Thursday, November 24, 2016

Reap What We Sow

Happy to have an essay, part of my MFA thesis, published at intima: a journal of narrative medicine.

Amid flowers and the smell of fresh dirt in Lowes’ garden department, my pager vibrates: a stat call from the labor room. Pat and I had been picking annuals for our yard; with its partial sun and dense shade Impatiens grow best. I’m partial to multicolored, but this year it’s her turn to pick and she’s opted for solid red. As she loads the crimson flats onto our cart, I step a few feet away to call Wafia, my family medicine resident. She trips over her words trying to tell me everything at once. A fifteen-year-old pregnant patient, let’s call her Casey, has broken her water and come to the hospital in active labor and… I don’t need Wafia to say much more, because I hear the nurse yell in the background, “Heart tones down in the 60’s. Get in here!”

I signal Pat we have to go with a sideways jerk of my head. She quickly slides the young plants back onto the shelf. Wafia tells me Dr. Dillon is the obstetrician on back-up call, and the nurse is paging him now. He lives close to the hospital and I’m half-hour away. “Great,” I say. “I’ll get there as soon as I can.” 

to continue reading, here's the link:

Monday, September 9, 2013

A Nudge for Marriage Equality

Meeting with Rich Fitzgerald, Chief Executive, Allegheny County
 September 9, 2013:

     While not exactly a win (he won't yet issue marriage licenses to same sex couples), it was not a loss. He is very open to helping us. We will meet again in a few weeks, and in the meantime, Sam Hens Greco will be working with his legal team. 

     Eight people spoke at the meeting. We covered the hits we take on homeownership, retirement, healthcare, and pensions. One women, not yet married, is pregnant, due any day, and rightfully worried about her family’s financial security. 

     Another man, who was recently married by Braddock’s mayor, Fetterman, said everyone asks why get married here in PA, where it is not yet “legal” (and so he risks his federal benefits). He likened it to the scene in Rudy where the team captain lays his jersey down on the coach’s desk for Rudy’s right to play in a game, and then others do the same, and Rudy gets to play and it means everything to him… At that point, Pat offered to give Rich Fitzgerald a jersey to lie on top of the Supreme Court's jersey, and Bruce Hanes’ jersey. Everyone laughed; it was a great moment. 

     When it was my turn, I tried to talk about the heart of the matter. Even brought family photos. Here's what i said:

Thank you very much for hearing us today. As you know, my partner Pat and I had plans to go to Montgomery County for a marriage license, but cancelled our reservation when we found out you were considering issuing them.

By way of introduction, I am a family doctor. I teach at Forbes Residency in Monroeville, I see patients at Metro, in Wilkinsburg, and I am the director of the Midwife Center in the strip. I have lectured about health care issues as they relate to LGBT community for many years. Evidence shows, and both my Academy and the American Academy of Pediatrics agree a two-parent household is best. This need not be mother and father; it is loving parents that make it work. Improving the structural integrity of the family helps children. Legal marriage builds structural integrity.

I’m also a mother, and a grandmother (here are some family photos). As you can see, my son and my granddaughter benefit from two large, loving families—Pat’s and mine. The black and white photo was from when Pat adopted our son Scott. It was 1994, and we were the first couple to do second-parent same-sex adoption in Allegheny County. Thanks to Kathryn and Sam Hens Greco.
"Now he's really ours," Pat's Dad.

I’m 58 years old, I came out in late 70s. To be honest, I am completely amazed at how far we have come in this country on LGBT rights. When I first came out, I was willing to live life on the periphery of society… not that I didn't start to fight it even then. But I knew, and accepted what I was getting into. That said, once the Supreme Court ruled, the last of my internalized homophobia dissipated. Almost overnight, I lost patience and tolerance for anything less than equal rights. That is why I am requesting you to grant Pat and I a marriage license here in Allegheny County.

On some level, it’s comical for Pat and I to think about getting married. It’s true, people our age get married, but generally they are actually “newly wed.” If allowed marry, Pat and I would be far from newlyweds. We’ve been together for 30 years; it’s clear who washes the coffee pot, and who sets it up for the next morning. We already know who loads the dishwasher the right way, and who will do it “wrong” every time. In fact, we probably looked like a bickering old married couple when we heard about the Supreme Court’s ruling on DOMA. We had been out of touch for nearly a week—on a medical service trip in Africa, when we arrived into Dulles airport in DC. As we road the transport bus from our plane to baggage claim, I read the news of DOMA on my iPhone.
           “Listen to this!” I said and began to read aloud.
“Let’s see that,” she leaned in.
As we both struggled to read the fine print, the irritation, fueled by the long flight, came out in her voice, “Don’t hold it like that,” she said. “I can’t read it if you hold it like that…”

It would be cliché to say Pat and I have stuck together through 30 years of thick and thin, and I would love to describe the thick times, as well as the thin times, but time won’t allow for that. Suffice it to say I believe a legal marriage may have helped us along the way, when we were near breaking points. There are couples out there now, teetering on the brink of a break-up. A legal marriage might make the difference.

So, why do I want to marry Pat? It’s simple. I want to make formal that which we have understood all along:  yes, you are my life partner, in thick times and thin, in sickness and health, until death do us part.

Wednesday, July 17, 2013

My Trip to Zambia

Last month I went to Zambia, Africa.* Each day, well, almost each day, I posted a short summary on Facebook. The response was heartening. Once I left Lusaka (for safari ! ), I no longer had even spotty wifi, so I ceased FB postings rather suddenly. Here are my posts, with some follow-up and pictures. Safari pictures follow.

*With Surgicorps International, 
Mission: provide free surgical and medical care  to
disadvantaged individuals in developing countries.

Day 1
      The smell of a wood fire permeated the air the minute I walked out of the airport in Lusaka. As I inhaled the sweet smell, I thought fondly of campfires and Christmas.

“Mmmm, smell that?” I asked a more seasoned traveler as we waited to load our bags and medical supplies onto the bus.

 “This is the third world,” he told me, “cooking and heating with open fire is the norm.”

Day 2
Full day if screening.  Mostly kids. Snake bite scars, or more often, burn scars from fires and cooking oil. We saw congenital anomalies like cleft lips and syndactylies--an abnormal connection between adjacent digits--as well as aggressive scarring. One man had a keloid—scar tissue that heaps up into mounds—the size of a grapefruit hanging off the side of his head. The surgeons, two plastic surgeons and two hand orthopods, plan to repair these skin problems, the majority of which limit function, over the next five days. Our team will basically take over the hospital’s three operating rooms (or theaters, as they’re called here).

Saddest case during screening was that of a six-year-old with ambiguous genitalia. This is caused by congenital adrenal hyperplasia, which comes from disorderly hormones before birth, and is not something our team can fix. When the child was born, the doctors told the mother her child was “both a boy and a girl,” and suggested she “raise it as a boy.” So, that’s what she tried. Her husband left them when the child was six months old. But the mother, god bless her, let the child be who she was. A girl. The community couldn’t accept the change from boy to girl though, so Mother has since had to change villages.

Because the testes are up inside, or undescended, they are more likely to lead to cancer and should come out. There are pediatric urologists coming to Kenya next fall, but this family can't afford to go to Kenya. In addition, the mother knew nothing of hormones her daughter will need. With her testes out, she won’t make testosterone, so her voice won’t fall when she hits puberty, which is good, but to develop breasts, which she’ll want, she’ll need replacement estrogen. Today, all we could offer was information and support, which, I recognize, was huge. Surgicorps will see if/how they can help. They are a really good organization.

(One of the plastic surgeons, Deb Johnson, has since contacted the traveling urology team, and they plan to go to Zambia this fall… good news for that young girl. And a good start on a lifelong problem.)

bandaged bed rails
Day 3
lawnchair--> wheelchair
Great day to be in Africa. We had all three operating rooms running, and the team functioned well. I am amazed how much can get done with so little. The ORs have what they need, and no more. Bed rails don’t always work, and the lights go out intermittently, but it is a good and functional hospital. Check out (, where there are a few photos of Surgicorps' trip.

Deb Johnson, operating in the dark
...flashlights helped!

This morning I was pulled to teach in the first Certified Nurses Aid course in Zambia. We discussed vital signs, and talked about the need for basic life support skills, also new to this country. I’m willing, and happy, to step in where asked, but feel underprepared. When I asked them (about 35 women and 3 men) to introduce themselves and tell me why they were taking the six-month-long course, I found it was difficult for many, if not most. After watching them stammer or giggle their words out, I realized how very, very shy they were (they call it “respectful”). They were so brave to still do it, and I realized I still have much to learn.... Tomorrow I’m to teach contraception!

Day 4: no wifi.

Day 5
I couldn’t be happier. I’m honored, lucky, and humbled by this experience.

Contraception talk went well yesterday; they asked questions despite their reserve (courage!). That gave me a chance to clarify some significant misconceptions, like, “don’t condoms cause cancer?” or “if you don’t have periods (on some forms of progesterone), where does the blood go?” I wouldn’t have thought to cover those things in a lecture.

In the theater today, we corrected scars that have prevented people, mostly kids, from elevating their arms, or extending their legs, or fingers. After the original injury, usually a burn or snake bite, the new skin, or scar, contracts over time. Sometimes they hold the limb or digit so still that it heals contracted—an upper arm to the chest, for example, or fingers flexed and stuck together. The surgeon opens the contracture, and then takes a skin graft from the thigh or abdomen to cover the gape in the wound. We have an O.T. with us who makes splints (so the patients don’t create the same problem), and then hopefully, six weeks down the line: fully functional.

burn scar contracture

snake bite contractures: knee and ankle

syndactyly, repaired and splinted

One girl, ten-year-old Eliza, has walked on her heel ever since a snake bit her on the top of her foot when she was five. Her contracture was so tight, her big toe nearly touched her shin bone (hard to even imagine, right?).  

Eliza: snake bite contracture
Thanks to Jack Demos, a plastic surgeon and founder of Surgicorps, Eliza'a foot is now at 90 degrees. But here’s the best part: I spoke with her today, post-op day number two, and found out she had thought she was going to lose her foot altogether. Boy was she happy when she woke up!

 See what I mean? I’m so lucky.

repaired and splinted
As I tried to get permission from Eliza’s mother to use her daughter’s story with her name and photo for the Surgicorps blog, and she had no idea what the internet was… let alone a blog or FB. She honestly couldn’t conceive of it.


Justin, Eliza's nurse and our interpreter for this session, helped us communicate. While English is the most common second language, there are 70 some dialects spoken in Zambia.

Using his third language, Justin kept tapping his finger on the screen of his phone. “On here,” he'd say, then, spinning his hand in the air, “and then around the world. Is it okay?”
Eliza's mother looked perplexed. “On the radio? In the newspaper?” she kept asking.

It took a while, but once reassured it wouldn’t be in her local news [please honor], both Eliza and her mother agreed it would be fine.

I thanked them with two bottles of lotion from my hotel room.
Eliza, smiling with nurse, Justin and Matt O'Conner, who took patient stories for Surgicorps' blog

During the conversation, I noticed Eliza, a preadolescent on day three post-op, seemed cranky and antsy. I wondered if she was in pain, and asked Justin.

In return, Justin, who, by the way, had abundant patience—his face kind and soft, and his words gentle during the ten minute repetitive internet explanation—said, “Oh, no. She’s not in pain… the ward has been quiet all morning.”

I’m beginning to see I have something to offer here, it's going to be very hard to leave tomorrow.

Day 6
I got up my nerve to discuss pain control with Justin. He is actually training to be an advanced nurse, online, in a school from the UK.

After tripping on my words, “I’m not trying to tell you what to do," or “I don’t want to sound arrogant, judgmental, but..." I began, "yesterday, you mentioned that you didn’t think Eliza was in pain, because the ward had been quiet--meaning no one had called out in pain. Do you think they might still have pain? Moderate pain that can be treated?”

“Yes,” he said with a half nod.

“Well, I brought some information on pain in children, would you be interested in reading it?”

Before coming here, I had had a brief communication with a local doc, and she had suggested I give an in-service to the nurses on pain, adding, “but we don’t have IV pumps or anything.”
I had read ahead about pain control, but not doing any in-patient medicine, let alone in-patient pediatric neurosurgery, the hospital’s main function when visiting doctors, like our Surgicorps docs, aren’t here, I felt incompetent to the task; I had no idea, then, the context. The reason. The need. But there it was, on Justin’s face. The only way he knew to recognize pain was a child moaning or calling out.

Justin gratefully and gracefully accepted my articles on pain in children, as well as copies of pain scales for preverbal children. He told me he planned to share the information with others.

Before we left the hospital at the end of the day, (when the women –mothers and nurses— sang us out! **see video below), I stopped by to give my stethoscope to Justin. He already had one, I knew, but I suggested he give it to the person who would follow in his shoes.

Upon returning home:
My time with Surgicorps was incredible. I would do it again in a minute. And hope to. It called on a deep part of me. Yes, I’ve lost sweet nostalgia at the smell of a wood fire. And yes, I made mistake after mistake (like the entire day I recorded mean blood pressures thinking I’d been recording heart rates, or the time I had to break scrub in surgery because I almost passed out--probably due to nerves or a too-tight mask or because I held that limb up in the air for too long given my fitness level). But I kept at it. I met the challenges to the best of my ability. I made a tiny little difference in a world full of big fat problems.  

And that made a big fat difference to me.


eliza, front and center, as the women sing to our team on our way out

Zambia: Safari in pictures

Friday, November 9, 2012

My (winning!) essay

So happy to have been published on Hippocampus, an online magazine for memorable creative non-fiction.  This essay has also been nominated for a Pushcart Prize.

How to Move in One Direction While Flying in Another
by Janice Anderson
       Start with an incident most people see as unfortunate but you perceive as life changing; the skewed perspective will enhance your experience. The incident should happen while on your Outer Banks vacation, the highlight of your year. It could be any incident—perhaps a random massage therapist from an upscale spa presses his penis onto your hand during your massage as if to silently say, “How ‘bout some of this?” and then, after you’ve tried, inconspicuously, to move your hand away, “Come on honey, I need the extra money … you sure?”

Deny to yourself and your god that this has happened. Forget it like you forget what you had for breakfast. You can do it. Get dressed. Meet up with your young niece who also had a massage. Smile with her at the checkout counter. Pay. And by all means, leave a tip.
Finish your vacation as if nothing happened. Make dinner. Play charades. Sip coffee at sunrise with your partner. Stroll the beach with…

Want to read more? Click this link:

Monday, June 11, 2012

Vietnam: Bike Wheels Past

I am humbled by the local's ability to live full and vibrant lives here. Vietnam faces infrastructure and educational deficits, poverty, and overpopulation. Over fifty percent of the country is under thirty, leading the ancient cultural to shift rapidly. Not to mention the heat, which is one of my biggest challenges (a few days ago it was 100° – perceived as 109°). Of course, this makes me feel guilty. My life is so easy. I am a 57-year-old family doctor working part time so I can take classes in the MFA program at Chatham University. That’s how I ended up here for two weeks, traveling with twenty-three of my fellow creative writing graduate students. Even where my life’s hard, it is a cakewalk compared to a day in the life here. The hardest thing I do physically is choose to take the hills on my daily walk in Pittsburgh’s Frick Park, or on a really big day, I’ll walk and do yoga. Still, surrounded by Buddhists (and travelers), I’m trying to be my best self in the moments I’m given.

That's not always easy. Today we have a bike trip to a rural farm on the outskirts of Hoi An, where we will help with farming and tour rice fields. As I wait in the precious shade to get started, I take a picture of the bikes. As if to sneak a peak at danger. At challenge. At dread. Nevertheless, I get on one. It has a classic bicycle bell that rings a little every time I go over a bump. I take that as a sign to stay present (gongs and bells are a call to attention, to meditation). Don't worry, I tell myself. You can do this.
When we start out, it’s wonderful. In Hoi An, merchants live in the backs of their shops and restaurants. They sit as families on the front sidewalk and share a meal at a low table with tiny plastic chairs. A father spoons noodles into his toddler’s mouth. He pays no mind to the passersby. We continue our ride though life in Vietnam as we navigate alleys and back roads. Aromas of open fires and breakfast food alternate with rotting fruit or magnolia blossoms. We pass large patches of golden rice as it’s laid flat to dry on the sides of blacktop roads and in front of huts and houses. With the city behind us, it’s refreshing to watch a water buffalo and her baby roll over in wet fields of rice or morning glory (a popular dish here, served sautéed with garlic). 

But it’s getting hotter by the minute and because I haven’t biked in years, my aching quadriceps muscles stop recovering during the few moments where I can coast. I stop enjoying the scenery because of my fretful and scattered thoughts: we’re only halfway there; I’ll never make it. Even if I do, how will I make it back in the mid-day sun? And what about the other students? We still have planting to do. Outside. In this heat. Two students have already come down with heat symptoms, and that was without exercising. (As a physician), I should know better. The best way to avoid heat-related illness is to avoid activity. It starts to seem crazy to me, risky. Unnecessary.

And then it gets harder. We leave the asphalt and bike on dirt roads. The paths thin out until there’s only a thin gully of dirt, thin enough for one foot at a time and ankle deep. Ruts from bike wheels past. These wind on tortuously on elevated mounds of dirt the between rectangular bodies of water – shrimp farms, they tell me. The mounds between the waters are the width and height of a trash truck. Plunge off one side or the other and I’m in shrimp water. It’s hard to keep my front wheel in the rut, and even when I manage to do it, I have to watch for divots and rocks. I almost fall multiple times, each time catching myself, but not soon enough to prevent the surge of adrenalin and the weakness and shaking that follow. Over and over. I am out of breath (and facing the fact that I’m not aerobically in shape) and oh, so hot. My cheeks burn. I pour water on my face, down my shirt. I’m grateful for the warm breeze – probably thanks to these small bodies of water, but my hat keeps flying off. As I try to adjust the strap, I veer off the path enough to create another near-fall. I fight back tears. I feel feeble and inadequate. Quit it, I tell myself. It’ll zap your limited energy. Just breathe and pedal and stay on the path.

I settle down for a bit, but the exhaustion, heat, and near falls persist. I think about my two sore knees. I’ve already fallen twice on this trip – once on the wet floor at the airport and another time on uneven sidewalk in Hoi An. While I’m distracted with my bruises, my front wheel catches the tall side of a rut and my bike drops sideways beneath me. I have to hop three times to avoid the fall. That’s it! I can't do this, I just can't. I curse out loud and nearly throw my bike in the water. 

Mary Jo, our tour guide, comes up behind me, shares her water (I am well out by now), and listens generously. I calm down, rest a little, and forge on.

As I try to fight self-pity I suddenly remember the war. The war. On this very land. In this climate. By boys my son’s age. Young and strong and for the most part, stoic. They had to dress in heavy clothing, thick socks and boots. They had to carry food and medical supplies and weaponry. They missed home. They performed and witnessed atrocities. Our boys feared the tricky Vietcong fighters, who themselves had to experience or create suffering and death. Then they all had to live with it later. It’s fleeting, the way I know this, but it gets me in the gut.

I remind myself that suffering happens when you want something to be different than it is, but right now, I sure wish things were different. Somewhere between facing my own discomfort and limitations (which pale pathetically in comparison to the wartime traumas), and worrying about what I’ll find in the way of heat-exhausted students when I get there, I find time to regret the past. The intense, and in my view, senseless, suffering of soldiers. All while navigating thin ruts in the road on an old bicycle. I wish I could say the ring of my bicycle bell brings me back, but it doesn’t. Somehow the past and future all roll into my present moment, and I indulge myself in a good cry.

After a few more breaks, and bringing up the rear, I reach my destination.  I’m wobbly as I park my bike with the others. As I turn, one of the students approaches me hurriedly. I must glance down or look away as she advances, because I notice she leans in and looks directly into my eyes, as if to get my full attention, or maybe to find something in me I don’t know about. She tells me another student is in a full-body shake. I scan the crowd on my way in. They are flushed and glistening with sweat, but they are all settled at tables in the shade. I somehow find a way to attend, if only briefly, to my overheated young friend. She is shivering and pale and tachycardic. They had doused her head, but she still has her shoes and socks on. I suggest she remove them. With that, and a little time, the shade, and some black-seed fruit juice, she does fine. And, having glimpsed my limitations and my strength, so do I. 

Tuesday, November 15, 2011

Check out inTravel Magazine for my first (creative writing) publication!

see: inTravel Magazine, Authentic Travel

Maho Bay Camps: An Endangered Species?
Janice M Anderson

If only I believed people really meant it when they asked, “How was your vacation?” I’d tell them about my week with no running water and the ten-flight walk to a bathroom, where pull-cord showers only ran cold. I’d show them bites on my ankles from sand fleas and mention the long flight delay. But then I’d urge them to book the same trip – before it’s too late. 
Pat, the adventuresome love of my life, likes to “travel.” I prefer “vacationing,” by which I mean beach-to-fridge on the Outer Banks. Maho Bay Camps, in St. John, U.S. Virgin Islands, seemed like a good compromise: restful Caribbean beaches for me, water adventure for her, and the idea of “eco-friendly” yet comfy camping, intrigued us both. To be honest, I’m not a good traveler no matter where I’m going. I get antsy on long drives. If I’m flying, I hate even one layover. This trip was scheduled for four: two flights, two taxis and a ferry.

very exciting.

Read more about Maho Bay Camps: An Endangered Species? by