Healing "tendinitis"

See end for an important update to this post.

I thought it was time for a post about what I've learned due to my injuries—but not what I've learned about life, the woods, and God this time. Just what I've learned about tendons.

This does mean that if your tendons are fine, you could skip this one—but maybe don't? I'm writing this in hopes of being useful to a few beleaguered people out there, and one of them just may be someone you know. And maybe you could point them to this post, today or sometime down the road. I hope so. Because as I've learned, injuries like mine—repetitive stress injuries of all kinds—can be truly horrible for people whose livelihoods depend on the very muscles and tendons they've been stressing. It can be extremely hard to recover, and extremely hard to find answers as to what, if anything, can truly be done.

And the truth is, there are answers now. They're new (in a way at least), and not very well-known yet. But if I can help spread the word, I may help restore strength to a few people who desperately need it, and I want to. I don't want anybody else to have to go through this.

1. It's not tendinitis, exactly

It's tendinosis.

This has actually been accepted medical doctrine for a while, but most people don't realize it because doctors have tended to use the familiar term tendinitis with patients, while officially diagnosing tendinosis.

So is this just semantics? Not quite.

The suffix "-itis" denotes inflammation. Tendinitis basically means an inflamed tendon. This does happen, but the newer medical research suggests that it's less common and much briefer than the condition I've got, and is usually caused by a sudden strain or injury—not by repetitive stress. Chronic tendon pain like mine, they now believe, is almost always tendinosis.

Now "-osis" suggests, not inflammation, but degeneration—actual changes to the tissue. That's why complete rest and anti-inflammatories were not enough to heal me. Something was wrong in the tissue itself, something that needed active physical treatment. I can't give a full explanation of exactly what was wrong (although if you have lots of time you can get one here) but here are the main things I understand: the repetitive stress I imposed on my hands & forearms caused scar tissue to form in my tendons. This scar tissue is matted and tangled whereas normal tendon tissue lies straight and smooth, and so it impedes function. This scar tissue also is far more sensitive to pain than normal tissue—and so using my tendon causes pain.

The scar tissue will never go away. I'll always have it. But there are ways to change it, re-align it into a healthier configuration that—though I'll always have to be a little careful with it—will allow me to work pretty much as I did before without pain.

Actually, there are almost too many ways…

2. Scar tissue treatments

The first time I ever heard of a therapy that could actively begin to reverse my condition was on the website of Dr. Schierling down in Missouri—and let me tell you, within an hour or two of finally deciding he was for real, I was on Google Maps looking for campgrounds in the Ozarks. (Fortunately, since our only option for travel to a rural area in another state would have been someone else's car, that didn't prove to be necessary.) It did take me a little while to decide he was for real—if you have a look around his website, you'll notice a few of his opinions are a little far out—but I do think that he is, and I think his distrust of the medical establishment is understandable in light of the fact that for years he's been using a therapy they didn't recognize but which did wonders for at least certain of his patients. He doesn't have to be right about everything—just as long as he's right about scar tissue, and how to change it.

Because that's the key. There are quite a few different versions of the technique by now, but the fundamental thing is this: what this type of condition needs is a direct therapy to break up the scar tissue that has formed in the tendon and remodel or recondition it. The scar tissue doesn't go away, but it can be changed enough by the therapy—and the stretches prescribed alongside it, which help the tissue to heal in the right configuration—to turn the tendon back into something that's usable without pain.

Like I said, there are different versions. And they're practiced by different types of practitioners. The first clue I ever had about scar tissue therapy, weirdly enough, was a guy telling in a forum how the only thing could ever heal his "tendinitis" was a strange balm bought in a little Chinese store in Chinatown and rubbed into his tendon by the seller, painfully hard (an extremely important part of the process, he was told.) Immediately following this story, someone else chimed in to say his chronic tendinitis never went away until he visited a bodyworker/massage therapist who gave him a similar painful massage.

I've learned since then that scar tissue work is indeed something that many massage therapists are trained in, though it's not well known to the public. (I have one story of a massage therapist who chose not to pursue training in it because she realized most massage clients don't want painful therapies. They want massage to feel good—it's seen as a luxury, not as therapy.) Which is too bad! It seems to me that in their not-officially-scientific way, they've held out answers for a long time, and science has only recently caught up. As many of us learned in math class, just because you're not able to show your work doesn't necessarily mean you got the answer wrong…

But like I say, science has caught up. There are now scar tissue therapies done by physical and occupational therapists, covered by insurance, Medicare and Medicaid.

But let's not get ahead of ourselves.

There are so many different versions of this, you guys. I don't know everything about them—I don't even know the names of all of them, most likely—but I want to give people a starting point for exploring and choosing. Most likely some of them are more effective than others, but it probably depends heavily on both the skill of your practitioner and how their technique connects with your condition. You can do your own research starting with the links here. So here's a quick overview with links.


Massage therapists:

Massage therapists tend to use manual techniques (as opposed to instrument-assisted techniques, which involve some type of metal or plastic instrument.) It seems to me there are advantages to this, and from my reading it seems a really skilled and experienced practitioner can feel how much scar tissue you have and where, as well as feel it breaking down. I gather that these manual techniques are sometimes painful and sometimes not—if you have concerns about that you'll probably want to ask your practitioner.

Here is an example of an apparently very skilled and experienced practitioner. She's in Australia:

http://www.marjoriebrook.com/private-practice/scar-tissue-release-therapy/

And an article by her about her technique, which she calls scar tissue release therapy:

https://www.massagetoday.com/mpacms/mt/article.php?id=14020

You'll find an abundance of different names in this business. These folks call it scar tissue massage:

http://www.medical-massage.net/scar-tissue-massage

It's also called scar tissue remodeling—a particularly accurate name, if I understand correctly, because the scar tissue is not destroyed but rather reshaped by the therapy. If I were still searching among different practitioners to find someone who knows some version of it, I would probably use the generic term "some form of scar tissue therapy" and maybe add "some therapy that can break down and remodel scar tissue." (I might also mention some of the names in the PT section further down, especially if I was talking to a PT.)

https://erikdalton.com/blog/scar-remodeling-adhesions-nerve-pain/


Chiropractors:

Like I said, the first place I ran across this kind of technique (scar tissue remodeling, in this particular case) was on a chiropractor's website. One interesting thing about this guy is that he learned of the technique (years and years ago) from another chiropractor who successfully treated him with it for the exact condition I have—tendinosis in both elbows. It seems to me that here is another very skilled and experienced practitioner—that does seem to count for a great deal in this business—and I can vouch that he responded to me promptly and helpfully when I inquired about coming down to see him about my elbows.

http://www.doctorschierling.com/

There are some other scar tissue therapy techniques practiced by chiropractors—I don't know many details about most of these.

Here's one called Active Release Therapy:

http://www.marketwired.com/press-release/vancouver-chiropractor-explains-scar-tissue-and-how-to-get-rid-of-it-2231274.htm

Another, called Rapid Release Therapy, which seems quite new and assisted by a type of instrument I've never seen before:

https://www.swinkchiropractic.com/rrt-soft-tissue-therapy/

And another, apparently more widespread, called the Graston Technique. The Graston Technique is a type of instrument assisted soft tissue mobilization therapy (IASTM) using metal instruments. More on that in a minute.

https://www.spine-health.com/treatment/chiropractic/graston-technique-instrument-assisted-soft-tissue-manual-therapy-back-pain

https://www.chiro-med.ca/scar-tissue-pain-how-the-graston-technique-works/

But first I want to give a shout out to a somewhat local chiropractic practice, in Peoria. I spoke on the phone with a man named Carl (I unfortunately can't find his last name) who works there—I believe his official title was as a massage therapist. He was so extremely knowledgeable and helpful—completely familiar with the different techniques, clarified things for me, gave me excellent advice—that I very much wished he was nearer (and that chiropractic was covered for me!), as I would have felt I was entirely in good hands. Believe me, that was not the case with everyone I questioned on the phone! Only one other therapist even came close.

So if you have tendinosis or other chronic pain and are in or near Peoria, go to Benningfield Associates and ask for Carl.


Physical and occupational therapists

And now we get to the therapy that I actually ended up going with. But first let me mention the generic term usually used by physical therapists: soft tissue mobilization. There are manual versions of this technique, as seen below:

https://ptcentral.org/services/soft-tissue-mobilization/

But one version that seems to be catching on and becoming more widespread—and of course the advantage of this is that you're likelier to find it near you, and covered—is called ASTYM. That acronym is a different version of the other that you saw before, standing for instrument assisted soft tissue mobilization. (This is important to note because due to the "stim" sound in the word, people tend to assume it's some kind of electrical stimulation therapy like an EMS unit.) It's an instrument assisted scar tissue therapy similar to the Graston Technique—I don't know the details, of course, but the obvious difference is that it uses plastic instruments, somewhat different in shape.

It seems like one of the advantages of an instrument assisted therapy is that it can be more generic—easier to teach a wide range of people, more replicable. This is probably why it's more widespread, and it solves the problem of finding a deeply skilled and experienced practitioner—you can be pretty sure of getting good therapy as long as someone has had the official training. And, of course, unlike massage therapy, it's more universally recognized by the medical community, and more likely to be covered.

And here it is:

https://astym.com/Main

https://www.therapeuticassociates.com/programs/astym/

Along with a more scholarly article about IASTM techniques in general:

https://www.tandfonline.com/doi/abs/10.1080/10833196.2017.1304184

My therapist—she is technically an occupational therapist, because apparently, at my hospital, occupational therapists work on hands and arms—has been in the field for 12 years but was only trained in ASTYM a year-and-a-half ago. She says it's given her better results than anything else she's ever done. She spreads cocoa butter on my arms and works them with various shaped plastic instruments, covering the whole forearm but with special focus on the elbow tendons and also a few particular areas of the wrists, hands, and shoulders (just one tiny place on the shoulder, actually, which is apparently a trigger point for certain forearm or hand muscles.)

It doesn't hurt—in fact it feels pretty nice. She and I can both feel a certain roughness or "grindiness" under the skin when she hits an area that has a lot of scar tissue in it—that's actually the feeling of the scar tissue breaking up. It's not a painful feeling, it's actually rather subtle, and she can feel it better than I can. It takes maybe half an hour for both arms—she follows it with a short ultrasound treatment on each arm to stimulate healing—and she says it takes 8 to 12 treatments for full healing. (I expect in my case it'll take the full 12!) I've felt a huge amount of improvement. This week she instructed me to try weeding half an hour each day—carefully, wearing braces and icing my elbows afterwards—and I did it with no ill effects. This would have been completely impossible before we started the treatment.

Yes, I would like it to work faster. It's still possible (I mean very easy) for me to overdo and set myself back, and I did so this week—but so mildly. I didn't get pain, just a bit of warning discomfort, and I skipped the half-hour of weeding for a couple of days and am back where I was.

It's working. Lord willing—and accordingly to the usual progression for ASTYM—I'll be better by the end of the month.

And that's amazing.

Important update for the sake of anyone who visits this post for tendinitis/tendinosis information:

Boy, I'm a bit incorrigible in my wish to tie a nice bow on things before they're finished, aren't I? Here's the truth:

ASTYM didn't end up fixing me. It did a lot, and I suspect that in people with lighter repetitive-stress injuries (OK, people who hadn't injured themselves as relentlessly as I did), ASTYM would have done the trick. But as it was, my therapist told me we seemed to have reached a "plateau" where the ASTYM treatment seemed to be merely maintaining the status quo rather than improving me further, especially as we gently introduced more freedom to use my hands for both light and heavy work into my daily routine. Insurance doesn't like "maintenance" treatments and, frankly, I'm not crazy about them either. I wasn't even working that hard yet! And pretty soon some of the pain even came back...

So we went with what for us had seemed like the nuclear option. (A day's travel to the boonies is NBD compared to losing the use of your hands, I know, but we don't own a car.) Hungry World Farm kindly let us use their farm car and we drove to Missouri to Dr. Schierling, who was exactly as he appeared to be on his website--friendly, professional, and wildly experienced with, & interested in, scar tissue. He explained that in his experience, though the more widely-accepted therapies are very gradual, breaking up scar tissue is frankly "the harder, the better." It's perfectly understandable why the medical establishment would find this a hard kind of therapy to sell people on--Dr. Schierling is very upfront about how much it hurts and what you look like afterward, and that is why what he tends to get (including from out of state and even overseas) is desperate cases like me.

It hurt. A lot. I'd do it again tomorrow if I needed to, though that would mean hopping in a car this instant to get there by then. The fun thing is that Dr. Schierling turned out to be a World War II buff, and explaining to him the history behind Flame in the Night was very effective in taking my mind off the pain while he worked! (I also gave him a copy.) I looked head-turningly terrible on the drive home--as Schierling explained to me, scar tissue contains capillary blood vessels and you're not really breaking it up hard enough if you don't see bruising. A very unusual kind of bruising--just beneath the skin and bright red. I had it on my shoulders, the sides of my neck, and all down the inner sides of both arms.

(Whereas the official ASTYM treatment for elbow tendinosis basically restricts itself to the arms only. That's one reason I now strongly lean toward relying on a practitioner's experience rather than official training: you may need someone who knows where & how to look for something slightly out of the norm. Schierling relied on testing my range-of-motion and pinpointing places where he found it restricted, and also on his process--a rubbing/scraping similar to other instrument-assisted therapies but a lot harder--by which he can feel the presence of scar tissue and see the bruising as it breaks up. I watched him do my forearms, where we found very little scar tissue--the skin got red just as it would if I rubbed it hard, but there was practically no bruising.)

And here's the incredible thing: one session. (And three very intensive days of all-important stretching exercises--every half hour except sleep time!--afterward. That counts, oh it counts, especially as I was hosting a family reunion during them. Ah, timing.) One session! I had two or three months of trepidation afterward, gently introducing myself back up to a full working schedule, but especially as I began to prune fruit trees and do other farmwork and my arm strength renewed, it was clear--I was completely well. I'll never be as much of a fool as I was before, pushing and pushing myself with no break, but I've relaxed. I type, I scroll, I work--I feel fine.

Thank God.

Broken hands and new roads

I was going to write about family separations at the border. I was going to. I didn't know what really could be said about it; in fact I don't know what to say now. I've tried and tried to write a blog post, to be honest--about that, or about anything.

The fact is, my hands still don't work.

I tried to write a blog post about that--to share what I was going through in the middle of it, rather than at the end as people always seem to do. I didn't know what to say. I've been wordless. Once--when the pain had started to come back and I knew I had nothing to lose by the experiment--I typed a sentence. What I mostly learned is that I've half-forgotten how to type.

There's hope for the hands. They actually are improving still, I'm able to do careful light housework without compromising them--it's so good to finally be able to do something, anything, and to get the place clean again--and after a great deal of research we've chosen a method and a place for therapy which by all accounts has a good chance of working. As for me--I've been wordless. I don't take back my previous post, all the meaning I've found in this, but I've been in the place of "I don't know what this is anymore." Sometimes when I look at my a-few-months-younger self, I see someone who couldn't bear to have plain old meaningless ordinary troubles happen to her. I mean, I did learn the things I said. But I set out to learn them. I don't remember asking God what this was. Maybe because it seemed pretty clear. I may have guessed right.

But I probably should have asked.

We're scared of the emptiness. Of not knowing what this is. Of course we are. That's what stories are about, in a way--why we like them and need them. It helps to watch other people go through it, see how they handle it. Robert McKee, the Story teacher, calls it the Gap--the moment when the familiar solutions stop working, when the character is forced to choose a new road.

Can I, for instance, learn to write by voice recognition? Write fiction by voice recognition? I would have called it impossible, but last night I wrote the first page of a short story. It flowed and grew and made me see things, the way good rough-drafting does. I couldn't believe it. I was just trying to write down a few lines I'd thought of, awkward as I expected it to be. Instead I wrote--spoke--a scene. Someone killed a rabid fox. I saw it happen.

In a way, I don't know why I'm boring you with this. To type or not to type? These things are so personal, huge on the inside of a life, very small when looked at from outside. Like a tendon in the foot or in the elbow, just part of the equipment of everyday life, disregarded.

As a child I wondered why prayer requests seemed to be always about health. I wanted people to be more spiritual, or more selfless. I was healthy as a weed.

I was going to write about the family separations. I still don't know what to say, except that when I think about it, really think about it, I feel like I'm trapped under the oak that fell last week just downslope from my spring in the woods. And I experience a burning anger toward Trump--utterly useless. And of course I think of other family separations, of the police official at Vénissieux who asked, annoyed, why all these people were yelling so much. To which a priest replied, "If someone took your children, wouldn't you yell?"

By the priest's account, the official looked thoughtful, and said yes. May God be with the people in parallel positions today, and give them courage to choose new roads.

Broken hands

I'm very sorry for my long silence. I thought it would be shorter than it was.

The short version is, I lost the use of my hands for two months.

Sometime before Christmas I told you all on this blog that I had hand pain and needed to take a break. I had not only stressed and inflamed many of the muscles of my forearm, but also one or more of the tendons that connect those muscles to the elbow. Unfortunately, I was pretty stupid in dealing with it. The story of my stupidity is pretty boring, I suppose, but basically I kept making what I thought were radical, difficult changes in my routine and they kept turning out to be too little, too late.

The last of these changes was to stop using my right hand entirely. I not only used the mouse with my left hand, I typed with my left hand, and I chopped up vegetables for supper with my left hand. You can see this coming, can't you?

I got tendonitis in my left arm too.

I barely know how to tell you what it feels like not to be able to use your hands. It feels like death. Because, I think, death—not a loved one's death, not a stranger's, but my death and yours—feels like helplessness. Death is the moment when it doesn't matter if your life's work is sitting unfinished on the desk, when the world doesn't care. The moment when you can't do anything about it. The moment that most of us, deep in our hearts, don't believe is coming.

I remember the sensation of stopping. The impatience in my soul, the forward momentum—I have to finish this edit I have to clean the house I have to start working on the new farm and show these people what I can do I have to plant my garden I have to—it died hard. Several times. The first time was at Easter. April 1st. I thought I'd be out for a month then. I thought that was a huge deal.

I didn't want to stop.

We found ways. I stored my laptop outside our apartment, bringing it in once a day to deal with urgent email using voice-to-text, manipulating the touchpad with my chin. My husband started doing all the dishes, and chopping vegetables for me when it was my turn to cook. I tried to come up with recipes with little or no chopping. I told my son gently and continually that I was sorry, I couldn't move the little car around, or build the Lego train with him, or get his wagon out of the shed. I accepted not planting my garden—and then my husband offered to plant it for me. I accepted things being done other people's way or not at all. I watched weeds grow, and did nothing. I watched dust thicken, and did nothing. I watched grass grow up around piles of split firewood that needed stacking. I could not change the world. I could only accept it.

I learned to sit. I learned to let my mind wander, and not try to force it into important and purposeful paths. I couldn't do anything important and purposeful, anyway; thinking about it only hurt. I learned to sit and accept the world, let it come into me, whether it was important or not. The movement of the leaves in the wind. The tiny flowers in the grass and the bumblebees visiting them. The ants, the woodlice, the holes in that dead tree that the woodpecker made. I learned to sit in the woods and let them breathe around me. I learned to sit among the trees and not tell them over and over that I was wasting my important time by being with them. I learned their names. I carried my field guides in a bag I could sling around my neck almost without using my hands, and I learned what an ash tree looks like, and an elm, and a basswood. Once I started seeing the shapes of leaves, I couldn't stop. I know so little still, but I feel like I've learned so much. I know where there's a spring now, two slender tunnels opening out of the clay inner structure of a hillside, one slightly larger, one slightly smaller, like mother and daughter. I go to that spring every day. I pray, some. I also just sit. I watch a chipmunk run up and down, or a bird whose name I'm not sure of in the fading light go about its peaceful business. It doesn't have to be something important. Several times I've seen a pileated woodpecker—rare in these parts—but I don't go there to see it. If that was why I went, I wouldn't go. Not after the first time it failed to show up on my timetable.

I don't know how to explain what has happened to me. There was a time when I loved the woods, yet when I could have gone to them, I stayed inside on the computer, reading funny stories about other people's bad books or bad behavior. (You may not be familiar with this particular pleasure; it's relaxing, because it tells you it's all right, at least you're doing better than someone. Might be best if you don't give it a go.) I'll tell you the truth: I never once got angry with God about what was happening to my arms, and that's not because I'm a good person. It's because I knew beyond a shadow of a doubt I had done it to myself. Yes, I partly did it to myself writing Flame in the Night. But if I had finished my writing and gone to the woods instead of sitting at the computer, clicking on little pictures of cards or scrolling and scrolling while laughing at somebody, I would be fine.

I'm not saying it was a punishment, either. It was a kindness.

Oh, it felt plenty mean sometimes. Like being pushed down and down. Every time I began to feel the joy of recovery, to believe I would be better, I relapsed. I let the joy tempt me into doing too much. Putting a few books away. Taking some notes by pencil. I felt the pain come back, and sat there watching my son play, wondering how many days I had lengthened my sentence by, and trying to look like I wasn't about to cry.

It was two months, in the end.

And it was worth it.

There are practical things. The benefit to my son, of having been called upon to be kind and gentle with me, to see that I'm not all-powerful; of having had to do things himself that he'd rather depend on me to do. The garden, which in spite of the weeds is a family endeavor now, my husband and son proud of what they've done for it—no matter if I go back to doing it all in time, I will remember and so will they. The bonds of need and help and kindness reaffirmed between me and my husband; I have felt so loved. But beyond even that, something has happened to me. Sitting in the woods; reading books, real books, at times of the day I used to spend online; not really wanting, anymore, to read about what's wrong with other people. (I'm not saying I never will again. But you know how they say that if you stop eating sugar, you stop craving it? It's like that.) I'm better at waiting for others now, not trying to fill every minute of my important time. I notice things more. I let the quietness come into my mind, the silence I used to run from so hard—I don't quite remember why. I think there were bad thoughts in it, regrets and fears—or I thought there were. I guess I've found some. They weren't so awful, once I stopped running.

Or I wonder if the silence itself frightened me. Nothingness, emptiness has always felt like my enemy. Doing nothing, being nothing. I wonder if it looked a little bit like death. I'm not saying I'm not scared of death, or even that I'm less scared. But I do know that it will come someday, and that seems like a step in the right direction. And in the silence--would I have run so hard if I'd known?-- is not nothingness at all. In the silence, where I die a little from my quest to be and be and be something, where I open myself, the lives of others come in. The lives of trees, humble people who stand where God planted them and drink sunlight, and make air. The small, humble animals, rummaging around the woods for their daily bread. Perhaps the silence will let the lives of other people in better too; I haven't had much chance yet to find out. Maybe that's not what God had for me this time. I already knew that listening to people was important. I could have spent two months doing that, and felt I had justified my existence. But there are very few people here now, and what they need from me is work. So I went to the woods. I went to the woods and sat at God's feet, instead of running around and around looking for something to lay at them.

I'm starting to use my hands again. A little. The other day I pruned back a potted heliotrope, scraggly and distorted from a winter of neglect. I cut it back hard—within an inch of where it comes out of the soil, sparing one bud to become the new stem. I layered good compost all over the soil around its roots. We think of these plants as flowers, but the life is not in the flower. The life, the strength, is in the root. I watered it deeply, let the nutrients from the compost leach down to where the roots drink. I prayed, You've cut me back, and You've nourished me. Help me grow straight now, and flower.

There's strength in the root: pruning and editing and the sharpness of choices

Pruning is fascinating. Would you believe that—and that editing is fascinating too? This time last year I wrote a post called “Pruning and editing”--in haste, because the editing I was doing was heavy and under deadline. This year I'm digging deeper. It's sinking into me. I know this may sound strange, but as I learn better and better how to prune—I find it helps very much to love the tree or vine. But love doesn't look quite like what you'd expect.

I'M NOT DEAD!

Have you ever seen a tree that's been pruned very hard? Or a grapevine? Commercial orchards and vineyards are unsparing in their pruning, eye on the bottom line and the highest possible fruit production—those trees and vines seem cut down to nubs. Our instinct when we see that is that the tree's been killed—like the instincts of a farm intern I had once, who became very worried when I picked all but the smallest leaves off the kale. Our instinct is that most of the plant is gone, so how can it survive? We forget how much, and how vital a part, we can't see.

The life in a plant is in its root. If we ever did to the roots what we do to the tops, the plant would expire in a hurry. But if the root is sound, you can cut the whole tree down at the base of the trunk and it'll send up a dozen shoots the next spring around the stump—so never worry about those nubs, come spring they will branch out in every direction in leaf and flower. There's strength in the root. I sing that to myself sometimes, while I prune or garden, to the tune of the hymn There's power in the blood: “There's strength in the root, there's strength in the root...”

I recently learned to prune grapevines properly. (I know apples and cherries now, and blueberries too, but grapevines were still an “OK, hope I'm doing this right” mystery last year.) First you have to know what good fruitwood looks like on a grapevine, then you make a goal to keep a certain number of fruiting buds per vine and take off, well, everything else. It's that per vine part that tripped me up—no one had taught me to look at each vine before. Our vineyard looked to me like a tangled mass of leafy streamers twining along the cables, sending down a root here and there. No wonder it was a mystery to me! I was starting at the wrong end.

Writers do this too, until we learn.

We start at the wrong end, at the surface, at the leaves. We start at the words. We don't see the words' source; that is underground. Beneath the surface of the page, beneath the dark sweet earth drawing life into our words, is the Story.

When I start at the source, at the root, I prune differently. I don't go branch by branch, bit by bit, asking “Should I cut this?” I look at the plant entire, I draw into my mind a vision of what it can and must be. The good fruitwood stands out to me, and I choose it. In choosing the good, it becomes easier to cut off what I don't need. The question is not “What should I cut?” but “what should I keep?” Ruthlessness is—strange as it may seem—a positive course, a joyous one. It's driven by the lovely vision of the thing as it should be.

Of course I'm talking about editing—though it's true about pruning too.

The rough draft is like the first wild growth of the vine. Sprouting in every direction, opening leaves to the sunlight, photosynthesizing, gathering strength into the new young root. You do need that part. You need to write till your story has substance, till your characters become real in your mind, even if many of the words you write at that point serve no other purpose. (I remember the moment Elisa became real. She was climbing the steps to the Fourvière basilica that towers over Lyon, looking apprehensively at the massive gold statue of Mary over it. None of that's in the novel. Cut. It was the right choice—writing it and cutting it both.) You write and write, till the root gains strength and shape—you write till under the words you see the Story. That is what you are making.

You keep going then, till the Story is made, till the end. Even if you see where you branched out wrongly, you don't start pruning yet. Pruning out of season is a dire mistake—the sap drips out of the cut (I've seen it drip and drip), microbes and insects get in, whole limbs can sicken. Editing out of season drains the energy from your story, leaves you open to attacks of discouragement and loathing. You prune in February, when the sap is not flowing, when the vine has already been dormant a long time. It's hard to wait—it used to make my brain itch, going on and leaving passages I knew weren't right. One chapter I left behind was mostly scene fragments with half-a-dozen empty lines between them. But I could see the shape of the story going forward, so I followed it. I knew it was the important part.

There's strength in the root

Then the break. I was beyond exhausted after I wrote the last word. The book and I rested. The sap ceased to flow. I came back to it after awhile, and that, that's the moment when you do it. The choosing. You look at the story entire, you carry a vision into your mind of what it can and must be. The good writing stands out to you, the passages that shine because they're not only good prose but are filled with reality, because they are moments where someone makes a choice she knows she can't turn back from, feeling both the weight and the freedom of choosing—they are Story. And then you cut around them, cut and shape and rearrange. In choosing the good, it becomes easier to cut what you don't need.

I keep talking about Story with a capital S—I know, it sounds a little funny. But that's what I've learned these past two years, is that it's a real thing, like the root, invisible and really there—and it's the source. What is Story? Short version, it's made of two things: forces and choices. Forces that oppose each other, the desires and aims of the characters, the forces of nature and of need, things that press together to a point and a dilemma: will this character choose the gun, and can he survive if he doesn't? And choices: once and for all, he either takes up the gun or throws it away. All the words of the scene, maybe all the words of the story, come to a point just at that moment—they serve that moment, they have no other purpose. They may be individually beautiful, they may make a beautiful pattern together, but if you cut them off from human dilemma and choice and action they will wither into sad, lightweight things, maybe keeping a melancholy beauty—but dead.

If you understand your characters' dilemmas, the forces they're up against, their choices, the consequences of those choices, you understand your Story. And the role of pruning is to bring it to light.

That's the last thing I learned about pruning grapevines this year—you want your fruitwood as high as possible. You want the fruit to grow on the top, in the light. This keeps the grapes dry and safe from bacteria and mold—and it helps the picker to see them. When your story is finished, those moments of choice will be the fruit—those moments when a character stands at a crossroads for a long moment, then turns and plunges down the path they've chosen, and we see where that path leads.

So I guess, if we're going to make the analogy precise: the forces, the dilemmas, are the root. The turning points, the moments of choice, are the fruit. The rest is a path between the two. If one of your scenes doesn't lead from the root to the fruit—you know what to do. Or if your moment of choice is buried in your scene, de-emphasized, you rearrange it, bring it up to the light.

To bring the strength from the root to the fruit; to bring the fruit to the eater. To sink the root deep into the soil of human experience, and draw up vitality. Those are the great things. And that's what happens when you love the vine—or the book—you see its true nature. You see where its true strength and glory lie, and you want to bring it out. I've become far more ruthless in pruning than I ever expected to be, and I'm glad, because I can see the thing as it can and must be. I don't mourn things I cut anymore—whether branches or pages.

I know what trees know now. You can always make more leaves.

How democracies die (they are not actually killed by Trump)

The other day I read an article on Vox.com, a review and analysis of a new book called How Democracies Die (by Steven Levitsky and Daniel Ziblatt.) It flabbergasted me. Partly because of the things it said--and how much they explained--and partly because I got to a certain section and thought "But I've thought this for years." I've thought it for years and never quite dared to say it.

I guess I've never dared to say it (besides the fact that it was only an unsubstantiated notion of mine) because if you start at the wrong end of the explanation, it sounds racist... and if you start at the other end it sounds like you are calling every American racist. And nobody likes that.

Still, I guess it would be best to go with option B.

Here is the thing: I know, or have known, a lot of people from countries that have universal healthcare. Life is easier for them. They would never (the ones I know anyway) trade what they have for a life where health decisions have to take into account the specter of complete financial ruin. They've asked me What's wrong with Americans? Why don't they want this? And I've thought, and haven't said, They don't want to pay for black people's healthcare.

I'm not saying every American who opposes Obamacare has this exact motive in mind. I'm really not. But I'm saying, first, that some do, and second, that--though it's all tangled up with other things too--this feeling quietly, subtly underlies the narrative, the whole narrative about social services in this country--this feeling creates the consensus that makes it seem more normal not to want healthcare security for every American than to want it.

That's just been my sense. See, I grew up in Europe, so I know what the other way is like. I know what it's like to live in a country that (for all its problems!) considers itself a community, considers it normal that we are together and we take care of each other, that within the community "every man for himself" would be inappropriate. And I know that that doesn't come from some sort of innate goodness or humanitarian ideal. French people don't consider themselves community with the entire world. They consider themselves community with other French people.

We have a little problem in this country. Our ancestors forcibly brought in millions of people whom they had no intention of being community with.

So when I read this in the Vox.com article:

"Our democracy was built atop racism and has been repeatedly shaken in eras of racial progress."

It resonates.

The article's fascinating. I really recommend reading it, because I'm not going to do it justice, but it first makes the case that:

- Nowadays when democracies die, they die quietly, crumbling from within.
- They are killed by people within the system who value their own political goals over the continuation of democracy, and who erode it in small, continual, technically legal ways for the sake of their own agendas.
- This is happening in the U.S.
- It's not about Trump. He's just a symptom.

And then it gets into the race stuff.

"The norms sustaining our political system rested, to a considerable degree, on racial exclusion."

It traces a story of stability at odds with equality--of a consensus that America was a community, yes, but only when it was a community that excluded African-Americans. (That sense that the world was safe and kind in the 50s? It was safe and kind--mostly--for the people within the community, which was white people. The memory isn't false--it just has a huge blind spot.) It traces a story in which the U.S. was stable when African-Americans were excluded, and unstable when--during the Civil Right movements, for instance--they increasingly weren't. Because the community of white people was willing to work together only when that one norm wasn't threatened.

And it uses the phrase "original sin."

This explains so much. I've had this sense of such strangeness in the past year--on the one hand Trump, and on the other hand the pulling down of idols--both statues and flesh-and-blood abusers! Two groundswells coming seemingly from nowhere, neither of which I would ever have expected, and completely opposed. But this makes sense of it. Because this is a time when the compromise has collapsed, the people trying for equality have felt themselves free to act. What there was to lose had already been lost, squandered, thrown away.

But it's so depressing. Is equality the enemy of stability always and everywhere? It may be; it's a fallen world. But these guys make an awfully good case that it's so here and now. And instability is awful, as the Iraqis could tell us. And injustice and inequality are awful, as generations of African-Americans can and do tell us. And who am I, really, a little semi-hermit of a fiction writer with no patriotism to speak of--sorry, I just don't have the instinct, it's the truth--to try to put my finger on the truth of this country? Maybe that's why I never spoke my thought aloud. It's not nice to say The foundation is cracked. It's not a smart thing when all you have to back it up is some notions and impressions you've gleaned.

But the authors of How Democracies Die, they can back it up. I mean I haven't read their book. But it sure sounds like they can.

And then they say this:

"The simple fact of the matter is that the world has never built a multiethnic democracy in which no particular ethnic group is in the majority and where political equality, social equality and economies that empower all have been achieved."

The implication, of course, is that we're all still tribalists at heart. (And my inner atheist whispers "Monkeys!") That we cling to our community, which must look like us. That even without the horrible history between white and black in this country we couldn't really accept paying for each other's healthcare with grace.

I'm not going with my inner atheist (no offense to atheists everywhere, but see, my inner atheist is an insufferable cynic and a truly scary depressive), and I do believe something more is possible for the human race. I believe it's our duty as Christians to live it. But for America, I don't know what to do. I have only the depressing lessons of someone who has watched a community die.

Here is what I know: it's better to be ready. It really is. And to be ready you have to accept the transience of human things. It helps because it helps you remember that the end of something is not the end of everything. It's better to spend your energy on facing into an unknown future, however scary, than on figuring out whose fault it was. And it's better, if you can, to try and find a way to be kind. To everyone.

The other place in the mind: learning to draw at 36

When I was a kid I always wished I could draw.

"Before": a self-portrait I drew a month ago

I remember, in one of the couple years here and there that I homeschooled because we were traveling/moving too much that year, how one of my textbooks--a math textbook, I think!--randomly had little pen-and-ink drawings of deer and other animals in it, to fill up the empty spaces. They were my favorite part of math class*, and I remember trying to learn to draw that year. I wasn't very good at it.

* My mom and I have a story about me and math. I came home from elementary school and said "I hate math." How my mom later told the story: she was surprised when she got my grades and it turned out I was performing just fine in math. What I said when I heard the story: "Mom, I said I hated it, not that I couldn't do it!"**

** (You're absolutely right, that is not where a footnote goes. Onward!)

Actually that makes an excellent segue back to drawing: I'm not very good at math now. I could fill out our tax returns but I am extremely happy to let my bookkeeping husband do it, and as for trigonometry, forget it. I'm not very good at math because I hated it from day one--I haven't learned, and I haven't practiced, beyond the necessary. (And I don't regret that!) Innate ability counts for something, but experience and practice count for a lot more. (Something we've taught our son maybe a little too hard--you should hear the way he says "EXPERIENCED.")

But with drawing, people--including me--tend to figure that innate ability is the only thing. That either you can or you can't. Imagine if we had that approach to reading! I ended up figuring I couldn't.

But I can.

Sometime in the fall, the Boy and I were at a thrift store with a little time to kill in the book section, and I found a book I remembered from my art classroom in high school: Drawing on the Right Side of the Brain. (BTW please don't jump up and debunk left/right brain just yet. I'm getting there.) I bought it, partly because "thrift store, why not," and partly because that little secret wish leapt up in me again. I decided to give it a go this winter, and try to learn.

The message of the book is essentially this: most people try to draw with the wrong side of their brain. The left side of our brain, the side that does both language and math, is obsessed with symbols. It gravitates toward drawing symbols--stick figures, trees with green balls on top, the idea of a house without finicking over every crack in the façade. You can play Pictionary with it, no problem--communication is its gig. But it doesn't draw what it sees. Or if it does, it doesn't see what's really there.

I copied this Van Gogh sketch upside down

The right brain, on the other hand, takes in what it sees without naming it, simply. It sees line and shape and color and lets them be themselves. So that when it draws them, what it draws looks like what is there. So that's what we have to do, to learn to draw things that look real: immerse ourselves in right-brain mode when we draw.

Now I know, because Ye Olde Internet Debunkers have been on about it for quite awhile, that the popular conception of right vs. left brain has been proven wrong. The book's pretty old. But what's interesting to me is that on a practical level it doesn't matter: the book is right. It describes a set of symptoms--a sense of wordlessness, of timelessness, of deep focus on a thing in itself without impatience or the need to name or define it--that point to a distinct mental state, which is the state needed to draw well. And in order to draw, I don't need to know exactly what my brain-scan would look like in that state--I need to be able to get there. (There's a super interesting analogy to spiritual things here--maybe I'll explore it eventually. There's a connection also with learning the wilderness--you need that same state.) That's what the book offers--exercises for getting there--and they work. I felt those symptoms, and I felt them when I was finally drawing something decent for the second time in my life. (By drawing upside-down, to cut down on my brain's instinct to name things.)

That's the funny thing--it was the second time. Once in high school, at my missionary-kid boarding school--just once--I was alone in the dorm all one Sunday morning. (It was allowed. Long story.) It was glorious. Remember high school? Well imagine you lived with those kids as well, and unless you were a jock you can probably imagine why it was glorious to be alone. It was spring, and I went out and lay on the green grass under the lilac-trees for a little while; then I went in and got a postcard I loved, of a kitten in light and shadow, and I copied it in pencil and then in watercolors. Time flowed sweet and silent as I painted. I was a third of the way done with the watercolors when the dorm vans pulled in carrying the crowds home from church, and that's how the picture--ten times better than anything else I ever drew--remains to this day. It felt like a magic moment, one I never could recapture. I never tried.

That's the thing about the right brain--or whatever it really is, that timeless mode. I remember the taste of it in that moment, the freedom. Freedom was a prerequisite for me then--I couldn't have drawn like that with all those people pressing on me, with their adult expectations or their hair-trigger teenage scorn--but also a result. And as I did the beginner exercises in the book, the ones intended to get you into that mode as you begin, I could taste it again. The book has you visualize images of it, and for me they were green, all green, rock and lichen and leaf and pine, and me climbing. That's the other place the timelessness came for me, always when I was a child--out in the woods, in the mountains, in caves even, in all wild and rocky places where I could use my body and trust it and let my mind be one with it, knowing my foot was firm in the foothold and my balance was clear and strong.

I drew this over this weekend. Me!

It was good, remembering that. I did feel like I was opening doors in myself to long-missed rooms.

The book claims that our education with its focus on symbols and definitions closes those doors, that we're moved more and more away from that experience and the particular skills it brings. But that they can be opened again, with time and practice. The book seems to envision a kind of equality of right and left--I wonder if that's affected by the idea of two paired sides, and whether it would be changed by whatever the real science is on these two (or more?) different ways of thinking. I wonder what would be the full list of skills that the "right-brain" mode enables--hunting? working with animals? my mind always goes to outdoor stuff--and whether more crossover between the two would help the problem I've so often seen in farm interns here, where they're so taken up with the image behind their eyes that they don't see the plants in front of them, don't learn from observation.

(I remember being that person. I remember push-cultivating a row of the garden and not seeing that the weeds hadn't died, because push-cultivating kills weeds by definition, right? Except nothing kills weeds by definition. And if any of the Logic Guys I knew in college are here, don't start in at me about weed-killer. You spray that weed-killer on some weeds and see if they die, and then we'll talk.)

I don't know the answers to all those questions. But to the last one I'd lay money on a resounding YES. I think this other place in the mind, whatever we call it, is indeed something we've tossed aside too lightly, neglected to our cost. The ability to look at the world and see what is there rather than the definitions we rightly or wrongly impose on it--how many mistakes might that have prevented, at the very least?

But it's not lost. It's right there, a path we can walk down if we choose. Who know what we'll find?

For example--as it turns out--I can draw.
_____________________________

The heart of the story ("My God, why have you forsaken me?")

In the end
Everything will be
All right
And if it's not
All right
Then it is not the end

That's how a worship song written by a dear friend of mine goes. Ah, but you should hear her sing it--and her church sing it with her, sounding like they believe.

It struck a chord with me, because for a long long time I've cherished a concept I call "the middle of the story." It's about... well, I should just show you.

The truth is I'm exhausted again. Hopefully this is the last of it. But I looked through my archives and found a write-up of the only sermon I've ever written, and here it is. The topic I was given was Jesus' cry from the cross "My God, my God, why have you forsaken me?"

________________________________________


Let me tell you a story.

Once there was a man who was a friend of God. God promised him he would have a son, and be the father of many nations. He waited many years, and trusted God as much as he could; and finally the son came, and was to him like a gift of laughter. And the son grew up happy, and loved, and one day God said to the man: take your son up on the mountain, and kill him.

And the man didn't understand, but he did what God said; he took his son up on the mountain, and he tied his son up, and he got out his knife. And God said stop. God said kill the ram instead. God said, you've passed the test; through you and through your children all the nations of the earth will be blessed. And the man and his son went back down the mountain; and what God had promised came true.

Let me tell you another story.

There was a man, the great-grandson of the other man, who was given dreams and visions from God; that God would someday lift him up high above his brothers. His brothers hated him for it, and sold him to slave-traders, and lied to their father and said he was dead. He became a slave in a foreign country. His master's wife lied about him and accused him of the most unpardonable thing a slave could do, and they could have killed him. And they sent him to prison to stay there the rest of his life; in prison, where God's promise could never come true.

Then he was summoned to interpret the king's dream; because he was known for interpreting dreams. The king saw that what he said was true, and he had him sit down at his right hand and oversee the country to save it from famine. And his brothers came to him, and he forgave them; and his father came, and he saved them all from the famine that had come on the land. And what God had promised came true.

Let me tell you another story. A little story.

When I was seventeen I spent my first summer on my own. My parents were overseas. I lived with a friend, a friend who said we could share the rent, and who didn't tell her landlady about me. I was a stupid kid, I didn't know what was going on, I couldn't find my picture ID for the tax forms at my job and they wouldn't pay me till I did; I'd been working for six weeks and I only had fifteen dollars left when the landlady threw me out. She gave me four days. My parents were overseas and my friend was out of town and I didn't know what to do. I went around to churches, to friends, anywhere I could think of and I got the brush off. I went in to work and there had been a fire. I had put chemical-soaked filters into the trashcan I'd been told to put them into, and they'd spontaneously combusted and destroyed two months' work. And there I was. And I said God, I don't know what you're doing. I guess you don't owe me anything. Whatever.

And the next day I went in to work, because they hadn't fired me. And it was weekly prayer-meeting so I told them what they could pray for me about. And one girl said hey, there's an empty bed at my house, my sister's gone for the summer, we could work something out. And two days later I moved in with her.

Her name was Grace.

And it was my first experience of the real world, and the first time I truly saw God come through. And without it, I probably wouldn't be up here today.

That's my story.

An author once said that God created humankind because God likes stories. I thought about that; it sounded cool; and then I thought about it some more and it sounded like a condemnation of God. Stories are fine when you're listening to them, they're wonderful, but I've been inside a story. It's something else to be inside a story. What is a story about, when you're inside it; when you're right in the middle? What is in the middle of these stories? Pain. A girl feeling alone, abandoned, afraid she'll have to sleep on the street. A man enslaved and in prison, falsely accused and condemned for the rest of his life. A man standing on the top of a mountain with his son tied up in front of him, his heart screaming “God, what are you doing?” At the heart of a story is pain and darkness.

Let me tell you a story.

God became a man. And that man was a teacher. He taught the words of life, he taught the way, to those who would listen, and he lived it too; and people followed him. He knew that it wouldn't last. He knew that he had to die, for our sins and because of our sins. He knew that those in power did not want to hear the words of life, would rather kill him than hear.

This man was not only God; he was also a man. No one can understand it. And like every man and woman he had to choose, it was his choice: to trust God or not. He cried out in the garden and he trusted, and he said Your will be done. But that was not the heart of the story.

They beat him and they laughed at him, and they spat on him and he couldn't wipe it off. He was exposed, nailed to a beam in front of everybody, and everybody turned away. There was no one there who believed that God was with him; no one. He was the scapegoat, he was hung on a tree and accursed, and even God turned away from him. And he cried out a desperate scream: My God, my God, why have you abandoned me?

At the heart of God's story is pain and darkness.

The cross of Christ is our salvation in a thousand ways. But for now, for today, let me tell you one small way. Because when we are honest about that moment at the heart of the story, that moment of pain and darkness, when we are honest we admit that there is no way out. That at that moment no courage can sustain us. That at that moment no amount of believing that God is there, even if we can't feel him, can hold up our heads. That at that moment we are alone in the dark. Think. Remember. Maybe you haven't lived any moment like that; but I think you have.

Jesus showed us the way to life, in everything; even in that terrible moment. And what did Jesus do, in the darkness at the heart of the story?

Jesus did not turn away.

He didn't say whatever. He didn't say, I should have known. And he didn't lie. He spoke what he felt, what his heart knew, what was all around him; he cried out the absence of God. But who did he cry it to? To God. My God, my God, why have you abandoned me? He cried out like a child to his father and mother, to the only good he knows: where are you? The cry of absence is a cry of trust; because he cries as if God is listening.

And God was listening.

And God was with him, and faithful, and never let him go; and though he went down to the darkest place God raised him up. He brought him to the end of the story, just like he brought Abraham, and Joseph, and me. And in the dark at the heart of our stories, it is still as dark as it ever was; but we're not alone. He has gone before us, showing the way in that darkness. "My God, my God, why have you abandoned me?"