Whatcha talkin' 'bout, Circle of Willis?


If you haven’t heard (because, let’s say, you’ve been locked in a dungeon for a couple years), my day job is an engineer. Non-engineers may imagine that most of my days are spent standing in front of whiteboards filled with equations. The truth: a huge majority of my time is writing. See, I work in the heavily regulated medical field and it can months of writing and revising in order to gain approval for a report that the actual testing took a few minutes of time. It’s interesting because the mechanics of engineering writing are different (passive voice only), one thing remains common between my fiction and my reports…I strive to explain complex things (for example, character emotions or arterial motion due to the respiratory cycle) with clarity and brevity. And today, for your pleasure (?) will attempt such a feat for you. Stand back kids. Don’t try this at home.

 
Specifically, I design and test medical devices. In my career, I’ve had the hand in getting a number of surgical products into operating rooms. From a line of gynecological instruments (which is as glamorous as it sounds) to a system which reversed blood flow through the brain to prevent strokes during carotid stenting procedures…

“WHAaAaA?” you ask. “Reverse blood flow through the brain while doing what?”

Ok, I’ll clarify…since you asked:

Most of you know that a stent is a device that gets installed in a person’s artery to help fix a blood flow problem. One common use of stents is when an artery gets plugged up with plaque. The stent is supposed to smash the gunk against the arterial wall and help open up the flow. Contrary to what people may picture, it’s not a delicate procedure and there are instances when bits of plaque break off and take to the bloodstream. For a stent in aorta (the artery in the belly…which is gigantic as far as blood vessels go), nobody cares if a little piece of plaque gets loose since it’ll be easily filtered out later. However, if the artery in question is the carotid (the vessel in the neck that supplies blood to the head/brain/face), even a tiny piece of plaque can clog the flow in the delicate capillary beds downstream, preventing oxygen to some vital areas of the brain (a.k.a it causes a stroke). In summary, there’s a risk that stenting the carotid may end up causing the much more serious issue of a stroke.


So the system I worked on is used to prevent these particles from going downstream and causing a stroke while the docs are stenting the carotid. We do this by…wait, here’s the clever part…reversing the blood flow through the brain.

The idea being that if the little chunks of plaque go away from the brain instead of into it, the danger of stroke has been nullified. If the blood has reversed flow, there’s no chance of stroke.

Now, before you throw up your hands and scream, “What kind of Sci-Fi BALONEY is this?!” Allow me to explain. It’s a matter of two important attributes.

First, liquids (such as blood) will flow from high pressure to lower pressure. And it happens that the venous half of the cardiovascular system (the part that returns deoxygenated blood to the heart) is lower in pressure than arterial system.

Second, as vital of an organ as they come, the brain has several redundant blood supply channels. Once they all get into the brain, they mesh and combine in what’s called, “The Circle of Willis.”



So, how does the flow reversal work?

Basically, at a point just upstream of the plaque, we use a fancy tube to connect the carotid being stented into a major vein. This makes the blood want to flow from the higher pressure in the brain through our tube and into the lower pressure vein. And because the Circle of Willis, there’s plenty of blood to do this. So the flow reverses over the part we’re planning to stent. The brain stays oxygenated and blood-filled because of the redundant supply. Once the stent is in place, the flow is restored to normal.


“Jeez,” you say. “Is there any harm to the patient by doing all this mumbo jumbo?”

In most patients, the answer is simply, “No, harm at all.” Many of the people getting these treatments already have diminished blood supplied to the brain through the plaque heavy parts anyway. Again, there’s an amazing amount of blood getting pumped into the brain through several routes.

Sorry, to have geeked out on you like that. As you can tell, I can be as passionate about my day job as I am about my writing. Thanks for indulging me.

My Writing Routine, aka Always


Sometimes people ask me what my writing routine is. Here’s my answer:

Always.

I write always. Seven days a week. As much as I can, while still maintaining a semi-functioning household.

As I wrote THROUGH THE EVER NIGHT, the second book in the UNDER THE NEVER SKY trilogy, always wasn’t even enough. I ended up taking myself out of town a few times, to a little spot in Half Moon Bay, where I’d hole up for intensive, fourteen-hour a day writing marathons. I had to do it. That book was a struggle for me. It was one of those that refused to click until the very last, and I was learning to juggle deadlines, marketing demands, and all the other responsibilities of a professional writer.

This was my writing hideaway.
I wouldn't call spending time here a sacrifice.
I’m pleased with the outcome. I finished the book. It exceeded my expectations by roughly a billion times when it hit the NY Times Best Seller List. I’m glad I put in ALL THOSE HOURS, but you know what? Something’s gotta change.

Not because I’m afraid of hard work. I am so not. I love hard work. I love getting freaky obsessed with a project. But what I learned this past six months is that I’m not doing myself any favors by being freaky obsessed ALL THE TIME.

What happened, essentially, is that I exhausted myself and my creative tank. I got to the end of writing that book, and I had nothing left. No gas. And I decided that I needed to not work always.

I still work very hard. Still seven days a week, to be honest. But now I’m making a concerted effort to bring other things into my day. Lunch with friends. Walks with the dog. The other day, I even went to the movies. In the middle of the week! For no reason! I totally blew off writing for a few hours… and I was so proud of myself for that. It felt good. What felt even better? Sitting back down at my desk, relaxed. Inspired. And eager to write.

In the Quagmire of the First Draft

I spent the last two weeks submerged in the quagmire of my first draft, paralyzed to the point where I could barely write 100 new words.  This hasn't happened to me for a while, so I guess I thought I was past it.  But every book has its own challenges, and this one is no exception.  I am in first draft hell.

I am always terrified of first drafts.  They seem so overwhelming.  All those pages to fill with characters and scenes and, you know, plot.   I always feel like I'll never make it from the first chapter to the last.  That I'll be stuck in the muddle of the draft and never make my way out.  But that ever-present fear is usually just that, a nagging worry that doesn't really stop me from pressing forward to "the end."

Until it does.

And boy did it.

I was just starting to feel like things were coming together, like I understood the characters and their journey and the story was flowing.  Then I hit 40K and everything came to a screeching halt.  I began to second-guess everything I had written so far.

Act 1 was too long, the main character was too serious, the story was too depressing.  No one would ever want to read this manuscript, let alone buy it.  The story was not turning out to be anything like I thought it would. I couldn't see past the flaws.  I couldn't write for a week and a half.

I considered abandoning ship.

I didn't.  And, while I still feel a little lost in the swamp, I can see a faint trail to the other side. Here are some things that are helping me get unstuck:

1. Muzzle the Inner-Critic:

Once I get through the first draft, there will be plenty of time to second-guess myself and address the things that aren't working.  I am much too close to the manuscript at this point to know what is really working and what is not.  I need to see the entire picture before I start axing scenes or changing characters.  I have to remember that three weeks ago, I loved this story, and I'm sure I'll love it again before I'm done with this draft.  It's okay to hate it for a little while, as long as I keep writing.  I'm willing to bet that when it's done, it's not as good or as bad as I thought it was while I was writing it.  It's just a first draft.

2.  Ignore the Word Count:

I barely look at word count when I'm revising, but I tend to be a slave to it when I'm writing a first draft. The great thing is that I can see my productivity and have an objective barometer for my progress.  The horrible thing is that I also have an objective way of measuring my failures. Yes, that 5000 word day was amazing.  But you know what, that 600 word day, when I spent hours staring at blank pages, but started to solve a major story problem?  It was every bit as important. Yes, there are deadlines, but writing is not a race.  It's a creative process.  It takes time.  It takes thought.  It takes courage to push through.

3.  Call in Reinforcements:

When you're stuck in the quagmire, it's much easier to get out if someone is there to throw you a rope.  Don't be afraid to ask for help.  I emailed the Muses, and spent a day with writing friends,where I got some objective feedback, and a supportive ear.  Sometimes it helps to talk through plot problems, or just to have someone remind you that you'll get through your story problem.  Or feed you chocolate.

4.  Take a Breather:

While it's tempting to try to push through the block, sometimes you just need a little time away from your manuscript.  Read a book, take a walk, go to a movie.  I find that the solution usually comes to me after I've stopped trying to force it.  A day or two away from your manuscript is okay.  You'll get back to it.

5.  Do Some Freewriting:

Can't write the next scene?  Open up a blank document and do some freewriting.  Write a scene from another character's point of view.  Do some character worksheets.  Write out a scene from your character's past.  Write a poem.  Write anything.  Just write.  You'll find your way back into the story.

6.  Remind Yourself that It's Supposed to Suck:

It's a first draft.  It will never see the light of day.  It's a discovery draft. Yes, some parts of it will suck. Keep going.  The good news is that you'll get to revise those sucky parts later.  LATER.  For now, ignore the suckage and move on.

7.  Write:

No matter how bad it feels, the only way through is through.  Open the manuscript. Write even though you don't feel like it.


On Being Quiet

Katherine Longshore 6 Tuesday, January 22, 2013
This week our theme is "All About Me"--our code for "Choose Your Own Adventure".  We can write about anything and perhaps get a little more personal than usual.

The thing is, I don't talk about myself.  Some people would say I don't talk much at all.  But I'm growing to realize that I'm just quiet.  I like to listen.  I like to observe.  And I like to take mental notes (that's a warning, just in case I ever meet you in person. :) I think a lot of writers are--though I'm constantly surprised by the number who aren't.  It's not that I don't want to be noticed--I have no desire to hide or be invisible--it's just that I don't want to have to tell people to notice me.

We live in an age and work in a business where it seems like everyone has to be wearing a sandwich board shouting LOOK AT ME.  The din on the Internet is deafening.  Yes, some of it is self-promotion, and yes, it can be irritating the 476th time you get a tweet from someone saying "Buy My Book!".

But I think the majority of it is just people wanting to be heard.  Wanting to be noticed.  Making a connection.  So people post what they ate for breakfast or how many words they've written or what they're watching on TV or what their dog just did.  Some people will tell you their entire life story as soon as they meet you.  Some people stand on the street corner with a sign explaining why they're there.  Some people fill lecture halls or write magazine articles or have endless dinner parties.

I write books.

It's in our nature to want to make a connection.  Whether it's on Twitter or in person or through a book or by carrier pigeon.  We are, by and large, a social species.  Maybe we don't pick each other's nits anymore, but we want to share that closeness.  Somehow.  Through some medium.  It doesn't matter what it is.  Whatever your choice may be, embrace it.  Embrace the media you're comfortable using.  Reach out.

Sometimes, I worry that people will think I don't talk a lot because I've never done anything--because I have nothing to say.  Because I am a boring nobody.  To look at me--even to meet me--you'd never guess I'd written a book, traveled the world, had a broken heart, or gotten into scrapes I consider myself lucky to have survived.  Quiet people live quiet lives, right?  Adventure is loud.  Success is highly visible.  Importance is garrulous.  I worry that if I'm not noticed, maybe I really will disappear.  That maybe I just don't matter.

But then I go back to the story at my fingertips.  I go back to my characters and let them take over.  Let them do the talking.  And I discover that--in a way--I don't matter.  My importance, my problems, my ego all disappear.  And that's when I know my writing is at its best.  Because I am at my quietest.


A Matter of Principals by Donna


This is our week on the blog to write something about our lives.  The theme is "All About Me" and it's means our choice of topic is wide open.

I spent my whole professional career in schools --as a teacher, then a building principal, now a teacher of principals and teachers.  The recent school shooting was horrifying in so many ways, and it reminded me of something I wrote many years ago at the end of one long week.

A Matter of Principals

            Last week, I was kicked, screamed at, bled on and bit all in the course of doing my job.  I'm not a doctor or a policeman.  I'm not even a professional wrestler.  I am a public school administrator.  I work in an elementary school in a good neighborhood with parents that, for the most part, are very concerned and involved with their children's education.  But even the "good" schools are not immune to the changing demands placed on our public schools today.
            On Monday, I told a teacher to lock herself in her classroom with twenty two four-year-olds.  One of those four-year-olds was wearing the marks of an abusive parent - a parent that was on his way up to the school.  I stood outside that locked door, between that large, angry man and those children, and prayed.  Prayed he didn't have a gun.  Prayed he wasn't going to hit me.  Prayed I would be brave. I never thought my profession as an educator might one day cost me my life.  I thought about it a lot last Monday.
            On Tuesday, I listened to parents.  Bobby Miller's parents said the teacher doesn't understand him - he's not meeting Bobby's needs.  Bobby is attention deficit and that's why he knocked out Suzy Johnson's two front teeth.  Martha Wilson's parents said the teacher
doesn't understand her either - she's not meeting Martha's needs. Martha's gifted and that's why she ate all the tape residue off the chalkboards. So many needs.  How can we possibly meet them all?
            On Wednesday, Joe Patterson busted his head open on the playground.  Due to the budget cuts, we don't have a full time nurse.  I got there first.  By the time I got him inside and calmed down, I was covered in blood.  The counselor kept waving those plastic gloves in my face, but I couldn't stop.  A child was hurt.  I wasn't going to leave him to go inside for plastic gloves.  Later, I washed the blood off my hands.  It will never come out of that white dress.
            On Thursday, Michael had a bad day.  When Michael has a bad day - we all have a bad day.  Michael was born addicted to crack.  He bit me three times on the way back to the office.  No one taught me the right way to carry a biting six year old out of a classroom so that others can learn.  No one taught me about Michael.
            On Friday, I listened to teachers.  I listened to them teaching despite the distractions.  I listened to them worrying in the teacher's lounge over children they couldn't reach.  I listened to them cry in my office over the stress of the job.  I listened.  It was the least I could do.
            On Saturday, I yelled at someone I loved.  He had no way of knowing about Monday through Friday.  He had no way of knowing it was not for him.
            On Sunday, I was back at school - working quietly in a deserted office.  And when the work was finally done, I walked those quiet halls on Sunday all alone.  I didn't think about being kicked, or screamed at, or bled on, or bit.  I thought about children - laughing children, reading children, learning children.  Children in a school where I'm making a difference one day at a time.
            
But on Monday . . .
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