Fall in Pittsburgh – foggy mornings, brisk sunny days. Walking to the coffee shop again is like putting on fluffy socks as the temperature drops. Much about the store itself has changed but not the customers. Every day, I see someone I know and we share a smile, sometimes a few words. Community, my friends. 

A quick health update: scans show no evidence of disease in my liver. That 7mm spot in a pulmonary lymph node – found in my December 2023 scan – is still there. We’re calling that a watched spot, lol. Next scans in January. So far so good. 

There’s a group behind me talking about sourcing materials. It’s a very serious discussion, almost presentation-like. Reminds me a lot of standing in front of a client, pitching our enrollment tools. That’s an experience I don’t miss at all. One time, many years ago, when I was responsible for creating the health plans that self-insured clients purchased, a potential customer approached us about creating a policy that did not cover pregnancy. We had a lot of internal conversation about that and as was often the case, I was the only woman at the table. Of the six or eight men in the room with me, only one agreed that it was grotesque to even consider that request. Luckily for me, having to write that coverage, and for the women who would purchase it, the man who agreed with me was the vice president of sales. We didn’t write the business. 

The coffee shop is bustling, lots of people enjoying the weather. A child – early teens, maybe – has just come in. They have that tentativeness of the teen years, when you think everyone is looking at you and you really want to act normal, whatever that is, or really cool, again however that looks. Their money is folded in their hand. They have to unfold the little square of bills to pay. 

After a few moments, they’re handed a large mocha with a mound of whipped cream and a drizzle of chocolate syrup. It looks delicious. Apparently, it’s not quite ready to drink, though. They head to the coffee bar, use a straw to stir the whipped cream into the drink and then pour in a bunch of cream. A taste of it confirms that it needs even more cream. A second quality check confirms that perfection has been reached. The lid is snapped on; their remaining money is carefully folded and tucked into a pocket, and off they go into the sunny afternoon. 

I just finished reading Demon Copperhead. Oh Lordy. Was that a journey of a book. It took me a couple weeks to read because it is stark, filled with trauma, making it one of those novels to be read in short sessions. I have to say, though, that it deserved the Pulitzer. Barbara Kingsolver has written a protagonist whose voice is so powerful I can still hear him talking in my head, days after I finished the book. 

Recently, thanks, I think, to all of the death in Demon Copperfield, I had a dream about my paternal grandmother. She died when I was 17 – cancer, plus two strokes – a particularly bad death. She was dying again in my dream and I was going to see her one last time. It doesn’t make sense – do dreams ever? – because in the real world I was with her when she died. It was, in fact, the first time I watched someone pass away. 

My sister and I had a challenging childhood. Grandma made things better. I felt closer to her than I can express; she only had two grandchildren so she lavished all her attention on us – not money as she had virtually nothing that wasn’t provided by my parents. We didn’t need to have expensive adventures. Sometimes we’d walk through the mall and buy a Friendly’s junior milkshake and fries to share. We’d guess how many steps it would take to walk the neighborhood and then we’d count as we walked and cheer whoever had come the closest. She taught us how to play Crazy Bridge and we taught her and her friends to play Uno.

Losing her in my teens was as inexpressible as re-losing her in my dreams. She already spends a not insignificant amount of time in my head. I can picture her clearly, a tiny woman with a huge personality, assertive, mouthy, fearless → except for cancer. She didn’t even tell us she was sick until it was far too late. 

When she eventually called my mom (rather than her only son!) and went to the hospital, it was her final trip. Doctors did exploratory surgery and concluded there was more cancer than body. It was the early days of hospice care. Grandma stayed in a regular hospital room surrounded by all the normal hospital noises. The care team did all they could to keep her comfortable while we waited for her to die. Just a few days after she was admitted, Grandma had the first stroke. She lost the ability to speak but could gesture to me that she wanted to roll onto her side (her left side because it was her favorite sleeping position). 

None of this reality occurred in the dream. Instead, she was sitting upright in a hospital bed and talking, her candy floss mass of white hair curling all over her head. I, on the other hand, was struggling to get out of bed, frantic to get to my last visit with her. What cruelty are dreams. I’d give a lot to dream instead about her driving us to Dunkin Donuts where we’d get honey sticks and the plain donuts with the dunking handle, the kind my mom liked to dunk in her coffee. 

Much love.