Sunday, March 11, 2012

Writing it Forward

Article first published as Prolonged Grief Increases Young Widows' Health Risks on Technorati.

Thirteen years ago I read a letter to an editor urging young widows to go for annual physicals. The timing of the piece reminded me of when I first read about the Heimlich Maneuver in 1974, just days after my grandfather choked to death on a bite of meat.
My uncle had rushed to Grandpa’s aid, pounding on his back to dislodge the piece of meat – all to no avail. If he had known enough to wrap his arms just above Grandpa’s waist, and pull into his gut, the morsel would have popped out and my grandfather would have survived.
The letter in the newspaper that advocated regular physical exams for young widows jolted me once again, for my 49-year-old husband had died a few weeks earlier.
One third of the 800,000 people widowed every year are under age 45. And when the death is sudden, as with my young husband's, the effects on the surviving spouse can be particularly severe and long lasting. Unlike older widows, young widows face the greater part of their lives before them. This puts the younger woman who has lost her husband at greater risk for long-term emotional and physical effects of grief.


A year ago, the medical community officially declared a broken heart can actually trigger a heart attack. “Emotional stress, conceptionally, is the same thing for cardiovascular risk as physical stress,” says Daniel J.Brotman MD of John Hopkins Hospital. “But a lot of doctors blow that off, because they think emotional stress is a psychological problem, not a physical one.”
When I lost my husband, twelve years ago, my doctor recognized I was in for the long haul. He immediately began monitoring my inevitable symptoms of grief: depression, exhaustion, nervousness, loss of appetite, insomnia, weakness, and aching. New evidence in the 1990s had indicated that grief and its related stress affect young widows more seriously than women who lose their husbands later in life. - because of the longer period of time the younger bereaved would likely experience elevated blood pressure, unhealthful eating habits, and weakened immune systems.

Just after my husband's death the doctor found my blood pressure elevated and he was concerned about my ten-pound weight loss – an outcome friends actually complimented me on – since the short time my husband had died. My doctor also wasn’t surprised I cried during the appointment.
Like most people, I did not feel a rise in my blood pressure. My weight loss certainly didn’t bother me, and I expected I’d be sad for a very long time. Yet, if these symptoms of grief went untreated for an extended period of time – which could be four or five decades for a young widow – unnoticed and insidious damage could escalate. Ultimately it would reveal itself in a critical episode, like a heart attack or a late-stage cancer.
None of my early symptoms of grief called for drastic measures. Yet, my doctor scheduled me for regular blood pressure checks and recommended the children and I see a grief counselor. I followed doctor’s orders through the next annual physical. My weight and blood pressured stabilized. I still grieved, but my physical reactions to my grief were being monitored. The same went for the next year and the one after that.


Five years after my husband died I still grieved but I felt fine, physically. I expected to go to my annual exam and not have to see the doctor again for a year. Instead, I got a phone call the day after my appointment.
“There’s blood in your urine and your liver function is off,” he told me on the phone. “We’ve got to find out why.”
I soon learned my "feeling fine" had been deceptive. The next day a tumor the size of my fist appeared atop my right kidney on an ultrasound screen. There had been no pain, no bleeding perceptible to the eye (just microscopic blood cells in my urine sample on the day of my physical), and no palpable lump.

An MRI followed. Then a diagnosis: Late Stage Two kidney cancer. Since I had no risk factors for kidney cancer, my doctor said the high stress I had experienced through five years of grieving could have had a connection to my cancer diagnosis."Possible but not provable," was the way he put it.Yet, I was fortunate. Within weeks, major surgery removed the tumor and kidney - before the cancer had spread. My lymph nodes were clean.


Every year, at my annual physical, I still tell my doctor how thankful I am to have found the letter to an editor advocating regular physicals for widows – especially young widows.
“Early detection,” my doctor replies. “Prevention is the way to go.” He doesn’t stop there. “Any loss can have negative cardiac consequences or weaken resistance.” I understand what he is saying. Dealing with a death, a divorce, a loss of a job –all of these create the added stress that can weaken the body and its defense against disease.
Even as a widow I have been lucky in a number of ways. Thirteen years ago, a piece in the morning paper got me to see a doctor in the first place. Then that doctor treated me for silent precursors of heart disease. Five years later, a routine exam detected cancer in an early, curable stage.
I wonder what would have happened if I didn't start seeing a doctor regularly after my husband's death. I am grateful I came across that letter to an editor. I'd like to write it forward.

Thursday, March 8, 2012

Another March Madness

Article first published as "" The Other March Madness  on

March is Small Press Month.

I could have just as well said March is Big Kahuna Month (it isn’t). Big as compared to what? The discerning reader will want to know. Does it celebrate wise men Kahunas (see or ad men Kahunas (see ?

Does Small Press Month celebrate media or muscle?

The designation is a mini-media shout out for “press”, as in independent publishers, and “small” as in annual sales under $50 million - with fewer than ten titles published a year.

Let me put it this way: If the Big Publishing Houses were corporate banks, the small presses would be credit unions. More accessible. Friendlier. Geared towards a particular neighborhood.

A database on the Poets and Writers magazine website lists hundreds of small presses, alphabetically and by genre: poetry, fiction, and creative nonfiction. I found a small publisher for my memoir on a list from the Writer magazine. Both of these sources are reliable, which begs a distinction that must be made between small presses and vanity presses.

The small press (like larger university presses) accepts quality manuscripts – and rejects substandard ones. Small presses also distribute their books and pay royalties. Vanity presses are virtually printers. They accept all manuscripts and sell the manuscript-turned-book, in volume, back to the writer. End of contract.

Writing magazines regularly feature articles like “Bigger Isn’t Always Better,” by Jeff Reich. He says the less-is-more perspective allows a small press to focus “on quality not quantity.” Big Name Publishers like Big Name Clients. They often opt for celebrity over craft – and hire a ghost writer for the celebs who can’t write.

Small presses give folk like you and me a chance to tell our stories. Case in point: Terrence McCarthy, a regular guy, writes a compelling memoir, You Had To Be There, about his career jumps from reporter to ad writer to counselor on a psychiatric ward. The manuscript won’t make it through the likes of Random House or Penguin Books - because Terrence isn’t well known enough. An independent press like Signalman Publishers in Kissammee, Florida offers Terrence the chance to put his story “out there” even though Terrence is not trending on Yahoo. Not yet anyway.

John McClure, president of Signalman Publishing, says, “small publishers can and do release titles that offer the reader unique insight on a topic without the filter of commercial success blocking it.”

Yet, small presses can be profitable. Only after corporate publishers repeatedly rejected Paul Harding’s Tinkers, did the new, unheard of Bellvue Literary Press (named after the New York hospital) publish the novel. Then Tinkers picked up a 2010 Pulitizer Prize.

McClure recalls that My Utmost for His Highest- a popular book of devotions –was first published in 1936 by a small press in Ohio. Now it’s the utmost meditation seller on Amazon. That’s right – number one in its category! And its 1930s small press — Barbour Publishing — has grown along with the book’s increasing sales, releasing 150 new titles and 1000 stock titles a year these days.

“A small press is essentially the same as a large independent or university press, except that... well, it's small, “ says Brian Clements, founder of Firewheel Editions, a non-profit press in Newtown, CT. Clements copyedits Firewheel’s selections, designs them, and puts thought into his books’ marketability and distribution. Firewheel has seven editions of Sentence: A Journal of Prose Poetics to its credit as well as its latest venture - Kugelmass:A Journal of Literary Humor -which Clements produces together with editor David Holub. Prose poetry isn’t going to attract most Dan Brown, Stephen King, or Suzanne Collins fans. Kugelmass can’t be expected to compete with The Onion. Yet, when Firewheel Editions stays true to its prose poetry mission in Sentence, and, at the same time, takes Kugelmass’ funniness seriously, readers are offered greater choice.

That said, March is Small Press Month shouldn’t evoke the muscle of March Madness as in NCAA , but a quieter strength in the world of literature.