One Shot

on anti-inflammatory states

Well, shoot. Suddenly it’s August and I last wrote here in April. It turns out — and I’ve definitely cleared this with The Kerning Lab editors — that I was supposed to write Substack essays in months that don’t begin with A as well! Mea culpa, amicis!

It’s been a busy summer with three teenagers in the house, but we’re only halfway through it over here. While much of the country (and two of our teens) start school this week, I don’t start Fall Quarter for another month and a half, so I’m filling my time with (even more, new, improved!) medical appointments. I’ve just returned from my doctor’s office for my annual physical (PSA: schedule yours today!), where, great news, everything from my lower calves down is in wonderful shape. And my ears. Truly, my ankles and feet are living their best lives.

I had to get a hepatitis B vaccine because newish research indicates that a decent percentage of the population has reduced immunity or, as is the case for two of us over here, never developed protective antibodies in the first place. So you're welcome for my second public service announcement in two paragraphs: check into your hepatitis B vax status if you work a job where you see people. Now, the nurse told me the booster is actually for people who are interacting with blood or body fluids, but based on my time riding buses, light rail, and in gyms and classrooms, I presume people are bleeding out in public more frequently than I’d like to imagine, especially if the way the teens ran through Band-Aids this summer is any indication.

Happiness is a warm shot, bang bang shoot shoot.

Speaking of shots, I have joined the crew of happy adults swinging on the playground equipment, hanging on the beach, and roller skating at the disco in your favorite TV commercials, and started Dupixent, which is an injectable biologic that I get to now administer at home twice a month. It targets and blocks two proteins in the immune system to reduce and suppress inflammation. And couldn’t everyone use a less inflammatory 2025* than how it’s all unraveled over these first eight months?

The injection is a humbling protocol; I spent about six hours procrastinating an abdominal injection, finally standing in front of a full-length mirror with full-length tears while my husband watched, after offering to help for almost all six of those hours, and dramatically proclaimed “it’s FINE. I’ll just do it myself.” (To research further: dramatic proclamations as effective pain reducers?) I understood more than ever why my daughter refuses to use her stomach as a new site for her insulin pod. There was something primal about the fear. As if I was just seeing for the first time that my belly was too innocent, too naive, and too precious to protect itself: like our golden-doodle Clover, helplessly looking at us, tail-tucked, when a bird or squirrel or bunny scampers by, or if any wind unexpectedly blows through her curls while she pees.

To be fair, I wasn’t just scared of an injection on virgin tummy skin; I had a scary, adverse response to my first loading dose of the medication two weeks prior. The laissez-faire days-from-retirement dermatologist, the deep-dive researcher and slightly judgmental allergist, the by-the-books GI doc, and Dupixent’s nurse-on-call, had NEVER heard of a response like mine. The medication has been on the market for 15+ years. Never? I do love to be special. At work, I’m often joked about as the unofficial beta tester because, as an early-adopter of just about any new software, feature, practice, teaching modality, etc., I’m also the one who discovers the errors or missed details and who frequently cites a less-than-positive user experience. But in medicine, I’d rather not be pioneering anything, much less adverse reactions that are “potentially an allergic response to the injection.” Swollen tongue and all.

Managing my emotions during what turned into a full seven days of recurring-and-then-resolving-and-then-recurring-again allergic reactions every 8-12 hours was especially difficult around the kids. The oldest, who plans to be an anesthesiologist, enjoys a casual pain is pleasure approach and chased me around like a lite Nurse Ratched with an ice pack. (I was grateful for the ice pack as it did reduce swelling, but a bit tired of sleeping with it by day three.)

Did I mention that this was supposed to be my summer of fleshing out two book proposals?

Listen, if I have learned anything from this season’s And Just Like That… (is anyone watching this Sex and the City reboot? If not, please don't, for the love of all that is holy; the writing on Bachelor in Paradise is much more realistic.) it’s that when a writer is not bothered by others—not a “family inhabiting a home” as Carrie pens in her new historical fiction novel—nor a pesky boyfriend** hanging around doing remote work (?) as a furniture builder (?), it turns out they can find time to finish that manuscript! Truly revelatory and applicable advice, thanks SJP! But seriously, and maybe this is just the stage of summer I’m in, if Aidan smashing her window (spoiler! but I’m okay with it and I promise you will be too.) wasn’t the epitome of the neverending disturbances, responsibilities, and clean-ups that all the writers I know have to deal with, I don’t know what is. And just like that, her cortisol levels were ruined by irreplaceable, shattered glass.

“Bang! Play Dead.”

Just as spring turned to summer, I got back-to-back good news. Amidst a stream of rejections, I had a short new nonfiction piece called Dependent come out in The Lincoln Review and then was short-listed for the Bellingham Review’s Annie Dillard Prize for Creative Nonfiction for an essay called Eviction Notice. Dependent was one of those essays that came out of me first as a 200-word micro essay, but I stuck with it, weaving bits of scenes from the early days of my daughter’s type 1 diabetes diagnosis at 9 with the growing panic and terror I developed as her mother, taunted by the fact that my own sister had died at 14. It explores the bodies we hold close but that aren’t our own, the memories that are all ours, and the impossible, ongoing work of trying to keep those we love safe.

I'm happy to be back here, writing through a misfired immune system, questionable plot lines with rogue panes of glass, and the everyday shatterings we never see coming.

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*As of press time, there’s no indication we’re anywhere close to this happening.
**Carrie’s neighbor and short-lived lover asks her whether the book would have happened if her relationship with Aidan hadn’t ended and there could be a lot to unpack here. Especially if the bag is a purse.