Quitting: Patty's Piano

Quick sensitiveness is inseparable from a ready understanding.

— Joseph Addison

Long after my grandmother lost the label for and concept of piano, my mother could lead her over to the baby grand and place her hands on the keys, an encouragement that would jump-start memories living in solitude somewhere deep in her brain. The connections that joined the act with the memory, linguistics and semantics of it had withered, but when Nanny's hands graced the ivory keys, they were able to range over them and make music; "Amazing Grace," "Autumn Leaves," "Moonlight Sonata."

My own mother's journey into dementia looked different; she began to falter in her music quite early, long before we even knew there was something terribly wrong. It didn't seem so strange in the living room, but her failure to pull off playing for a school or church function was, in retrospect, a harbinger.

That piano, a 1949 mahogany Knabe, has a matrilineal history; it went from my grandmother to my mother to me. It moves again this month, into a new home at the Portsmouth Music and Arts Center. I want to tell you its story.

It came into the family in 1949, as a gift from my grandfather to my grandmother. My first memory of it was in the double living room of my grandmother's North Hampton home, next to her organ, and within reach of the built in bookshelves that housed music, so much music.

I remember plucking out tunes and learning chords, but mostly gathering around and singing as a family group. My mother would play the piano, my grandmother the organ.

After Nanny died, the piano was moved to my mother's house. Shortly after, she and her own piano man, Tommy Gallant, took up together, and the gatherings around the piano became decidedly more professional. Happy Birthday was an occasion to improvise; holidays gave way to harmonies from Tommy's pitch-perfect family, and merely listening to him warm up for a gig was like attending a concert.

When my mother was moved to a nursing facility, despite the fact that my primary instrument is not piano, I took custody of it. It was housed for a time in my small crooked living room in Portsmouth. You didn't quite have to crawl under it to get to the front door, but almost. The playing to room-taking-up ratio became too great, and I lent it to a local family.

They had a perfect room for it, children to learn to play it and cared enough to move and house it.

After my mom's passing, I began to wonder what to do with it. My sister still owns my mother's other piano, a blonde upright that fits neatly into middle class homes.

What to do with this gorgeous behemoth? Should it go to the University of New Hampshire? Tommy would like that. To the Portsmouth School Department? A wonderful thought, but who would be its caretaker over the years? A private sale? No, doesn't feel right.

I remembered, finally, the wonderful blues classes I took a few years ago at PMAC, the professionalism of the faculty, the folks I know on the board, the commitment of local musician Russ Grazier to passing on the love of learning to play. It seems a perfect fit; the piano will stay locally and will exist in service to music education and edification of children. There is no better choice for Patty's piano. It has gotten harder lately to remember her clearly, or summon her support by imagination. I have had the gift three times in the past month of having someone approach me to tell me they knew my mother, followed by the story of how; her advocacy for children, her ability to demystify print for the struggling reader and her quick sensitivities.

Her friend told me I have never seen anyone cry as hard as your mother, with such depth and pain. That is a strange comfort to me, because I need her to tell me that our family will coalesce, that I will survive unexpected threats against the lives of those I love. Her saying, for years, was "Life is a series of adjustments."

It is easy to remember, as a daughter, her strength and fortitude. Of course she would shield me from the grief of her own worries. Where I can't, she would be able to tell me that although I too am sensitive, take too long to get over circumstances and entered the social world much later than the typical adult, that I am going to survive and even thrive.

It's a lot to think about, but perhaps PMAC will let me sit with Patty's piano soon, and pluck out some old tunes and maybe feel her there with me.

Smoking? Is this a column about smoking? Maybe next week. suzanne.danforth@gmail.com.

Quitting: Weeping, Tobacco and Fair Play

Ouch. People are taking sides in the Chantix debate, some who have pointedly penned this week that I am over my head writing about this subject and a failure to boot. Because I am attempting to distill the science in a way that is manageable for the rest of us, there is some small measure of disdain coming my way.

It didn't come during a particularly good week. I have been weepy this week, prone to welling up unexpectedly. Beyond some of the larger issues in my life and the lives of those who are dear to me, I have been sitting day by day in the Brentwood courtroom where the trial of the year is playing out. The macabre information streaming from there has been wiggling its way into my thoughts even after the day is done.

A week ago, I left the courtroom briefly, when the reality of what was being discussed hit me square, both in the tear ducts and the gut. I'd like to be able to compartmentalize, but it seems my lot to tend to the integrated opposite.

Science is uber-compartmentalized, which may be why one Chantix developer seems to be taking what I write personally. This is the same person I wrote of a while back and who has never given me his credentials or agreed to come on record. He e-mailed me that "you are writing about a subject that is way over your head. There certainly are nicotine receptors in the brain and that's where nicotine from tobacco binds and it's the same place that Chantix binds."

In homage to accuracy, I have read more and continue to maintain that there are no more nicotine receptors in the brain than there are Ben & Jerry's receptors. There are acetylcholine receptors, to which nicotine binds. I'm not quite sure where ice cream binds, but it must be somewhere.

This e-mailer pointed out the role of confounding variables, characterized patients as being able to "claim all sorts of things" and pegged the ISMP report as failing to pass scientific muster. All leading to a situation ripe to "inflame a scientifically ignorant public."

Seems I am the ignorant media and you are the ignorant public. It is my long held principle that anecdotal experience is valid. Perhaps the scientifically ignorant public counts on the scientifically gnostic to acknowledge real-world effects?

This person positing a role in the development of Chantix attached a report by Jonathan Foulds, a professor of public health in New Jersey, but not before reminding me that the lack of peer review in the ISMP report made "a big difference."

Dr. Fould's report was also not peer reviewed, since it was published in a blog on May 28. Read it online at www.healthline.com/blogs/smoking_cessation/.

Fould's concerns and conclusions are well stated. However, he calls three out of four methods of adverse drug event reporting voluntary and haphazard. These methods (direct reporting to the FDA by the public, health care professionals and lawyers) are subject to influences like drug novelty, frequency of use and media coverage. The fourth method is above those messy concerns. That method? Drug manufacturer reporting to the FDA of reports brought directly to it.

The primary concern that Fould states is that the ISMP report does not take in to account the massive number of Chantix prescriptions relative to the numbers of adverse events being reported. It does make sense that a drug prescribed in the millions (ka-ching) may logically result in higher numbers of adverse events.

Fould also points to the difficulty of teasing out the effects of Chantix versus the effects of nicotine withdrawal. Nicotine withdrawal is nasty, no doubt, but at least in my case history, quitting before Chantix never made me stay up for days on end, produce volumes of writing and fail to discern between sleep and waking states.

Just as there are people out there scratching their heads and wondering how the anti-Chantix people reach their conclusions, I remain puzzled how Fould can write his way to this statement; "It therefore remains unclear whether any of these serious adverse events were caused by varenicline (Chantix)."

Without information on funding pipelines, stock shares held or seats on boards of directors, it continues to look from this vantage point more like a case of market forces driving the drug harder than old-fashioned axe-less science.

Finally, this comment from the un-named scientist stung the most. "Remember, your activism could cost lives by preventing folks from quitting smoking."

My activism responds thusly: Quit. Quit now. Quit again. Keep trying. Quit any way you can. But if you decide to try Chantix, pay attention to how you feel and stop if it isn't normal for you.

Losing the battle. suzanne.danforth@gmail.com.

Chantix Antics

By Suzanne Danforth
May 29, 2008 6:00 AM
It's been a big week for Chantix, reader. The kind that makes we want to jump on and shape the story, but since one source of my income flows from on demand writing (it's not pretty, but it pays) and the other doesn't come from a benevolent editorial source with health benefits, I have to make do with making the case once, here, on one Thursday morning of many.
Early last week I received a Chantix e-mail. The same day the FAA banned the drug for pilots and air traffic controllers. Each story was triggered by a report of the ISMP, the Institute for Safe Medical Practices, a non-profit in Pennsylvania that stands alone in the country in its mission of safe medication use. The day after, the Wall Street Journal reported that an arm of the Department of Transportation, the Federal Motor Carrier Safety Administration advised medical practitioners not to qualify "anyone currently using this medication for commercial motor vehicle licenses."
The ISMP report demonstrated "a wide spectrum of injuries, including serious accidents and falls, potentially lethal cardiac rhythm disturbances, severe skin reactions, acute myocardial infarction, seizures, diabetes, psychosis, aggression and suicide."
The back story behind this week's move by leaders in the trucking and aviation industries to ban Chantix in their workers is threefold. In the most recent quarter alone, more serious adverse event reports were made regarding Chantix than any other drug on the market. Any drug at all, regardless of market share or numbers of prescriptions sold.
Those reports, which the FDA publishes to the public, were analyzed by the ISMP in a pilot program meant to track drug risks. Their data are strong, because of the high numbers of people taking Chantix (much higher than Pfizer's clinical trials that brought the drug to market), and the real-world circumstances. They are not without limitation, however, including that the numbers cannot point to causality as sufficient to answer all the safety questions.
Even so, the ISMP concluded their report by noting "concern about the use of varenicline (Chantix) by persons in settings where the risk of accident is high."
The third aspect of the story is that the legal community is on it. Kristian Rasmussen is an attorney working the legal angle of the more nefarious effects of the compound in question. From his Alabama practice, Rasmussen said last week that "It is clear that Chantix is dangerous and evidence suggests that Pfizer has known the risk for a long time."
Rasmussen is the co-author of several legal articles showing that the base compound in Chantix, cytosine, has been prescribed for years in Europe for tobacco cessation. As far back as 1972, there are cases linking cytosine to suicide, both attempted and successful.
Rasmussen called the magnitude of the evidence mounting against Chantix alarming and noted that Pfizer, as its manufacturer, has been attempting to "hide this information since the release of the drug on the open market in 2006."
Just how can one drug be responsible for so many systemic reactions, from suicidal impulses to heart attack to diabetes? Some of the theories being advanced are complicated, but sensible. Because of the nature of medical literature, these theories are coming well in advance of peer-reviewed journal articles.
In the meantime, we'll just have to use our common sense. Chantix works on certain receptors in the brain and nervous system that are responsible for pleasure. These are the little brainiacs that move you unconsciously toward a pack of cigarettes, and which release all kinds of warm fuzzy chemicals into your system when you do light up. These are not nicotine receptors, no such thing in the brain world, they are pleasure receptors. Chantix is an inhibitor; it blocks those receptors so you crave the pleasure of nicotine less, and if you do smoke it blocks the resulting warm fuzzy chemicals and sense of satisfaction. Nothing gets downstream to one of my favorite brain systems, the meso-limbic dopamine system. Forget all the fancy talk, just remember that pleasure, reinforcement and reward are the watch words.
As humans, we derive reinforcement and reward from countless acts ranging from organic to physiological to actual interactions out in the world. Chantix may be blocking a system that allows all kinds of pleasure and reward, whether it comes from kissing your kid or smelling a flower or smoking tobacco.
This makes the simple explanation seductive; why wouldn't the world turn gray and dispiriting? But how to account for aggression, psychosis, heart attacks, diabetes? This is more difficult, but perhaps we walk a delicate balance in our inner lives that exerts cascades of influence on a variety of bodily systems, all relating in some way back to pleasure, reward and reinforcement.
It might really be, after all, about pleasure in all its forms; sybaritic delight, Utilitarianism and Epicureanism.
What's your pleasure? Visit www.ismp.org/docs/vareniclinestudy.asp for the ISMP report. suzanne.danforth@gmail.com .

Quitting: Long Drives and Personal Trials

I have been faced with a novel challenge this week in my quest, journey, desire and intention to quit smoking. It is called "being in the car." I need to "be in the car" on a fairly regular basis right now because of work.

The good news is that it is real, live writing-type work. The bad news is that it is for writing-type pay and it takes me 27 miles to and from my house each morning and evening. It is during these miles that I am having trouble forgetting that I don't smoke on long drives anymore.

The fight starts quickly between the nail biting, pen-cap crunching, gum-chewing confident self and the knocked-off-center-at-the-improbability-of it-all self. One of these selves sometimes has cigarettes on her or stops to get some. Can you guess which one?

It is a small personal trial in the big scheme of things, but I was dismayed to realize that I haven't quite broken the car habit.

The patch is still my friend, it can be found in various places on my body, in case you are looking. But it seems to forget it has a job to do once I get in the car and am faced with the very long drive to or home from the courthouse.

For a smoker, to "be in the car" means to be in a solitary place in which to light up. This became such an ingrained habit that I used to light up between home and Pic 'n' Pay (a shamefully short distance to either drive or smoke).

Smoking and driving got to be habitual, ingrained, reflexive.

For a long time now I have not had to rely on my car to transport me very far. There were a few long drives between here and there, but mostly I stayed put enough to walk where I needed to go.

With my recent move back to Portsmouth I anticipated working mostly from home, walking to get groceries, have fun and exercise the dog. I did not anticipate getting this temporary work.

Until now, I was sure I had broken the car habit. I stopped equating my car keys with a butt and I was able to get in my car, zoom off and not even miss the little ... sticks, a name I use in the interest of keeping this column censor friendly. "Sticks" is not the first word that comes to mind, but I can't print the first word that comes to mind here, or even the second.

I really want to use those words, though, because "being in the car" is a danger zone. Evidently I broke the car habit because I wasn't really driving anywhere. Couldn't the gods have seen clear to visit me with one more year of not really driving anywhere, so I could really truly break the habit?

Once I arrive, I'm fine; I have a job to do. Never mind that the subject matter is mass market, true crime, burn barrels and horrifying details; it's a job, it pays and I focus on it. During breaks, I can walk the grounds, enjoy the spring breezes, eat my brown bag lunch, gaze at the pond and forget I am a smoker.

Twists of fate, no matter how small, bite one on the butt. It has to do in part with expectations. I have high expectations, too high, of myself and others and I have worked to rein them in. Even so, I have circuitously learned that it is the expectations you don't know you have that really hurt.

I remember the first time I had an expectation that was not fulfilled. My mother's friend, a former nun, was in need of a room at my (private women's) college, where she had lived many years prior. Her husband was next door in Beth Israel with a heart attack. He was a former priest. They met. They loved each other and left their respective orders to try and navigate the world of relationship. The administration said no, she could not stay there.

Naively, until it occurred, it was an expectation I didn't know I had.

He recovered. And she did OK too, although they did not ultimately make it as a couple.

All I can come up with for an explanation of my current situation is that the gods work in mysterious way. We are each visited with situations we could never anticipate, and that we don't want but that present themselves to us nonetheless.

If the gods had not seen fit to offer up the surprises of this job, I doubt the patch would be suffering this type of amnesia.

Perhaps my new job and its personal attendant trials are meant to desensitize me?

It's the best I can come up with.

What's the best you can come up with? suzanne.danforth@gmail.com.

Quitting: Stories of Portsmouth

I am back in town for the time being and there are so many stories begging to be told.

First is that nicotine patch co-inventor Murray Jarvik died on May 8. I would like to give him a special thank you, because the back story of the patch shows a true scientist at work. When Jarvik and his partner could not get approval for human trials of the patch, they tried it on themselves to gather data. What they found is that the patch mimicked the bodily changes in a person who smokes a cigarette. Jarvik's work helped to prove that nicotine is all by itself an addictive substance.

Boy is it. I'm gathering my own data right now, but am finding that of everything I have tried in the past eight months, the patch is far and away the best method for me. More about that next week, there is too much going on to focus just on smoking.

Portsmouth-isms comprise another story. How about that report of Gary Dodds coming out the front door of the Cutts Mansion breathlessly bidding hello to the city attorney on his walk home, whilst state police waited for him out back? Like MasterCard: Priceless.

Dogs are a story too, and you know my position on dogs. They sully my bed at night, keep me company during the day and don't understand why local restaurants don't offer "hund-wasser." That would be "hound water" for those of us stateside. Many businesses (including restaurants) in Europe routinely offer water for the four-legged companions of the patrons. My understanding (never investigated on first-person basis) is that in Europe, your dog is welcome wherever you are welcome.

Dogs (and by default their owners) aren't so welcome right now in many parts of the Port City. No to Prescott Park, no to fields where we bury our dead, at least until June 1, no to Creek Farm, where island denizens are trying to encourage a mainland ecosystem for study and no to New Hampshire beaches, except before 8 a.m. and after 6 p.m. I hear that Seapoint beach wants to welcome only dogs with a Kittery license. The beach regulations posted online don't support that, but it might be in the works. Thank goodness for the outer reaches of Peirce Island.

I guess I am glad for the relative lack of restriction; in the western part of Massachusetts, I would only walk in the cemetery across the street when my friend was able. We would bring the three dogs and the plan was that if anyone gave us question, she would pull off her hat and explain she was looking for a plot. Some days, it was the only place we could go, verboten though it was.

Dogs need to walk, to run, to play. That can't always happen on leash. Are we responsible at all for having domesticated them? How do we fill their need to socialize, to play, to shake it out, if we face ever-shrinking places to let them off leash?

Finally, there is the story of not having enough pre-bought oil in the tank, a la Simply Green Biofuels versus Rye Fuel. Beyond the fact that there is enough material to keep a reporter deep in stories on all aspects of the energy beat, we just have to be happy with the story of the day as it comes to light by way of the most insistent and disgruntled voice. Mr. Murdoch, why isn't there enough money to finance decent community journalism?

I will just have to be happy telling my smoking story. Natch; telling my not-smoking story. The patch continues to be my friend. I would like to take credit for the idea of making the patch a fashion statement, but I can't.

One reader (Kathleen of the good humor from Maine) suggested carrying around a permanent marker and inviting people to decorate it, a la a tattoo. I really liked that idea, and if the darn thing didn't have to be rotated along my body on a day to day basis, I would take up that suggestion. It would be easy to invite people to decorate it on the days when the patch is on a distal limb, a tad racy when I have to place it on other body parts.

I found out the hard way that the patch needs to be rotated. It irritates the skin if it is placed in just one area. (Yes, the box does state that, if you read far enough). Is this an argument for the gum? Or the lozenge? Perhaps, but I am not ready to move on to either of those in serious way.

The patch is doing the job. When I work it, it works.

What's your story? suzanne.danforth@gmail.com.

Quitting: Patch up those excuses

Nicotine, nicotinic receptors, agonists, pleasure centers, dopamine, Chantix, ecchh. I'm sick of it all. For a good two months now, I have had no pleasure, none, from the nasty little weed sticks my body and my mind crave so unrelentingly.

Even though it is warmer and I can take it outside, mister, for every pleasurable bit of the action I used to derive, there is now the famous equal and opposite reaction. A break became an interruption. The yummy taste became ashy. The quiescence that followed a cigarette became shameful. Because I have been smoking less, when I did smoke it gave me a headache.

Yes, my tenses are all mixed up. Past, present, do I, don't I? We'll get to that. Let me say first that it is probably a good thing that I write in both the present and the past about my nicotine habit. The literature indicates this means I am changing. Finally! It's about time. I've been whining about this publicly since last July, dissecting the journey, casting about for topics, impugning science, scientists, brain chemistry, pharmaceutical companies, you name it.

Could it be that the rubber is hitting the road? I hope so.

Many months ago, my sister gave me a couple of boxes of "the patch," a square little thing to slap on the body somewhere that delivers a steady dose of the core drug. The boxes languished in the cabinet, became dusty and lonely. In the meantime, I tried Chantix, gum, cold turkey, cutting down and bumming only. I even tried not trying, hoping that my desire to quit might magically allow me to eschew without the pain of quitting.

Success remained elusive.

Chantix, as you know, made me nuts. The other tactics didn't make me crazy, but they didn't quite work, either. I don't know what made me wake up recently and dig out those boxes, rather than reach for a butt. I'd like to say it was purposeful, goal directed, lofty. It was none of those things.

I had two dosages to choose from, 21 mg or 14 mg. There is program to follow, but since I haven't followed a norm since Pa fell off the bus, I decided simply to put on the stronger patch.

Lo and behold. The day passed and I didn't smoke. In some ways, it was like the early days of Chantix, before it took deep hold of my brain. I forgot about smoking. I didn't look for butts, crave butts, lament lack of butts or have to slap myself upside the head and remind myself I wanted to be a non-smoker. I just. Didn't. Smoke.

Buoyed by this success, and blighted by my own personality, on day two, I chose a 14 mg patch. Enter mild irritation, seductive thoughts of smoking, motor restlessness. But, I still didn't smoke.

Until.

You can insert whatever works for you here. Until ...; the addiction came roaring back, until ...; life intruded. Until ...; the siren call from the pretty mint green package became too hard to ignore. Until ...; whatever. Excuses all.

On day four, I peeled off the patch and waited enough time to believe I wouldn't have a stroke from double dosing nicotine and I smoked. Have I mentioned there was no pleasure?

There was purpose, to be sure. I smoked for three long days, enough to get me through another transition. Round about hour 12 of smoking, I knew I would get back to the patch as soon as I possibly could. I knew that desire was sufficient. There was something gritty about knowing that I was going to put that patch back on, as soon as I was over the hump.

One could argue that I should have just put it on and not waited for the right moment. One could also argue that there are plenty of high bridges around. The knowledge that I was going to put the damn thing back on was sufficient. There was a quality to it that meant business. I knew that there would always be a reason not to put the patch on, a social gathering, a deep crave. But I also knew that I was reaching a point where that was not going to be good enough.

So, last night, during my typical two hours up in the middle of the night, I rooted out the patches once again. I don't smoke during my nightly wakefulness, never have. I figured that putting the patch on would allow me to wake up in the morning and not be faced first thing with a craving.

I take nothing back about what I think and have written about Chantix, let that be said. It remains, in my opinion, imperfect, poorly studied and dangerous enough to be taken off market.

I chose the 21 mg patch. Wish me luck, light, and the courage of my conviction.

It's time to spring clean up dog poop in the South Cemetery! May 10, 8:30 a.m. See you there. suzannedanforth@gmail.com.

Come for a Walk with Me

Walk with me, reader. I have become a walker, much to my surprise. I don't walk to reduce my carbon footprint (a lovely side-effect nonetheless), lose weight (still waiting for that to happen) or accomplish tasks. I walk to amble, meander, and meet the occasional toddler who just learned to walk themselves, yesterday.

I'll tell you straight up that I am not smoking, so there may be some irritability, some snappishness. Truly, I'm not. Any moody storms will be quick and sure to pass, not to worry, because I am the beneficiary of an efficient nicotine delivery system. It is located on my left arm in the form of a patch. How is that going, you want to know? In time. In time, I'll tell you.

It's not that I want to make you wait (I'm not one of those who delights in some perverse way at holding out, not me at all) rather, I want to protect and nurture this new feeling of drawing in, holding close, not choosing or deciding on an outcome before the scene has even had a chance to play itself out.

So we'll walk and admire the canvas of greens put before us in spring, sniff earth smells, and hurl a stick to water for a while to watch the young dog's muscle and joy when she dives in after it. My whole life I have walked only to get from point A to point B. Same with the telephone. Hello? What time are we meeting? See you then, I have to go now.

I have lived, on reflection, to get from point A to point B. How very American. How un-Zen. Such a lot I have missed focused straight ahead, straining to influence, impress, solicit imprimatur. Although there is something seductive about the scoffer-type, the one who says, to hell with that and you, this is my house and you are a guest, I don't want to exchange my type of chip for that type of chip.

You know I harbor a secret desire to write, string just the right word here with that one there and build a story that opens the curtain for a glimpse of the mystery. One that explains, inadequately and perhaps just for a moment, the ambiguity of love. I do write, you say? Well, yes. I do write, it's why you know anything at all about me, isn't it reader?

But I tell no stories, I weave no threads of truth into a canvas that, unfurled, narrates a picture map of life. I pick book after book off my shelves that do just that thing, I read fiction with highlighter in hand, notebook at my side, to re-read, re-write, marvel at word pairings, word symmetry, word progression.

I get that same feeling sometimes reading the non-fiction in the New York Times or the New Yorker, but it's not non-fiction I yearn to put on paper. Some local writers summon me too: Trevor Bartlett can turn a revealing phrase, Gina Carbone can make me sit through a movie (trust me, that's a big one) and Heather Mackenzie makes me wonder every week why she never tackles the question of sexually transmitted disease.

Dan Brown? Not so much. I'm envious of his bankroll, and the themes in his blockbuster are good on the face of it, but the transparent formula seems simply a mass-market version of my fifth grade discovery of Sidney Sheldon.

Lean in, I don't want to say this next too loudly, for fear of scaring off my continued attempts at writing. I think (I hope) there is a story in me. I handle my well-worn copies of "Art and Fear" (Bayles and Orland), "If You Want to Write" (Ueland) and "Sifting through the Madness for the Word, the Line, the Way" (Bukowski) and hope and wonder and write and wait.

I walk. Idleness, say all good writers who write about the craft, is the essential beginning. That toddler? The one who learned to walk yesterday? We offered her a flower from the garden, we labeled them, yellow, red, soft, tall, short. Each word a new universe.

Take my hand now, on our walk. Just for a minute, help me down this incline. I won't hold on too long, or too intensely. My hand I can pull back, my heart, I cannot.

Walk your fingers to the keyboard and e-mail suzanne.danforth@gmail.com.

Quitting: Letters from Chantix users

Quitting this week is going to visit some of the correspondence received from Chantix users around the country who wrote in about their own experiences on the drug, and end by updating you on Chantix news.

Stephanie from Virginia wrote that my description of the dissolution of boundaries between sleeping and waking made her say "YES! YES! YES! This is exactly what I was feeling after three weeks taking Chantix. While it worked beautifully at keeping me from smoking, I would wake up every morning like clockwork at 3:30 a.m. and begin the madness of being unable to fall back to sleep."

In addition to the sleep problems, Stephanie wrote that "funny enough, today I had such sad feelings all throughout the day, times where I would just want to sit and cry for no good reason."

From New Jersey, Bill writes that although he has never been prone to violence, "by the third week my wife said some little thing that set me off and I banged my fist on the kitchen counter so hard that literally half of my hand was discolored for over a week." A few weeks later, "when I began reading about the violence experienced by some otherwise non-violent Chantix users ...; I realized what had happened to me."

In an eloquent statement, Bill takes pains to communicate that he has a loving marriage, a job he likes and is good at, no debt beyond a mortgage and is a generally satisfied person. He goes on to describe both his experiences on Chantix and its lingering aftereffects.

After the fist-banging episode, Bill chose the eyes-wide-open approach and continued to take Chantix while monitoring and controlling the feelings of anger "since I knew what was causing it." He also experienced the Chantix Buzz, Chantix Dreams and sleeplessness. "I functioned OK at work, but only because I know what I'm doing. I couldn't have learned anything new if my life depended on it."

When nausea became a problem, Bill weaned off the drug and by mid-December "I was done, or so I thought. It is now mid-April and I haven't taken Chantix for four months. The buzz has diminished but still comes around when it feels like it." In addition to the buzz, Bill continues to experience fatigue "like someone just pulled the plug on my body" and counters that "the only thing I have to be depressed about is what I think Chantix is still doing to me."

Across the river in Maine, Kathleen brings a great sense of humor to her experience. She writes that she began Chantix reluctantly after her doctor suggested it. She chronicles the fact that she has never needed more than five hours of sleep a night "but now I wake up about every two hours (told my doc that people probably want to harm themselves or others because they are so freakin' tired)." In addition to exhaustion, Kathleen is missing the more oral side of things. She doesn't "know which is worse, being tired or being hungry all the time ...; I'll keep at this prescription at least for the 30 days (maybe) or until I'm so tired I forget to take the pill or so hungry that I take them all at one time."

From Alaska, Karen writes that in the third week "I was getting paranoia, persecution complex, memory loss and homicidal thoughts. One day my co-worker was leaning over my shoulder criticizing me and I was seriously trying to remember how to rip her throat out by hand." Karen's ex-boyfriend was a Marine trained in hand-to-hand combat.

And now for the news: Ralph Nader is at it again, but not as an election spoiler. His consumer advocacy group Public Citizen issued a call this month for the Food and Drug Administration to levy its highest category of warning, called a black box, on Chantix.

"Black box warnings" per FDA statements, "are designed to highlight special problems, particularly those that are serious, and to give health care professionals a clear understanding of a potential medical complication associated with a drug."

Many black box warnings are dire; heart attack, bone density erosion, liver failure. But the politics of them can be slippery. In February 2006, an FDA advisory panel on drug safety recommended a black box warning for most ADHD drugs, but a scant five weeks later another in-house advisory panel for pediatrics rejected the recommendation. The rejecters trumped.

A Chantix black box warning might alert consumers that taking Chantix could be life altering, if not life-threatening.

No public word yet from the FDA on whether it will accept the recommendation.

What's your bet?

E-mail Suzanne Danforth at suzanne.danforth@gmail.com.

Quitting: Consumer Watch - Johnson & Johnson and the FDA

What's worse than breast tenderness and nausea in the female effort to prevent pregnancy? Heart attack, stroke or death. Quitting this week is going to consider the everyday erosions of our medical liberties by the political and economic culture at large.

Loss of liberty is not necessarily obvious when we flip on the television at night and pharmaceutical advertising flows over us like, well, Flomax. Happy couples in which one has and one is free from genital herpes (Valtrex). Lumbering turtles or careless hares (Chantix). Heartburn grimaces (Nexium), or virile older couples sitting astride powerful motorcycles (Viagra, Levitra, Cialis).

The government watchdog of pharmaceuticals is the Food and Drug Administration; but since it is both a political animal and under-funded, it doesn't come nicely packaged into your living room to influence your drug choices, cajole you to ask your PCP for the brand-du-jour or conduct clinical trials of questionable design.

A current crop of lawsuits against health-care giant Johnson & Johnson over the Ortho Evra birth control patch is showing how the FDA is being ushered by the Bush administration ever closer to the anti-regulatory precipice.

The story is not quite like the Chantix one — where the company in question left out the very demographic meant for the drug — but the company's own documents show that it obscured critical information on dosing, leading to increased risk of blood clotting.

Johnson & Johnson documents show their scientists cooked some numbers on their Ortho Evra birth control patch back in 2000, after the clinical trials for the drug were finished, when pesky data came to light showing the patch delivered more estrogen than was legally allowed (read: safe). This recipe, which the company called a "correction factor," was buried deep in a document sent to the FDA and comprehensible only to a mathematician. It was not part of the original study protocol, not published publicly and not part of the rationale for the 2001 FDA approval of the drug.

More than 3,000 women, or their next of kin, are suing Johnson & Johnson because they wore that patch, took in a far higher dose of estrogen than is delivered in pill form and suffered something awful as a result, life-changing awful.

And yet, in a riveting "not my problem" defense strategy, Johnson & Johnson will be arguing in the Supreme Court (friend to big business) that it cannot be sued for the ruined lives because the FDA approved the drug, despite original labeling listing the wrong amount of estrogen. They knew, they knew. They knew taking this drug could, and likely would, end up in brain bleeding, pulmonary embolisms, and clots in leg muscles. And they sold it anyway.

The legal argument is one that attorneys, pharmaceutical companies and our very own Bush administration wants to see in place. It goes like this: the FDA is the expert for overseeing drugs and it should not be subject to court judgments. If the FDA says a drug should be approved, it should be approved and all liability to the original company should be forgiven. Forever.

Never mind that the agency is of a size nowhere able to match budgets, conduct independent research or levy sanctions that actually hurt. No, the FDA is really only in a position to rubber stamp whatever information the drug companies want it to have, in order to get things to market.

The director of the FDA, Andrew C. von Eschenbach, M.D, spoke publicly on Feb. 29 to the National Press Club, where he noted that the "FDA of the 20th century is not adequate to regulate the food and drugs of the 21st century." To his credit, he sketches out a detailed plan that might actually work — if someone funded it.

I do have an idea for a new FDA logo. Remember the seemingly fearsome abominable snowman in that Rudolph animation at Christmas? His fearsome visage became pathetic, if you recall when he opened his maw to show nothing more than gums.

Chantix antics are reaching Canada now. Back to that story next week. suzanne.danforth@gmail.com.

Quitting: Bailing on bailouts

Quitting this week is delving into hard news over health news.

Reporting has long been known as a "first rough draft of history." That elegant phrase was coined by the Washington Post's Phil Graham, who married into print but who thankfully treated it less as business and more as social imperative.

Social imperative was on the front page of the Sunday New York Times this morning in an article reported by Nelson D. Schwartz and Floyd Norris, two financial newsmen on the roster there. Although it was clearly flagged as news analysis, the piece accomplished what good reporting is at its heart; wake 'em up, shake 'em up.

The writers had advance copies of the United States Treasury white paper meant to curtail the spasms shaking our less than rock solid position in the global economic world. Bear Stearns, collateralized debt obligations, Countrywide shenanigans and the like.

The article notes that the proposals do "virtually nothing," give oversight a "light touch" and cement the neo-con commitment not to hamper the American markets with any kind of toothy regulation.

This interpretation stands in stark contrast to stories (not labeled analysis by the way) that lead with phrases like "creation of new regulatory agency" and "broad powers." These stories regurgitate the spin, shore up their own agenda of non-regulation or begin with names like Ann and end with Coulter.

By this Thursday morning, you will already have heard about the Bush government's attempts to right the ship, but unless you get (read: seek out) real news, you will have had a one-sided and diluted snippet of information, likely nestled between stories on a tasty spring recipe and the tale of another sad celebrity. One of the big network talking heads (the same networks that occupied the three channels available when we were kids) will mention it in passing, possibly with a furrowed brow at story's end.

Jon Stewart and Stephen Colbert will skewer it and aid us in tittering nervously while we digest dinner. But unless we read and make an effort to understand, our local, regional and national media will follow, rather than shape, the news.

It's an old refrain, but the media mavens have a vested interest in remaining mavens. No doubt Katie Couric really likes her apartment in the city. But here we are, regular Americans of all stripes, on our own killing fields five years later, with our civil liberties in tatters. The futures for Medicare, Medicaid and Social Security are uncertain, not because of execution but by dint of slow budget strangulation.

And to think, all we got was a picture of the president in codpiece on an aircraft carrier.

The piece in the Times, easily found by searching "Reluctant Eye Over Wall Street," also attains something far loftier; it is a historic call to economic arms. To paraphrase one of Portsmouth's very own teacher emeritus, the article merits rank as history-making because it reports the facts while paying homage to ideas that are socially useful and personally meaningful.

The writers point out that the regulatory umbrella created in the turbulent 1930s by F.D.R. would in fact grow bigger, with the trend being concentration of power in ever fewer agencies. Call it regulation lite as administered by mini-oligarchs.

Although observations such as these are easy to make, what to do about the state of our country is less clear. Vote, yes. But what else? It is unlikely that the single mothers in Baltimore or the elderly men outside of Chicago who are trying to restructure ballooning mortgages have time to hit the streets. It falls in part, or should, to the media to be the architects of agitation and stewards of American polity.

Recalling the 1970s kismet-like coming together of Deep Throat and plucky duo Woodward and Bernstein, can we dare hope for someone to step out of the shadows and ally with a member of the fourth estate sometime soon?

Modern history would do well to serve up a stew made of a smart reporter or two, a brave well-placed source, responsible editors and law to bring the ball home. Something, anything, to move these henchmen of the Carlyle Group on to greener pastures, say Antarctica, before our country is irrevocably dismantled for all but a few.

The $500,000 paid to the next of kin of each soldier killed in Afghanistan or Iraq seems to be one variable keeping folks quiet for now. But our lesson now needs to be regulation and oversight.

Michael Greenberger, law professor and former Clinton administration player, was quoted in the Times as saying the new regulatory policy is "equivalent to the builders of the Maginot Line giving lessons on defense."

It is worth exploring the details of this simile to drive home the underlying point. Get to work America.

Suzanne Danforth occasionally strays from health-related columns, but rest assured her battle against smoking continues. Write to suzanne.danforth@gmail.com.

Quitting baskets: Hand and cases

Everywhere I turn these days it seems as if the entire world is going to hell in a hand basket. It could be me, it is springtime after all. I ascribe, always have, to the tune "Spring Can Really Hang You Up the Most."

The song, devastatingly sung by Betty Carter, is the modernist's answer to the raw vernal landscape of T.S. Eliot's "The Wasteland," which reminds us that "April is the cruelest month, breeding lilacs out of the dead land, mixing memory and desire, stirring dull roots with spring rain."

Similar to the beautiful woodcuts in the book "My Dog's Brain," a drawing of my brain of late would depict pockets of worry that range from personal to global.

First, there is the collapse of the investment bank Bear Stearns and the subsequent bailout by the Federal Reserve. Their Web site puts the collapse down, simply, to extraordinary market conditions. Mix a little Alan Greenspan in, call the crisis inevitable, and there I am having nightmares involving box cars and wrathful grapes covered in dust.

Truly, though, the magnanimous gesture by the Fed was the first time the government has lent money to a security firm since the Great Depression. That's a hand basket, I'd say.

This is mere steps away in my mind to the sub-prime housing crisis. The ballooning of all those adjustable rates on the McMansions could bring a whole new class of folks into Cross Roads House. Nobody'll be complaining about it being Bums Motel anymore. Instead, decorative grasses will be planted out front and a cappuccino maker installed in the dining area. Something to make the imminent homelessness for who-knows-how-many a little more, well, tolerable.

The health-care crisis is located right next door to the housing crisis. This one looms a lot lately. For example, I took a receipt for a $3,000 shot just an hour or so ago (helps with the white blood cells). Every time I do that, I wonder if people on Medicaid get to have this drug. I wonder if people on Medicaid know that both Republican and Democratic governors oppose Boy Bush Government's new rules on Medicaid. Haven't heard about 'em yet?

Let's see, the rules reduce federal payments to public hospitals, teaching hospitals and services for the disabled. I have an idea, though, about how to fix this one. If doctors, professors and the disabled start dressing up like a Bear Stearns executive when they go to access Medicaid, I'm sure there won't be a problem getting the money.

Don't worry, don't worry. All you privately insured folks who get your care at hospital corporations are going to be fine, just fine. And pay no mind that you are part of a shrinking demographic — more for you in the long run.

Next to health care, in this tour of my worried brain, is global warming. It is easy, however, after this endless-winter to be lulled into the gun rack argument that global warming is a myth perpetrated on us by people who actually like regulation. La Nina pshaw. Those disappearing song birds, frogs and honeybees were probably just coming up to the end of their time on the evolutionary ladder anyway.

The upside here is that cruisers up in Alaska right now are promenading out on the Lido deck dressed in nothing but their fleece jackets. I wouldn't know, but would hazard a guess that there is nothing more awesome than seeing a skyscraper size chunk of ice slide off a piece of an Artic ice floe. What a splash!

Over there is China. Ah, China. Land of tainted heparin, and landlord to Tibet. Except for that pesky moral authority, China is an honest-to-goodness nation-state. Near China (due north, actually) is the Soviet Union and Vladimir Putin's dismantling of democracy. Who will play him in the Steven Soderbergh film, do you think? Will something better looking than Uggs be popular at the film festival that year? Let's hope so.

On to more personal worries, here we see that I wonder when I am going to re-discover my desire and commitment to be a person who does not smoke. Ever. At all. Not even one I bum. Over there, I wonder what to do when my right to buy in to health insurance (albeit at highway robbery rates) lapses. Yonder, you can see me wondering how my mom's grave is doing and when I will get home to clean it up.

Finally, every time the phone rings, I worry. I keep expecting to pick it up to find Condi Rice on the other end informing me that someone looked into my dossier and that she is calling to apologize and offer me stock in J.P. Morgan in return for the oversight.

It's not all that bad. I was just having fun writing this and got carried away. suzanne.danforth@gmail.com.

Quitting: Feedback goes up in smoke

My experiences with Chantix and my belief that it came to market too soon and significantly understudied inspired strong reactions last week in everyone who took the time to read and then write to me.

It's no news that information travels near the speed of light these days. Still, it was unsettling to wake up last Thursday morning, just two hours after this column was posted on the Internet, to find my inbox full of e-mails alternately praising or chastising me.

It was equally strange to realize that only a fraction of the mail was regional; the rest was from far-flung outposts around the country. I read through each and was at times puzzled, humored, disbelieving or grateful. One letter made me cry.

I almost wish I were an investigative reporter again in working this story. I would get to break out the trench coat, make lots of phone calls on someone else's dime and have resources in legal to call when I get nervous.

Not only will the story not go away, I suspect that what we know and what is available publicly is just the tip of the proverbial iceberg. The tobacco industry needed a whistleblower at some point, and perhaps the pharmaceutical companies do too. Granted, the basic ethics of tobacco companies and pharmaceutical companies differ greatly, but the bottom line is still big business.

Pfizer, for example, in 2006, had no fewer than nine medications with product sales of more than $1 billion each, and that amounted to just 64 percent of their pharmaceutical revenues that year. If you don't think there is a machine out there protecting that, and if that doesn't inform the analysis of all the information available in reporting this story, then it is probably good you are not the reporter in this particular dyad.

Chantix became available to consumers in August 2006, after receiving priority review from the FDA. These are granted in cases where there is evidence of a big public health benefit. It doesn't mean corners are cut, it means that more scientists and resources are put on moving a particular medication through established channels.

Pfizer showed the FDA the results in six clinical trials, which demonstrated an overwhelming benefit in a total of 3,569 chronic cigarette smokers. Only problem was, Pfizer excluded from those trials the very demography that makes up a relative majority of smokers in this country.

It is a well-established fact that about half the chronic smokers of tobacco in the United States have some form of mental illness. You can find scientific articles all the way back to 1990 with titles like "Blue mood, blackened lungs."

But it was an epidemiological study published in the Journal of the American Medical Association in 2000 that is cited again and again for its accuracy in design and analysis. Its conclusion? That "persons with mental illness are about twice as likely to smoke as other persons." Encouragingly, it goes on to say these persons also demonstrate substantial quit rates.

The chronic smokers who made it into the Pfizer studies for Chantix made the screening cut for mental illness. The 3,569 chronic smokers studied did not meet criteria for mental illness. If they did, they were eliminated. At least half the population for which this drug was being developed was not included in the studies that were important for bringing it to market.

Was this an oversight, do you think? The result is that real-world effects remained a big unknown when it came to Chantix, until it reached population at large.

A read of the transcript of the press conference by the FDA on Feb. 1 of this year begs an underlying story. The FDA representatives used words like "increasingly concerned" and "a number of compelling cases." They were diligent to point out that evidence is pointing more to exposure to the drug rather than other causes (read: baseline craziness).

For those who would be quick to argue that the Chantix nut bags are only made up of people with either diagnosed or undiagnosed mental illness, I say not so quick. There are also cases occurring in people without history of depressive illness.

Dr. Bob Rappaport, a director at the FDA, said at the press conference that "the concern is that there are many patients out there who are taking this drug who — for whom these kinds of serious outcomes could be prevented simply by being aware of the problem."

The woman in Florida who wrote the letter that made me cry would probably agree. Her husband was taking Chantix.

"Had suicide been listed (as a warning)," she wrote, "I have might have been listening more clear to what he was mentioning the three days prior to his death." He died by hanging himself from a tree in their front yard on Jan. 7, 2008. She put what she called his personality change down to the rigors of quitting.

"As much as I wanted him to quit smoking, it certainly wasn't worth his life."

Suzanne Danforth can be reached at suzanne.danforth@gmail.com.

Quitting: Some in Chantix Evening

It's time once again to talk about the nasty weed, tobacco. I began this column last August and soon after was prescribed the quit-smoking drug Chantix. I had spent the week prior smoking more than I ever had, after somebody else's junior high-style gambit to force hands landed square in the middle of my life.

I was wretched, didn't want to smoke anymore but couldn't seem to shake the damn little marmoset off my back. I would do anything ...; and anything came my way in the form of a pill engineered to block pleasure receptors activated by smoking.

Here is a snippet of what I wrote about it last October:

—¦the pill has visited me with some strange effects. In detail, I can tell you that my Chantix odyssey has been a burst in creativity, sleeplessness and the kind of energy that is just shy of scary."

I went on to refer to writing with a vengeance, a brain buzz and a ramped-up internal engine. Seems because I was neither suicidal nor homicidal, I got off easy. I didn't write openly about the degree to which I was disturbed by Chantix. It permeated every waking and sleeping moment (when I could sleep) and truth tell it was not shy of scary, it was scary. The boundaries between sleeping and waking dissolved and at times I wasn't sure if I was asleep or not. Despite its success in keeping me from smoking, the potential sacrifice of the remaining shreds of my mental health just wasn't worth it. I quit.

On Feb. 1 this year, the FDA issued a public advisory that Chantix "may" be linked to mood changes, behavior changes, suicidality or actual successful suicide.

Finding the data on the heels of this meek admission has been difficult, but most outlets consistently cite the FDA as having received 430 reports of suicidal thoughts and behaviors, with 34 of those cases being successful suicides.

A plucky little news outfit in Texas made a Freedom of Information Act request to the FDA in November and was given a computer disk with no fewer than 5,157 complaints on it. The complaints were from Chantix users and consisted of mentions of anger, aggression, amnesia, hallucination and homicidal thoughts.

There isn't even any point in mentioning the dreams; evidently everyone has what in the vernacular have come to be known as "Chantix Dreams."

In FDA speak, this is all called post-marketing adverse events. How is that for euphemism?

I said it before and I'll say it again: we are all part of clinical trials these days. Whether a substance is approved by government agency or not is immaterial. We take experimental cancer drugs, cholesterol lowering statins and quit-smoking pills. We feed our babies from plastic bottles and microwave our Styrofoam. We eat genetically modified foods grown from genetically modified seeds and sprayed with proprietary chemicals, without which the seed would not sprout in the first place (thank you Monsanto).

Carcinogens and human tissues are decidedly less sexy without George Clooney to promote them, eh? The logic of the chemistry and technology that has catapulted us ostensibly forward in the past 50 years has demonstrated a continued failure of predictability. Our compounds and circuit boards and nanorobotics are born in laboratories and then set upon us, usually in the name of profit.

Sure, Pfizer can claim a medical noblesse oblige of sorts in its quest to assist the remaining stupid ones to quit smoking. That would be easier to swallow if the pill were covered by insurance and if Pfizer weren't banking on Chantix to provide blockbuster sales. (Blockbuster sales, by the way, are defined annually in the neighborhood of $1 billion.)

Instead, statins cause muscle weakness, quit smoking pills make you crazy and experimental cancer drugs ravage bodies in the name of tumor shrinkage. Still, as a species we fall short of anticipating the failures and we focus on the possibilities. I suspect that we will focus on the possibilities right into the greenhouse.

Speaking of smoke and mirrors, all this bluster leaves the question of whether I still smoke. I do. I could equivocate and tell you how much less I smoke now (true), how much less I spend (true) and how much better I feel when I hike local mountains (true).

But that would bring it in to the realm of the gray and we all know I'm not that. So, black it is. I'm smoking. Wanna step outside with me?

Despite appearances to the contrary, sanguine I am not. suzanne.danforth@gmail.com.

Quitting: Teapot Tempests or Lister Redux

Is anyone tired of this topic yet? I hope not. It was plain envy that initially compelled me to continue to expound on the Lister fallout.

If you had seen me reading the letters to the editor on Feb. 22, you might have noticed me pounding my head on the table and uttering the Homerian "D'oh!" over and over. I just hate it when the best, most obvious and supremely logical point is made by someone other than me.

In one letter former city business administrator Joe Bove posed a question to the sitting school board: —¦where were you when the school budget was presented for your examination and approval?"

This is the kind of point that is usually non-partisan on the surface, apparently beyond argument, and which engenders a sudden silence in the room. If anyone does bother to speak after such an astute observation, it is usually to say something like "never mind." This is the kind of point that masquerades as trump, reminding you to get back to your homework and stop playing with your food.

Unless, reader, unless you begin trying to chase down facts. Facts are funny things, is-ness is elusive. Fact is Bove's question is not as transparent as it seems.

Fact is Lister's salary in this year's budget does not reflect his sick payout. That line item is somewhere else, lumped into a number along with all the other sick payout for retiring personnel. Although budget makers review the budget in work sessions, this particular line item is not addressed specifically.

Facts is facts. Lister notified board chairman Kent LaPage in October of 2006 of his intent to retire three years hence, referring specifically to sick payout. Job done. Fact is LaPage could have called a non-public session according to New Hampshire state law, which specifically states that discussion around compensation of a public employee is reason to call such a meeting.

The information eventually made its way to the city human resource director in August of 2007, but fact is we don't know exactly how. We do know that most of the school board was left in the dark until Adam Leech put his math skills to good use.

In April 2004, when Kent LaPage was president of the N.H. School Board Association, the leadership advocacy group published rules of thumb for new board members, including:

  • Only a majority of the board has the ability to set policy, hire and fire staff, negotiate contracts or make requests of the superintendent.
  • Effective boards require TRUST (their caps).

When I opined two weeks ago in this here space, I made an assumption that LaPage was under some sort of obligation to keep the information about Lister's retirement confidential. Well, he was, per the contract, required to keep it confidential within the central office.

Does the school board constitute the central office? Um, I think so. Does the resignation of the superintendent constitute policy, hiring or firing staff? That is trickier but I'm going to say yes. The school board should have been apprised of Lister's intentions by Mr. LaPage and Mr. LaPage alone.

What do we want for our community? What should characterize the relationship between a city board and its city? Should our elected officials be able to read a budget? Or should the budget-makers be charged with demystifying the fine print? Should our boards and the city have a collaborative relationship? A watchdog relationship? What is forgiven for inexperience or oversight?

These are difficult questions. A long time ago in this very town, the leadership of a now-defunct upstart little newspaper brought in their comptroller to aid in a news investigation. The public record in this case consisted of years of tax returns. I remember the walls of the back office pasted with them.

We needed the experience of the comptroller to point out inconsistencies that mere mortals could never have gleaned otherwise. But we were all on the same side, unlike the current uneasy relationship of public versus private, confidential versus right-to-know.

In these past weeks we have seen fingers pointed at administrators, school board members, the fourth estate and even the candlestick maker. But it sure does seem like the one person in possession of the public information regarding Lister's retirement chose not to share it with the rest of the representatives of the community.

Here's a final fact for you. New Hampshire law states nothing about separate duties, roles or obligations of the chairperson of the school board than it does for any other school board member.

You are, truly, a body of one.

Turns out Suzanne was a coal mine canary when it comes to Chantix. Check in next week. suzanne.danforth@gmail.com

Quitting: Philosophical Musings

I need my bike.

Have you noticed the slow lengthening of the day, reader? The violet hour is inching ever forward and encroaching into the domain of night. At midday, the sun no longer hangs weakly along the horizon, agreeing to a brief appearance, mostly while we work. Pretty soon, we will put on fewer layers and look out the window in the morning for a robin red breast on the lawn. This means pedaling, people.

I learned to ride a bike on mid Broad Street with the help of Mr. F. Although my memories are faded washed impressions for the most part, I remember a few families on my block really well. One, the G's, were a red-headed freckled-faced blue-eyed bunch, punctuated in the middle by one tall gentle sister, Georgette, with dark hair and dark eyes. The other was the F's.

I'm sure the fierceness of my memories when it comes to these clans is due in no small part to the fact that each had a father who had never ever moved out. (Too bad it took so many years for me to figure out that the truly fascinating one is the one who stays.)

The day I hit that magic balanced place on two wheels was warm. My bike had a banana seat with flowers on it and big curvy handlebars. I remember nothing about how many tries it took, or even taking the training wheels off. But I do remember the one time it worked. Mr. F. was there along side me and then he wasn't. And I was riding.

He remained behind me, giving me tips, tricks and ways to keep it up and I could feel my accomplishment through him.

Lately, I have been in need of someone to run alongside me and tell me surely what to do. A childhood fantasy, I know, but it's nice to indulge. Which road will turn out for the best? Will one make me more peaceful? And while we're at it, what is going to happen? And when?

Thankfully, being Impulse Girl, I have only been faced with a handful of decisions that are difficult to make. And it's a good thing because I couldn't go through this torture over what kind of bagel to get, what color my hair should be or even whether to be as open as I am.

In August of 1986, I was in California, running out of seed money, without a job, lonely and in a culture I didn't understand. I remember talking to my mother from my apartment on Pacific Avenue. Despite the view in the distance of the Marin Headlands and the Golden Gate Bridge, I didn't know what I was doing or why.

On the telephone, I kept urging her to tell me what to do. Nope. I reminded her that she usually didn't have a problem directing my actions. No go. She lovingly wouldn't budge and said I alone had to make the decision to stay on the left coast or return to New England.

She came to visit not long after, all the way out to San Fran Cisco. That's how she said it, in three syllables with equal stress, just like that. I ended up staying for two years and am glad for it.

I realize now that the decision to stay ultimately chose me, I didn't choose it. It is strange the things you notice as you get older. Take the lengthening of the days for example. Of course I learned about trajectories, and the axis and tilting and rotations and solstices, but in my youth it was summer or winter, spring or fall.

Suddenly it was October and the air was crisp and the dry leaves scraped along the street on a blustery day. Poof, it was hot and humid and I was paying my quarter to get into Peirce Island pool, the old way. Whoosh, I had a nephew, then two.

Now, there is no suddenly. Now, I am aware of each increment of light we gain day by day. I am aware of the invisible push of the earth waking up the crocuses and preparing them for their imminent debut. I am painfully aware that I have to hold small print far away to read it and am glad I still can.

Timing has been on my mind too, lately. Like the seeming harmony between your blinker and that of the car in front of you, unless the clicks are perfectly timed, it will, eventually, become asynchronous.

And so I wait now for the right path to make itself known to me through the underbrush. It sure would be nice to be riding my bike in the meantime. Can someone deliver it?

More about school boards next week. But only if I can figure out fact from smoke and mirrors. suzanne.danforth@gmail.com.

Quitting: School board, press brouhahas and life in the shark tank

This one was just too good to pass up, reader. Portsmouth Juicy at its best.

I was born in City Hall when its corridors were peopled with caregivers and not politicos. I read the Portsmouth Herald when it reported nothing more interesting than grips and grins. I went to Peirce Island pool when it was a quarter and you entered through the building. I remember Jay Smith, Cal Canney, Eileen Foley and Joe Sawtelle.

As a native, I could easily stand here and recite a litany of bad local behavior, from accountants who bilked old ladies to boy cops who ganged up on girl cops. I could remind you of the questionable people who at one time ran the Chase Home to beloved teachers who invited girls into their office and initiated them into situations theretofore unknown to their innocent selves.

Not today, though, not today. Today we are quitting school, the school board, the city legal department and brouhahas in the press. What would we be reading if Kent LaPage had told the school board of Bob Lister's intention to retire? How is this for a different spin on the Lister story:

"The school board chair resigned today citing excessive legal costs and personal distress over the lawsuit leveled for the decision to disclose School Superintendent Robert Lister's retirement in advance of the timeline outlined in Lister's contract."

You can write the rest of that faux news story: fulfillment of Lister's contractual legal obligations would be summarized, and the outrage, perhaps, would be directed toward a different person of poor judgment, one dumb enough to violate a contract, a confidence or a personnel matter. Your choice. That might have cost the city even more money than Lister's accumulated sick time.

And a word about that sick time, taxpayer. It may be a lot of money over three years, but what it represents is a man who didn't call in sick on your dime. Ever.

Let's review some of the factoids, shall we?

The financial minutia of municipal employees is public information, as it should be. Long live freedom of information. It looks like Adam Leech did a good reportorial job in noticing the spike in Lister's salary, reading Lister's contract and giving him a call about it.

It looks like Bob Lister then uttered a comment to a scribe before thinking of its implications. This is puzzling, not quite audacious as charged by the editorialists, but most certainly puzzling. How can one spend so much time in a public position jockeying with reporters not to have learned to say "Good question. I'll get back to you." Or, at the very least, "No comment."

Lister's failure was not one of dishonesty, lack of integrity, withholding of vital information or even poor communication. It was a combination of being in the shark tank, being without a trusted assistant because of a nasty sudden death, and of taking Leech's phone call without red flags flying.

I used to be an investigative reporter and in all that time, only once did a public official properly go off the record. This was a highly placed person in state government and he asked if I would agree to go off the record before — not after — he disclosed information. He also waited for an answer before proceeding.

I was used to dude ranch style Portsmouth town, where off the record was tossed out cavalierly and only after the speaker had spilled guts. As if they had a right to dangle, give and retract. There are guidelines for these sorts of things and that alone may be the story here.

It's too bad Lister isn't as good at spin as Dick Cheney. And while we're at it, it's too bad Lister isn't the kind of person he is being made out to be. If he were, I assure you a full-scale and debasing war of words from that office would be under way and someone truly innocent would be caught in this very public crossfire. That is deflection, people. That is blatant, desperate and confession-worthy. This ain't that.

If no law was broken, skirted or massaged, then let the man be and change the laws, change the contracts. I have read enough about failures of communication and not enough about the letter versus the spirit of the law. We live in a democracy and if you don't like the way the letter of the law plays out in our dirty little culture, change it. Don't kill the messenger, it's a waste of ink and trees.

I re-quote here what veteran teacher and current board member Ann Walker was recorded as saying. "We have a lot of things going on that need Bob's experience and guidance."

Step back and let the man do his job, or come in and do it yourselves.

Suzanne is going to have a kid real soon so she can eventually collect on all those taxes she pays into local education. suzanne.danforth@gmailcom.

Quitting: All Kinds of Love

Was yours a meet cute, reader? A meet cute is a serendipitous coming together of two movie characters fated for love. And although we are in no movie, I suspect we will read a few such stories here today.

Manufactured holidays have never been high on my personal to-do list (except of course for my birthday). All I knew about Valentine's Day could fit on to the head of a conversation heart (Kiss Me!). Being the perpetual single girl never got me much in the way of flowers, chocolate or greeting cards.

Nonetheless, a little cyber research on our Saint Valentine revealed the following: there probably wasn't a Saint Valentine. (Because today's is a truncated column, I am forced to leave out my findings on martyrdom, avian mating rituals and Chaucer, all part of the history of today. Drat.)

No Saint Valentine? Why, Virginia, not to worry. Even without a fat cigar smoking patron to dispatch cupid on cue, there is such a thing as love. Modern love can take on many forms, but most of it boils down to Eros, Philia or Agape.

Eros, of course, is the typical focus of today's celebration. For the uninitiated, Eros burns, and antibiotics take care of that only sometimes. It is hurdy gurdy, fertility, rivened fields, vertical monuments, clefts, passion and the like. We may dress it up and call it a fine romance, but that old basic rhythm resides deep in each of us.

Philia is a kind of friendship love. Although I could find no etymological link to the root word, I think of this love as affiliative. This love is a picnic at noon with friends in Prescott Park followed by a snooze on the grass. Biblical scholars treasure each mention of Philia because it takes a far back seat to its oft more cited cousin, Agape.

Ah, Agape, selfless, unconditional, sacrificial love. Like Eros, Agape can be given to one not worthy of it, but unlike Eros, Agape is purely of the heart and not the nether regions. Agape, I suspect, is what is left after the long unraveling of the years. Surely, it is the kind of love responsible for Sandra Day O'Connor's acceptance of the nursing home love of her husband, simply because it brings him comfort.

Whatever the kind of big love in your life today, enjoy.

XO. Google O'Connor and dementia. It'll make ya cry. suzanne.danforth@gmail.com.

Quitting: Action

There are years that ask questions and years that answer.

— Zora Neale Hurston

Several years ago, when my mom was in the middle throes of her long passage, one of my first supervisors in speech pathology and an eventual friend sent me a T-shirt. It is a wearable piece of art, really, by one Sue Handman.

The plain black shirt is embellished with fabrics and an old-fashioned picture. Under the picture is a quote; the one by Hurston at the head of this piece. At the time I received it, the shirt alternatively brought me great comfort or despair. On a good day it was a reminder that things go in cycles and that pendulums inevitably swing. On a not so good day, it was a plea.

Overall it is a hopeful message, one that holds the promise that the world will yield answers at some point, for the apparently pointless. The thing I am having trouble understanding right now, however, is that there seem to be many more years that beg questions than there are years that give answers.

You know by now that I am impulse girl, a grand schemer. It is my strength and my weakness. But since Nov. 30, I find that I am learning, finally, to wait.

Not waiting has given up a good yield in my life. I didn't wait as a child for my grandmother to ask me to sleep over; I just showed up with my bags and engendered much head shaking in my family because of it. My grandmother was quite different from her own daughter, my mother. Nanny was the picture of patrician reserve. She spent day after predictable day to my childhood eyes. Church on Saturday. Beano on Friday. News at 11. Winters in Fort Lauderdale, summers in North Hampton. A new Caddy every year whether she needed one or not (usually not).

I didn't get to know my grandfather, he died when I was 2, but all signs point to him as the one responsible for my tendency to act first, ask questions later. My vision of him is of a larger-than-life kind of guy. There are his friendships with Johnny Pesky and Ted Williams. There is the letter to him from John F. Kennedy. There is the company he built, and the stories of my grandmother telling him, Larry, you come home now or else.

And there is his final night with us, my brother and sister and myself, in the house I was born in on South and Broad streets. The story goes that he taught us to jump on the bed that night. Sounds about right.

Without his joie de vivre as model, I sometimes ended up feeling the fool. But, call me foolish, I got to go to Florida every year to visit my grandmother. Because I asked. I got to spend summer weeks on end at her house on Chapel Road, walking to the beach, rolling down the hill or wandering through Fuller Gardens. I think my solitary love of reading was born in the gazebo across the street from her house.

As I aged, not waiting got me into a good school, a very good graduate school and a wonderful job in Boston. It got me to California and back. It got me to start writing. And it got me to start writing again, just this past August.

For all I gained by plunging ahead, though, there were the inevitable losses. They ranged from opportunities to people (some better lost, some not). The important people, though, I have realized, have waited for me. They waited for me to come around, to change my mind or my actions. They waited for me to shed my cocoon and try to be a butterfly. They waited for me to learn ... to wait.

My friend and I were on a meadow walk in Western Massachusetts this week when we hooked up with another dog owner for a while. Since I could talk to a stump and get it to talk back, we eventually got around to the question of why I moved to Northampton.

I waited before answering. What I told him, eventually, was that I had always wanted to live in Northampton (true). I said that I was between jobs (also true) and that it seemed like the thing to do (most certainly true).

What I didn't say hung in the air between my friend, this man and myself, like bits of snow blown off the trees on a sunny day, glinting. But, because I waited, he was unaware of why, at midday in late January, I had the pleasure taking a long walk in the woods and along a river with three dogs and my best girl.

Wait wait! Don't hit that send button yet. suzanne.danforth@gmail.com.

Quitting: Virtues of the Virtual

In this global electronic culture, presided over by Web wizards and new media mavens, 15 minutes has been whittled to just six or so minutes. This is about the amount of time the New York Times Web site had as its lead story the unexpected and as yet unexplained death of actor Heath Ledger.

Warhol himself, father of the original 15-minute prediction, only foresaw as far as his artist sensibilities would allow from the vantage point of 1968. And just how far can you get on sparkly wigs, soup cans and Edie Sedgwick smoking long cigarettes in the corner? Warhol might have predicted we would each be famous for 15 minutes but he could not have prophesied it would be within 15 minutes.

This is not a piece about Ledger, sad losses or why there is such a thing as a market that commands a more than $20,000 per month rent bill, even in Manhattan. This is a piece that wonders where writing fits in these digital days, how our ability to communicate in pictures, via IM and text messaging may be eroding our essential language capacities, and whether the species will survive in a recognizable way as a result.

Tall order for 800 words, I know. But if Japanese girls can write novels on cell phones (with the obligatory short sentences and lack of plot or character development) surely I can raise sweeping cultural issues in the local newspaper on a Thursday morning.

Let's consider the big issue first; could our species actually change as a result of our electronic habits? Looking to the children, I would argue yes, that as a result of favoritism, our brains will change shape over time in response. Stranger things have happened (some on the HMS Beagle).

Ask any occupational therapist on the street and they can tell you that many little people starting school have not developed the classic tripod, or pencil, grip. Although some kids tend toward less dexterous fine motor skills than others, more recent trends seem to indicate greater numbers than your garden variety bell curve distribution.

Many kids these days come in to school with PlayStation thumb instead of pencil grasp. The muscles developed in manipulating video game controls are literally opposite those developed in learning to manipulate a pencil. Your 5-year-old may be able to beat your butt on a video game, but can she hold a pencil? Does it even matter anymore? Maybe the digital shift will favor those with game, rather than tripod, grip skills.

One well known fact of development is that when brain real estate is unused, adjacent brain real estate takes over. If a person becomes blind because of an eye injury, the brain section devoted to sight slowly begins to be taken over by the neighboring brain section for hearing.

Stunning isn't it? The amount of brain matter devoted to hearing actually grows into the area formerly reserved for sight. So much for specialization.

So, if that kind of change can happen in individuals, why not in species? Why wouldn't the digital immersion of children raised in an electronic culture result in changes in neural architecture?

The second big question is whether our essential language capacities are eroding because of YouTube, Instant Messaging and text messaging. Marshall McLuhan might have been prescient enough to herald the medium as the message, but where will all this leave language?

When I began writing in 1986, I wrote my first pieces longhand. I did not encounter a computer until I was hired as a reporter. I can still recall the difficulty I had switching from composing by hand to composing on computer. At a symposium I attended at UC Berkeley that year, authors Tom Robbins and Ken Kesey spoke about their own writing habits. Robbins spoke of writing his fanciful stuff longhand on yellow legal paper. Kesey, on the other hand, plucked out his messages on computer. The messiness of Robbins' method (with all the attendant innuendo) contrasted deeply with Kesey's custom. But both resulted in lovely writing.

Lovely writing is harder to come by these days. Sure it still exists, but it is countered everywhere with writing more suited to the medium. To wit: Japanese cell phone novels.

This leads us inexorably to our third big question: whether the species will survive in a recognizable way as a result of all these other (unsubstantiated) changes. Who knows? Not me.

Better minds than mine have wrestled with this question.

: o

For more scary dystopian-isms, see www.wired.com/wired/archive/8.04/joy_pr.html

suzanne.danforth@gmail.com.