My amazing wife

When I read the entries in the blog that Luciana writes I am always humbled by her spiritual strength and her beautiful prose. Ila miglior fabbra

cleft palate

I could hear beneath the curtains in the triage room. She was 33 weeks pregnant, checking her baby after a bad fall in the icy walkways of New England. We both waiting for the nurses with their well practiced amiability and their expertize. This is her first baby and the grandmother sits at a glider nearby, listening and consoling the woman: the baby has cleft palate and something wrong in both feet. The fall was not the most important issue, considering that this child was already marked as atypical, marked and - horrible fate - not beautiful. Protected by the fragile privacy of the curtain, the young mother allowed herself to vent her sadness and frustration, looking for explanations as if that would minimize the pain. In and out, the nurses participated in the conversation. Does it run in the family, yours or his? No, dear, it has nothing to do with anything you have done...We are going to check on his heart rate, don't worry...
The mother questions God - whose sins would bring down to life a suffering inocent - and give it to me as my first son? I closed my eyes and thought about it for a while, consoled by the fact that I was no longer looking for a God measurable by the human rules of justice and love. I had given up on miracles, and felt good about it. Until I heard the high-pitched voice of a nurse, telling mom,
- Oh I am so happy you came on my shift! I was a cleft palate child and I love when they come my way!
What followed was a sequence of reassurance, compassion and hope that dismantled my theory about the distant God. Someone had sent that nurse, bending the inertia of randomness. I turned my big belly to the other side and let my soul rest over the plastic pillow.

Yesterday

Was a hard day. I hit the emotional wall. Never clear why it happens when it happens. It happens. I was mad all day. Then finally about about 9 pm I managed to give up and wasn't mad anymore. Maybe the fried fish and potatoes helped.

Never underestimate the power of fried fish, HBO, and the prospect of sleep in the near future.

Give us this day our daily news, January 27th

In the news today: what humans are capable of doing with their lives:

• A woman in California gave birth to eight babies. Eight!?!?!?!?! We salute you!!!
  
• Microsoft, Caterpillar, Home Depot, Sprint Nextel and many other companies announced that they are laying off workers. Total jobs lost in this recession so far: 2.55 million. We have nothing to fear but fear itself, unless we were planning to retire in the next ten years, in which case: bummer.
  
• Illinois Governor Rod blagoyevich went on The View and talked to Diane Sawyer on national TV yesterday while back in Springfield the state legislature convened to impeach him for trying to sell his power to appoint the Senator to replace Obama. A complicated man with a simple plan... or a simple man with a complicated man.
  
• Neil Gaiman won the John Newbury Medal for his book, "The Graveyard Book." The courage to create.
  
• Dina Vierny died at the age of 89. She was the muse who inspired Aristede Maillol to create many great scupltures in the 1930s and 1940s. A nice Jewish girl from Moldava who wanted to study physics and chemistry, she was also a nudist and had a physical and spiritual beauty that attracted the attention of artists her entire life. During WWII she joined the Resistance and led refugees over the Pyrenees into Spain. She was arrested twice, spent six months in prison in Paris in the hands of the Gestapo, and survived the war. She became a well-known art collector and established the Malliol museum in Paris. Hat's off!!! The courage to live!!
  

Baby B

Today we learned that baby B is significantly smaller than the other two. Baby A is 2 pounds 6 ounces, Baby C is 2 pounds 3 ounces, Baby B is one pound 10 ounces. She is tiny. This lag in growth could be attributed to many different factors and it isn't possible at this time to determine the actual reasons. However her vitality appears to be strong. She is breathing actively, moving a lot. So she is "tiny and tough." The hope is that she continues to grow. They are going to do a biweekly growth study. The medical team is monitoring the three very closely. If their health appears to be deteriorating, the team will decide to deliver them. We hope to avoid that and keep them inside for two or three weeks more.

The hospital room is an architecture that arranges experiences

What kind of experience is being arranged on this structure?

The Waiting Place...

...for people just waiting.
Waiting for a train to go
or a bus to come, or a plane to go
or the mail to come, or the rain to go
or the phone to ring, or the snow to snow
or waiting around for a Yes or a No
or waiting for their hair to grow.
Everyone is just waiting.

Waiting for the fish to bite
or waiting for wind to fly a kite
or waiting around for Friday night
or waiting, perhaps, for their Uncle Jake
or a pot to boil, or a Better Break
or a sting of pearls, or a pair of pants
or a wig with curls, or Another Chance.
Everyone is just waiting.

--- From "The Places You'll Go," by Theodore Geisel (Dr. Seuss)

In that intermediary neither-here-nor-there waiting-for-time-to-pass place, where people's activity consists of "monitoring," "checking," "keeping an eye on" and people are afflicted with sensations of boredom, anxiety, uselessness, fear, annoyance, and confusion. Questions can only be answered over time, situations can only be resolved over time. And while we are waiting, and wishing for waiting to be over, the babies are breathing, drinking, kicking, blinking, touching with fingers and toes, reacting to sounds and pressure, turning in the womb and (recently) putting their heads down toward the exit. They have been waiting too - developing from a single cell!!!!! to these complex creatures -- humans about to begin being with us!!!! In the excitement of it all, that gets hung like a coat on a hook on the wall of this bare utilitarian room, I find myself saying, "Take your time, there's no rush, we can wait two weeks, three weeks, four weeks, get yourself ready, we will be here when you need us." And I find myself feeling, "I can't wait!!!"

But I can. Luciana can. We all can. So we do!

Contemporary images of pregnancy

Interestingly, when I was searching the web for an image to illustrate the previous post (on confinement) I came across a number of links to "pregnancy" and "confinement" that ran along the theme of "pregnancy is no longer associated with confinement." See the picture of the active young lady celebrating her pregnancy here.
And I quote:

Pregnancy is not the confinement that the relics of the Victorian era will have women believe. It is a cause for celebration, not hibernation!

Exercise has become a vital part of many women's lives. However, theoretic concerns have been raised about the safety of some forms of exercise during pregnancy. For pregnant women exercise has added benefits. It has been accepted for some time that the general health of a mother during pregnancy is of profound importance to the development of her baby. Unless problems restrict activity, it is advised to maintain your pre-pregnancy exercise levels. There have been no studies in humans that have shown problems in developing embryos caused by moderate exercise.

I'm not sure what this writer means when s/he refers to "the relics of the Victorian era" who would "have women believe." But s/he certainly is in tune with the contemporary ethos of pregnancy, which is that you need to keep going to the gym, working out, running, swimming, yogi-nating etc. as long as you can. This was the year that the English marathon champ ran a race three days after giving birth... It is pretty hard for any of us to imagine ourselves taking time out from our professions and obsessions. People ask me how much time I'm going to take off when the babies arrive, and a large blank space appears in my mind, which is my experience of the incapacity to compute.

Confinement

I was emailing with a friend of mine, Susan Shulman, a wise therapist, and detailing some of our ups and downs of the past week. She reminded me that in the Victorian era (when the rates of maternal and infant deaths were quite high, if I remember correctly) the proper English lady went through a period called "her confinement" that brought into focus an entire regalia of social etiquette and mannered emotions. My Lady Luciana is now in her confinement as well -- but the way they roll in new-school at Tufts Medical Center, you're in an electrically-powered bed under the observation of a ($4/day) television screen, and subjected to arduous tests on baby vitality three times a day. Not so restfull.

Things I learned today

Things I learned today include:
a. all three babies are breathing (amniotic fluid) and actively getting their lungs ready for real life.
b. they have interlocked their legs and are running and kicking a lot.
c. Baby A has the hiccups today.
d. a kidney specialist is going to be
consulting with the team to ponder the intricacies posed by Luciana's double kidney.

Here's a picture of a 28 week fetus inside the mom. Imagine three of them! Well, ours are smaller, but at this point they measure in the 45th percentile for size compared to the population of single babies!!

That's all ... so far!

Sing praises of Marina!

Marina has taken a term off from school to stay in Framingham and help Luciana and me get from where we are to where we are going, and we would be completely lost without her!
Yesterday I went to work, and Marina drove Luciana into Boston to Tufts Medical Center. Helped her pack, put her in the Jeep, and got her to the hospital, helped her in. Insisted that the staff get a wheelchair for Luciana so she wouldn't walk through the garage and down the hallways. She is thinking of so many things.
And -- she got the news Friday that she won another scholarship from Dartmouth. She is her second! "It is my pleasure to inform you that you have been selected to receive a second endowed scholarship this year, one of Dartmouth's Kenneth H. and Ruth K. Murray 1927 Scholarships... the late Mr. Murray, a noted alumnus of the Calss of 1927, established this fund. He received his law degree from Columbia University and spent six years practicing law in Rio de Janeiro, Brazil... This honor is bestowed only on Dartmouth's most outstanding students. Your personal and academic achievements demonstrate that you have the potential and promise to make a significant contribution at Dartmouth.... Congratualtions on this fine honor and recognition!"
Awesome!

Your basic news update

What's happening now is:

• Luciana began to experience spikes in her blood pressure
• She began to spill protein into her urine
• She only has one functioning kidney anyway, and it's doing all the work of filtering toxins and waste products from her blood for her and three children
• She is pumping nutrition & oxygen through three placentas to supply three two-pound 28 week embryos 24 hours a day
• Ten days ago the doctor gave her a letter and sent her home with the instructions: no more work
• She found being home and feeling useless almost intolerably intolerable
• So she was more often up and out of bed, working on reports ("I only have three more, I only have two more..."), connecting to her online posse, cleaning the kitchen, doing the laundry, pushing furniture around, shredding mountains of waste paper.
• When I was out at work, she would lie down and sleep. When I came home she would bemoan the lost hours and start working at things again. Then we would argue with each other about this.
• On Monday she had high blood pressure and I made her call the medical team. They had her come in and detected some signs suggesting early stages of eclampsia. They kept her in the hospital much of the day, sent her home "on bed rest" and ordered her to collect urine for 24 hours and come back in on Friday.
• All week she struggled to learn how to lie around and rest. It was a struggle, a struggle with a struggle, a struggle against struggling. Mantras like "I am a flower bed" didn't help much.
• On Friday she went in and they analyzed the data. On Friday night they called to say, Tomorrow come back and we're admitting you for a couple of days.
• Yesterday they admitted her. The on-duty doctor told her, Settle in, you're going to be here for a month.
• When I visited last night, she looked okay! Cheerful, bored, unhappy to be in the hospital. Mentally it's a torture. But she notices that when she lies in bed her blood pressure goes down, and when she sits up, her blood pressure spikes.
  
• The regime looks like: rest, lie down, watch TV. Blood pressure monitoring several times a day. Monitor the babies' heart beats three times a day. Every other day an ultrasound to measure the babies' growth.
• If the babies keep growing, good. If her blood pressure stays controlled, good. Because at this point, 28 weeks, their lungs are not up to the task of absorbing O2, their brains are not up to the task of breathing regularly, their GI tracts are not up to the task of absorbing nutrition. In two weeks, they will be.
• The immediate goal is to get through the next two weeks and see how things are going.
  
  

What would Target do?

I visited Luciana in the hospital last night. The medical center bustles with busy people during the day, but at 7 pm on a Saturday night you can rattle and shuffle all by yourself down the long hallways.
The only person I saw asked me, "Is this the third floor?" I held up two fingers for her to see, and she muttered in dismay, a sound I have made myself many times because it's not possible to get found in this place before you first get lost. A minute later I realized that she was right. It was the third floor, Once she figured I knew where I was and she didn't know where she was, that woman became lost. That's the way it goes in here.
I did find Luciana, by calling her on my cell phone and getting repeated redirections, finally closing in on "maternal and infant health." Part of the disorientation to the hospital environment is that everything is named from the perspective of the workers.
That's why I like shopping at Target. Everything is labelled from the shopper's perspective: cookies in this aisle, vacuum cleaners in that aisle, air freshener beyond the prilosec area, batteries every third endcap, help desk over here, and exits clearly marked with red signage. Shoppers are the people pushing bright red carts, Targeteers are the people in bright red shirts and tan pants.
In the hospital, you have to learn to look at things from a medical provider's perspective. She's not longer my wife, the mother of my children, a woman with high blood pressure induced by the demands of providing everything necessary to three two-pound gestating embryos. She's a patient who ... I can't actually twist my mind around into the perspective that comes up with "maternal and infant health." I guess the patient is not relevant here, in that the name has no direct orientation to a patient. The designation's primary target is "health," an abstraction for which I have no immediate reference (except that, like pornography, I generally know it when I feel it). Specifying health a bit more, we are dealing with maternal and infant health. I suppose they used to call it the maternity ward. Why can't they call it Mothers & Babies Ward? Or "Your Family Starts Here"?

How I spend my waiting time

In case you thought I spend all my waiting time washing floors, doing dishes, cooking meals, cycling laundry, shoveling driveways and seeing clients. I also provide a significant amount of lap time for Xuxa and also have been educating myself about the life, times and art of Francisco Goya, an artist whose work spanned the years of the Enlightenment, the French Revolution, the Napoleonic Wars and after -- and was an engraver and artist like William Blake, my hero. All of which takes me far away, for short periods of time, from my daily life.

Just for fun

This morning before I left for work, a tender moment.
I look funny because I'm hugging and also taking the photo.

Here we are -- January 23

This is how we are doing today, January 23rd. It's been a busy week of learning to do less and less, and Luciana is getting better at it. We have all the daily problems of life, but since we seem to be managing them better, they are more or less just a backdrop for our big event. We have been down to one car all week because my car went into the shop last Thursday, and it took them three days to diagnose the problem, and since then can't get the right part. It has snowed several times, so there has been lots of digging, snowblowing and salting. Some neighbor recently figured out they could get on our wireless network and grab tons of bandwith for BitTorrent downloads (I'm guessing) so I had to learn (finally) how to program the router to have a password. In the midst of this, Luciana's computer lost its (tenuous at best) connection to the internet, and we still haven't puzzled that one out. The garbage disposal is jammed, so we are constantly unclogging the sink drain and thinking vaguely about getting someone who knows what they are doing to come fix it. Perhaps on Saturday Varlei will come, as he has promised, to fix the many things. Meanwhile we are learning to move slowly, and we are learning to reassure each other. Last night it turned out that I was not mentally prepared for the day of the birth at the hospital, in that I had always figured I would be there through the whole process, and then when everyone was settled in and safe -- if everyone was settled in and safe -- I would go home for a few hours sleep before coming back in the morning. No! No! No! What kind of husband thinks this kind of thing?!? It must have been my autistic side getting activated. So it turns out the proper plan is -- I will sleep in the chair, ever ready to jump up and make sure the babies are alright so I can return to reassure my poor wife, who will be recovering from major surgery. Of course, if I had undergone major surgery (does appendectomy and gall bladder removal count as major surgery? maybe not) I would just as soon be left alone. But... hey, that's me. Luciana does NOT want to be left alone. Now that I understand that, things are fine.
I think for the first time I began to visualize the situation at the hospital and I realized I will probably be so excited that I will stay up all night anyway!

Around the well

We want to know how each other is doing: if the baby is moving inside our wombs, if eating yogurt will ease our intestines, if the nurse will find out if we had sex the night before when she checks our inner parts. There are the usual optimists and the prophets of disgrace and we want to listen to them all, just for the sake of it.
We are gestating destinies, facing uncertainties and risks - that is what brings us together. Our stories, circulating through many voices, calms most fears and nourishes even the tiniest bit of courage. We see on each other bodies how Nature carves its way and makes us part of something much bigger than our vanities. We are pregnant women.
We used to stand around the well - and that was a long time ago. When the waters were tamed in our kitchens, we moved to the church social hour and then to the doctor's waiting room. And now that we are kept apart by the urgencies and conveniences of modern urban life, we meet again, online.
Our posts travel through the electronic sky to find each other's fears, questions - and wisdom. We found our well again.

What was this guy thinking?

This photo takes me back to a simpler time. A time when all I wanted to do was enjoy the sunshine, and walk around Barra, and get to the clinic on time for our appointments.
Before fertilization, before placing of blastocycsts, before learning that there are three!
Look at this guy. Does he look like someone who knows what he is doing? (No.) Does he look like someone who thinks he knows what he is doing? (Always.)

Old skills in new situations

You know why I like to spend time at work? Beyond the sheer pleasure of being with people and the endless puzzles and knots that people present, there is the reassuring experience of being on solid ground with myself. I know what I'm doing, I know what there is to do, there seems to be a reasonable match between these two sets, and so "I'm okay."
Which helps me understand the distress of a person -- like my wife -- who has been thrust into the opposite case. She doesn't exactly know what she is doing, and she doesn't exactly know what there is to do. All the challenges and questions that come up evade any automatic answer, because she is simply not allowed anymore to do anything she normally does.
Can she get out of her maternity bedrest to attend a meeting at school on the very important topic of X? No, she cannot. Her boss gets wind of her intent to attend, and calls her up to say, You can't come to school, it's not allowed, you're on medical leave, we can't tolerate the liability issues.
Can she keep working on reports while at home? No, she cannot. They want her to turn in her raw scores and hand over her laptop. They are saying, We'll take it from here.
Which leaves her in the lurch with herself.

Trying to calm down

We are going through a tough transition. L really hates being on bed rest. She lies down and sleeps when I am out -- as soon as I get home, she jumps up and starts "doing." So we have sit-com style conversations:
L: "Oh you're here. I can walk the dog."
Me: "Nooo (irritated) I can walk the dog."
L: "Well, I can make some dinner."
Me: "Nooo (more irritated) I can make some dinner."
L: "Well, while you make dinner, I'll go out and get some firewood to start a fire."
Me: "You're driving me bananas, woman. Lie down on the couch and watch the g**d**n inaugural parade and let me take care of this stuff."
L: "But I feel so useless!" (sniffles)
Me: "You're not useless, you're taking care of three infant babies! So please go do that."
None of these conversations end too happily. But in general we are trying to hang in there.
Like all else in life, this is merely transitional. See quote from Samuel Johnson below....

Thought of the day from SJ

While reading Samuel Johnson's essays in search of lunchtime distraction I came across a useful line:
"Private life ... derives its comforts and its wretchedness from the right or wrong management of things which nothing but their frequency makes considerable."
As my son Felix would say, "Tru dat, tru dat."

First scary scare

Today we had our first scary scare. Up to know, all the scares have been unsettling and even concerning but never scary. This morning L woke up feeling bad. I took her blood pressure and it was high. She had a headache and felt very swollen, and she was groaning and moaning every time she tried to walk from room to room. All this is complicated by the quotidian demands of life. The RCN technician showed up in the midst of this to settle our HBO-cable problem, which he did with admirable despatch, but his presence compounded the complexity of our calculations: my client appointment schedule, her need to get into Tufts Medical Center to be assessed, and our having only one functioning car (the MB is waiting for a new catalytic converter, and has been waiting down at Junior's garage since Friday). All this is intensified by L's tendency to minimize everything because she doesn't want me to worry, which exacerbates the intensity of my concerns because I can't really judge how badly she is feeling.
It all seems to be working out. She got into the medical center, where they admitted her for a couple of hours of observation. Her blood pressure went up, down, up, and then settled down. There is some protein spilling into her urine. The consenses for today is that she probably is NOT going into pre-eclampsia -- more likely, the babies are getting ready to be born. They are saying today that she should go on bed rest (only getting out for purposes of hygiene and nutrition) and that we can expect the babies to be born in the next 2-3 weeks. Which has a strong ring of "Holy S*** this is getting awfully realistic" about it.

Today's my birthday

And I got a wonderful voicemail message from Marina wishing me the best for my birthday and encouraging me to be happy about the coming year. What a sweet heart she is!

Moving to house (ar)rest

The big development of the past week is that on Friday Luciana stopped working. She had a letter from her doctor telling her to stop working, and Thursday she gave that to her employers. It is so hard for her to settling into house rest, however. Several times a day we get into cross-purposes. I want her to rest, to sit or lie down, to do nothing -- and she can't stand the feeling of doing nothing. We have a mantra for her -- "I'm a flower bed" -- but that doesn't quite do it. She is facing four to six more weeks of this, and it seems to be terrifying to her. I don't blame her -- I wouldn't want to be doing what she doing, or undergoing what she's undergoing. It seems like the last part of the pregnancy is an ordeal -- scary, painful, exhausting, mortifying.

What a world they are going to join...

My three girls are going to join the onrushing current of human history at such a propitious moment. I listened on NPR this morning to a piece on the Smithsonian Institute's Museum of African-American History, which is set to open in 2015, and I thought, "The girls will be six, we can go there to see it together." I am thrilled that they have the chance to see, learn about, and begin the process of understanding that our country was founded on slavery as a central economic, social, cultural and psychological institution, and that we have as a country worked to overcome this heritage and change ourselves into a nation of peoples. The news is full of stories about Obama's upcoming inauguration (as it is also full of news about Bernie Madoff's world-historical fraud, about massive layoffs, the moribund state of the Detroit-based auto industry, the bloodshed in Gaza, the nuclear arms race in Iran, the natural gas battles between Ukraine and Russia, and on and on). What a moment in our history to join in.

A road not taken

Here's a reminder of the simple life we nearly had. A dinner of steak and vegetables, cooked over an open fire, behind a rented cottage in the Northeast Kingdom of Vermont, in August of 2006. It was our little vacation together -- Luciana and me, and the two dogs Sally and Bruce. A simple restful time full of conversation and many many ideas: about attachment theory and The Sopranos, about private practice and school psychology, about books we could write and trips we could take.
The road not taken. Not regretted -- but remembered and not taken.

Who is this guy kidding?

This was one of those vicious phases of organization that sets in, like a bowel spasm, and then finally eases and releases and lets us all go back to our life as normally lived -- in a total mess. One Sunday afternoon - before all the house renovations began, so this had to be December or January or February of 07/08, I bought this piece of peg board at Home Depot, capably screwed it to the garage wall, and carefully hung all the tools where they would be available for instant use in the event of any home repair episode. It was such a proud moment that Luciana came out to memorialize with a photo. If you could only see things in the garage now... Last Sunday I spent an hour tussling mano a mano with piles of our stuff, the possessions that had accumulated in the garage over the past year during the renovations. There was the sunny Sunday when we disemboweled the basement and garage, with hired help, no less, and carefully rearranged all this stuff - giving things away, selling a few things, repacking things and arranging them into the attic, basement and -- and -- yes, and the garage, which resumed its status as an impassable crevasse of possessions rendered useless. Somewhere in all that mess, this pegboard is still on the wall -- but it is so encumbered with tools that it too is useless -- even if you could reach it beyond the impediments of piles of piles of possessions.
And all this has to be worked out before the babies arrive!!!

I remember

I remember Bruce. He was such a sweet dog until things suddenly reached the point where he was driving us crazy. One of the phases of pregnancy was: getting very worried and concerned - I knew it was up to me to work things out so that the dogs could all stay with us. If I was able to train them, exercise them, take care of them so that they were all peaceful, calm, quiet, cooperative, so that they didn't make the house a muddy sandy mess, didn't steal food off the counter top and out of the shelves, didn't bark endlessly in the house, didn't bark endlessly in the back yard -- it was all up to me to make sure this didn't happen. And once it became clear that I was going to fail, suddenly there was a shift in me. Bruce, emotionally, was the first to go. Sally I had a harder time parting from. But when Bruce destroyed the slow-cooker, ate the can of sardines and the can of soup, and ruined the couch, and jumped on everyone who came in the front door, and scratched the newly-painted doors and scraped mud on the newly-painted walls, then Bruce had to go. And he went to Buddy Dog, but not before a grand extended family brawl.

Time has passed

Geez, I haven't written on this blog since the end of September. Let's see, I think I was still exuberant about the triplet situation back then. Even through the financial markets were crumbling away. I didn't care. I was euphoric. Then one day I was driving the Jeep down
Route 9 and I suddenly thought, "Triplets! Jeeez. I didn't want Triplets! I only wanted one. A Baby. Not three. Just One." That was the beginning of a long middle period. In the middle period, I was somewhat remote from myself, irritable with people, overly focused on work-related issues, and prone to complaining about life. People would ask about the babies and I would force a smile and say, "Great." This was the period when the psychiatrist next door would see me every week and say, "Triplets?! I'd shoot myself!" and I'd say, "Yeah, thanks for that!" The middle period lasted what seemed like a long time. I am recovering from the middle period the past few weeks. The first signs of recovery from the middle period are symptoms of fear and panic. Holy Crap! My wife might die! I have to say, nothing could be worse than that. Children with birth defects and life threatening illnesses I can handle. Luciana dying - unimaginable. She said to me about three weeks ago, "If I die, I want you to take the girls and go to Brazil and my mother will help you raise them." I used all my patience to restrain myself at that moment. But as my recovery from the middle period progresses, I am less covertly panicked and more openly panicked, which is progress. Today Luciana saw her doctor, who gave her a letter releasing her from work after this Thursday. She'll be home, not on bedrest, but resting and not traveling around town. For that I'm grateful. I'm constantly hounding her: Don't bend over to pick that up, don't get down on your hands and knees to rummage under the sink, don't carry the laundry up from the basement. Etc. etc.