But...If My Life Was Perfect...

     But...if my life was perfect....
     I would not:
          Be sensitive
          Be compassionate
          Be understanding of other people--of the world around me
          Be flexible in how I approach and accomplish physical tasks
          Be flexible in how I view the diversity of people, beliefs, and cultures
          Be awe-struck by beauty around me
          Be wonder-filled about life within and around me--life distant from me
          Be appreciative of basic human capacities--thinking, and walking, to name a few
          Be attentive to how words are used--how I use words
          Be attentive to how my words and actions affect other people I know and do not know
          Be blessed with a sense of humor
          Be determined to live my life fully
          Be passionate about pursuing my interests
          Be interested in learning every day--each moment--of my life
          Be willing to apologize when I had offended someone else, or stolen someone's dignity
          Be dedicated to fulfilling my human potential, and encouraging others to do so
          Be open to the notion that this list is not complete
          Be baptized...be willing to seek an ongoing living of baptism        
     If My Life Were Perfect, I Would Not Be Human.

If My Life Was Perfect...

     I have struggled to advise a family member as to how to fulfill their unique human potential.  Knowing the position of respect bestowed on me has given me a sense of responsibility.  Only following the Boston Marathon Bombings have I been given an inkling as to how to fulfill my responsibility.
    My family member lacks the sense of how to fulfill his adult responsibilities--fulfill his human potential.  Ascribing responsibilities on other intimates how they have failed their responsibiltiies to my family member has clouded his willingness to look at his own human potential--the gift he has been given by God--by his belief in God.  I know that belief exists in him.  I do not know the form of belief.
    My belief--the form of my belief--calls me to offer something.
    From an unlikely source--the Boston Marathon Bombings suspect--I understand one way--one something--I may offer.
    Optimist--idealist--that I am, recent years have taught me, "life is not perfect."  Self-pity is not the sum of that equation in my life.  So where does that leave me--how does that affect my offering to my family member.
     A List.  An Itemized--A Humbling List.
     If My Life Was Perfect...    
     I Would Not:
          Need to wear my ankle foot orthotic--my brace on my right leg
          Need to walk long distances with a cane
          Need to use a wheelchair
          Need to take medication to control my intentional tremors
          Need to take anticonvulsants to control my seizures
          Need to grab the right handrail with my left hand when walking up or down a flight of stairs
     I Would Not Fear:
          Outstretching my left hand--lose the use of my left and right hand by:
               Opening doorknobs
               Carrying heavy bags of groceries
               Carrying heavy loads of laundry
            My capacity to stand up from the ground
     People Would:
         Think my handwriting was beautiful

Victims. Entitlement.

"There are 47 percent of the people who will vote for the president no matter what. All right, there are 47 percent who are with him, who are dependent upon government, who believe that they are victims, who believe the government has a responsibility to care for them, who believe that they are entitled to health care, to food, to housing, to you-name-it -- that that's an entitlement. And the government should give it to them. And they will vote for this president no matter what. ... These are people who pay no income tax. ... [M]y job is not to worry about those people. I'll never convince them they should take personal responsibility and care for their lives."
                                                                        Mitt Romney
     I do my best to steer clear of political commentary.  Excessive ranting, raving does grave injustice to the issues that demand our attention.
     But...
     I must speak out against Mitt Romney's broad strokes.  You see, some may say I am within the group of which he speaks--not completely, but, sufficient to respond.  I no longer work.  Although I do pay taxes.  I receive SSDI.  I am covered by Medicare.
     Some may say, "Don't take Mitt Romney's words personally."  I must.  The only way I know to live is personally.  If I do not live from my personal experience,  then, I have nothing to offer this world.
     Oxford Dictionaries defines "victim" as, "[noun] a person harmed, injured, or killed as a result of a crime, accident, or other event or action."
      If you define "cerebral palsy," as a result of the event of my birth, then, yes, I am a victim.  However, "victim", when spoken in common parlance, has a heavy burden of pity that exceeds its dictionary definition.  I do not include myself in that group.
    "Personal" is defined as, "adjective.  of, affecting, or belonging to a particular person rather than to anyone else."
    "Responsibility" is defined as, "the state or fact of having a duty to deal with something or of having control over someone."
     I do what is within my power to take responsibility to care for myself--for the impact of "cerebral palsy," "osteoarthritis," "epilepsy," and "intentional tremors."  I take medications twice daily.  I swim three to four hours a week.  I use a straw to drink--to counteract a tremor-laden hand.  I adjust the arrangement of my home to accommodate my physical capabilities.
    Dependent?  Yes, I am dependent.
    I don an ankle-foot-orthotic--a leg brace--daily.  I use an electric wheelchair when traveling long distances.  I submit to lab tests to evaluate the amounts of medications in my bloodstream.
    Dependent?  Yes, I am dependent.  Everyone is.
    But...that is not the whole story of who I am.
    I do give back.  To my family.  To my friends.  To my church.  To my community.  As I am able, I do give back.
    Research.  Writing.  Listening.  Advising.  Advocating.  Volunteering.
    Entitlement is defined as, "the fact of having a right to something."
    Entitlement.  Respect?  Yes.  Respect--basic, human respect.  That is the Entitlement that I offer each individual I meet and know.  That is the Entitlement I expect from others.

Epilepsy Chronicles: The Pill

     Not as you might think, I took The Pill.  Not The Pill, but, The Pill, nonetheless.  Not as a young woman, but, as a young child--a six-year-old, perhaps.
     Born not of an egg, but, of tissue wrapping my left brain--scar tissue.  Five times, at birth, my umbilical cord was roped around my neck.  Five times, my umbilical cord--my Boa--constricted the flow of oxygen to my brain.  The Boa choked the left side of my brain lifeless.  The Boa wrapped my brain in tissue--scar tissue.
The Boa damaged my brain for life.
    The Boa chokes me.  Not satisfied to choke me once for all time, the Boa wraps around my neck
 again and again.  He charges my brain with surges of electrical energy.  Bolts of lightning travel from my brain down through my right arm to my right leg.  In thunderous storms, the Boa wraps himself more tightly around the left side of my brain.
    As the winner of a bad Miss America contest, the Boa falls into a satin Miss Seizure America sash.  Through the satin sash surges the seizures electrical energy.  From left side of my brain down across to my right arm and right leg the lightning bolt travels.
    Not concerned with my eggs' cycles, my eyes see no further than The Boa's wrap.
    Not as you might think, I took The Pill.  Not The Pill, but, The Pill, nonetheless.  Not as a young woman, but, as a young child--a six-year-old, perhaps.
    Not as you might think, I remember, "The First Time."
    With great anticipation of an unimaginable "present," I received a gift I did not request--a gift I needed.
    I sat at the round, teak, dinning room table.  With my brother, sister, and dad, I waited.  I looked out the window.  On the long driveway, my eyes were fixated.  The Saturday morning sunshine lit the auburn, teak dining room table.  We sat.  We waited.  Beyond the blond pocket door, Mom prepared a special breakfast.  Pancakes, perhaps.  Something to soften what was being forced down my throat.
    Before me was presented a pale, yellow-faced pill.  A small, triangular pill.  Dilantin, Mom tells me.  It is chewable. Hmmmm.....What will it taste like.
    I place the pill into my mouth.  I bite down.  Not bad.  Not sweet.  Not candy.  I never liked candy, anyway.

Epilepsy Chronicles: Misinformed

     Deeply disturbing information was disseminated, and stereotypes were reinforced last night during a television interview.  On September 10,2011, University of Minnesota football coach--Brad Kill--had a seizure during a football game.  His players, and colleagues knew of his seizures.  I have not met Coach Kill.  I report regarding what I understand of him.  Media coverage.
     I do understand what it is to have a seizure.  I have had seizures since childhood.  I am 51.  Each individual's seizures are different.  Yet, I am compelled to respond to the misinformation given, and stereotypes reinforced by a neurologist last night.
     Most disturbing of what the neurologist said?  Something to  the effect of, "People with epilepsy foam at the mouth."
     This is not true.  Case closed. 
     "Seizures are frightening."
      Yes.  Both for the observer, and for the person having the seizure.
      However, fright is not an excuse to stand by--panic.  You can help. 
      First, it is possible that an individual having a seizure may be able to hear what is being said during a seizure.    Often, I am.  Yet, the excessive electrical activity in the brain--the anatomical thunderstorm--drains me of the energy that otherwise I would use to respond.
     Second, not holding an individual during a seizure may be too extreme of a directive.  Beyond getting the medical attention I need, the most helpful--reassuring--action ever taken was from a colleague.  While my right leg was convulsing--shaking violently--she caressed my leg.  She told me I had done nothing wrong, I had no reason to feel embarrassed, and I would be OK.
     She caressed my leg.
     My colleague trusted what I had said--valued what preferences I had expressed to her regarding my seizures--such that she resisted the nurse who said not to hold my leg.  She was not restraining me from movement.  She was touching me firmly--reassuringly.  There is a huge difference.  Never have I heard a medical professional make that distinction.  There is a difference--a huge difference.
     As to embarrassment--being embarrassed by having a seizure--I understand.
     Yet, far more embarrassing than any seizure could be ever is not telling someone how you prefer to have your seizures handled, if you have seizures.
    Early in my career, my loved ones were concerned about I would say during an interview that I had seizures.  I understand.  I appreciate their advice.  Fear existed, and exists yet today.  I assure you, I did not walk into job interviews and say, "Hi, I am Patty Thorsen.  I have seizures.  Can I have a job?"
    I did inform my supervisors, and colleagues that I had seizures.  I gave them the basic emergency contact information.  I took one more important action.  I informed my supervisors, and friends how I preferred to have my seizures handled.  Embarrassment, or fear I felt in doing so was mitigated by the knowledge that they would know how to handle my seizures.
    Embarrassed by having a seizure?  Yes and no.  Yes, the times I have had a seizure in public are not my proudest moments.  Yet, once I have a seizure, I need to channel every ounce of energy I have, and every ounce that I don't have toward staying as calm as possible during the seizure--praying that the words I spoke about my seizures were heard.  During a seizure, I pray that people around me--people who have the energy to take constructive action--are courageous enough to do so.
    Whatever embarrassment we well may feel, we--any of us who have seizures--need to channel that embarrassment into helping other people to help us.  We need to make an investment in creating calm understanding--not fearful chaos.
    Friends and family may offer their loving questions as to how someone with seizures how they wish to have them handled.  Whether it be a reassuring word or touch, humor or whatever.  Honesty is the only way to dispel awkwardness, fear, and chaos.
    I have serious doubts about some medical professionals I have known, and with whom I have had interactions.  I have had, and continue to have the benefit of extremely helpful, competent medical professionals.
     Yet, the comments made by the neurologist this week made necessary my response.

Medicare

     Medicare.  White-haired senior citizens.  Medicare.  65-year-olds.  Medicare.  Part A.  Medicare.  Part B.  Medicare.  Part C.  Medicare Part D.  Medicare.  Medigap.  Medicare. Open Enrollment.  Medicare.  Fraud.  Medicare.
     Each of these are aspects of Medicare.  Yet, Medicare--the word, "Medicare"--evokes emotions as inflamed as arthritic joints.  I cannot--I will not--inflame the word further by engaging in the political debates surrounding the federal program.
     I find myself at a peculiar crossroads.  Had you told me five years ago that I would be selecting which Medicare Parts B, C, and D options to select, I would not have believed you.
     An envelope from the Social Security Administration arrived this week.  My question, "Do I need to initiate contact regarding Medicare?" was answered.  No.  As I hoped, I could read the wealth of information given to me, sign onto a helpful website, www.Medicare.gov, and create an account.  My guard against anxiety, and obsession is a playful detachment.
   I love crossword puzzles.  I love the World Wide Web--navigating the structure of its information, the internet.
   With playful discovery, I found a database into which I may search for my doctors, hospitals, pharmacies.  Nursing homes?  No, I am far from ready for that move.
    It is ironic.  I tell one of my nephews to join the world of adult responsibility.  Yet, I tell myself not to get too obsessed regarding the eventualities with which the plan options confront me.
    One of the options I will not select is Plan H--Political Hyperbole--which plays on the emotions of senior citizens, and others eligible to receive Medicare.  I will steer clear of candidates, who use a condescending tone in their discussions of Medicare.  I will steer clear of Victims' Volley--a game too often played by politicians, in which recipients of Medicare become political footballs.
     Do you think Medicare will judge ear plugs I buy as medically necessary?

Epilepsy Chronicles: A Firm Grip

     You have a hold on my right arm and leg no longer.  Yet, your grip on me is firm--firmer than I realize.  I try to erase you from my memory--put you in the well within me.  Yet, I look back to my own words--my sentences.  You have a firm grip on my mind.  You take words from my sentences.  You steal the precious part of me that, so desperately, I want to--I must give.
     You give me no clue as to where you are--no hint as to where to look.  You give me no key to find you.
     Where are you?  You are hiding from me.  Where are you?
     I try to understand.

Epilepsy Chronicles: Precursory Shakiness

     Honestly, I don't know if what I am about to describe is germane to the Epilepsy Chronicles.  I think it is.      My thoughts, words, and descriptions deal with brain damage most directly, moreso than epilepsy per se.
     I work very hard to stay as calm as is possible--humor, empathy, patience, among other attributes that elude me.  These attributes may be seen as laudable, and, in one sense, they may be.  Yet, there is a neurological basis that makes these attributes essential.  I am not a doctor.   I have not studied neurology, or any scientific discipline that might offer me insight.
     I can quantify the dosages of anticonvulsants I am prescribed to tame the extra electrical activity in my brain--milligrams.  I can quantify the level of anticonvulsants in my bloodstream, which are determined by a blood test--a therapeutic blood level range.  Based on my weight, at least, there is a numeric scale established. If the therapeutic blood level is too low, my experience has been that more medication is prescribed.  The opposite is true, too.  In my experience, blood levels that are too high on that scale lead doctors to prescribe a higher dosage of medications.  Sometimes, an altogether different anticonvulsant is prescribed.
    Yet, I cannot quantify the threshold I have for anger, and frustration, which leads to shakiness of my whole body--I cannot quantify it for myself or for others.  I recognize it myself.  All I know to do is to cry, and then, isolate myself until my jangled nerves are tamed, and my body is steadied physically.  The crying is the cleansing agent essential to taming the extra electrical activity in my brain.
    Compounding my own response, I know that the apologies of other people, well-intended though I know they are, only exacerbate my initial response.  Trying to be rational long enough to isolate myself for my necessary cry, and quiet time is extremely difficult.  I know that a part of that quiet means removing any activities that I know will involve further neurological agitation.  I try to be rational, so as to explain that I can withstand some tension, frustration, and anger.  Yet, my rational efforts are useless.  My nervous system has been hijacked such that being physically steady is next to impossible.
     What I have just described is not a seizure, as I understand it, after having lived with epilepsy for more than 40 years.  My description today is fresh to my life--fresh to this moment.  After anticipating a personal training session for several weeks--a session to identify further efforts I may take to strengthen my arms, hands, and legs--I met with tremendous disappointment, frustration, and anger that a perfectly understandable mixup in appointment times occurred.  Not knowing precisely what to ask for to reschedule--what specific terms to use (a neurosis of mine)--my neurological response is intensified.
     I need peace--inner peace, calm, perspective, and determination to reclaim goals I know have been strengthening me, irrespective of reliable help I expected, and hoped I would be given today.  I need insight. Am I merely making an excuse for unnecessary, irrational behavior, or is there some credibility to my thoughts--my descriptions?

The Epilepsy Chronicles: A Firm Grip on Me

   You have a hold on my right leg and arm no longer.  Yet, your grip on me is firm--firmer than I realize.  I try to erase you from my memory--put you in the well within me.  Yet, I look back to my words--to my writings.  You have a firm grip on my mind.  You take words from my my sentences.  You steal the precious part of me that I want to give.  You give me no clue as to where you are.  You give me no key to find you.  Where are you?  You are hiding from me.
     I try to understand.

Epilepsy Chronicles: The Other Side

      I turned the corner.  Sixth and Cedar Streets.  The 14B bus stop.  I have arrived.  1:30 P.M.   I am ready.  A 2 P.M. appointment with my college adviser.  My purpose?  To enroll in a pastoral ministry program.  I am prepared.
     As I round the corner, a man in his mid-60s is struggling to stand up an unresponsive woman from the ground.
     "Is she having a seizure?" I ask.  I know the answer.  I need my question's time to marshal strength.
     Is she having a seizure?  I think she is having a seizure.  This is strange.  Not unfamiliar, but strange nonetheless.  Never have I been on this side of a seizure.
     I grabbed the older man's arm firmly.
     "She seems so helpless.  Are they ever going to get here?" the man cried plaintively.
     "Let the woman sit here on the bench.  The police are on their way.  I know it seems like a long time...
      You have no idea how much I understand...the time warp...I understand...seconds seem like minutes...minutes seem like hours...I understand...believe me, I understand.
     Several minutes later, help arrived.  Finally, help has arrived.  She will be safe now.  The paramedics arrived.  She will get medication in her bloodstream immediately--anticonvulsants.  They will minimize recurrence of such seizures.
...
     Moments later, the 14B bus arrived.  I was off to meet my college adviser.  I was off to explore enrolling in a pastoral ministry program.
     I boarded the bus.  I sat down.  Suddenly, tears came streaming down my face.  I lost my composure completely.
     My witness at the bus stop was no accident.

Crossed Wires...Jangled Nerves...

Crossed wires….jangled nerves….

When you were born,

your umbilical cord was wrapped around your neck five times.

Crossed wires….jangled nerves….

The corded gifts that keep on giving—epilepsy…cerebral palsy.

Crossed wires….jangled nerves….

You have excess electrical activity in your brain--epilepsy.

Crossed wires….jangled nerves….

Epilepsy is like a thunderstorm in the brain.

Crossed wires….jangled nerves.

I can do it myself, Mom, don’t you know, I can do it myself….

Can’t you see, Mom, I can’t do it myself, I need your help.

Crossed wires….jangled nerves….

The faster I walk, the more I trip.

Crossed wires….jangled nerves.

Your cerebral palsy accelerates your aging process.

Crossed wires….jangled nerves.

The harder you intend to use your left hand, the more it will shake—intentional tremors.

Crossed wires….jangled nerves….

The more hostile I am, the more intense my tremors.

Crossed wires….jangled nerves...

The more data you throw at me, the slower I compute.

Crossed wires...jangled nerves...

The more instructions I hear, the more I must write them--

the more Velcro from my ear to my brain I need.

Crossed wires….jangled nerves….

The more instructions I hear, the more I must write--

the more Velcro from my ear to my brain I need.

Crossed wires….jangled nerves….

The less I write, the less I remember.

Crossed wires….jangled nerves….

The more I write, the deeper I think.

Crossed wires….jangled nerves….

The more challenges I am given, the more I want to surmount them.

Crossed wires….jangled nerves….

Epilepsy Chronicles: The Other Face

     Some coworkers feared I might have a seizure on command.  Others feared it happening in their presence.  I understand.  Being out of control of my body in my mind's eye.  I understand.  Yet, not moreso than when I happened upon a seizure of a man awaiting a bus. 
     "Focus on the positive, and ignore negative behavior,"  Mom chants in the deep reaches of my memory.  From my earliest memory, "Focus on the positive, and ignore negative behavior."
     I understood what he needed.  Not medically.  Yet, I knew what help he needed from the many helpless people who surrounded him.  I knew the helpless individuals, who surrounded him, were far from helpless.  While others surrounding me were viewing their first seizure, I was on the other end of the seizure.  I understood what he needed.
     I had never met the seizing man before witnessing his seizure.  I have not seen him since that day.
    Yet, I was given a voice--words to speak---for a reason.  I am not committed to vengeance against other individuals.  Yet, I can and must commit myself to positive vengeance against the excessive electrical energy in my brain, the root of my disabilities.  I can and must be the human irritant--the nacre--that contributes to pearls of understanding.  

Epilepsy Chronicles: The Morning After

...
     Slowly...ever so slowly....I awaken from a deep sleep.  I awaken.  I have slept off my throbbing headache.  Or so I think.  Is my epileptic hangover over?
     Can I be so bold as to hold out that hope?
     Slowly, I question....
     Was that just a bad dream--a nightmare--or did I have a seizure last night?
     My headache is gone.  Will I have another seizure?
     My knees feel wobbly.  The firmness of my step tentative.  Will I have another seizure?  Honestly, I don't know.  But, I can't admit that, at least not to everyone.   
     What can I do?  What should I do?  What action will give me what I need--what we need, to move us forward from doubt, uncertainty, and fear?  God, I don't think I am being selfish.  But, what can I do?  What should I do?
     I can't add to the doubts, and anxiety of my coworkers as to whether I will have another seizure.  God knows, some people are convinced that I can have a seizure on command, without my feeding into their fears.
    I need their confidence in me.  So, what do I do?  How do I garner that confidence--that positive energy?

Epilepsy Chronicles: In the Throes...

     I fear the worst.  My body is out of control.
     Relieve me of my consciousness.  At this moment, relieve me of my consciousness.  Help me.  God, help me. Help me to hang on.
     My right arm and leg are falling off my body.
     God, help me. ... Mom, help me.  I need you.  Mom, help me.
     Home alone, I cry as though Mom can hear me from the next room.
     Mom, help me.  I need you.
     "You will learn to live independently," she said.  "You will learn to live independently."
      My roommate is gone.  I need you.  How dare you leave me in my time of need!  How dare you leave me in my time of need.
     I am alone.  Someone has been here, always someone has been here--within earshot of my cries.  However embarrassed, or shame filled I have been that I have not taken my medicatiion, someone has been within earshot. 
     I am alone.
     Maybe if I turn on my right side, my arm and leg will stop shaking.  Maybe, they won't fall off my body.  What else can I do?
     Relieve me of my consciousness.  Let me sleep.  My head is throbbing.  Let me sleep off my throbbing headache.  My head is throbbing.   
     Finally, without my knowing, sleep is given to me.  My consciousness relieved.

Epilepsy Chronicles: How Long Did It Last?

"How long did the seizure last?"

     You know I live alone!  Let's see...I should be able to figure that out.  After all, I wasn't doing anything.  Oh, that's right, I forgot.  I know that I am lucky, because I usually get an aura--a feeling like you get when coming inside on a sunny day.  So, I knew to look at the clock before the seizure started.  Once the seizure stopped, I looked at the clock again.  Based on that the seizure lasted....Get real...my attention was hardly directed toward how long the seizure lasted.

    I do know it is important information to him.  I know that my neurologist can diagnose a seizure, in part, by its duration.

    How do I tell you that there is more to my seizure than its length?  How can I convey to you--you know--I live alone.  I am capable of doing so.  Yet, I am a bit preoccupied during a seizure.  But, how on earth do I tell YOU that.  You are a skilled neurologist, but, your people skills leave a lot to be desired.

     In the future, I will do everything I can to check the clock before and after the seizure.  After all, I don't want to disappoint you.

     There has to be another way to determine how long a seizure lasts.  After all, not everyone with seizures can live with someone or be with someone every moment of a day and night.  It just isn't practical!  

     What are people thinking?  Or ARE people thinking?  And people say that I am not very responsive.

The doctors tell me that my thought process is messed up after a seizure.  But, what about their thought processes? What excuses do they have for  being messed up in their thought processes.

    "How long did the seizure last?"

     Do you have any idea of how ridiculous your question sounds?  Have you ever had a seizure before?  Are you aware of the time warp I experience during a seizure?  ...Seconds last for minutes....minutes seem like hours...

    "How long did the seizure last?"

Earthquakes and Seizures???

Eyewitnesses are reporting that a 7.4 earthquake has occurred in Japan.  I fear earthquakes.  I have never experienced an earthquake.  My fear is not routed in its unknown quality to me.  Not exactly.
     I have spoken with California earthquake veterans--Minnesota natives.  My questions??
     First, what does an earthquake feel like?
     Second, what distinguishes an afttershock from a separate earthquake?  Is it a function of time?  Is it a function of the earthquake's location?  Is it a function of the earthquake's strength?
     Third, how can you quantify the exponential nature of earthquakes on a human scale?
     Fourth, is there any parallel--scientific, or otherwise--between a seizure, and an earthquake?
     I have never heard anyone posit a correlation between earthquakes, and seizures.  I know individuals familiar with earthquakes.  I know some individuals with seizures.  Yet, no such lay experts have expressed this question.  I have had seizures since I was a kid.  Some of my seizures have been grand mal--tonic clonic seizures.  I have told family, friends, and coworkers that if I have a seizure to reassure me.  Specifically, during a tonic-clonic seizure, it feels as though my right arm and leg are going to fall off of my body, due to the violence of the shaking.  In my conscious moments, I know otherwise.  Yet, I have heard no one else report such feelings, or experiences.
     Finally, if a correlation between seizures and earthquakes does that correlation inform how seizures, and earthquakes exist?
     I don't know whom to address.  I don't know what forum to direct the individuals with information, and insights to offer what they know, feel, and experience.  I do know that information, experiences, feelings, and insights must be given credence if these questions are to be addressed.  The specific answers are not as important as is the use of a deliberative decision-making process.