Note: The Nocturnists is created primarily as a listening experience. The audio contains emotion, emphasis, and soundscapes that are not easily transcribed. We encourage you to listen to the episode if at all possible. Our transcripts are produced using both speech recognition software and human copy editors, and may not be 100% accurate. Thank you for consulting the audio before quoting in print.

Emily Silverman  

You're listening to The Nocturnists: Stories From the World of Medicine. I'm Emily Silverman. Today we're excited to be featuring one of the stories from our live show in New York City in November 2023 on the theme of taking care, which we co- produced with Danielle Ofri and Ashley McMullen of the Bellevue Literary Review. This was our first collaboration with BLR, a fantastic literary magazine which published an issue on the theme of taking care in tandem with the show. It was a great night filled with stories about the joys and challenges of caring for each other and ourselves, and it marked new territory for The Nocturnists, as it was our first show featuring patient voices as well as the voices of clinicians. The first story from the show comes from Lu Chekowsky, an Emmy-winning writer and creative director who built a successful career in media through what she describes as, "gut, intuition, and addiction to approval." Lu is also a 2023 New York State Council In the Arts fellow in nonfiction literature. But this story isn't about Lu's professional career. It's about her personal relationship to her late mother Rose, who taught Lu some very important lessons about how to be in the world, including all the ways that charm and charisma can protect people with larger bodies who are trying to navigate a healthcare system that can be really dismissive and sometimes even cruel. After the story, Lu and I talk about Rose's big and warm personality, Lu's personal experiences as a patient and what it's like to have a larger body while working a high stakes job in advertising. But first, let's take a listen to Lu's story, *The Art of Being Seen*.

Lu Chekowsky  

It's Thanksgiving morning in Central Florida, 1996. There's ice on the palm trees and a Publix Turkey is defrosting in the sink. Last night, my mother Rose fell, and she's been spending the last five hours begging my father and I not to call an ambulance. "I can get up on my own," she keeps repeating, but she can't. My mother's voice is rough. She's unrecognizable. She doesn't sound anything like the body bodacious mom I love, the one who could have been a Borscht Belt comic, if only she wanted to. In the fall, my mother soiled her housecoat. Her stomach was so sick from all the cancer treatments, so I helped her change out of it in the middle of the night, and I gave her a crisp white sheet to cover herself with. She draped it over the top of her chest where her breasts used to be, and she looks like a statue of a Greek goddess and the atrium of the Met. I'm 22 years old at this point, and this is not at all how I saw my life going. I'm back living at home with my parents. I just got fired from my first job out of college writing the junk mail that comes stuffed in your bank statements, and now I'm working at Circuit City, doing double holiday shifts, selling portable CD players to the very same girls who made fun of me in junior high school. The thing is, I'm not just home because I'm a failure. I'm actually home because my mother is dying. I sit on the floor with my mother all night, and it's filthy. What happened was she got up to use the bathroom, and she lost her footing and screamed. And when I got to her, she was half in the bed and half out of it, and it was up to my father and I to lift her back up to safety, so with him on one side and me on the other, and with her right arm in his hands and her left arm in my hands, we counted down together like we were working at Ground Control at Kennedy Space Center, just a few miles north. "On 321, go," we say, and we lift up, and just like that, my mother's arm breaks into two clean pieces in my hands. She doesn't let out a sound. The chemo and the radiation had made her almost immune to extreme pain, and in my panic, I dropped her, and she landed on the floor with a thud on our turquoise shag carpet, and that's where she's been ever since. And now the sun is coming up and no one, not even my bossy mother can deny the fact that we are all living in a horror movie, and she finally concedes, "call an ambulance already," and I do. Almost immediately, like magic, five men arrive at our front door, like guests arriving for Thanksgiving dinner, except these men are towering strangers in clunky work boots, all surrounding my mother, standing over her, some with their hands in their pockets, some with their eyes averted. They can't stand the scene. My mother knows how she looks to them, and this is why she didn't want to call them in the first place. One of the paramedics is asking her a series of questions off a prepared list. "Ma'am, what's your age? What drugs are you taking? How did this happen exactly?" They're professional, but professional is not what my mother wants. I mean, they're talking to her like she's in the garage and she has a check engine light on, like she's a busted sedan, and they're mechanics. My mother, she wants to be more than just another patient. For her, it's really important to try to get real care, because at over 300 pounds, my mother is used to being written off in pretty much every healthcare setting. Every single one of her ailments gets traced back to her fatness, from hangnails to hives and now cancer. But luckily for my mother, she has a powerful secret weapon she can deploy whenever she starts to feel this bubbling up, and that is my mother's ability to get doctors to fall in love with her. My mother has cracked the healthcare cheat code, and she wants me to have it too, because she knows she's not going to be alive for very long, and she wants to give me as many lessons as possible. "Listen, Louisa, these doctors, they're having a bad day. Their schedule is backed up. Maybe they're having problems at home. We don't know. It's up to you to make it nice for them. You know, tell a joke, compliment them, whatever it takes for them to see you as a person, because then you'll get better care. Here's my advice to you: become your doctor's favorite." On Thanksgiving morning, 1995, on the floor, the filthy floor with my mother, while my father is in another room having a panic attack, I know what I have to do, and what I have to do is what my mother would normally do, but she's too sick to do it. I lean over like I'm going to tell her secret, but I say it loud enough for everyone in the room to hear all the paramedics. I say, "Hey, Ma, so when was the last time you were naked alone in a room full of guys?" The paramedics? Look at me. Look at her. Look back at me. They can't believe it. Their eyes are big as saucers, once, covering his mouth, busting out laughing. My mother, she doesn't miss a beat and she shoots back, "Not recently enough, I'll tell you that much." Immediately the room bursts with laughter, and we are no longer separate. We're not caretakers and patients. No, we are united on the same team, in on the same joke. My mother is unleashed, she goes on, "So have you met my beautiful, available, accomplished, gorgeous daughter, Louisa?," pointing to me, "Perhaps you'd like to take her out on a date." This arm is in two pieces for a reminder. The men laugh, they see her, and one of them gets down on the floor and makes eye contact right in her eyes, touches her hand and says, "Rose, we're going to take good care of you." The paramedics surround my mother like their group of teenage girls at a sleepover, seance playing light as a feather, stiff as a board, and they levitate her up onto a gurney without breaking a sweat, and she flirts with them. "You're all so strong," she says. And the ambulance pulls away. Three months later, a week after Valentine's Day, my mother will die, and I will be still 22 years old, and I will inherit a lot from her, her love of celebrity gossip, her penchant for poetry and her huge empathic heart. I will also inherit her body and the tools she left me to navigate the healthcare system once I became a fat woman with a chronic illness. In fact, just like my mother, it happened so frequently at the doctor that I'm written off because of my weight, or told that my weight is the issue of every one of my problems, and it happens so much, I'm often left wondering if maybe these doctors are right and I should just come back when I'm finally skinny, But I try not to dwell too much on all that, and instead, I move into action like my mother taught me, and I work on becoming irresistible.

Lu Chekowsky  

At every doctor's appointment, I go on autopilot. I become a whirling dervish of sweetness and gratitude. I portray a deep interest in everyone there, even though, by definition, I am only at the doctor because of a deep, deep, deep interest in myself. This is not generosity of spirit. This is survival. I need help, and I'm going to do anything to get it. To the front desk staff, I bow. "Oh, thank you so much. Yes, here's my credit card. I appreciate it. Thank you." To my doctors, I ask about their childhoods. "So did you always dream of becoming a gynecologist?" And I always make jokes at my own expense, of course, "Oh, you mean a bagel isn't a food group? I didn't know." And it works so much, except sometimes, when it doesn't. Like once, not that long ago, in the emergency room, when the triage nurse told me that I was acting too cheerful to be having a real emergency, and I was in the waiting room for over eight hours. Still, I use my mother's tricks a lot because they work, and they have helped me assemble a killer healthcare team. I am now believed. I'm understood. I have the personal cell phone numbers of a few of my doctors to call when I'm really in trouble, and I use them. I have graduated from being an anonymous patient in an anonymous healthcare system to being a real person with real needs that deserve to be really addressed, and I have real relationships with real people who know how to do that, and they help me navigate all the bullshit that comes with having a body, and it is a lot of bullshit. Still, whenever I use my mother's tricks, I'm wrecked with guilt, and I wonder if doing these things makes me a bad person, like does getting doctors to want to fall in love with me make me a genius or a fucking shitbag? Few weeks ago, I go to see my physical therapist, Sam. Samm's great, she helps me with my chronic headaches and the pains in my neck and the numbness I feel every day in my hands. And Sam knows a lot about me, and I know a lot about Sam. I know she likes to go axe throwing at this brewery nearby, and I know she makes a killer lentil soup because it always smells like garlic in her office, and it smells amazing. And on this visit, Sam says at the end of it, "Hey, Lou, do you want to know my secret dream?" And of course, I say yes, because I want to know literally everybody's secret dream. And then she tells me that she's thinking about buying a building so she can expand her practice and help more people. And when she tells me this, I think, holy shit, all this intimacy and kindness and relating that I want with my doctors, maybe some of them want it with their patients too? Later that night, I get into bed and I do what I do pretty much every night, when I fall asleep, I go through the very long list of crimes I've committed over the course of my entire life, real and imagined. We all do this right? And on this night, I'm particularly haunted by this idea of Sam. I think about what she would say if she knew that our relationship, this one I've really come to rely on, that is so important in my life began with this trick my mom taught me like, would she like me any less? Would she want to help me any less? It's hard to know, but the truth is, this is the origin story of our relationship, even after all this time, and I like her so much, it's the origin story of not just me and Sam. It's the origin story of so many people who helped me with my pain. And I wish my mom were still here so I could ask her about it. I picture us having lunch at one of our favorite restaurants. Maybe you've heard of it, the Olive Garden, and she'd be wearing one of her brightly colored polyester tunics and stuffing lukewarm breadsticks in her purse for later. And I would just ask her. I would just ask, "Ma, you don't think it's bad, this thing I do, you know, with doctors, you know, getting them to try to like me?" And she'd smile at me with her warm brown eyes, and she would reach her hand across the table to me, and she would assure me, "Oh, Louisa, don't overthink this. In this life, we all have to do what we have to do to survive." And then she'd take a sip of her tab soda and leave a bright red lipstick ring on the plastic of the straw, and she would lower her glasses and look at me and say one of her trademark lines. "Also, who are you kidding? You're already so lovable you don't even have to try." Thank you very much. Applause.

Emily Silverman  

I am sitting here with Lu Chekowsky, Lou, thank you so much for coming in today.

Lu Chekowsky  

Thank you so much for having me. I'm so happy to be here.

Emily Silverman  

So it's been a long while since you told your story in New York City with us, which was an amazing night. And to start, I am wondering if you have any reflections on that night, does it feel far away? Does it feel like it was just yesterday? And how did that experience end up landing for you?

Lu Chekowsky  

It feels very far away in some ways. I think seasonally, it's very warm today where I am so I remember it was wintery fall, but also, yeah, it almost feels like a dream of a thing that happened. I knew when you picked me to tell my story that there would be an opportunity to be in the podcast. And so much time had gone by, I thought, "Oh, yeah, maybe, maybe that was just a moment in time, a flash on the stage, and whoever was there will be the ones who hear it." And then when you wrote, I was like, oh, okay, I guess here we go. So it does feel like quite a long time ago to me, actually.

Emily Silverman  

Your story opens in Central Florida in 1996 and you say a Publix turkey is defrosting in the sink. And I grew up in Florida, so I've been to many a Publix and just imagining that Turkey defrosting, and the word Publix, and you mentioned something about palm trees, it immediately brought me into Florida. Did you grow up in Florida and tell me about your Florida life.

Lu Chekowsky  

I was born in Baltimore, and when I was six years old, my father moved our family to Central Florida, to the Space Coast. We lived in Indian Florida, which is about a quarter mile from the Atlantic Ocean and another quarter mile to the Indian River, hence in the Atlantic. And then subsequently, I lived in Florida. I went to college in Florida, so I have about 20 years of my life growing up in Florida, but specifically that central Florida time, watching the shuttles go up and the space influence around me and the smell of the ocean and the sea and the shells, and it's very visceral, deep memories of growing up in that area.

Emily Silverman  

Did you ever go to a launch in person? 

Lu Chekowsky  

Yes, I have been to launch in person. But honestly, where I grew up, I frankly, didn't have to go anywhere, because we would have fire drills in school to watch them go up overhead and you would hear them. It would almost become sort of boring, like, I remember we would be excited to see a launch because we might miss a math test or something like that, or the sonic boom. Sometimes, when they would land, which was not as often, they would often land in Texas, but sometimes they would land at Kennedy Space Center, and sometimes you wouldn't know they were coming, and then all the windows would shake, and you jump and, oh, it's just the shuttle landing. So it was, it was in the water of my youth.

Emily Silverman  

And you grew up with this extraordinary mother, Rose, who we meet in your story, and I know you were incredibly close. Tell us about growing up with Rose.

Lu Chekowsky  

Wow, I was a very lucky person to have my mother, who was a firecracker of a person, deeply interested in causes of humanity. She was always marching or protesting different things. She had a bumper sticker on her station wagon that said, one nuclear bomb can ruin your whole day. So she was deeply involved in causes of the environment and anti war and human rights and also body acceptance, way before her time. I talk about it somewhat, I think, in the story. But my mother was obese and identified as such, and even wrote a newsletter she tried to get some followers for, called The Fat Lady is Singing. So she was very much situated in a time where I grew up with a lot of different media influences that she was helping me parse. I'm remembering, like the soap operas we'd watch in the afternoon, or Dynasty and the sparkle and shimmer of kind of 80s shoulder pad culture. And she would always be trying to help me understand my place in those things, or the sparkle of them, and how not real they were, giving me the subtext to life. And I should also say she got cancer the first time. She had her first mastectomy on the morning of my 11th birthday. So there was always this sense that there was a clock over her mothering of me, and there was a sense of urgency of what kind of tools she was trying to give me to navigate the world. And so there was a real sense of time running out, and that she needed to give me everything she could while she was still here,

Emily Silverman  

You mentioned her breast cancer in your story, and the fact that she underwent a lot of different treatments and surgeries and so on. Tell us about her experience in the healthcare system. You allude to this a bit at the beginning of your story, but did she speak with you a lot about her time inside healthcare, or is it something you more observed, and what was that like through her eyes?

Lu Chekowsky  

Some of the logistics and the real in and out of my mother's care and the medical system. My father, who's also since passed away, not even two years ago, was more her partner in that like on the ground. I think some people have this experience from their parents, the parents want to protect them, or whatever, from the real depths of it. So the things that I knew about my mother's experience in the healthcare system were things I pieced together because I was sneaky, and I snooped around a lot, and I eavesdropped a lot, and put context clues together. But that's when I was much younger. She had cancer from my age 10. She died when I was 22 when she was 63 so as I matured, she started to bring me in a little bit closer to the details of her experience. So I'm remembering in college when she was having her second bout, and it was much more serious then I would be in appointments or in hospitals, or I was living at home, so I would be calling, as the story talks about, calling the emergency crew, traveling with her in the ambulance, these kinds of things. And I knew what she told me about it, which was that it was challenging and it was exhausting, but she was always the kind of person, find the good in the hard. I feel like the thing the story is about is something that I heard about from her, mainly, which was, I'm going to do my best to get the best care by being somebody that they want to take care of. I mean, that really was a pivotal message. There's a memory I have when I went with her to the emergency room on another time when she was there and I held her hand before she was going in for a surgery, and I said, "Let's look at the ceiling lights and pretend we're in a disco." You know, the lights were so bright, and I was dancing next to her, and then the nurses were dancing with her, and everybody was like, we're in a disco. She had this ability to create alternative realities, not just for me and her, but also for the people that were working to help her navigate those spaces, and I found great pride in that. My mom has kind of a magic quality. I always felt she had a frequency that was very special. 

Emily Silverman  

In this essay that you wrote in The Rumpus, it's called Fat Ghost, you mentioned how she was deeply sensitive, like you just used the word frequency, and you said that she would often almost feel other people's emotions, whether it was happy or sad. Would you describe her as an empath? Or how do you think about that special skill set that she had, and is that one of the reasons why she was so capable to create magic is that she was just deeply in tune with other people?

Lu Chekowsky  

Empath is definitely a word I would use to describe my mother. She was a special education teacher by trade, so she had a real interest in finding qualities in individuals, maybe that were not always celebrated or at the forefront, and finding specialness in people's unique world views and approaches. My mother was raised in a home where her father left the family very early. They were on welfare. She was raised by a single mother in the 1930s 1940s like sometimes the empathic side of things, it's a gift, and it's also sometimes a survival tactic. There's also these things you learn when you're in environments that can be challenged, where you start to pay attention and you start to navigate context clues, how to put things together, to find your way and survive. So she certainly was an empath. I think she had a natural gift for that, and a natural affinity and love for human beings in their human-ness. She was not a robot person. She was a very, very deeply feeling person. But I also think there was a sense that what she was also gifted with was a survival instinct that came through in these ways.

Emily Silverman  

You wrote, "On the morning of my 11th birthday, Rose had her first mastectomy. Before she left for the hospital, she slipped a five page letter she'd written in perfect teacher's penmanship under my bedroom door. The letter had been placed inside a blush pink envelope she'd sprayed with an eye an eye perfume. I don't know if I'm pronouncing that right I'd bought for her on Mother's Day. She licked the glue to seal it shut and left a smear of red lipstick behind. I'd seen after school specials. I knew this was the kind of letter a mother writes a daughter when she's dying." And then you write, "Rose left me instructions on how to be a person." So this wasn't just like she was casually teaching you lessons throughout life. It sounds like there was a real intentionality in what she wanted to pass down to you. 

Lu Chekowsky  

I felt that every day of my life with my mother after her first cancer, so after age 11, that was sort of our relationship for the next 11 years until she died. I was at the University of Rose. It was like a college level program of let me tell you what you're going to need to make your way in this world. Or let me just tell you what I think you'll need. Or let me tell you what I can give you. And I do think there was a sense of, take what you need and leave the rest. It was a sense of, like building a map or a GPS, of like, where are you situated in the world? And let me give you what I can because I'm not going to be here forever to guide you.

Emily Silverman  

And what were some of the teachings? 

Lu Chekowsky  

There's so much. I've been working on, a book, a memoir, about my career in advertising. And when I got into the advertising business, I was convinced that I could change it to be more inclusive, representative of other people, more human. And the reason I thought that is because of what my mother taught me about understanding the influence of media, the sort of 2D of it. She was always trying to deconstruct the images in film and in television. I remember I had a crush on Michael Stipe from REM when I was in high school, and he would always wear these hats in all the music videos, and she'd say, "You know, it's because he's balding, right? Like, trying to cover that up." And I would be like, what? That's just one ridiculous example, but I'm saying, like, there were always, like, this kind of DVD commentary of media, and I've been thinking a lot about that in the process of writing my book. Why would I think I'd have the power to alter this machine of advertising? And I think it's because of the things she taught me to see, and the power that she instilled in me, that she believed I had power if you can see the truth of things, you might have a power to affect their outcomes. But I think you know beyond media, beyond how to navigate doctors, she also gave me an incredible sense of humor. There was always this sense of like you make your reality. You choose it every moment. And sometimes the worst things can be the best things for different reasons. They might bring people together. They might prove some kind of way that you're stronger than you thought. There were a lot of pieces of her teachings that really became sort of the bones of me as an adult now, a 51 year old woman.

Emily Silverman  

We didn't hear much about your career in the story that you told on stage because, of course, there was limited time, but I was so intrigued by your bio. It says that you're an Emmy winning writer and creative director who built a successful career in media through gut, intuition, and addiction to approval. Tell us a bit about your professional life. You already alluded to how it paralleled your personal life, but I'd love to hear some more about that. 

Lu Chekowsky  

I sort of fell into the advertising business when I read a classified ad on the back page of The Onion newspaper looking for students for the first year of an experimental advertising program at Wyden and Kennedy in Portland, Oregon. And Wyden and Kennedy is the ad agency, famously for Nike. So I fell into the ad business from an effective ad that I was the target for. And I went to ad school in Portland in 2004 and then learned about the world of advertising from one of the best agencies, arguably in the world. And I worked there for many years, working on all kinds of brands, from Michael Jordan to Delta Airlines. Then from there, I was recruited out into television. So I ended up working for MTV. I was basically marketing all the MTV shows, both on MTV and then more broadly, so I'd work on things like the VMAs or Jersey Shore. I went within Viacom at that time to Comedy Central, where I did a similar job at a larger scale. And then my last job I had in the advertising business was at Facebook in Menlo Park in 2018 right around the time of the Cambridge Analytica scandal, I was working there. And then, very famously, had a bit of a burnout, physical breakdown, after really working myself into the ground and working in these ways where my body could never be seen in any of the work that I did because it was all about aspiration and youth and sexiness, but I work myself to the bone to put other people in front of the camera and present an image that would make people want to separate themselves from their attention and their money. And so I've spent the last six years trying to figure out exactly why I would choose to go into those fields and what happened when I was there. So it's been quite a journey.

Emily Silverman  

Sounds like a book I would want to read, that's for sure. In the essay, you talk about the difficult period after your mother died, you say in the year after she died, I gained 100 pounds. Yes, tell us about that time.

Lu Chekowsky  

That time after my mother died. So again, I was 22, she was 63. I had gone back to graduate school at the University of Central Florida, where I had done my undergrad with a group of wonderful writers. I was in the creative writing program, and I sort of just thought, I'll take a couple classes just to kind of keep my head straight, but I ended up graduating with a master's from there because I buried myself in school. It was a time of a great breaking inside of me, and it was a reactionary time, meaning my awareness of what I was going through and my ability to affect any other outcome than what I was experiencing. I had no connection to it. I think it's also I was very young, and the way that my mother died over several months years was quite for lack of a better word, you know, just gory as these things go, the Internet was barely a thing in 1996.  I didn't really understand. Like, yeah, this happens to a lot of people. I was very in my own experience of what had happened. I was very reactionary, looking for any life float. Like, I just didn't know how to float. My father was on another planet from his grief. They were married 40 something years. And 22 everyone's out, going to the club, hanging out their whole lives ahead of them. And I was just like, knocked on my ass. So as the essay talked about, I turned to food, which was a thing that I shared with my mother again. I said, you know, she was an obese woman, and she had an eating disorder that she worked to try to manage with 12 steps and Overeaters Anonymous. So I grew up with 12 step books all over the house and highlighters and phone calls ringing from people in her 12 step programs.

Emily Silverman  

I didn't know that there was a 12 step program for Overeaters Anonymous.

Lu Chekowsky  

Yes, there is. There still is. She was very deeply involved with them in the 70s. I know she would go to retreats with them. And I think my mother's fear was that I would have her eating disorder, as she wrote to me, as you referenced, there's this letter that she gave me her first cancer surgery and slipped it under my door, and it mentions this guidepost of, don't eat when you're sad, because then you're left with two problems, the problem that you started with that made you sad, and then the fact that you ate too much food. And you know, I was 10, so she saw something in me then that, I think, gave her pause about it. But to bring this back to your question, when my mother died, I turned to food again. It was a full body reaction. There was nothing about it that was thoughtful or present, it was like an emergency box that you hit and I just woke up maybe a year later, and I had put on about 100 pounds, and then still took a long time to understand what had happened or how to get my way through that.

Emily Silverman  

And in your story that you told on the stage, you talk about interacting with the healthcare system in a larger body, and you allude to some of the cruelty that happens in that space, but especially since a lot of the people listening take care of patients, was wondering if you'd be willing to share more about what that experience was like for you.

Lu Chekowsky  

Being in a larger body and trying to navigate the healthcare system, it's a terrifying place to be. I think that would be what I would say about it. I think the fact that I have been able to find tools to help me navigate the kind of care and find the right people to help care for me, it's a very confusing place to be, because to me, it says maybe I'm not as sick as I think I am. If I can rally myself to do the things necessary to be seen as a person like, I think, if I were really, really unwell, could I make the joke and smile? Like it becomes a real trip in my mind, because it's like, I feel I always need to have this presentational kind of armor when I go to a doctor, like, Can I trust this doctor? Am I going to be seen? Is this going to be another time where I have to go through every diet I've ever been on, like, just to gain any kind of trust? It's exhausting and it's terrifying, and as I said in the story, I manage chronic pain. And two years ago, I did my very first Botox for migraine treatment in my trapezius muscles in my shoulder, which it traveled to my throat and made it unable for me to swallow solid foods for almost three months. Luckily, I could swallow fluid, so I existed on blended food and fluid for three months, and when I went to the emergency room four days after I had the injection, once I began to not be able to swallow, the triage doctor said, "Well, you can survive for a while without eating." That's the kind of thing that I have come to expect, unfortunately, and I guess he wasn't wrong, but the fact was, I tried to eat an olive and it got stuck in my throat, and I nearly choked on it, and that was a very real and potentially life threatening, known side effect of Botox. And that was his reaction to me. So I continue to be afraid of what this is, the words I want to use an out of bounds body, what access it allows me in medical situations. And as the story says, I've been very fortunate in finding several incredible people who helped me navigate the current state of my body and my journey to be well and pain free.

Emily Silverman  

Yeah. And in the story, you talk about this tool of charisma that you have at your disposal, passed down to you by your mom, that you can use to protect yourself and to survive. And sort of like you mentioned, this mental knot of trying to disentangle that survival strategy from your authenticity, which is that actually you are genuinely a funny, charismatic person. And so how do you tell what's real and what's not real? And should I feel guilty that I'm manipulating these people? But wait a minute, like these people are really cruel to me, and this is a survival strategy. And I just thought that that that mental loop was really interesting, and I could see how one could get stuck in that logic. 

Lu Chekowsky  

I will say this like I appreciated the opportunity to formulate the story with The Nocturnists, with your team, with you, because it is a mental knot. And I knew when I pitched the story, I was like, I don't totally know how I'm going to thread this or untangle it. I'm mixing my metaphors, thread the needle. But I knew I wanted to, and the story lands right with you know, this dream of my mother saying you don't even have to try this sort of permission that, like, actually, whatever I've been tormenting myself with as potential moral blurriness is actually really not a thing. This dream of this conversation I had with my mother was quite healing, maybe when I told the story on the stage, and maybe when I crafted the story last year, I wasn't as clear on it. And to the point of your question, I feel a sense of relief. I don't think I'm a manipulative person. I don't think that I'm doing something wrong by trying to be a human being first to my doctors or get to know them as people. I don't think that there's something intrinsically wrong with that. I have landed on, that I'm actually blessed to have the tools, and many people do not, for whatever reasons, all kinds of reasons, and that I should just see it as a gift, and it doesn't always work. I guess I should say that too. I don't want to sound so sure of myself. There's a lot of times where it just is what it is. You know, that the strategy that I describe in the story isn't going to elicit anything, and that will be fine too. But I think telling the story on the stage now here on the podcast, and it's in the world, I think it's allowed me to release some of the agitation I felt around it, which has been really helpful.

Emily Silverman  

Yeah, the healthcare system isn't set up to accommodate those human interactions, and so any way that you can short circuit that and just get right to the human heart of it, I think is great. And one of my favorite moments in your story is when you realize that there actually might be people on the other side who are trying to do the same thing, like you talk about your physical therapist Sam, who you know pretty well. And at the end of the visit, she says, "Hey, Lu, do you want to know my secret dream?" Which is like, of course, who doesn't want to know somebody's secret dream? And then she tells you about her dream to expand her practice and take care of more people. And then you say to yourself, all of this intimacy and kindness and relating that I want with my doctors, maybe some of them want it with their patients too. And it was just such a beautiful acknowledgement of the fact that there are so many people like you said, not all, but so many people in the provider role or the clinician role who want to connect as well. I don't know if that's something you've continued to notice as you move forward. And how has that played out?

Lu Chekowsky  

Yeah, well, I want to say it's so funny, because you asked at the very beginning, this felt like a long time ago, and Sam has since bought a building, moved her practice and expanded. Go Sam. I know, and I go there all the time, and it's a beautiful place that she's built. So when I realized, like, wow, that's how much time has gone by, was I told that story when it was her secret dream, and now it's come true. So that just felt wonderful to think about, but when it was just a dream. I also think similarly, having the perspective and a little bit of the rear view of telling this story, it seems sort of like a no brainer to me now. Bbut you said the systems aren't built this way, so it seems like both the patients and the practitioners, right, we're butting up against the. Things that we both want to break through. So I guess it does make sense to me now, maybe only after having told the story and sitting with it for a while that, yeah, why wouldn't doctors and health care providers want that kind of intimacy is a, you know, it's a tough word, but, you know, just humanity, that thread of personhood beyond the science of it, like, of course, some would want that. That makes sense. And it's a hopeful thought, like actually, it feels very hopeful to me.

Emily Silverman  

Yeah. And I think one can understand how it might not seem so obvious when you're in the throes of a crisis and you show up to the ER and someone says something cruel to you. It's both and, and I think the fact that the system isn't set up to accommodate that can be one of the inputs into these little moments of harm. But again, the hope that people on both sides are working towards something better and something more compassionate. But it's not just the healthcare system, it's our society at large, and the way that we portray and or don't portray people with larger bodies in the media. What was it like to be a larger person in advertising? I mean, I know you're writing a whole book about this, and you alluded to the fact that, like, why am I working myself into the ground to portray this aspirational image that doesn't in any way reflect what I look like. Can you bring us into that for a minute?

Lu Chekowsky  

Well yeah, I mean, cut to me working on this book for the next year and finalizing the manuscript, but my personal relationship to that business, I remember, I used to say to people, "I'm ahead on a pair of feet." Like I was proudly disconnected from everything going on in my body, I just turned it off. And that, you know, isn't just the effect of advertising. That's sort of my individual story with my body, is that I just wanted to achieve and be in spaces where important, quote, unquote, things happen, which to me, somebody raised on media and mainline media, and always had had a fascination with it, just being on the bubble of that was my goal in some ways. And so my experience of being a larger person in advertising is just really the matrix by which you could look at how I live my life in sum total as a larger person, which was, I'll take what I can take, and I'll get as close as I can get to the thing, and I'll take the crumbs of the thing. You know again, this is my own, just to be very clear my own belief about being a larger person and my own internalized ideas about it. It's not saying anybody else might feel this way, but I had sort of decided that, like if I could make the image that made millions of people want to tweet about something or put it on their Tumblr, or that that was somehow me, because it would have my ideas, or my words or my ideas for the image baked in. And I could feel that feeling, and I thought that would be the best and the closest I could ever get to saying something valuable in the world or being heard in any way that was a little bit of like a Trojan horse kind of thing. Like I just felt like a little bit like I could sneak into these places that wouldn't have me in them. But on the flip side of that, there's also this thing that I'm going to talk a little bit about in the book. I coined this term with a friend of mine when we were in Las Vegas at the 21st birthday party for Tyler Posey, who played the star of the Teen Wolf show on MTV. And I was invited with my friend Matt to go to his birthday party because we were friends with him, and I was, like, 40, and I'm, like, hanging out in Las Vegas, and I'm this larger woman. And I said, "You know what, Matt, tonight, I'm a power group." It's every now and then you'd see these other women, like in meetings or in Hollywood, and I would be in rooms sometimes with other, "powerful" larger women. And I called, you know, I never said this to them, but it was like, this idea of, like, if you throw your weight around in a certain way in those rooms, and people sort of humble to it, like, "Oh, you must have done something, right? Like, How did someone, like, you get in here?" And so there's also this kind of mysterious, like, powerful thing that you could spin up, but that took a lot of energy and little bit distorted of a worldview. But yeah, I would sometimes power grip my way through this world.

Emily Silverman  

I wanted to ask you your thoughts on where we're at now in the culture with a lot of these topics. Because on the one hand, I think people are starting to reckon with the fact that our society unnecessarily shames a lot of people who are living in larger bodies, and there's been so much pushback to that shaming through body positivity and artists like Lizzo, who are really shifting the narrative. At the same time, there's people out there who caution against downplaying the fact that some people do experience negative health effects related to obesity. And now, of course, there's the whole Ozempic revolution. And so how are you seeing this moment? Are we headed in the right direction with this? Are we headed in the wrong direction? Are the conversations happening that need to be happening? And what's your take?

Lu Chekowsky  

I think the answer is I don't have an answer, but I will say this, I've lately been wondering, "What if my mom were still alive in the time of Ozempic?" I've really been thinking about that because she struggled such a profound struggle, and we talked somewhat about my relationship with body and food and fat. But I've been thinking so much about her, and I don't know what that means, except to say, I think an individual having a tool to navigate their body is still an individual choice, in my opinion. And so as it pertains to the cultural ripples of that drug, it's hard to say, I do think it comes back though to the person's relationship to their body. And so then I'll go a step further and just quickly say this, I talked about having a bit of a physical breakdown after my career, I had to have a hernia repair surgery with mesh in my midsection. And the doctor, who I adored, right before I went into the surgery, he said, "Look, this is now a math problem. If you don't get your body smaller, this mesh is going to tear open in 5, 10, 15 years, and it might cause you even more of an infection I had to have an emergency surgery, and you might die. But if you take the weight off your midsection, the mesh is probably going to be pretty good for the rest of your life." Then I, like, was under in like, 10 minutes after that, and I woke up and I was left with that thought, and why I'm sharing that in an answer to your question, which is, sometimes it is just a math problem. For me, it has turned out to be a math problem, this idea of my weight and my body and that has been really helpful for someone else. That could be incredibly triggering. Somebody else might find that incredibly offensive. Again, I'm speaking only about myself, and so I think my inclination to answer your question with personal anecdotes is just more indicative that it is going to continue to be a personal decision and that everybody's body is their own to navigate as they want. How does that stack up with medical advice? There's many ways people make decisions in their lives that are not suited to their greater good. And fatness, for whatever reason, is the cheapest way to blame somebody. But there's drinking socially, and there's smoking this, and there, you know, whatever, there's sitting at a desk for eight hours a day and not standing up enough. Like there's a million ways you can, quote, unquote, go against doctor's orders or medical advice, but for whatever reason, fatness continues to be the one that there's just constant berating around that. But nonetheless, it's still the same thing as any other medical advice that someone may take or not take in the end. And so my hope is that people find peace with their bodies and the advice they're being given, and find a way to navigate the road that they want to be on with their body, and that can mean a lot of different things.

Lu Chekowsky  

There's a line from your essay that says, "Today, I am 15 years younger than the age Rose was when she died. Sometimes she and I talk." Do you still talk?

Lu Chekowsky  

Oh, yeah, we talk. Not enough, not often enough. In fact, when you just asked me, I heard her say, "We don't talk often enough. You don't call enough." I just got emotional saying that, like, sometimes it's such an overwhelming wave. I'm getting emotional talking about it that it's hard to talk because I'm putting my fingers in quotes, because her presence and her power and her love for me was so big. It's hard sometimes to tap into it, like on a regular Monday afternoon, and so I have to kind of be in the right headspace. But as I venture to write this book that I will soon be contracted to write, I'm very excited about I've been thinking of her a lot because one of the things she told me actually one of her last hospital visits before she died, it's been my dream my whole life to write a book of my life. I even knew that when I was younger, and she said, "I'll help you write it from up there." And she pointed up to the sky, I think that's probably one of the last conversations we had. Actually, I've been thinking about that a lot, so I think I'm going to be calling on her a lot as I would do this project, and not just for her. You know, the story had some difficult elements, and I think those are things that are defining, but also for her humor and her lateness and her power and her truth. Capital T, she just did not fuck around. And I just really would like to do that in my own art and in my own life. So I think we do talk a lot still.

Emily Silverman  

Well, I can't wait to see you continue to create. For those of us who want to keep up with you, where can we find you? What's the best way to stay in touch? So to speak.

Lu Chekowsky  

I'm on Instagram, as one does. Lu Chekowksy on Instagram, and then my website, lchekowsky.com you can find my writing and hopefully some updates on the book as it comes to pass. I'm also on Substack. I write a substack called Don't Buy. I'm taking on these ideas around advertising and the influence in our lives. So those are the places I'm online.

Emily Silverman  

Amazing. Well, I'm so glad that you brought your story to The Nocturnists and got to tell it on stage. Obviously, it's a very different format from writing, and you just have a natural stage presence, and I'm sure the audience could hear in the clip at the top of the episode that it was an incredible performance, and we're just so grateful to have you in The Nocturnists family. So thanks so much for coming on.

Lu Chekowsky  

Thank you so much. It's an honor to be a part of this and to have an audience with people who do this kind of work, and it's really meaningful to me and to Rose and and I really want to thank you for the invite to be a part of this community, and thank you so much for what you've built and for having me here.

Emily Silverman