Ramblings: On Writing

Yesterday was an exciting day. I finished the rough draft of my new novel Retribution. For writers, this is really just the beginning. Ahead are weeks of the nitty-gritty work of editing, rewrites, and etc. The granular stuff.

I’ve said before, if I have a gift in writing it is my imagination. For the past two months I’ve had the privilege of living in war-torn Yemen and related to the characters, Bryan, Jabbar, Alam, Sheila, Michel, Ray, and others on a daily basis. This other world (just like Winston, Halem, and Sandra in Rock Harbor of Ristretto Rain) is so real to me, that there are times that I forget that I’m sitting on my deck in Anacortes.

The book is about a Physician Assistant (Bryan Rogers) who is working with the International Rescue Committee in Yemen. Disaster strikes when a Saudi jet bombs a school bus, killing 40 children. Bryan’s closes friend was Jabbar, the father of one of the young boys killed on the bus. In his period of extreme grief, Jabbar is recruited by Al-Qaeda to do a major terrorist attack against America, where the bomb was manufactured. Bryan, while dealing with the health care crisis on the ground, his hot and cold relationship with Doctors Without Boarders (Medecins Sans Frontieres) and a romantic relationship with a colleague, he must also try to thwart this attack on New York City, where he is from and his family lives.

School Bus Remains After Bombing in Yemen 2018

This book will diverge into heart of the quagmire of war, peace, hate, and terrorism with a focus on the human component.

The way I write is that I create characters and their nature (how they think, act, and live) and then put those characters in a particular situation and allow them to interact. I don’t know how they are going to behave, but then I observe and record what I see. It is the same with language. If I am good, and I’m not always, I let the characters speak in their own language. That’s why they may use a vocabulary that I personally don’t. I try very hard not to be a “helicopter parent” to my character, where my words or reactions become theirs.

The Achilles heel of my writing, and you may have noticed here, is my dyslexia. This gives me a tremendous challenge in putting my story, the story I’ve lived, into a syntax of sentences that communicate that world. My brain does not see things that can be blatant to others. I can read this sentence 10 times and not see the error, “I went to the store with my friend to bye a cake.” Now of course I know the difference between bye and buy. But it is very difficult for me to see it. This problem has been a long-term embarrassment of this problem, ever since I was excelling in grade school but failing spelling tests.

This new phase of writing is what I call the coal-mining phase. After attending 6 different 5-week workshops on creative writing, led by very successful writers, I was happy to see that some of them have the same problem as me. Margaret Atwood was one of them.

But it is not all drudgery. In my next cycle I will also start to lay down color over the story I’ve written. I do like that part.

Years ago, when I first started writing books, I approached major publishers with my work. I had one publisher accept my book, Butterflies in the Belfry, but I didn’t like the terms and rejected the offer. The principle problem was they wanted to print it in hardback as a college text book and charge over $30 per book. My mother would not have purchased it at that price.

I became disillusioned with the publishing process. Most publishers were not interested in seeing my material because of my lack of notoriety. But in ways, I’m glad they didn’t ask to see my work. I am embarrassed by my first three books and it would be painful to go back and read them now. It is because I’ve worked hard to become a better writer. I did not come to writing via education, creative writing degrees, so I’ve had to humbly sit at the feet of such people to learn from them. I’ve done this through classes and reading hundreds of books with an eye to their technique.

Writing a book – how Agile can it be? - PM Power Consulting

I really want to work hard on Retribution and to make it superior to Ristretto Rain and I’ve had comments that that Ristretto Rain reached the level of being as good as the books by their favorite authors. But I have plenty of room to improve and find my voice. I am satisfied that I’ve sold over 500 copies, which is not bad for a small independent author. However, the royalties so far have been $5.75. More will come by the end of the year when things are tabulated. But the challenge to being a successful author is having people read and enjoy your work, but also having it to be sustainable, financially. It cost $2-3,000 to bring a book to the market, most of that going for a professional editor services. Unless you can recoup much of that money or your are rich, you cannot continue to write. I think most of the people who have followed this blog have purchased it and I am indebted to you. If you have not, please do. Read it. If you enjoy it, that’s enough. If you didn’t like it, write me a private message telling me why, and I will refund your purchase price and try to improve for me next book.

After avoiding the big publishers for 15 years, I want to go back with Retribution so it must be polished. In these times, it requires contracting with an agent first. The typical agent has 100 query letters per day. They choose one new book per month. So that means 1 in 3000 potential authors are contracted. I have a huge strike against me, and that’s my age. Being 65 and not having a book published by a major publisher greatly reduces their interest from the start. It is like a major league baseball team passing on a potential player simply because they are 35 years old. It is a business, and they look at long term potential of profits. If they know I’m dealing with cancer, they will have less of an interest, in the same way the hospital closed my clinic because they didn’t seen a potential in me anymore.

Mike

Ramblings: Western Medicine, One Critique

I have shared my opinions a few times when it comes to alternative and complimentary health care (CAM). My major gripe with them is calling something a treatment or cure with no supporting evidence (or worse, lying about the evidence). But, CAM has done a much better job in creating a empathic relationship with the patient than evidence-based medicine.

I want to pivot and speak about one area of concern in evidence-based medicine or what some call “western medicine.” Again, this is one single critique point, not any type of comprehensive examination of the whole enterprise. While I’ve had my own challenges with my healthcare, this is really not about me personally.

I am a story teller. But I try very hard to be honest and to tell the truth. I do cherry pick stories, often the worst of the worst, just to illustrate a point. That’s precisely what I will do here.

In my previous life, I was a headache specialist and for a while, owned my own headache specialty clinic. In many regards, the clinic was very successful, full schedules every day, drawing patients from six states and four countries. We had had praise from our patients and I think we gave them excellent care.

Business Side of Medicine

While I was not naïve when it came to the medical-business side of healthcare, it became a real eye-opener as an owner. We were successful as a clinic, we were a complete failure as a business. For the last six months of business, I took no salary, and came close to losing my house. The reason? We could not get paid for the services we rendered.

There were several ways that we failed to collect fees. We had some patients who gave us false insurance information (that’s another story) and ran up huge bills and never paid a penny. But the real crux was the low payments by insurance companies.

When I opened the door, I wanted to see all patients. Soon, I learned the hard lesson that Medicaid, and some situations Medicare paid below the cost of seeing a patient. For example, I figured my hourly cost for running the practice, not including my own salary, was about $120 per hour. This included the salary of my employees, rent, insurance, and etc. Medicaid paid us at a rate of about $40 per hour and Medicare, about $60-100. So you can see right away, this business model doesn’t work. Also, medical business are far more expensive than a normal business like a hardware store. We worked in a very lean way, yet, it took two full time employees to manage the paper work of insurance companies. We had to pay $20K per year in malpractice premiums and then there are many other expenses.

But then comes the way that commercial insurances reimburse for services. We are far removed from the days when a medical practice could roll in the dough with minimal effort. Insurance companies have turned the screws tighter and tighter, requiring more and more paperwork to prove you did the work (which adds the cost of the employees) and then pays less and less.

The poor headache patient has been discriminated from day one. It is for two big reasons. First, it is a disease that affects women twice as often as men. Secondly, it is invisible except for the expressions and stories of the patients, and now with some very complex imaging research. It is easy for insurance companies and providers to dismiss a disease that you can’t see, especially a disease that mostly affects women. Now I will give one of two stories to illustrate this point with commercial insurances.

The Montana Martyr

I had a patient once, a really nice man, who his family drove him 700 miles from Montana for care at our clinic. He had already been seen at about 20 clinics, including several headache clinics and the Mayo Clinic, where I used to work. Yet, he suffered from a very complex headache disorder that kept this hard working farmer in bed as an invalid for over 10 years.

natural-remedies-migraines

I studied his chart, about 400 pages of it, in advance and knew we needed to set aside 90 minutes for the visit. When he arrived, his sons almost had to carry him into my office. They had three large boxes of files, which I had not seen. To make a long story short, I spent over two hours with him, and he needed every second of the time. I was trying to find something to change his life. He was to the point of committing suicide so my intervention was to be a life-saving measure.

After seeing him and documenting everything we did and the very high level of planning for his care, especially knowing he lived so far away, I billed the insurance company, based on time, for 2 hours. This was 30 minutes less than what I actually spent.

I got a letter from the insurance company a month later. It was a very harsh letter. They were going to pay $0 for the visit because I had bill an outrageous time, of 2 hours, for something as simple as a headache. I will remind you that I clearly documented all the prior treatments and the severity of the disease. I had submitted my own records, which were about 10 pages. But not only were they not going to pay me for my time and the visit, they had turned our clinic over to the state to be investigated for fraud. This cost me many nights of sleep and we had to spend many more hours on his case just to not being fined for fraud. The insurance commissioner finally let it go because of our good documentation, however, the insurance company never paid us for that visit or his follow up visits (via telemedicine). While this story might be cherry picked, a less severe but same type of problem, happened with most of our patients. The insurance companies pressured us to spend no more than 15 minutes with a patient, no matter how severe and complex their headaches were. The do this by a payment fee schedule that drops for each additional 15 minutes you spend. While the first 15 minutes is paid at A, then 30 minutes isn’t paid at 2 x A, but more like 1 1/2 x A. And then 1 hour is not paid at 4 x A but maybe 2xA. This is one reason that the five great headache clinics that were here when I moved out 16 years ago, all folded but one. It is due to low reimbursement for this disease.

I lobbied the insurance companies in behalf of my patients. I met with the Vice President of what was then Group Health. He had been a doctor in a previous life. After I presented how terrible of a disease headache can be, he had the audacity to say, “Headache, isn’t that what Excedrin is for?” Then he gave me this horrible, and heartless grin. Group Health’s failure to pay for over 100 visits was the death nail to our clinic.

One Compromise Medicine Makes

Now, I want to tell another story, one to illustrate, not more bad things about insurance companies, but how western medicine has, sadly, reacted to this toxic environment.

As my clinic started to struggle during its fourth year, I began grasping at straws for ideas to save it. I loved my patients and wanted to do everything I could. But like I mentioned, I had already stop taking any salary, so I was working 60+ hours for free. It was an unsustainable situation. I sometimes wonder if that period of extreme stress was what bred the cancer in my marrow. I started to see a mental health professional to help me.

It was so painful and stressful that the following day, after I closed my clinic, I flew to Malta alone and lived in a cave for a month. Seriously. Denise joined me after two weeks. It was 10 feet from the Mediterranean and a great coffee shop. A great place to decompress . . . and to finish my (not so well written book, due to the circumstances) Butterflies in the Belfry. But, to my good favor, I was able to connect with N.T. Wright (Anglican Bishop), who was also on “holiday” but in France. He was very kind to read my manuscript in two days, and his wife did as well. He gave me some pointers for clarification. I was lucky because he said he had such requests daily but never had the time. But I digress.

My Coffee Shop in Malta, Where I Wrote Butterflies in the Belfry

Now to my next story. It is extreme, but true. It is to illustrated this point of the bad choices some practitioners make to survive in this new insurance environment.

First do No Harm . . . Unless it is Lucrative

A few months before I closed my clinic, I heard about a nurse practitioner who also owned a headache clinic in another part of the country. The two of us were the only non-physicians in the country, who owned headache clinics. However, she was much more successful than me and I wanted to know how she did it.

She told me these “tricks” to survival. “Mike” she asked, “how many procedures do you do in a day?” (In headache work, a procedure are things like nerve blocks or Botox treatments.)

“Uh, maybe two.”

“There’s your problem. I do twenty.”

“Wait a minute, how do you do twenty procedures per day?”

“Well, I see thirty patients, 10-15 minutes each, and I do a procedure on most of them. I have two MAs that help me.”

“What kind of procedures?”

“Mostly nerve blocks.”

“But I don’t have that many patients that could benefit from such a procedure. The research is iffy about the long-term benefits and could cause more harm.”

“Doesn’t matter. This is about survival for our clinics. I couldn’t care less if they need a procedure, but I’m telling you that it doesn’t cost any more for you to do a procedure, but an insurance company will pay you double.”

Now don’t get me wrong. Don’t think that everything you doctor wants to do for you is about him or her getting the most money. I think that is an uncommon motive. But I also heard this same message (about doing procedures whether the patient needs it or not) based on the money you will get when I attended procedure workshops at national conferences. But this is the dark side of medicine. I have talked to headache providers during conferences in Europe who work under national healthcare systems, and thought such things, as doing procedures based on reimbursement was absurd and immoral. I agree.

Mike

Health Update: Brief

My long, long list of 1 year post transplant tests are complete. I (Denise can’t come this time) will be going to Seattle Cancer Care Alliance on September 28-29 for a comprehensive exam and review of the tests to establish the course going forward. I hope I can become one of their long term patient after that. Studies have shown that Multiple Myeloma patients live more than twice as long if they are followed by a specialist. So far, I have not been able to establish there, partially due to their restrictions due to COVID.

I have been doing very well with my current chemo, however, with my new insurances, our co-pay was $2600 this month. This creates tension of how do we will go forward? But after four months of working on this we exhausted all avenues without help. If I had no insurance the drug would have been free. I hope the plan in Seattle can help steer me in a new direction.

Today, after 100 straight days of painting on our house, we finished! Denise was able to help this past two weeks, which was a godsend. I am grateful that neither of us were injured after working very high and in complex situations (ladders on boards, boards on steep roofs, ropes, and etc.).

Being laid off from work was about as difficult as the cancer itself. Tonight I applied for a cancer research position. The high cost of my chemo and the missing of working in medicine was my motivation. Cancer research would also be rewarding and would also be self-serving. There are no headache positions available that would allow me to work from home.

Thanks for your interest, prayers, and love.

Mike

Ramblings: The Problem with Heroes

I have never been in a cult, but I have been in groups that have some cult characteristics. I am thinking about this because I just finished a novel, The Innocent. I would give it a 3-4 stars, not one of my stellar reads. It is a story about a group of Christian cult survivors going back to rescue a young girl. The story gave me the creeps (which is a good thing as the author intended to do so) because of the men who had been elevated to prophet status, thus infallible. For example, one of the prophets often called adolescent girls into his private office to scold them for “disappointing Jesus” but having them sit on his lap and him rubbing their butts as he quoted verses to them. To make clear that this touch was inappropriate, he fathered children by some of the young girls.

The heroization (my word for the process of making someone a hero) of people is the cornerstone of most cults. In the cases where my group was toying with being a cult, leaders were heroized. They were bestowed with such accolades as “man of god,” or “godly man” or “a man after God’s own heart.” We were encouraged to emulate them.

Soon, with such a cloud of delusion, the shortcomings of such a person fade from the radiance of our self-imposed hero worship. Like when one of these godly men had an affair with a college girl and we were told to pretend it wasn’t happening. My departure from evangelicalism started with this issue of heroization.

Statue Of Caesar Augustus Photograph by Robert Emmet Bright
Roman Leaders Were Exalted to the Point of Being God-like

I have many stories of people leaving a variety of religious groups, evangelicalism, the Catholic Church, and etc. after their heroes have fallen. I bet it is one of the most common reason for people leaving the church, given them the false expectation of a prefect leader. The point of this article isn’t to make a political statement. However, I do want to pivot and point out how I see this playing out within the political realm, as just a side bar to this topic.

While I did fall into the heroization process within evangelicalism, I don’t think I’ve ever done it in the political realm. Yes, I was a Republican for years. I (falsely) thought Reagan was a good president. Now, I can say he had some good skills, did some good things . . . and did some bad things to our country. I voted for both Bush’s. I think the father was a smarter man than the son and probably rank him higher. Junior, I think was a decent and kind man, but just not very smart. He caused the unnecessary deaths of over a million people (Iraqi war) but did so out of ignorance, not evil intent. Unfortunately, the results are the same.

I think Obama was the right man for America at the time. He was smart (smarter than Bush) and I think he had the best interest for America. He stood up well in spite of the demonization of him by the right (mostly because he was black. I don’t think they like people of color over there). But I don’t see him as my hero. I see him as a hero to many, especially people of color. Maybe Obama was missing the ability to connect with common people, which Bush excelled at. I still get chills when I hear George Bush Jr speaking in the megaphone at the Twin Towers ruins.

While I think Joe Biden is certainly not my hero, but he’s a decent man and at this point in history, the is the way out of the hateful, chaotic, dishonest state America has been reduced to.

But then there is Trump. His base has a level of allegiance that I find unhealthy, maybe as creepy as the prophets in The Innocent. I have many friends and probably my entire birth family (we are from the south) are strong Trump devotees. But this is what I find as odd, they see no flaws in this man, the same man that 60%+ of Americans see as profoundly flawed and a con man. We see him coning people with a fake patriotism and a fake devotion to God. I’ve had many conversations with Trump supporters and they become very defensive if you suggest that Trump is not perfect in every way.

I will have to vote for Biden for a thousand reasons, but I could name 5-10 things about him I don’t like. I check everything he says, just like I do with Trump, to see if it is true. I heard Biden say something the other day that I don’t believe is accurate. That doesn’t threaten me. Trump says or tweets a hundred words everyday that are (easy to prove) factual lies. His followers believe everything that he says without critical thinking. Things like hydroxychloroquine cures COVID, Antifa is behind the BLM and are a violent group, global warming isn’t real, COVID will soon go away, and I could go on and on. If Biden said any of those things, I wouldn’t believe it, because it isn’t true.

So this brings me to the point I want to make, discernment about heroization. When is it good, when is it bad?

There are two groups who I think are most vulnerable to hero worship. Okay, maybe three. One is in the area of sports. But most sports heroes are loved and looked up to for their skill in that sport. Most of the time we don’t look up to them for moral direction, except for kids. They might, so that’s why sports stars should try to be good role models.

Heroism pointed to one trait, like which most common in sports, is reasonable and probably healthy. If I make Stephen Curry my hero for his dribbling and shooting abilities, that’s okay. But if I see him as near perfection in all areas, I’m in trouble. I will call the former, trait-centric heroism and the later, comprehensive or blanket heroism. Fortunately, blanket heroism is not that common in sports.

The second area is more vulnerable to blanket heroism and that is in business. When someone is earning a million dollars a year, others within that business my see him or her as their star, with no flaws. Those people are eventually disappointed when their star fails, such as going bankrupt or you find out they were making a million dollars a year because they were ripping off someone. Read the book or watch the movie, The Wolf of Wall Street, and you will see this type of blanket heroization in business.

The Wolf Of Wall Street Movie Trailer, Reviews and More | TV Guide

Lastly, blanket heroism is most vulnerable within religion. It is because most of these religious affiliations falsely believe that when you are part of that sect, you are better than everyone else, and you have a path of (sanctification) that can render someone perfect. That’s what we meant by “Godly.” Of course that is a lie. So then, disappointment comes and so many are hurt. I’ve seen it over and over.

The problem with blanket heroism is that eventually that hero disappoints you . . . or leads you further and further away from reality in order for you to remain loyal. If reality shows that they are infallible, yet you believe that they’re not, you really have no choice but to give them up or live in the hero’s prescribed delusion.

The problem with blanket heroism is that eventually that hero disappoints you . . . or leads you further and further away from reality in order for you to remain loyal.

The latest example of this is Jerry Falwell Junior. Here is what we know for sure. Jerry Falwell Junior and his wife visited the Fontainebleau Hotel in Miami Beach. A pool boy there, Giancarlo Granda, became close friends with the couple, vacationing with them. Then Falwell loaned Granda 1.8 million dollars to invest in a “gay-friendly” hotel. I only mention the later because in his public life, Jerry has opposed homosexual relationships ferociously.

The deal went sour and Granda was threatening the Falwells with a lawsuit. He also claimed to have photos of Mrs. Falwell naked, which he took when they had sex in front of her husband, and by his wishes. We know that Donald Trump’s lawyer Michael Cohen got involved and was able to get the photos destroyed. Soon afterwards, Jerry Falwell Jr. endorsed Trump for president (this was 2015) and it is rumored, this part not proven, that it was a quid pro quo, Jerry saying, get rid of the photos and I will endorse Trump and get the evangelicals to follow suit. At this time, before his endorsement, the evangelical community was behind Ted Cruz, which made more sense. Falwell’s endorsement may have been what won the election for Trump.

Jerry Falwell Jr. says blackmail led to recent controversial behavior

One of the reasons I’m so critical of evangelical mischief, isn’t because I “hate God” as someone recently accused me of. But because I love the real God, the Jesus of history. So it frustrates me when these phonies are raised up as Christian heroes and then when they fall, thousands become disillusioned. Didn’t Jesus hate the phonies of his day?

We can look up to people, friends, pastors, leaders, politicians, and etc. and appreciate their positive traits. But when we assign on to them as being above the herd in their righteousness, that’s when we are asking for real trouble. I’m really concerned that’s what has happened to the Trump followers. They cannot (psychologically) see his faults. They cannot appreciate his deceptions. I’ll vote for Biden as the best choice for America, but I see his faults and he is a good man, but not my blanket hero.

Because of my personal experience, I am also leery when I hear Christians raise certain pastors, writers, or leaders too much. Francis Schaeffer is my Christian hero, but he was full of faults . . . and oddly, his faults (because they are a lot like mine, like a temper) makes me like him more because I know he’s was human.

Mike

Ramblings: On Writing

As part of my desire to be a better writer, I am consuming books at a rapid rate. I’m doing it mostly by listening. I have a window of about 2-3 hours per day that I can use my eyes or reading/writing due to a post-stem cell transplant worsening of dry eyes. I use that window for writing. My “reading” time is via listening to books. The Washington State Library has been a godsend. I can listen to books as I do any mindless tasks, like cleaning inside the house or painting the outside, kayaking, hiking, and most commonalty, when I’m laying awake at night. This way I can finish 1-2 books per week. This week, I found a new gem of novels. I will tell you about it in a minute.

I do read novels for the entertainment, but most of all, I do to observe how others do it. I am driven to be the best writer I can be and to do so, I must observe the gifted. Some do it well. Others, not so much. In this strange world we live in, some of the most lucrative writers are some of the worst. But they are great in business and self-promotion. Some of the best novels are obscure.

In Praise of The Echo Maker

After spending a few weeks with mediocrity, I returned this week to novels with quality. I started with Hemingway’s collection of short stories. I had read most of them before, some many times. However, Hemingway offers an oasis from the humdrum. His writing is simple and pure. There are writers who write more poetically . . . but none more rhapsodic. There is a rhythm to his writing that reflects his training in music before becoming a writer.

I also feel somewhat of a spiritual connection to him. I guess all readers do so with the authors that they read. When I’m an author I feel a spiritual connection with the characters I create, and the readers who embrace them. But my spiritual relationship with Hemingway stems from me living for a short while on a small lake, Waloon Lake, near Petoskey, Michigan (the town where our previous music director of my church is also from). A house on that lake called Windemere, was Hemingway’s boyhood vacation home.

The Ongoing Mystery Of Hemingway's Misdiagnosed Death: Accident, Suicide Or  Genetic Disorder?
Hemingway at his Prime

That’s not why we lived there. We lived there out of the generosity of a friend who loaned us their vacation home while we were waiting to move to Egypt in 1988. Actually, it is hard to believe, one of our neighbors on the lake pointed out Windemere to me. It was just down the shore from our house. I was unimpressed at the time. But I was a narrowed minded person then, not reading anything that wasn’t written by an evangelical. Sad.

Dark-haired man in light colored short-sleeved shirt working on a typewriter at a table on which sits an open book
Younger Ernest Hemingway

Hemingway also lost his soul (his words not mine) where I used to work, Mayo Clinic, Rochester, Minnesota. He was being treated there for depression (in 1961, way before my stint there) and they used ECT (shock therapy), which damaged his memory and creative mind. Because of those side effects he went home and shot himself in the head at his cabin in Ketchum, Idaho. He did so because he knew he could no longer write. I understand.

The Death of Ernest Hemingway. When Ernest Hemingway awoke early on… | by  Steve Newman Writer | Medium
Hemingway with His Gun Before His Death

After spending a couple of weeks back with my friend Ernest, I did a search only for books which were finalist for a Pulitzer Prize. I had found several great books this way. This time my search did not disappointment me. I am now in the middle of The Echo Maker by Richard Powers.

To me, the writing in The Echo Maker is super-human. I am constantly asking, “How does he do it? How does he write such rich dialog? How does he weave such an interesting tale?” I look at his reviews and not all of them are positive. What were those reviewers thinking? It is now at 65,000th on the best-seller list as its time in the lime light has past.

My Journey to Better Writing

I have no clue if I can write well. I started down this course of writing way back in the 1980s. I wrote 30 magazine articles and got a lot of praise for them. I started writing books and I had praise for my work. But were they sincere? I don’t really know. Maybe I’m like the person who thinks they can sing and performs at every open mic, but can’t carry a tune. But I keep trying to improve and to learn from the masters.

Ristretto Rain

I think the life of Ristretto Rain is drawing to a close. It is typical that a book best sales are with the release. When the chosen audience, in this case people I know, is saturated, the sales fall like a brick. I am profoundly grateful for those who bought it. Please share it. While Ristretto Rain was # 13,000 on the best selling list at its peak (which sounds unimpressive, but for a no-name author with an independent publisher, that’s pretty good) but has suddenly reached the 1 millionth mark this week . . . the dead zone. I’m trying to get reviews by major papers, but I won’t hold my breath. If I do, and if they are decent, it would breath new life into Halem and Winston (two main characters).

I will not have the count of sales for several months but I think it is around 500. I am happy with that and considering that it is via word of mouth advertising. I am considering releasing Ristretto Rain as an audio book, but that takes some more investment of time and money.

Ristretto Rain was a very difficult book to write for a couple of reasons. First of all, I wrote most of it before I was sick. Then it was lost for a year (during which I was too sick to write much, except I did write Christina Athena during that time). Then, when I found it, it was in pieces. I had to sew the pieces back together and finish the story. Then the book was huge, almost double the published size. The original had several more characters and a more protracted ending. The original has more resolution. But in the world of publishing today, if your book is over 120,000 words, you can’t sell it because it will cost more, ($17-19). No one will buy a book a that price from an unknown author, except for maybe his or her mother. I am considering writing a sequel to bring back the characters I had to delete and to tidy a few things up.

Retribution

I’m working on chapter twenty-six of my latest book Retribution and it will have two more. I can finish the rough draft in a week. Then I start the long, hard process of editing and re-writes with a new editor. That will take a couple of months. I want to do my very best with it, even better than Ristretto Rain, so I would have a shot at getting an agent, who could sell it to a major publisher. With each book, I try to improve over the previous one. So I will get to live in a refugee camp in Yemen, (in my mind), for a while. I like that. But my commitment to my readers is that I will do my best to make it worth reading. But in the meantime, if you like a well-written book and don’t expect an unrealistic narrative (like most best sellers in the US), you will love The Echo Maker.

Mike

Ramblings: Remembering 9-11, A Different Perspective

With so much written about 9-11 in the past and on this memorial, I wanted to add to the conversation. But I wanted to add something concise, meaningful, . . . and different.

There were 19 men assigned to carry out this attack plus Osama bin Laden and his associates who planned it. This was a very complex mission taking years to organize. Now the question I want to focus on is why and how can we make sure this never happens again?

The basic human instinct is to react on those instincts without thought. I’ve heard from countless people, Christians and non-Christians, who had the attitude, in response to 9-11, of “Damn those bastards! Kill them all! I hate them!” But then we play right into the hands of the terrorists and fulfill their greatest hopes. Their goal was to punish America for meddling in their countries, politically, and to sow hate toward Muslims. If America hates Muslims, then it would help the terrorists prove their point that America is bad, and therefore they can recruit more Muslims and the carnage continues in this never-ending cycle. That’s exactly what happened. We were co-conspirators in the creation of Al-Qaeda and Isis. It was not with an ill intent. America meant well, but we followed our animal instincts, allowing the voice of hate whisper in our ears, rather than thinking this through like real patriots . . . or in the case of Christians, real Christians.

Real patriots don’t circumvent looking at their own country with critical thinking. I think it was the TV character Archie Bunker that said, “My country right or wrong.” But believing that to be a good patriot you don’t do self-examination of your country, is like saying to be a good father you won’t bring up the needle tracks on your daughter’s arm. No, a good father addresses such things so that they can improve things. A good patriot does the same.

Our Mistake

America lashed out after 9-11 like a wounded dog but with noble intentions. However, if you add up the toil from 9-11, 2,977 innocents died on that day, not counting the 19 hijackers who were not innocents. Another 2,372 American troops, good men and women, were sacrificed in Afghanistan. Another 4,424 American troops died in Iraq, all because of 9-11. Another 200,000 Iraqi civilians have died because of our invasion, most of them innocents or killed in the civil war which our invasion unleashed. They estimate 157,000 civilians have been killed in Afghanistan since we invaded. There is an estimate of the wounded, both US servicemen and women, but civilians, in the millions.

So, a terrorist attack by 19 men, which killed 2977 good people, had a retribution that killed another 363,000+ people, more than a 100 times the original. And for what? Are we any safer? I don’t think so. The hate toward America has never been higher. I think we did exactly as bin Laden had hoped. We fell for it. Hate always makes suckers out of the haters. But, this is not a piece just to be critical, but to encourage us to change course in how we think.

To look at the why of 9-11, I will give you a link and I won’t elaborate on it here. I’m not trying to justify any of the evil done on 9-11. But the perpetrators met their judgement that day as did most of the accomplices, weeks to years later. But who has suffered the most from our rage? We have. We have squandered trillions of dollars because of hate and the lives of our dear patriots in uniform. We could have had beautiful roads and bridges, free health care for everyone, free education for everyone through college AND all those dear loved ones who were killed back in our lives with all their gifts, to still be receiving all of our love. This does not mention those hundreds of thousands who have been scarred for life . . . for them to be un-scarred.

Here is what a smart choice it would have been in 2001. Yes, we could go after the perpetrators. We could have served justice completely. However, we should have sat down and asked, “Why did this happen? Why do they hate us? How can we change the world for peace and prosperity for all?”

World politics explainer: The twin-tower bombings (9/11)

After World War II, America was the most loved country in the world. We were the moral leaders of the world. Not now. We squandered that good name with meaningless wars, and selfish political interventions, that have cost us the most. If you really believed in “America First” or “Make America Great Again” then you should be the one most interested in this process. Now, don’t faint, but this is one area I’m in agreement with Donald Trump (although I still think he is a narcissistic idiot). These wars have ruined us and were a huge mistake. How can we learn from our mistakes going forward?

The False Narrative

In order to cover for our mistakes we quickly wove a false narrative about 9-11. This is human nature. This narrative is the same one the Christian Europe used in the Middle Ages (they may have been more justified with the Turks on their doorstep and aspirations for an Islamic Europe). This false narrative says the Muslims are violent people coming to kill us or force us to convert to Islam. That’s what this narrative says happened on 9-11.

I’m writing a novel right now that deals with terrorism and I had to research the lives of the 9-11 hijackers. They weren’t men devoted to Islam. This act was a political act and they used things like Jihad (الجهاد, struggle) as justification for their action. In Islam, Jihad is the struggle for righteousness and justice. To used it as an excuse for hatred was rejected by most Islamic scholars. No one is coming to steal your babies and convert them. It is beyond the scope of this article to discuss the differences between Islam and Christianity, but it certainly is not that former is the religion of violence and hatred and the latter the religion of peace. If you are a real student of history you will quickly learn that as many or more people have died in the name of Christianity than Islam. Jesus did not teach violence, but the Church rarely listens to the real historical Jesus.

I am especially disappointed that my Christian friends who have adopted this political narrative. I am often so puzzled by evangelicals that say they make “Biblical teachings” the center of their thinking, when really they don’t. From a Christian perspective, we should be slow to anger. We should practice self-examination. We should seek peace with all people. Most of all, we should stop sharing hateful lies.

2006 Myself (in the middle) in a shed with 10 pro-Taliban locals. These two with me are friends from the U.S.

In summary, the problem of 9-11 was political. It was horrible, but its roots were in political issues that date back decades. If we really want to prevent these meaningless wars, we need to find political solutions. But we can’t win this if we believe that the only way for us to be safe is to bomb the hell out of them, men, women, and children who are not like us. That’s clinical paranoia.

These things are my opinion, however, it is an informed opinion. I know I’ve mentioned this before here in this blog, but I’ve had a recent influx of new followers and some don’t know. I studied Islam for about 5 years in preparation of going to the Muslim world as a missionary. I’ve had many Muslims friends, including my best friend at times. I worked with a group of medics from New York City. They are the ones who recovered the injured and dead from the disaster. We went to the heart of Taliban country inside Pakistan in 2006 on a good will mission to help with their earthquake. We stayed 100 yards from where Osama bin Laden was living at the time (Abbottabad). I had a long discussion with some of the pro-Taliban leaders. They later threatened to kill us and we held up, again, in Abbottabad in a Pakistani military barracks until we could escape.

I will comment that when I had a long discussion with them about 9-11, it reminded me so much of Americans who follow right or left wing web sites. These Taliban people believed all kinds of crazy conspiracy theories. For example, George Bush did 9-11 to get oil from Iraq. American troops are paid by being allowed to rape virgin Muslim girls, that’s the only reason they enlist. You get my drift. But it is just like the hate talk on the extremist websites, but in America it has “Christian” or American national themes.

We can do better. Let’s be the peacemakers. Let’s fight hate with love. Let’s bring hope to the hopeless. When America did that, we were the real beacon on the hill.

Mike

p.s. Pardon any typos. I did this quickly and wanted to post it while it was still Sept 11.

Ramblings: Life after Death

No, it is not what you think. I’m not talking about the mysterious realm beyond the grave. I am talking about that interesting process where you were “all but dead” and then get a chance at life again. Think of Wesley in the Princess Bride, who was mostly dead. I bet many here have been there. It changes you doesn’t it?

It has now been twenty months since I was diagnosed. There has been a lot of water under that bridge, some of it not pretty. This is not melodrama but when I was first diagnosed, all I heard (and it wasn’t what my ears wanted to hear) was that it was grave. I’ve mentioned before that for some reason when you combine the cancer of multiple myeloma and renal failure the prognosis is very poor, an average life expectancy of nine months.

THE PRINCESS BRIDE Recap-Chapter 7: The Pit of Despair
Wesley Becoming “Mostly Dead”

So, the doctors in Bellingham were not being pessimists when they told me they would do what they could, but I must prepare to die. Then, as days matured into hard weeks, I began to read research paper after paper. That’s what medical providers do when they’re sick. The studies were not reassuring but showing that it would be a real struggle to make it to the fall (after being diagnosed in January). I won’t even go into how painful that period was for me and my family. Terrible goodbyes. Many of you have been there and you know what I’m talking about. I wrote on those days here, and was too raw and painful for me to re-read.

But here I am. It’s twenty months later and except for nuisance and persistent symptoms, I’m feeling okay. My cancer is in partial remission. But the dreams were all discarded and the goodbyes said. Is it safe to dream again? Is it safe to hope? It is safe to plan on a future?

I have many projects that I’m working on, most of which are for Denise in case I’m not here. I plan projects only a month in advance, not knowing what the next month will bring. My house painting is in its third month, but not by design. But I do have a time bomb in my marrow, a tinderbox in my kidneys. But, we all do, don’t we? You are not guaranteed a tomorrow are you?

Some would say that my survival so far is a miracle. A real work of God. I am not so fast to say so. And no, it is not because I don’t believe in God or that God doesn’t have the power to do miracles. It is certainly not because I’m not grateful. I agree with Einstein’s point of view that either everything is a miracle. . . or nothing is. I’m the former. Everything from the “Big Bang” forward is a miracle. But what happened to me, I mean surviving like I did, is within the boundaries of the natural. People (rarely) who started out like me have lived 20 years. . . I think? The average is nine months. When I believed that supernatural miracles were common not only was I delusional but I found out that if an expected miracle did not occur, those people who assure you it would, are the first to abandon you when things go sour.

I admit, there are days when I (from strictly an emotional place) think that things may have been better if I had not survived. Would Denise have moved on by now? Would I just be a fond memory and she builds her new life?

I have been fighting with insurance companies for 100 straight days. I cannot express the frustration I feel. I’ve lost many nights of sleep over this. It is like doing your taxes for the IRS once or twice a week (filling out forms for various programs) and then being disqualified or they loose everything and you have to start over. Today was one of the worst such days. I cannot count the hours and hours I’ve been on the phone. On Thursday, I will miss my first day of chemo due to insurance problems and I methodically started this process in April (the 100 days are the most intense part). I can’t believe this is happening to me when I planned so carefully to make sure it didn’t. Does stopping chemo put me at risk? Eventually it will if they can’t resolve this. That’s what makes it so frustrating, as if fighting cancer itself wasn’t hard enough. Anyway, it is days like this that I have to ask if survival was really worth it. I have fought hard. . . but sometimes I ask for what? So I can paint my house? Is it just to give the insurance companies someone to fight with? Am I more than that? But if you are honest, I think many people have these bad days of such thinking.

On the positive side, my son Daniel and his girlfriend were here this week-end. The first time I’ve seen them since COVID-19. They got tested an were negative so they could come home. Ramsey also came home and my son Tyler and his new wife Katie (she is not new to us). The last two have not tested so we have to treat them with social distancing. We added my last two children and their families via zoom on Sunday. When I see my family, I realize that I stay on this side of the dirt for them and to enjoy them. That’s what makes me happy. But are you allowed to dream for yourself again? To hope for a tomorrow? When do you start to live again, and not just prepare for death and for your absence? Is there life after near death? I really don’t know. I need to ask Wesley.

Mike

Health Update: 9/4/20

I know this saga has now entered its 20th month, so I don’t blame those who have lost interest. The other, good reason, that my updates are not as important, is that I’ve been stable. . . and remain so.

I just finished my testing for the month and the values are in. Basically, my kidney function is slightly improved, after worsening last month. That is always good news. My GFR (best measurement for kidney function) is now 22.5 and was 20.7 last month. > 60 is normal.

But also, my electrolytes were all very normal for the first time since I’ve been ill. This is profoundly important to me because I was on a miserable diet for months (only plain oatmeal for breakfast and plain noodles for lunch and dinner). With my potassium being so normal now, I ate a tomato sandwich yesterday, with one of Denise’s garden tomatoes. This is my favorite food and I had to avoid tomatoes (high potassium) for the past year. My next dream is to have a glass of orange juice. I may do that next week. I have also had to avoid citrus for the past year.

My cancer is still in partial remission, still present, but low counts and stable for the past six months. I will have a full body scan next week to look for “extramedullary lesions.” This is another term for cancer spread outside the bone marrow. I have an appointment at the Seattle Cancer Care Alliance in three weeks and I’m looking forward to that, to get their direction on care.

Overall I’m feeling quite good. If it were not for my modest anemia (and my neurological problems) I would be normal. I’ve now climbed our Mount Erie five times. It is hard, due to the anemia, but I can do it.

Speaking of hiking, my dear hiking pal, Greta the Saint Bernard, had a serious leg injury last week on a hike. She will have to have surgery to be able to walk on all fours again. That will not be until October.

Ramsey, my son, was a godsend. I don’t know how I made it through March until May without blowing my brains out. It was the perfect set-up for serious depression. Cancer, almost complete isolation, and dark skies. Ramsey came home (after testing negative for COVID) and lived for 3 months. I can’t believe those days expired so quickly.

Denise has quit her 12 hour per day hospital job. It has been nice to have her home. She starts a new job in two weeks. It will not be as isolating as before for me, as she will work some from home and then when she is away, it won’t be for 12 hours per day.

I hope all the above came across as positive (except for poor Greta), because I mean it that way. If there is one negative, it is the fact that we finally dialed in the perfect chemo with very few side effects, but now the insurance company will make it cost-prohibitive ($2600/month copay) and I will have to come off. I have spent hours and hours on the phone for the past 4 months over this and at times it has left me emotionally exhausted. I picked this insurance because they told me in April that they would cover this med, except or a “little copay.” They could not tell me the amount at the time. Then I go to fill it and am told this outrageous copay amount.

I am still house painting and doing chores like the rest of you. I am near the end of my first draft of Retribution. It has been fun living in Yemen within my imagination for the past two months. I hope all of your are doing well and that you too have mostly good things to report.

Mike

Ramblings Part II: The Gift of Joy

I am continuing to listen to the Book of Joy by Desmond Tutu and Dalai Lama XIV. I like how the two men express ideas from a Christian and a Buddhist perspectives. Sometimes they are in total agreement, sometimes not. They also bring in brain research and it was nice to see both men believed in science.

I could write a long review and article, but I’m trying to cut these shorter. In a synopsis, if you have one take away, that Joy (as I mentioned last time) is the one positive human emotion. The book goes into details of the brain networks work to create the sensation of joy. But the bottom line is that the more we focus on the needs of other people, the more we can experience joy ourselves. The more we focus on our own needs, the more joy evades us. Desmond drew from scripture to support this and the Dalai Lama did from some of the teachings of The Buddha.

One of the ways that cancer can rob someone of joy relates to this idea. When you are fighting cancer, it takes so much of your thoughts and attention that it is very hard to look to others, their suffering, and their needs. I discussed this same thing in this posting.

I said before, I think the happiest I’ve ever been was when I was doing something to save others. It may have been overseas or even in my own practice. I wish I could do that now.

Santa Cruz's Doug Abrams Crafts The Book of Joy | 90.3 KAZU
Dalai Lama XIV, Desmond Tutu, and Doug Abrams (the editor and narrator of The Book of Joy)

I have a friend Jerry who does an excellent job of focusing on other people. He volunteers for many programs to help people and just his attitude as a friend is to focus on whoever he is talking to.

For me, I pray that despite my constant attention that I must give my cancer (like I’ve been fighting for weeks not to have my insurance throw me off my chemo, which is about to happen this week), so that I can focus more on others. I wish so much that I could give time to serving refugees from wars. My present novel, Retribution, which I’m working on, takes place in war-torn Yemen and the protagonist is a PA like me. So, I can live out this dream in my imagination, but it does nothing to help the refugees. At least I hope the novel tickles the imagination of the readers.

I’m off now to the lab once again, on that serpentine journey to see if I’m in the process of living . . . or dying.

Ramblings: The Gift of Anger

This is an impromptu posting and it is about an issue I’ve spoken about many times and this is fuzzy area of when to be angry and speak up, and when not to. What has brought this to my mind is a plethora of issues, the social stress in our country, the fight for absolute truth in an age when truth doesn’t matter, and others.

Yesterday, while working around the house, I was listening to the book, The Book of Joy by Dalai Lama and Desmond Tutu. In that book the comment was made that there are only four human emotions, three of them negative and one positive; fear, anger, anxiety, and joy. It was brought up within that conversation about the place for anger. After all Desmond Tutu struggled tremendously against social injustices and abuse, as did the Dalai Lama, who has been exiled from his home for 57 years. While the goal is joy, they made it clear that their anger caused them to speak out and work out their anger in real social changes.

In the Christian world, the Bible clearly tells us to “be angry.” But it also warns us not to have what I would call a frivolous anger. This frivolous anger is usually directed at personal injustices. “The person stole my parking spot.” “My fees went up.” “They got in front of me in traffic”, “she disrespected me”, and “I didn’t receive what was mine.”

Then there is the external anger, much of which can be righteous, or not.

I have said before, I feel things deeply. I feel joy deeply. I feel fear deeply. I feel love deeply (which I hope I expressed through the characters in Ristretto Rain), and I feel anger deeply. Yes, I have had frivolous anger in my life, at times it has consumed me, but not in recent years or a decade at least (as far as I can remember). No, I have never been angry about my cancer, not for one second (although some have tried to twist my good anger as anger about my cancer). I may speak more forcefully about the issues that anger me because at this stage in life, what do I have to loose? I may not be here in six months. I have already lost a host of friends and family who don’t like it when I speak up about these issues. Many of them never voice their views. It reminds me of the Beatles, Nowhere Man.

He’s a real nowhere man
Sitting in his nowhere land
Making all his nowhere plans for nobody

Doesn’t have a point of view
Knows not where he’s going to
Isn’t he a bit like you and me?

Nowhere man, please listen
You don’t know what you’re missing
Nowhere man, the world is at your command

He’s as blind as he can be
Just sees what he wants to see
Nowhere man can you see me at all?

Nowhere man, don’t worry
Take your time, don’t hurry
Leave it all till somebody else lends you a hand

Doesn’t have a point of view
Knows not where he’s going to
Isn’t he a bit like you and me?

Doesn’t have a point of view
Knows not where he’s going to
Isn’t he a bit like you and me?

But I digress. I have to try to understand that when great ills grip us, that often you hear crickets within the church. No, it is not political. If my pastor endorsed Donald Trump or Joe Biden, it would be my final day with this great church. But, she would never do that. She does speak up about the general principles and in a loving way.

I think much of the fear to speak up has to do with the false character requirement of “personal peace at all cost.” I will not judge those who never speak up because that’s within their own soul to figure out. Some fear rejection, and I can attest that it will occur if you speak up, especially though social media, which is the major way our culture now communicates in this generation. But calling people out has to be done in love, the first priory of Jesus’ teaching. But I will also say, don’t judge me when I do speak up, as long as my speaking up is from a place of righteous anger, not from myself, and is not done in a hateful way (which , I confess, I have done at times).

As a Christian, my favorite life verse is “To act justly, and to love mercy and to walk humbly with your God.” … Micah 6:8. I also draw my inspiration from Jesus, but not the recycled Jesus of American Evangelicalism, the historical Jesus. He is there in plain view and much different than what I was taught in my Baptist unbringing.

Here are the issues I will speak up about and fight for.

Justice

Hypocrisy

Lying

But if you ever see me getting angry over how I’m being treated or not speaking up in a loving way, call me out on it. Mike

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