1 of 19

From the New York Times: FDA Likely to Add Limits on Painkillers

I was 1 of 19 who voted to reschedule hydrocodone, a Schedule III prescription opioid used to treat and manage pain, to the more restrictive schedule II.


14 generic companies make 81 versions of this narcotic combination drug most know as Vicodin and as House's drug of choice. Hydrocodone is THE most commonly prescribed medication in the United States. It is supposed to be prescribed for moderate pain related to acute conditions.


I have opined about the need for prescription opioid control before. Indeed, this is a topic I have struggled with in my professional--and personal--life.

My decision came after considering close to three inches of documents, two days of scientific and public testimony, and my own experience the past twenty years studying both the under-treatment of chronic pain and the ravages of prescription drug abuse. Amidst much rhetoric and appeals to improving the education of prescribers, dispensers, and patients about this product, my decision ended up based squarely on the science.

For me, though, this was truly a Sophie's choice--there will be unintended, adverse consequences no matter how the Food and Drug Administration eventually decides. If rescheduled, restricted access for those with legitimate medical need may result in poorly managed pain; if kept in its current schedule, hydrocodone will continue to contribute to the burgeoning epidemic of opioid abuse.

This is not a new problem. Education has not worked, professional regulation has not worked, nor have the current incarnations of prescription drug monitoring programs, to curb the abuse, diversion, and deaths due to unlawful use of opioids. Upscheduling hydrocodone is no panacea, but at least it has the potential to blunt the rise of abuse and, most of all, made it tougher for our young people to access. Peace...

LOST

No, not the way I feel, but my newest obsession. I know, you watched LOST live when it premiered eight years ago, and I remember catching parts of a few episodes, but it never quite stuck. Maybe it was the late (for me) time slot, maybe it was that then, as now, I hate shows interrupted by commercials. Maybe it was we had a crappy 19 inch Sony.

But this past summer at a yard-sale I found the entire first season DVD set, still wrapped in shiny cellophane. For a buck. So every night as a family, we watch it, never able to stop at just one episode, inhaling at least two every night.

I have pondered why I am drawn to the show. The plot twists and turns, filled with survivor-type action, as well as mysticism: monsters, the Others, the way compasses don't really point north. Fascinating characters, presented in a perfect blend of present-time action and flashbacks. These folks are FLAWED, and endearing because of their flaws. And eye candy galore, both scenery (shot in Hawaii) and, ahem, the actors themselves.

As a writer, these are all characteristics to emulate.

Last night, Boone Carlyle died. He is, er was, my favorite character. A callow, privileged youth, hobbled by his infatuation with his step-sister. I like him, he reminds me of Ben, one of my own callow young male characters. My daughter and I wept, at the loss of our favorite character, at the sacrifice the island demanded of him, of Locke's duplicity, at the unfairness of it all. Tonight, perhaps we will discover why the window  to the hatch found deep in the jungle began to glow, whether the Others will come out and play, find why those blasted numbers--4 8 15 16 23 48--are part of the hatch's structure, and what they mean.

Thank God huluplus has the remaining seasons!

Peace...

I've Always Wanted to be a Surgeon

Which is probably why revising stories is my favorite part of writing. First drafts typically make me tremble in fear--the page daunts, the characters not fully gelled (if at all), the infinite possibilities. So many choices can deaden the process.

But after the first rush of story is laid down, the fun begins. The first revision stage involves building up--fleshing out the character, filling in plot and story gaps, developing the environment. Sometimes characters are added, as are new scenes. The first revision of a novel is the longest time I spent with any revision--sometimes years--more than the initial draft.

I then let the story marinate.

The second revision stage involves subtractions--killing my darlings, including characters who don't do double-duty, the endless scenes in coffee shops, dialogue which takes up space but which does not fill. The second revision,and many of the revisions after, are often bloody, and it is this part of revision which scares and fascinates me so. I feel a bit in awe when my characters and chapters lie bleeding on the floor.

The story then marinates, again.

But this stage also involves a more important piece, and that is the revisioning of the story: how it should look and feel. Once again, the possibilities are endless, including changing POVs, tense, voice, era. Often, the second revision stage entails rewriting, if not the entire story, then large chunks.

The final revision is when I polish, when I work the sentences and word choice, the epigraphs, remove tics and tags and redundancies. I shine my apple to a high polish.

Like all good things in life, writing (especially novels) takes a lot of time. I recently undertook a challenge with a colleague to polish our first novels. We had a deadline, part self-imposed, part real, which essentially gave us a month that spanned the holiday 'break'. I had not revisited my story for almost a year, even though I began writing this story January 2, 1996. (Seven is an auspicious number).

We read each other's work, provided extensive critique, absorbed, and revised. She provided the key as to why one of my two protagonists didn't work--the voice (always the voice) and the reason: the narrative distance was unclear, which made the audience muddy.

I spent 2 weeks revising her voice, coming close but falling short, and then in the thick of it i received some input from an editor in the small press business, who echoed what another agent in the biz told me over a year ago, when I placed CLOSER TO NORMAL into marination: tell the story from one POV.

In once week, I revisioned my story to Ben's POV. It is a leaner, more elegant story, and one that certainly places you in his head. Removing Phoebe required losing 25,000 words, several plotlines, and her voice, sweet but overridden by Ben's charisma.

The story is submitted. It also is marinating, again, for now I cannot shake Phoebe, she's a little pissed she's relegated to supporting role. When she screams loud enough, I'll pull her and story out of marination, and revision, again.

Peace...

So Much to Say...

I want to talk about reviving my first novel and totally hacking out one of my two POVs... and about this issue of narrative distance and how important it is to *know* when establishing voice... and LOST, the television show we're watching and how fantabulous the scripting and characters and acting are... (yeah, I know, you watched it six years ago but I'm always behind the ball, and I never read NYT best-sellers until they're bumped off the list)... and the winter issue of Winter Issue of JMWW, which is phenomenal... and the mindfulness meditation course I'm taking and how excited I am about FINALLY doing this program... and how I'm totally grooving on my children and their little passions... and gorge, which is a raucous and bawdy and hilarious novel told in stories by amazing writers like Robert Vaughn, Gay Degani, Meg Tuite, Gill Hoffs, Susan tepper, and oodles of others, even MOI, and edited by the intrepid Matt Potter... and Kurt Cobain was a very good person, a gentle soul, and his music haunts me... the rash of assaults on my campus, it's the economy, stupid... and class starts up again in two weeks and I'm excited because this professor is sooooooo excellent and we'll read eight or nine novels and DISSECT them for form and structure, EXACTLY what I need right now... I really want to talk about all this stuff, a lot, but... I'm out of time, on deadline with a novel and I must, must, must get revisions done so I can start to submit this baby, again.

Peace...

Seven Year Itch

Hard to believe I've been writing seven years. I remember feeling this urge, a compulsion, to write about someone named Benjamin Michael and all his unnamed troubles seven years ago today. Back then, I thought I was, like my protagnist, insane. Later I found out it was merely the muse grabbing me by my female balls and handing me one of the greatest gifts I have ever received.

I had dinner tonight with friends. Three of us, all artists, spoke about how we often felt we had no choice in creating--the creation chose us, we served to channel something greater than ourselves. The energy one feels while in the flow is remarkable, miraculous, and once touched you always want it. The elusivity of the muse is one thing that spurs me on to write, the desire to be consumed by its gift, for most of the time creating feels a futile task, one word marching before the next. Creation at times feels like duty, an onerous task.

I feel grateful writing chose me. I feel thankful for the inspiration, for the dreams and ideas that spawn Benjamin Michael and all my other characters and their worlds. Mostly, though, I am thankful for all of you who read my words, for without an audience, a writer is but a lone tree falling in a desolate forest.

Peace...