, I would be scheming on how to get rid of it the next. So now, the day of reckoning has come. Years of chronic dehydration and potassium imbalance have left my kidneys little more than scar tissue. There is no one to blame - not the system - certainly not my family who have painfully watched this unfold...nor the many doctors who tried to help. I am not a victim, but I do have an illness, one that over-rides my kidney woes by one thousand fold. And the truth is - this is why I am actually not a credible candidate for transplant - nor would dialysis have a legitimate shot at success. Well-meaning people in my life have suggested I should buck up and fight it...and to them I gently say, I have been fighting my body for decades now and I am beyond tired. I know what I am, where I stand and if I choose not to pretend that what I couldn't overcome before, will miraculously disappear now - then so be it. I worry in sharing this so publicly, how your image of me will change, how I will be judged, how my terrible weakness will be exposed. I could keep this to myself and perhaps no one would be the wiser - though I know many have suspected. I guess it is because people continue to suggest I have options that just don't exist.

Tales from my Grade Two Notebook

February 22, 1974

Checkers

I like the game checkers. I think it is very fun. I play checkers with my dad. I like the game checkers because it is a very fun game. (?? Seriously upping the word count with that last line) It takes a lot of thinking. You have to make the right move at the right time. Sometimes the wrong move changes the game completely! (Earth to Adrian Dix?) I don't care if I lose or win, because it's only a game. Anyone who doesn't have a game of checkers should get one!

Postscript: Note the subtle political overtones, still relevant today. Also, this marks the start of my life-long love of exclamation points - which still burns in me today. (!!!!!)

Stereotype Much?

In a blog post in the Sun on costly Vancouver condo prices, Fazil Mihlar writes: 'The City of Vancouver is the "pretty, tall blonde" with a bad attitude who thinks she can get away with being pouty, demanding and carrying on with her expensive habits.' He says buyers are instead opting for the "pretty brunette in Surrey" or the "lovely redhead in Burnaby". Why not the leprous goth girl in Langley? Good Lord, what century are we in?

A meeting with the specialist...

I have two of the world's greatest doctors. My family doctor, on learning my news, sat with me in her office and cried along with me...I would suspect sadly that is not a typical response. She cares for me in ways that are about so much more than body parts and test results - and her connection to me is one of the things I treasure most. So on the morning I learned my kidneys were failing and found myself an hour later admitted to hospital and waiting to meet the specialist - I was more than a little fearful about what I would find. Fortunately, it was love at first sight. Not only is he considered the "best" in his field, but he is warm and funny, and has never shied from telling me directly what I need to hear, whether I like it or not. Although he admits he struggles with my stance of seeking only "conservative measures" (code for no intervention) he told me yesterday he's had patients with numbers as low as mine, who have carried on for five or six years - not feeling the best, mind you, but not feeling horrible and sick. We both know that may not be my story...but for today it gives me a little bit of light where there was none. I don't know what fate brought these two people into my life...but for today let me say I could not be more grateful.

Think I just saw a pig fly by...

I'm no expert, but here is what I've learned from the upset of the ages, dear reader. Let's face it, maybe three British Columbians in total imagined a Liberal majority of this magnitude. Even the Liberals were avoiding their election night party until it dawned on them mid evening there was a reason to celebrate!
1. Messaging counts! Let's put it this way - if I offered you two kind of ice-cream and called them "Secure Tomorrow" and "Practical Steps", which would you choose? Since when is "practical" even a selling point? We live in a world where the majority of TV viewers pick reality shows - they want improbable outcomes where straining yokels grab the gold against all odds. They want "possible" not "practical".
2. Style and smiles trumps book-readin'. By the end of the campaign I'd seen more than a dozen references to Dix's penchant for books as if we lived in some dark age where we suspiciously eyed readers like they were goblin-people trying to infect our minds with "thoughts". Leave War and Peace on the bus - and go play hockey.
3. Half of us just don't care. No matter how you slice it, half of eligible voters sat on their hands. The Canucks are out of the play-offs, so that isn't an excuse. Precisely what was more important? (And if you stayed home because you don't like anybody, that's no excuse. I don't like anybody either and I still voted!)
4. Waffling makes it worse. No question, Dix made a fatal error when he turned a reasonable position on Kinder-Morgan to an unreasonable one mid-campaign. You could feel the collective air sucked out of his momentum.
5. Politics is no place for a positive campaign. When someone is going for your jugular, standing there with a flower in your hair and reciting the Koran will not help you.
6. Social media is a game changer. Pollsters and pundits spent the last four weeks saying social media was irrelevant. Well the landslide is directly in line with Twitter output and Facebook likes. We only need 140 characters and an Instagram to know how much we love you.

Get set for...celebrity news!

In celebrity news we don't care about today, Kanye West's 750,000 car crashed into Kim Kardashian's security gate. This is not a metaphor. That is all.

Dear Shae Alosius Montgomery Greenfield...

The Horror! Candidate Samuel L. Jackson has had his beauty treatment mysteriously postponed until 6 o'clock this evening. Conspiracy? I think so!!! This RUINS our planned photo opp at the voting station as he is clearly not camera-ready. Who is behind this travesty? Time to name names!

Don't Stop Believin'...

From rampaging bulls to Gordon Wilson, with a pinch of embittered Martyn Brown; spinning weather-vanes and age-dependent apologies...and let's not forget 50 shades of Hamish...feel like I'm getting off an unpleasantly wild ride. Party politics have always left me cold but today I will cast my wee ballot for a candidate who is above all else...a good person. Call me crazy, but I think that counts. In my daily missives to the departed (departed as in, in Toronto!) Shae Alosius Montgomery Greenfield I have mocked the parties and their leaders mercilessly - because as my mother always said, if you didn't laugh, you'd cry. Yet I will always respect the fervency of belief  that drives my friends on all sides of the spectrum who have given every ounce of energy to this campaign. I salute you and send you love....

When you're dying and you know it...

Clapping hands just somehow doesn't seem appropriate. It has been about six weeks since my world started turning in a different direction with the news that I have end stage renal disease. I am still processing what this means - at times numb; resigned; overwhelmed; and horribly sad. Even the moments of happiness are tinged with the stain of a gnawing awareness that there will be an end to this...a struggle to find meaning in any of it, that just won't come. I veer from wanting to hide under the covers to desperately reaching out - to share love, a funny story, a smile. Of course, we know we are mortal and that this ride doesn't last forever...but let me just say it becomes a new shade of real when a doctor sits at his desk and reminds you that you haven't asked him how long you have. (Answer: Months, a year...he can not say...) There is no cure - of course there are options - not a cure mind you, but options. Dialysis, transplants...one could give one's body over to a desperate and expensive bid to hang on...for months... years. Fighting the infections, side effects, drugs...until the moment when they just don't work anymore. While in the hospital, late at night, a nurse who knew I was struggling with an I.V. asked me gently whether I knew I could say "no". The concept was revelatory...I could choose, I had power in a powerless situation. So I told them to take it out and I understood in that moment no matter what comes next...nothing will happen unless I choose it. For now I choose to be here...and that is enough.

Change for the Better?

So it is election eve, which is like Christmas Eve - only with less tinsel and more nail-biting. Miss Daisy has gone to the groomers to ensure she is "camera-ready" while Samuel will wait until tomorrow morning for his makeover. What will tomorrow bring?

This is the sound of one voice...

After much hawing and hemming, I have decided to commit my intermittent musings to an actual blog as it is: 1) better than a real job and 2) the hours are convenient. From time to time I will be aided by Samuel L. Jackson (the dog, not the actor) and Miss Daisy (also a dog) who are keen observers of life's indignations.