tag:blogger.com,1999:blog-33469826931927358672024-03-13T14:43:13.065-07:00Journal of the post plague yearStevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.comBlogger39125tag:blogger.com,1999:blog-3346982693192735867.post-42326730010294112772019-03-12T13:01:00.000-07:002019-03-12T13:12:12.277-07:0019,200<br />
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<span style="font-size: 16.0pt; line-height: 150%;">Nineteen thousand, two hundred. Jesus Christ.<span style="mso-spacerun: yes;"> </span>Now what?</span></div>
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<span style="font-size: 16.0pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>We recently
decided to reduce testing. We were to forgo scans and blood work unless
necessary. We felt liberated in our decision. We would stop sweating the small
stuff and just enjoy our limited days.</span></div>
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<span style="font-size: 16.0pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>It’s not that
simple. We decided I would continue receiving IvIG, <span style="mso-spacerun: yes;"> </span>a $5,000-dollar, monthly infusion, that lessens
infection risk.<span style="mso-tab-count: 1;"> </span>Unfortunately, I need blood work before receiving IvIG. Rules are rules.</span></div>
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<span style="font-size: 16.0pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>Of the 33 blood
tests the Farber ran, 32 were fine. The 33<sup>rd</sup> was my white count. It should
be around 5. Mine came back 19.2 yesterday.</span></div>
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<span style="font-size: 16.0pt; line-height: 150%;">Shit. We could ignore the result. Ted my oncologist suggested
as much, hold work- up and repeat the test in a week.</span></div>
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<span style="font-size: 16.0pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>Now, 19.2 is
high.<span style="mso-spacerun: yes;"> </span>Life threatening infection high.<span style="mso-spacerun: yes;"> </span>But if so, where was the infection?<span style="mso-spacerun: yes;"> </span>I am taking high dose steroids, they raise
the white count. I was just hospitalized with pneumonia so, we decided a chest
X ray would be non-invasive and helpful. The X ray blandly reported “resolving pneumonia.”
<span style="mso-spacerun: yes;"> </span></span></div>
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<span style="font-size: 16.0pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>As a hematologist,
I see 19.2 and think Leukemia. Specially, Chronic myelogenous leukemia. <span style="mso-spacerun: yes;"> </span>A pill now exists to treat CML. <span style="mso-spacerun: yes;"> </span>I don’t think I have CML.<span style="mso-spacerun: yes;"> </span>Any hematologist would tell you an increased neutrophil count without anemia, a left shift, early forms, or nucleated red cells
is probably a stress reaction, from infection ,most likely.<span style="mso-spacerun: yes;"> </span>Flow cytometry would make the diagnosis.<span style="mso-spacerun: yes;"> </span>Flow is another<span style="mso-spacerun: yes;"> </span>$5,000 test. </span></div>
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<span style="font-size: 16.0pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>So, what to do?<span style="mso-spacerun: yes;"> </span>I am upset when Ted says he is, “open to
suggestions” about next step.<span style="mso-spacerun: yes;"> </span>He would not
be saying this if I weren’t a physician. Doctor, heal thyself. Cyn, who didn’t even
come to Boston, calls Sam, my pulmonologist. <span style="mso-spacerun: yes;"> </span>He recommended I start two new antibiotics.</span></div>
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<span style="font-size: 16.0pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>And then I
realize I am not treating myself to get better, I’m treating myself for a more comfortable
death. <span style="mso-spacerun: yes;"> </span>My last <span style="mso-spacerun: yes;"> </span>near demise, from elevated carbon dioxide,
would have been a good passing.<span style="mso-spacerun: yes;"> </span>If I do
have a lung infection now, holding treatment may result in the same lovely
drifting away. On the other hand, holding treatment might not be the good death
but could sentence me to a dark, chronic care ward, where I would have to
beg a loved one to kill me. </span></div>
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<span style="font-size: 16.0pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>What if this is
leukemia?<span style="mso-spacerun: yes;"> </span>If I don’t treat it, I will
develop an infection, or enter a “blast crisis” in which large sticky leukemia cells<span style="mso-spacerun: yes;"> </span>form multiple blood clots and stokes. That’s
no way to die, either. <span style="mso-spacerun: yes;"> </span>I bitterly
remember the med school joke/saying:</span></div>
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<span style="font-size: 16.0pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>"Pneumonia is an
old man’s best friend” </span></div>
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<span style="font-size: 16.0pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>I was a
hematologist, I have seen the results of “life prolonging therapy” <span style="mso-spacerun: yes;"> </span></span></div>
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<span style="font-size: 16.0pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>There is an old
Jewish saying “He was so sick he would have to rally to die”. This appears to
be my situation.<span style="mso-spacerun: yes;"> </span>I am an airplane pilot and
we are out of fuel. We will undoubtedly crash. I should attempt a smooth
landing (death by CO2 narcosis). Not treating my pneumonia may result
in a painful, lonely, angst ridden ride.</span></div>
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<span style="font-size: 16.0pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>I try to discuss
all this with Cyn, but it is brain numbingly sad and complex.<span style="mso-spacerun: yes;"> </span>On some days, I feel better off dead. This
once healthy body now struggles to walk half a block.<span style="mso-spacerun: yes;"> </span>On the other hand, we had a lovely dinner
with Abby and Sam last night, that was worth hanging around for. And I can
picture Cyn telling me “Your weight is up! Your endurance is improving!”<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>“Don’t
die,” she says, after telling me it would be OK to leave. </span></div>
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<span style="font-size: 16.0pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>As cousin Larry
and therapist Mitch always say, “you never know what the future brings." In the
end, it will be decided for me.<span style="mso-spacerun: yes;"> </span>For now,
all I want is a life with minimal pain, occasional moments of joy, and to die with
peace.<span style="mso-spacerun: yes;"> </span></span></div>
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<span style="font-size: 16.0pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>Or so I
say.<span style="mso-spacerun: yes;"> </span>I decided to start multiple antibiotics
to treat what is most likely a recurrent pneumonia. I forced myself to attend
outpatient physical therapy today, using a cane to walk the 1,000 feet from car
to care. If my white blood count doesn’t drop, I may need to consider searching
for the cause, not necessarily to get better but to<span style="mso-spacerun: yes;"> </span>better aim the crashing plane for the runway
that suddenly appears below. </span></div>
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</style>Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com1tag:blogger.com,1999:blog-3346982693192735867.post-22488308906543380392019-03-08T12:35:00.003-08:002019-03-08T12:40:08.256-08:00Modern Romance<div class="MsoNormal" style="font-family: "Times New Roman"; line-height: 18pt; margin: 0.1pt 0in;">
<span style="font-family: "times"; font-size: 16pt;">Another brush with death or, as we call it, Monday.</span><span style="font-family: "helvetica";"><o:p></o:p></span></div>
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<span style="font-family: "times"; font-size: 16pt;">First, a confession. We are at a medical - ski conference in Utah. “Jesus," I hear you cry, “He’s whining about being unable to cross a room and now he’s at some swank resort in Utah?" In my defense, shut up. Look, we booked this “conference” six months ago, when I was still alive. Cyn deserves this trip. She was anticipating a break from the daily drudge. I had two choices. I could stay in West Hartford, alone but for TV and trips for donuts with L. My other option was to travel to Utah, attend conferences with Cyn and play with my doctor friends.</span><span style="font-family: "helvetica";"><o:p></o:p></span></div>
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<span style="font-family: "times"; font-size: 16pt;">Mounting a trip in my condition resembles planning the D Day invasion, but with more complaining. We mailed my enteral feedings to the hotel, had American Airlines wheelchair me across various airports, and arranged for portable oxygen. Park city is at 7000 feet. I saw my pulmonary doctor, Sam, who said I could go if I brought my own oxygen in case of an emergency.<o:p></o:p></span></div>
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<span style="font-family: "times"; font-size: 16pt;">We arrived at Salt Lake City, despite my vow to shun red states until the national nightmare ends. Unhappily, Colorado’s Telluride is at 10,000 feet. My personal dead zone.<o:p></o:p></span></div>
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<span style="font-family: "times"; font-size: 16pt;"> I thought I might occasionally need extra oxygen. Unhappily, I have had to use the oxygen constantly. Yesterday, I was reading in bed and the oxygen generator died. Shit. Now I die again.</span><span style="font-family: "helvetica";"><o:p></o:p></span></div>
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<span style="font-family: "times"; font-size: 16pt;">Cyn is happily skiing somewhere. I am alone in our hotel room. Do I bother her? I figure I have 60 minutes before passing out. I don’t want to annoy her,<o:p></o:p></span></div>
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<span style="font-family: "times"; font-size: 16pt;">I wait. I wait and wait. I finally call Cyn when I decide she has enough time to return before I pass out. I could have called 911 but that would result in a hospital stay. “I am on my way,” she says, clearly disappointed. Suddenly the oxygen machine restarts. I am safe. I call and urge her to remain on the mountain to ski little longer. She happily complies.<o:p></o:p></span></div>
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<span style="font-family: "times"; font-size: 16pt;">I have avoided discussing Cynthia in my blogs, I want to preserve her privacy in a difficult time. The disease has altered our relationship. I’ve mentioned my wild, so-far undying gratitude. But we have changed. First, we can’t have any sort of angry, door slamming argument. We haven’t had a history of domestic turbulence in the past, but I no longer have the option of slamming the door and driving off into the night. I would survive about 12 hours without medical intervention. Most of my supplies are at home. I’d die in about three days away from Cyn, who has developed a sixth sense when my sugar is 23 and I am about to lapse into hypoglycemic coma.</span><span style="font-family: "helvetica";"><o:p></o:p></span></div>
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<span style="font-family: "times"; font-size: 16pt;">So, we cannot fight. I have become “super beta.”</span><span style="font-family: "helvetica";"><o:p></o:p></span></div>
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<span style="font-family: "times"; font-size: 16pt;"> In the past, if Cyn provoked me, I’d have the option to escalate the argument. Now, provocation is futile, one must never bite the hand that feeds my G tube.</span><span style="font-family: "times"; font-size: 16pt;"> <o:p></o:p></span></div>
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<span style="font-family: "times"; font-size: 16pt;"> As is usually the case, most marital arguments begin over simple silly issues, a forgotten appointment or a broken glass without sufficient clean up. I’ve lapsed into a vaguely supercilious demeanor, in which my apologies are followed by backing down. I have become Canada.<o:p></o:p></span></div>
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<span style="font-family: "times"; font-size: 16pt;"> We keep hoping I will improve. Anything is possible but I’m starting to worry Cyn may be stranded with a cripple. I want to be a pleasant life partner. I owe her my life, many times over but that gratitude is robbing us of one important aspect of our marriage, conflict. Conflict is that frisson of tension that keeps us on our toes and adds energy to conversation, which is 99.5% of any good marriage.</span><span style="font-family: "times"; font-size: 16pt;"> </span><span style="font-family: "helvetica";"><o:p></o:p></span></div>
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<span style="font-family: "times"; font-size: 16pt;"> When we married, I loved Cyn’s strong will. She is her litigator father’s daughter I also know she doesn’t care for my new passive behavior. I should grow a pair, I guess, but first I’d need to grow a new pair of lungs, and a suit of healthy skin. Until that time, I’ll stand down.</span><span style="font-family: "helvetica";"><o:p></o:p></span></div>
Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com1tag:blogger.com,1999:blog-3346982693192735867.post-71175779810520472942019-03-04T14:45:00.002-08:002019-03-05T16:07:21.966-08:00L<br />
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<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">The
past is prologue</span></div>
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<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I was an oncologist in the mid 1990s.<span style="mso-spacerun: yes;"> </span>My days were filled with drama, but the
occasional 48 hour work day were taking their toll.<span style="mso-spacerun: yes;"> </span>Cyn worked part time.<span style="mso-spacerun: yes;"> </span></span></div>
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<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>We were raising three children,
delightful toddlers who shared blue eyes and <span style="mso-spacerun: yes;"> </span>weak lower esophageal sphincters . For this
reason, the house smelled faintly of baby formula, the carpets were sticky and
crusty, and we realized our decoration schemes had to camouflage the <span style="mso-spacerun: yes;"> </span>beige color variation of oatmeal <span style="mso-spacerun: yes;"> </span>and Similac vomit. </span></div>
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<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Because of our long work days, we hired
a series of Au Pairs. These young women appeared <span style="mso-spacerun: yes;"> </span>in July and lived with us for a year. They
were given room and board and a stipend. In addition, they were treated<span style="mso-spacerun: yes;"> </span>as members of the family, with access to our
car, and a spot<span style="mso-spacerun: yes;"> </span>on our vacation
travels.<span style="mso-spacerun: yes;"> </span>The program ended after a
series of<span style="mso-spacerun: yes;"> </span>horrors, committed both by the
Au Pair and the families . </span></div>
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<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>We loved the<span style="mso-spacerun: yes;"> </span>program. The kids learned about<span style="mso-spacerun: yes;"> </span>other cultures and the Au Pairs learned not all Americans were fascist-crypto-neo-nazi-tubs O butter. Ah, the Clinton years. </span></div>
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<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Cyn and I<span style="mso-spacerun: yes;"> </span>established vaguely parental relationship
with our Au Pairs. We worried when they<span style="mso-spacerun: yes;">
</span>were out late, or dated local West Hartford boys. I was suddenly the
father of a series<span style="mso-spacerun: yes;"> </span>of young, usually,
Norwegian, women.<span style="mso-tab-count: 1;"> </span></span></div>
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<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Flash forward to 2019<span style="mso-spacerun: yes;"> </span>The<span style="mso-spacerun: yes;"> </span>baby
formula has been replaced by Two Cal HN, Dense <span style="mso-spacerun: yes;"> </span>Protein nutrition to rebuild my<span style="mso-spacerun: yes;"> </span>decaying <span style="mso-spacerun: yes;"> </span>body. I spend much of<span style="mso-spacerun: yes;"> </span>my day forcing this viscous off -white liquid
down my G tube and into my stomach. I spill a little, so the house once again
has that<span style="mso-spacerun: yes;"> </span>faintly sweet sticky<span style="mso-spacerun: yes;"> </span>vanilla scent and<span style="mso-spacerun: yes;"> </span>the carpeting<span style="mso-spacerun: yes;">
</span>beneath my “ feeding chair” has developed a nostalgic crust.</span></div>
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<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I am well into my second
childhood.<span style="mso-spacerun: yes;"> </span>I am unable to lift more than
five pounds, I can’t stay awake past 7:30 or so and, although I am starting to
drive again, my reflexes are a little slow. The GVHD has stiffened my joints
and muscles, getting dressed is a 20-minute production. Socks? Forgetaboutit.</span></div>
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<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Enter L.<span style="mso-spacerun: yes;"> </span>L. is. Twenty something college student. She
has become my au Pair.<span style="mso-spacerun: yes;"> </span>She treats me
with the same amused condescension <span style="mso-spacerun: yes;"> </span>I once
reserved for my Au Pairs<span style="mso-spacerun: yes;"> </span>Karma, is, in
fact, a bitch. <span style="mso-spacerun: yes;"> </span>She texts Cyn about my
mood. ( I’m worried about Steven. He is particularly dark today)</span></div>
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<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I am grateful for her presence.<span style="mso-spacerun: yes;"> </span>I find our relationship disconcerting, I am certainly
not her father (although her real dad is one year younger than I). I am her
charge. I’m certainly not her peer, I’m a creepy, creaky <span style="mso-spacerun: yes;"></span>old man.<span style="mso-spacerun: yes;">
</span>I try to connect though music, but she doesn’t know about the Beatles,
whose music, I realize in horror, is 55 years old.<span style="mso-spacerun: yes;"> </span>Music written 55 years before birth included
“Give my Regards to Broadway” I am horribly old.</span></div>
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<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">She
has no knowledge of Steely Dan, so when I quote them:</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Hey 19, that's ‘retha Franklin’</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">She
doesn’t remember the queen of soul</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Hard times have fallen us soul survivors</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">She
thinks I’m crazy but I’m just growing old</span><br />
<br />
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">she gives me a blank stare </span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Thank god for<span style="mso-spacerun: yes;"> </span>bicycle spin<span style="mso-spacerun: yes;">
</span>classes<span style="mso-spacerun: yes;"> </span>where contemporary music
is played<span style="mso-spacerun: yes;"> </span>so I have some idea of the current
music scene. Taylor swift is still a thing. I have that peculiarity old men share, an incredulous <span style="mso-spacerun: yes;"> </span>anger that young people have no idea of what good
music is. How<span style="mso-spacerun: yes;"> </span>can anyone exist not
knowing<span style="mso-spacerun: yes;"> of </span>Paul Simon’s existential "Graceland?" I finally
understand the true meaning of the word “ whippersnapper.”</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">I
am grateful for her help. I am taken aback by her bemused attitude. We both
know who is in charge.<span style="mso-spacerun: yes;"> </span>When I do particularly
well at a doctor visit,<span style="mso-spacerun: yes;"> </span>she takes me
for donuts.<span style="mso-spacerun: yes;"> </span>When we get home, she feeds
me<span style="mso-spacerun: yes;"> </span>250 ml of<span style="mso-spacerun: yes;"> </span>enteral<span style="mso-spacerun: yes;">
</span>feeding through my <span style="mso-spacerun: yes;"> </span>G tube. </span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">She
plans to go to medical school.<span style="mso-spacerun: yes;"> </span>She needs
a place to stay<span style="mso-spacerun: yes;"> </span>after she graduates college. Cyn
and I will offer her the old Au Pair<span style="mso-spacerun: yes;">
</span>room.<span style="mso-spacerun: yes;"> </span>I hope she doesn’t date
our<span style="mso-spacerun: yes;"> </span>next door neighbor's son. He’s
three.</span></div>
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</style>Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com1tag:blogger.com,1999:blog-3346982693192735867.post-71949205236154946892019-02-28T16:08:00.002-08:002019-02-28T16:08:34.138-08:00End Game
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<br />
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"> By
dying, I have made peace with death.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"> I
spent my childhood terrified of dying. My<span style="mso-spacerun: yes;">
</span>chest tightened as I panicked of a world in which I would be no
more.<span style="mso-spacerun: yes;"> </span>I’d lie in bed and think
“These eye will see death”. In my seven year old egocentric <span style="mso-spacerun: yes;"> </span>universe, my death would be the
ultimate tragedy.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">Now,
I am not so sure<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">I
have entered the End game, hanging between Erik Erikson’s <span style="mso-spacerun: yes;"> </span>stage<span style="mso-spacerun: yes;"> </span>7, Creativity<span style="mso-spacerun: yes;">
</span>versus<span style="mso-spacerun: yes;"> </span>stagnation ( the
blog…) and<span style="mso-spacerun: yes;"> </span>stage<span style="mso-spacerun: yes;"> </span>8, Ego Integrity versus despair. I<span style="mso-spacerun: yes;"> </span>remain optimistic<span style="mso-spacerun: yes;"> </span>I will<span style="mso-spacerun: yes;"> </span>improve , but that’s really my method of managing the uncontrollable.<span style="mso-spacerun: yes;"> </span>I almost died a 2 and a half years ago.
This was a blessing , really, because it occurred<span style="mso-spacerun: yes;"> </span>during the 2016 elections. I was spared the agony that all
of you went through, watching a madman<span style="mso-spacerun: yes;">
</span>gain control of this country<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>The
last time I died, though,<span style="mso-spacerun: yes;"> </span>felt
like the real thing.<span style="mso-spacerun: yes;"> </span>A slow graying
out of the edges, a indifference<span style="mso-spacerun: yes;"> to </span>the outside world, an acceptance of the inevitable. I have <span style="mso-spacerun: yes;"> </span>already been dead<span style="mso-spacerun: yes;"> </span>for 14.8 billion years, and I
weathered<span style="mso-spacerun: yes;"> </span>that period pretty well.
I suppose the next 14.8 billion years will pass as pleasantly.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
am a Jew, we don’t believe in an afterlife.<span style="mso-spacerun: yes;"> </span>The very idea sounds so narcissistic, that our lives
are so precious as to be preserved forever. Nabokov<span style="mso-spacerun: yes;"> </span>pointed out that<span style="mso-spacerun: yes;">
</span>heaven would become hell for anyone who<span style="mso-spacerun: yes;"> </span>lost a spouse and then remarried.<span style="mso-spacerun: yes;"> </span>Then all three would spend eternity with at least one<span style="mso-spacerun: yes;"> </span>person miserable.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">But
that isn’t the point. The point is<span style="mso-spacerun: yes;">
</span>that<span style="mso-spacerun: yes;"> </span>I have been given a
gift,<span style="mso-spacerun: yes;"> </span>I have been able to<span style="mso-spacerun: yes;"> </span>pass through death and return to<span style="mso-spacerun: yes;"> </span>this world. Death wasn’t all that bad.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>My
revered father in law<span style="mso-spacerun: yes;"> </span>felt it
important to tell us<span style="mso-spacerun: yes;"> </span>in his final
weeks<span style="mso-spacerun: yes;"> </span>he was not afraid to die, that
his beloved was also gone<span style="mso-spacerun: yes;"> </span>and his
time was at hand. At the time, I thought this was his bravado, his courage
at<span style="mso-spacerun: yes;"> </span>facing mortality. Now, I
understand he was<span style="mso-spacerun: yes;"> </span>gently telling
us youngsters that a time would come when Death would not be a<span style="mso-spacerun: yes;"> </span>transcendental tragedy.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>It’s<span style="mso-spacerun: yes;"> </span>amazing what one can get used to. I
have the same story that all<span style="mso-spacerun: yes;"> </span>medical
<span style="mso-spacerun: yes;"> </span>students have, of meeting their horrified<span style="mso-spacerun: yes;"> </span>mummified corpse<span style="mso-spacerun: yes;"> </span>in general anatomy and finally growing
comfortable to be alone in the dissection lab at 2 AM in a room full of bodies.
<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">I
think of Michael Herr in Dispatches<span style="mso-spacerun: yes;">
</span>who wrote “The only corpse I could not <span style="mso-spacerun: yes;"> </span>bear to see would be the only corpse I would never have to."<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">I
want to travel back to find that scared stupid child. I want to tell him that
it’s OK, the person<span style="mso-spacerun: yes;"> </span>who will die
60 years from now had a wonderful life.<span style="mso-spacerun: yes;">
</span><span style="mso-spacerun: yes;"> </span>I want to hug him and tell
him that he will see wonderful things, he will love college, make love with
women, travel the world, and <span style="mso-spacerun: yes;"> </span>marry
his true love . He will find in medicine a calling that will benefit<span style="mso-spacerun: yes;"> </span>others and give him comfort and support
<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
want to re assure his unbelieving eyes that death<span style="mso-spacerun: yes;"> </span>will become a comforting friend some day,<span style="mso-spacerun: yes;"> </span>and that, after years of distress,<span style="mso-spacerun: yes;"> </span>death will float in, a<span style="mso-spacerun: yes;"> </span>soothing Zephyr of tranquility. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>I want to tell him that<span style="mso-spacerun: yes;"> </span>every one dies,<span style="mso-spacerun: yes;"> </span>the good and the bad,<span style="mso-spacerun: yes;"> </span>and that even in the future, there will
be death, no matter how long<span style="mso-spacerun: yes;">
</span>science can preserve our<span style="mso-spacerun: yes;">
</span>consciousness. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>I remember a saying, but I’m not sure if
it’s a joke or a Koan “ Live every day as if it’s your last, and one day you will
be right.”<o:p></o:p></span></div>
<!--EndFragment--><br />Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com0tag:blogger.com,1999:blog-3346982693192735867.post-21660559594475872812019-02-26T11:05:00.002-08:002019-02-27T01:14:51.969-08:00It's complicated<br />
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">Thanks,
Aunt Nancy for the mot juste.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">I
love Nancy. <span style="mso-spacerun: yes;"> </span>She is my wife's Aunt.<span style="mso-spacerun: yes;"> </span>Nancy has been a devoted blog reader since I began writing
these in 2010. </span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">She
lives in Vermont with husband Miles.<span style="mso-spacerun: yes;"> </span>We were
visiting the other day. Since my last hospitalization, we have felt the need to
see family.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">Over
<span style="mso-spacerun: yes;"> </span>simple lentil soup and turkey sandwiches,
Nancy turned to Cyn and said “You have complicated lives.”</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>This opened a floodgate. We’ve used endless,
sad adjectives to describe our fate<span style="mso-spacerun: yes;"> </span>We
cannot shake the suspicion that at some point in history, I, or one of my past incarnations
, stole a golden monkey from a mummy’s tomb or mocked a blind gypsy woman.
Karma’s a bitch.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>“Why us?”<span style="mso-spacerun: yes;"> </span>Cyn asks. “Why have we been saddled with an unending
succession of treatments, side effects, and infections?”</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">The
real question is: “Why not us?”<span style="mso-spacerun: yes;"> </span>Nancy has
a complicated life. Her mom lived well into her 90s and was severely debilitated
for much of her final decade. Nancy couldn’t travel far from Burlington, she
spent much time caring for her mom.<span style="mso-spacerun: yes;"> </span>Nancy
had a rocky childhood. </span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">It’s
a vicious cycle.<span style="mso-spacerun: yes;"> </span>Our friends express <span style="mso-spacerun: yes;"> </span>pity, and this feeds back and amplifies itself
into prolonged attacks of anger and despair. Why bother when the Universe gives
you the middle finger?</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">I
am now on disability leave, vowing to return to work.<span style="mso-spacerun: yes;"> </span>At work, my patients express a similar
sentiment. “We feel so bad for you, Dr. Weinreb. We are praying for you.”</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">They
ask how I am doing.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">‘”
Well,” I complain.<span style="mso-spacerun: yes;"> </span>“The medication to
control the GVHD isn’t working, and I am short of breath.”<span style="mso-spacerun: yes;"> </span>I then realize I am talking to someone who just
lost her husband of 40 years.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>“I’m <span style="mso-spacerun: yes;"> </span>so sorry for your loss,” I say, when I suddenly
remember, pulling myself back from the abyss of self-pity.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>If only a non-judgmental, non-angst-laden
word existed to describe our current situation. </span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">The
word is “complicated.”<span style="mso-spacerun: yes;"> </span>Our lives are complicated.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>I
spend my days taking pills, giving myself insulin shots and pouring 40 ounces
of formula through my G tube to gain back the 30 pounds I lost. Cyn is burdened
with making sure I don’t <span style="font-size: large;">accidentally</span> kill myself, a situation that arises far more
often than you would think. </span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>My life is complicated but I am not disabled.
We just saw daughter Abby and boyfriend Sam and his parents. We visited dear <span style="mso-spacerun: yes;"> </span>Aunt Nancy and Uncle Miles. There were moments
of joy interlaced with the complexities.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">But,
the point is, everyone has a complicated life.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">Cousin
Carol cares for my elderly Aunt.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">We
all have complicated lives.<span style="mso-spacerun: yes;"> </span>Our pain is
not unique or special. It is time consuming, but my children are healthy. I
know several <span style="mso-spacerun: yes;"> </span>people who spend their
days caring for sick children<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>We all have
something. </span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">Cynthia
and I derive comfort from Nancy’s definition.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">Our
lives are complicated. Everyone’s life is.</span></div>
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</style>Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com0tag:blogger.com,1999:blog-3346982693192735867.post-33270611635081529762019-02-20T09:38:00.001-08:002019-02-21T05:48:33.979-08:00Someone Saved my Life Today<br />
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">Is
it possible to have an egalitarian, mutually supportive relationship in which
one’s spouse has relentlessly, literally saved the others’ life?</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">It
has </span><span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";">become cliché, the song in which the singer
praises the love of his life who appears at the bar to spirit the singer
from the Jezebel about to doom him to a life of fruit wine, pork rinds
and satellite Television.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";"><span style="mso-tab-count: 1;"> </span>Those of us of a certain age (old) remember
Elton John’s “Someone saved my life tonight” in which Elton was probably saved
by a gay lover from the charade <span style="mso-spacerun: yes;"> </span>of a
heterosexual sham marriage (although he had one of those too)</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";">Cynthia
has literally saved my life, on a monthly basis yet. The most recent episode
occurred a few weeks ago when I woke feverish and confused, in Boston. Had I
been alone, I would have fallen back to sleep and death.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";"><span style="mso-tab-count: 1;"> </span>The problem is, I have become overly
solicitous .I will never be able to repay her.<span style="mso-spacerun: yes;">
</span>I can never show my gratitude, perhaps she should start walking into the
road so I can pull her from speeding trucks.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";">This obsequiousness
annoys her. I keep asking “Are you OK?” hoping she’ll have some complaint that
will help even the score. My adoration quickly turns annoying. We cannot live
this way .</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";">I think of
the Madonna /whore dichotomy. Men apparently want to marry a Madonna for every
room in the house but the bedroom but a whore in the boudoir. I<span style="mso-spacerun: yes;"> </span>have a trichotomy, a Madonna/whore/superhero<span style="mso-spacerun: yes;"> </span>one.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";"><span style="mso-tab-count: 1;"> </span>She has saved my life on numerous occasions.<span style="mso-spacerun: yes;"> </span>She has pulled me from the jaws of hypoglycemia
on countless occasions. She has contradicted one of my physicians when he was clearly
wrong and started a life-saving therapy.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";">It has become
somewhat of a joke; the number of people who have saved my life.<span style="mso-spacerun: yes;"> </span>I remember the lovely Dutch couple in Iceland
who gagve me chocolate and a blanket when I became hypothermic. Betty and Alan
have saved my life often just by showing up. It’s. difficult to owe so much to
so many people, wishing I will never, hopefully, have to repay them.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";">The point
is, I don’t live with Alan or Betty (yet) I must make our marriage work on a daily
basis. I am depleted, I can’t run or climb or bike yet, and may never be able
to. I feel<span style="mso-spacerun: yes;"> </span>guilt that<span style="mso-spacerun: yes;"> </span>the love of my life has <span style="mso-spacerun: yes;"> </span>struggled so hard to<span style="mso-spacerun: yes;"> </span>save <span style="mso-spacerun: yes;"> </span>damaged goods. She ran into a burning house to salvage a beloved<span style="mso-spacerun: yes;"> </span>photo, only to find
the<span style="mso-spacerun: yes;"> </span>photo suffered water and smoke
damage .And a limp. </span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";"><span style="mso-spacerun: yes;"> </span>I’m home bound now, and I frantically try to find
interesting topics to discuss when Cyn comes home.<span style="mso-spacerun: yes;"> </span>It is the least I can do for a superhero.P: blogging?</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)"; mso-bidi-font-size: 12.0pt;">Marriage
is lived moment to moment. In the dwindling time we have left, neither of us
benefits from my hero worship. I find it hard to believe Lois Lane could ever find
comfort in Superman’s embrace (or did he have to give up his powers?<span style="mso-spacerun: yes;"> </span>I dunno.)</span></div>
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</style>Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com1tag:blogger.com,1999:blog-3346982693192735867.post-23266889141274613392019-02-19T07:42:00.002-08:002019-02-20T01:56:34.270-08:00Ted's Text<br />
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";">Ted’s text
haunts me. </span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";">The scenario:
I am drifting away, calmly, peacefully. My last two years have been difficult,
times of pain<span style="mso-spacerun: yes;"> </span>and immobility but yes,
also moments of intense joy.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";"><span style="mso-tab-count: 1;"> </span>But I am ready. The carbon dioxide in my blood <span style="mso-spacerun: yes;"> </span>has made a dreamscape of the Brigham’s <span style="mso-spacerun: yes;"> </span>Boston campus. </span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";"><span style="mso-tab-count: 1;"> </span>This would be a good death.<span style="mso-spacerun: yes;"> </span>No<span style="mso-spacerun: yes;">
</span>stroke, no searing chest pain.<span style="mso-spacerun: yes;">
</span>Kids are grown, wife<span style="mso-spacerun: yes;"> </span>intelligent,
funny and attractive enough to find companionship when I’m gone. I had the rare
luck of finding my calling as a physician . Unpublished novels aside, no
bitterness.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";"><span style="mso-tab-count: 1;"> </span>My bags are packed, <span style="mso-spacerun: yes;"> </span>I’m ready to go</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";"><span style="mso-tab-count: 1;"> </span>I’m standing here<span style="mso-spacerun: yes;"> </span>outside <span style="mso-spacerun: yes;"> </span>your door</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";">Cyn has
made it clear to the house staff that I am not to be intubated if I stop
breathing </span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";">Then Ted
sends Cyn a text.<span style="mso-spacerun: yes;"> </span>I’ve known him eight <span style="mso-spacerun: yes;"> </span>years.<span style="mso-spacerun: yes;">
</span>He is smart, humble, and knows my peculiar situation.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";">He has
watched me decline. He knows I love to ski, hike<span style="mso-spacerun: yes;">
</span>and take 100 mile<span style="mso-spacerun: yes;"> </span>bike rides. He
knows I now walk slowly, stiffly. He knows Cynthia, and how she has suffered.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";">He is no
stranger.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";">So why <span style="mso-spacerun: yes;"> </span>the text?<span style="mso-spacerun: yes;">
</span>WE NEED TO INTUBATE STEVEN THIS IS A TREATBLE PROBLEM AND HE WILL
RECOVER</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";">Does he understand
that <span style="mso-spacerun: yes;"> </span>my quality of life is poor?<span style="mso-spacerun: yes;"> </span>Does he really believe that a 59 year old in
poor health will ever recover after<span style="mso-spacerun: yes;">
</span>being on a ventilator? <span style="mso-spacerun: yes;"> </span>I have
lived a remarkable full life . Does he understand that <span style="mso-spacerun: yes;"> </span>I have already seen London, I’ve seen France
and, in my prime, saw women’s underpants?</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";">A deeply unsettling
aspect of our relationship is that <span style="mso-spacerun: yes;"> </span>I
have sent him patients.<span style="mso-spacerun: yes;"> </span>Some have not done
well.<span style="mso-spacerun: yes;"> </span>We shared a patient in clear
decline. I kept asking<span style="mso-spacerun: yes;"> </span>Ted <span style="mso-spacerun: yes;"> </span>if<span style="mso-spacerun: yes;"> </span>hospice
was appropriate . “No no, this is a treatable cancer, we’ll push on”</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";">The
patient <span style="mso-spacerun: yes;"> </span>died, horribly, a “full code”<span style="mso-spacerun: yes;"> </span>of gore and broken bone .</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";"><span style="mso-spacerun: yes;"> </span>Am I on the same<span style="mso-spacerun: yes;"> </span>glide path? <span style="mso-spacerun: yes;"> </span>Am I being spared a shot at a good death because
a possibly worse one awaits?</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";"><span style="mso-tab-count: 1;"> </span>So why the instance that I be “Full
code?”<span style="mso-spacerun: yes;"> </span>Is it that<span style="mso-spacerun: yes;"> </span>we have become friends and he<span style="mso-spacerun: yes;"> </span>feels <span style="mso-spacerun: yes;"> </span>bad
for ne, and this was a misguided but touching display of concern? Perhaps an ego
thing, <span style="mso-spacerun: yes;"> </span>prolonging my life to add good
data to a planned paper?</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";"><span style="mso-tab-count: 1;"> </span>I mention this because<span style="mso-spacerun: yes;"> </span>I have found <span style="mso-spacerun: yes;"> </span>my patients who get the best care are those
who annoy me… slightly. My patients who have become family over the years have
a problem. I love them, and don’t want then to die,<span style="mso-spacerun: yes;"> </span>Perhaps I’m more<span style="mso-spacerun: yes;"> </span>likely to shrug off a slightly elevated <span style="mso-spacerun: yes;"> </span>liver function because I want then to be
healthy. <span style="mso-spacerun: yes;"> </span>The patients<span style="mso-spacerun: yes;"> </span>that irritate me<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>get
the best medical care. </span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";">Pt X has
been my patient<span style="mso-spacerun: yes;"> </span>for 20 years. X <span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>is
always in pain, always<span style="mso-spacerun: yes;"> </span>mentions symptoms<span style="mso-spacerun: yes;"> </span>I suspect may be due to depression, although X
refuses to seek counseling or medication.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";">X
presents<span style="mso-spacerun: yes;"> </span>with <span style="mso-spacerun: yes;"> </span>lower left<span style="mso-spacerun: yes;">
</span>back pain .The story sounds off for skeletal or osseous<span style="mso-spacerun: yes;"> </span>pain. <span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>If<span style="mso-spacerun: yes;"> </span>X were
a beloved patient, I would probably reassure.<span style="mso-spacerun: yes;">
</span>Why expose a loved one to excess radiation? <span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";">I also
suspect she would be furious if I<span style="mso-spacerun: yes;"> </span>missed
anything. In any event, I somewhat passively aggressively ordered a Real CT,
showing an early<span style="mso-spacerun: yes;"> </span>renal cancer. She is
doing well. <span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";">Moral of the
story is to make sure you annoy your physician on a regular basis.<span style="mso-spacerun: yes;"> </span>The best way to do is to insist on a 15
minute visit and bring in a typed list of<span style="mso-spacerun: yes;">
</span>at least 10 symptoms</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%;">Oncologists <span style="mso-spacerun: yes;"> </span>have to remain
optimistic . If they weren’t, their job would consume them. I always feel better
when Ted <span style="mso-spacerun: yes;"> </span>reassures me that I will get better.
I am willing to suspend <span style="mso-spacerun: yes;"> </span>disbelief. <span style="mso-spacerun: yes;"> </span></span><span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman \(Body CS\)";"></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%;">I am glad to be alive. I am glad I am DNAR.<span style="mso-spacerun: yes;"> </span>The term “Do not resuscitate” was changed <span style="mso-spacerun: yes;"> </span>to “Do not attempt to resuscitate ” because <span style="mso-spacerun: yes;"> </span>the original phase implied. Resuscitation was
a likely outcome. </span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%;">When asked, most physicians would want to be DNR, because we
have seen the horrors of<span style="mso-spacerun: yes;"> </span>resuscitation. <span style="mso-spacerun: yes;"> </span>So why<span style="mso-spacerun: yes;">
</span>did Ted want me to be<span style="mso-spacerun: yes;"> </span>Intubated?</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%;">Make your wishes <span style="mso-spacerun: yes;"> </span>known
now,<span style="mso-spacerun: yes;"> </span>document <span style="mso-spacerun: yes;"> </span>your advanced directives .Patients think its ghoulish
<span style="mso-spacerun: yes;"> </span>to discuss, but the opposite is true.<span style="mso-spacerun: yes;"> </span>You don’t want your loved one to make a
decision about your<span style="mso-spacerun: yes;"> </span>terminal<span style="mso-spacerun: yes;"> </span>hospital care without your guidance. </span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>I have had the good fortune to experience my
own DNAR death. It was great. Had I been intubated, as the house staff requested,
I’d probably<span style="mso-spacerun: yes;"> </span>be in a nursing home right
now,<span style="mso-spacerun: yes;"> </span>too depleted for rehabilitation .</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%;">So, why the Text from Ted? </span></div>
<div class="MsoNormal">
<span style="mso-tab-count: 1;"> </span></div>
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</style>Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com0tag:blogger.com,1999:blog-3346982693192735867.post-54852711361123648642019-02-18T09:08:00.000-08:002019-02-18T15:42:30.374-08:00after the endI’m back. I’m back in so many ways. I started blogging ten years ago as a method of coping with a new situation, my diagnosis of chronic leukemia. Been a long crazy road, picked up a few readers, made a few jokes, shared when I though doing so would go beyond narcissism and platitudes. And then life returned. And then it didn’t. My life has entered a new bizarre phase, I hope I can write about it without relapsing in maudlin cliche. I learned along the way we all suffer, that my misery, while odd, is part of the human existence . <br />
Things changed. I was working part time, but feeling weaker. I started losing weight. My leukemia is gone, but its ghost , GVHD lingers, stiffening my skin, choking my breathing.<br />
And then, crisis.<br />
Marriage, as I know it, has had clear stages. You meet, you fall in love, you may have kids. You may divorce. If you hang around long enough, on one inevitable day, if you’re lucky, you say goodbye. I said goodbye to Cyn a few weeks back. Despite all we’ve been through there was always the expectations that there would be an afterwards, time to reflect and heal.<br />
I said goodbye to Cyn the other day.<br />
Hospital. Pneumonia. Unbeknownst to me, I was retaining CO2. I was suffocating but in no distress.<br />
I remember little. I remember driving to the hospital, telling Cyn I was ready to die, life has become low level discomfort punctuated by hospital visits every few months. I was ready to go<br />
I remember Cyn’s crying face “they want to intubate you. I told them no, what do you think?” Odd bitter irony! The one moment you need to make the ultimate existential decision is when you are confused, tired. “I want more time” I said, stalling to see what came next. My next thought was how much I’d miss her , but of course, I wouldn’t miss her at all. Cyn turned to the intern "he is DNR. DNI." “Well you’ll need to put it in writing” the intern said. On reflection how odd. You’d think the house staff would welcome avoiding the complications of putting someone on a ventilator . “ Fine” Cyn said. Ted ,my oncologist ,called annoyed . “ This is not fatal, this is reversible” he told her. Once again, amusement on my part. He has no way of knowing my current quality of life. Who is this pisher making life decisions for me?<br />
Cyn holds firm. She says goodbye. to me. She is exhausted. I flash back on the death bed scene from Love Story when Ollie gets into Jenny’s hospital bed and she dies in his arms . I was a tangle of tubes and wires, it would have been impossible. I remember putting our cat to sleep. The Vet had a “bye room”, furnished like a hotel room where one holds ones pet as the pentathol flows. Clearly American hospitals need bye rooms.<br />
Cyn leaves. I lose consciousness peacefully. I am warm, I am loved, I will be missed, but Cyn will be OK.<br />
And then. And then. I’m in a hospital room and the house staff is poking me.” Dr Weinreb, Dr Weinreb. Where are you? “Hospital”. Why is this a special day? “Because the patriots just won the superbowl ”. ( no kidding). I must admit, I was a little annoyed at being woken from eternal tranquillity to be quizzed on sports trivia.<br />
<br />
It’s two weeks later. Life feels differently. I feel as if I died and the afterlife bears amazing similarity to the one I just left. Cyn is so tired and has full blown PTSD.<br />
What have I learned? DOCUMENT YOUR DNR orders. I have learned to be wildly excited by simple stuff. I walked 3/4 mile yesterday without oxygen and felt as if I had just run and won a marathon.<br />
The hardest part of the afterlife is letting hope back in. I need to hope that perhaps I could..,..return to work.....maybe take a trip. Otherwise life. Is just cans of ensure and constant frantic motion.<br />
I have much to say. Will say more tomorrow.Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com0tag:blogger.com,1999:blog-3346982693192735867.post-62941324942587423712016-01-06T15:30:00.000-08:002016-01-06T15:30:10.958-08:00Stay Strong, Brother
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<!--StartFragment-->
<br />
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><br /></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><br /></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">“Stay strong, brother.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">I smiled weakly.<span style="mso-spacerun: yes;"> </span>Certainly, he deserved acknowledgment. <span style="mso-spacerun: yes;"> </span>He was reaching out, trying to be
encouraging, supportive, and friendly, but I was late.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">I was late because I had driven to
the wrong site for my Reclast infusion.<span style="mso-spacerun: yes;">
</span>I drove to Hartford Hospital through treacherous morning traffic, pissed
I was late due my own ineptitude. I wasn’t going to cope with employee parking,
either.<span style="mso-spacerun: yes;"> </span>Every orthopedist thinks
he or she is Dale Earnhardt.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">So, I drive up to the Valet parking.
<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">A young kid (these days, anyone under
32) runs to my car.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">I’m here for my treatment at the
cancer center, ” I say. “May I park here?”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">He gives me a sad look. <span style="mso-spacerun: yes;"> </span>"Sorry, its no longer free…”
he trails off, not finishing the rest of the sentence, "... For you cancer
warriors." I did actually think parking was free.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">“Fine,” I say, “Thanks.” <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>I jump out, and head for the Helen Gray Cancer Center<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">Stay strong, brother” He calls
after me.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">“Stay strong brother” the statement
carries dread and peculiar emotional weight. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">I’m pretty sure,<span style="mso-spacerun: yes;"> </span>“stay strong brother” Is not the response
when a patient pulls up and says:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">“ I’m here for the AA meeting,
where can I park?”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">“Where is Diabetic training?”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">Or even (and this is weird)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">“Where do I park, I have an
appointment <span style="mso-spacerun: yes;"> </span>at the Chronic
Heart Failure Infusion suite?”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">Why do I get a free ride?<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">More to the point, why don’t I stop
and say, <span style="mso-spacerun: yes;"> </span>“Oh no, you
misunderstand, I <i style="mso-bidi-font-style: normal;">had </i>cancer, Now I’m
in remission, and prednisone has caused osteoporosis, so I need a Reclast
infusion.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">That’s why I am here.<span style="mso-spacerun: yes;"> </span>In my mind, Cancer is a
tragic but non-lethal disease that leaves its victims sadder but much
wiser.<span style="mso-spacerun: yes;"> </span>Fighting cancer apparently
was the only way I could have gotten a New York Times Op Ed piece.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>I would not have been published if my piece began, <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>“
I have ambivalent feelings about my job.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">I would not have been published without
help from friend Judith, but that’s another blog. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">Cancer is less lethal than end
stage chronic heart failure,<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>“
I spend one hour a week receiving infusions that permit me to live a few years
more, because circumstance beyond my control has denied me the chance at a
heart transplant and survival.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Oh
wait… Judith, you reading this?<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>In
my 30 years in medicine, the death rate among those receiving infusions for CHF
is<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>still 100%, while the survival rate for chemo
insensitive<span style="mso-spacerun: yes;"> </span>CLL has gone from 0%
to… well, much more.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">Cancer may be <span style="mso-spacerun: yes;"> </span>a serious<span style="mso-spacerun: yes;"> </span>disease, but curable ( ptoo ptoo) in 100% of the bodies in
which I have inhabited.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Prednisone,
on the other hand, is a tablet of pure misery, Satan’s own Pharmaceutical.<span style="mso-spacerun: yes;"> </span>Prednisone has ravaged my
body , turning my skin to paper and my<span style="mso-spacerun: yes;">
</span>lenses to opaque, <span style="mso-spacerun: yes;"> </span>cataract -clouded stones. Prednisone has dissolved my bones
giving me a T score of -2.7 ( look it up, on a roll)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Since
my hip bones will transform into chalk within 5 years, I receive Reclast, a bi phosphanate.<span style="mso-spacerun: yes;"> </span>It binds to the bones, and makes difficult
for our osteoclasts (cells that remodel our skeletons ) to destroy our lovely
bones.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">There is a wonderful aside here
about how plumbers discovered that<span style="mso-spacerun: yes;">
</span>bi phosphanates unclog soap- clogged <span style="mso-spacerun: yes;"> </span>(read calcium- containing compounds) pipes. That’s for
another time.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Cancer
has become a lovely, benign tool for me.<span style="mso-spacerun: yes;">
</span>This reminds me of Curb<i style="mso-bidi-font-style: normal;"> your
Enthusiasm</i> when<span style="mso-spacerun: yes;"> </span>Larry David
discovers that saying,<span style="mso-spacerun: yes;"> </span>“ I can’t
come because my father just died” is such an effective dodge that he uses it
well after Shiva is over. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>When
must someone stop play the cancer card? When Chemo is over?<span style="mso-spacerun: yes;"> </span>That’s true at the Farber, where suddenly
parking is no longer free. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Must
one return to the banal world of the cancer-deficient <span style="mso-spacerun: yes;"> </span>after one has a statistically good
chance of long-term survival? For me, that was ( ptoo ptoo) over 2 years ago.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Or,
is cancer like the military, 20 years after the battle is over, one can still
get a Free sundae at Friendly’s on veterans and I presume, cancer survivor day?<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">I’m cranky these days from a withering
combination of my medications, the effects of prednisone and the overall
irreversible bodily mayhem that<span style="mso-spacerun: yes;">
</span>occurs even years after treatment.<span style="mso-spacerun: yes;">
</span><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
have the lungs of an 80 year old, and, believe me, after a day of seeing a
mandated 2.2 patients an hour, those 80 year old lungs are fighting for
survival.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Is
it fair for me to say, “I just can’t see another patient, Olga, it’s...”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>“I
know, Doctor Weinreb. Stay strong.”<o:p></o:p></span></div>
<!--EndFragment-->Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com0tag:blogger.com,1999:blog-3346982693192735867.post-91856501544423309102015-12-24T13:15:00.000-08:002015-12-25T12:05:15.000-08:00Merry Christmas, Mr Shkreli<div class="MsoNormal" style="line-height: 150%;">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://4.bp.blogspot.com/-Y7_9aB8iRDA/Un5G7JpYW2I/AAAAAAAAABg/v3Yv3_i0cYk/s1600/scream.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/-Y7_9aB8iRDA/Un5G7JpYW2I/AAAAAAAAABg/v3Yv3_i0cYk/s1600/scream.jpg" /></a></div>
<div>
<br /></div>
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"></span>
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><br /></span>
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">I’m
having a real problem hating Martin Shkreli.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">You
probably know about Mr. Shkreli. He is the 32-year-old Wunderkind and hedge
fund manager who cornered the market on Daraprim, a medication that <span style="mso-spacerun: yes;"> </span>among other uses, is a treatment for
AIDS patients<span style="mso-spacerun: yes;"> </span>with <span style="mso-spacerun: yes;"> </span>toxoplasmosis. His pharmaceutical
company became <span style="mso-spacerun: yes;"> </span>the world supplier for
Daraprim, and raised the medication to<span style="mso-spacerun: yes;">
</span>$750 a pill, triggering worldwide outrage and a series of sarcastic op Ed
pieces. These pieces all ran along the lines of ” Now that he needs a lawyer,
let's charge him $ 10,000 an hour for legal help.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Ah
Gail Collins, you cut up, you.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>Why the anger?<span style="mso-spacerun: yes;"> </span>Could it have stemmed from the Uber self-indulgent you tube
videos of him in his Manhattan apartment, blathering on about life as seen
through the eyes of a drunk 32 year old Plutocrat?<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">Is
our scorn<span style="mso-spacerun: yes;"> </span>based on the concept of cornering
the market in a precious commodity?<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>American
history is filled with those who have done so with<span style="mso-spacerun: yes;"> </span>varying degrees of<span style="mso-spacerun: yes;">
</span><span style="mso-spacerun: yes;"> </span>success and/or fame.<span style="mso-spacerun: yes;"> </span>Jay Gould cornered the gold market a century
ago.<span style="mso-spacerun: yes;"> </span>The Hunt brothers did the
same in the 1970s in the silver market.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">In
any event, we glorify those<span style="mso-spacerun: yes;"> </span>scoundrels
who have the knowledge and intestinal fortitude to corner commodity markets. <o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: center; text-autospace: none;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: center; text-autospace: none;">
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Helvetica;">From Ohio Mister Thorne<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: center; text-autospace: none;">
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Helvetica;">Calls me up from night 'til morn,<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: center; text-autospace: none;">
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Helvetica;">Mister Thorne once cornered corn and that ain't
hay.<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: center; text-autospace: none;">
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Helvetica;">Aha!<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: center; text-autospace: none;">
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Helvetica;">But I'm always true to you, darlin', in my
fashion,<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: center; text-autospace: none;">
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Helvetica;">Yes, I'm always true to you, darlin', in my
way.<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: center; text-autospace: none;">
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Helvetica;">--Kiss me<span style="mso-spacerun: yes;">
</span>Kate ( as if you didn’t know) <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Helvetica;"><span style="mso-spacerun: yes;"> </span>I’m terrified when scarce drugs suddenly
become unavailable for<span style="mso-spacerun: yes;"> </span>obvious
reasons. I occasionally lose my bottle of<span style="mso-spacerun: yes;">
</span>Rapamune, a<span style="mso-spacerun: yes;"> </span>GVHD suppression
drug,<span style="mso-spacerun: yes;"> </span>and I have a buy a few to
tide me over. They’re $50 a pill because only one company makes then…
well,<span style="mso-spacerun: yes;"> </span>they’ve gone generic,
so<span style="mso-spacerun: yes;"> </span>Sirolimus is somewhat
cheaper.<span style="mso-spacerun: yes;"> </span>I understand the terror
of develping toxoplasmosis, an insidious<span style="mso-spacerun: yes;">
</span>parasite that<span style="mso-spacerun: yes;"> </span>grows in the
brains of the immunocompromised.<span style="mso-spacerun: yes;"> </span>Daraprim
is the accepted treatment and <span style="mso-spacerun: yes;"> </span>now unavailable
Fortunately, as is almost always the case,<span style="mso-spacerun: yes;"> </span>substitutes exist, so when I develop toxoplasmosis from
cleaning the cat litter, I can<span style="mso-spacerun: yes;">
</span>probably get by with Bactrim.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Helvetica;">Mr.
S isn’t alone charging outrageous fees for medications. Amoxicillin costs 2.5
cents a pill<span style="mso-spacerun: yes;"> </span>to make.<span style="mso-spacerun: yes;"> </span>CVS sells 20<span style="mso-spacerun: yes;"> </span>Amoxicillin for $ 48.50,<span style="mso-spacerun: yes;">
</span>or<span style="mso-spacerun: yes;"> </span>about 2.40 a pill, a
mark up of 1000%. Daraprim sold for<span style="mso-spacerun: yes;">
</span>17 dollars before Mr. S bought the company he charged $750 a pill,
about<span style="mso-spacerun: yes;"> </span>1/ 2 of the CVS mark up. I don’t
see any of us protesting CVS, although we should for so,so many reasons.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Helvetica;">But
this case deeply troubles me because I feel we ( that is me, and<span style="mso-spacerun: yes;"> </span>you, dear reader, who I hope has a
soul, a sense of justice and right versus wrong) <span style="mso-spacerun: yes;"> </span>are partially responsible for this sad<span style="mso-spacerun: yes;"> </span>situation.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Helvetica;">First
off,<span style="mso-spacerun: yes;"> </span>Amorality doesn’t<span style="mso-spacerun: yes;"> </span>evolve in a vacuum. No one sat Martin
down as a child and said, <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Helvetica;">“Martin
dear, just because something is LEGAL doesn’t mean it is MORAL and you<span style="mso-spacerun: yes;"> </span>should do this. “<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Helvetica;">Did
the guy ever go to church or Synagogue? (I’m afraid to look up which) <span style="mso-spacerun: yes;"> </span>Didn’t his parents <span style="mso-spacerun: yes;"> </span>ever read <span style="mso-spacerun: yes;"> </span>little Martin he teachings of Robert Fulgrum whose<span style="mso-spacerun: yes;"> </span>cliché ridden<span style="mso-spacerun: yes;"> </span>“What I leaned in kindergarten” should <span style="mso-spacerun: yes;"> </span>be taught <span style="mso-spacerun: yes;"> </span>at Business schools across the country<span style="mso-spacerun: yes;"> </span>because his<span style="mso-spacerun: yes;"> </span>preaching, although treacley, is sound.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Helvetica;">I
believe <span style="mso-spacerun: yes;"> </span>Baruch College ,where<span style="mso-spacerun: yes;"> </span>Mr. Shkreli<span style="mso-spacerun: yes;"> </span>leaned his moral compass, should have<span style="mso-spacerun: yes;"> </span>told him:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #131313; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;">1. Share everything.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #131313; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;">2. Play fair.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #131313; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;">3. Don't hit people.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #131313; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;">4. Put things back where you found them.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #131313; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;">5. CLEAN UP YOUR OWN MESS.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #131313; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;">6. Don't take things that aren't yours.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #131313; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;">7. Say you're SORRY when you HURT
somebody.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #131313; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;"><span style="mso-tab-count: 1;"> </span>And
then<span style="mso-spacerun: yes;"> </span>Mr. Trump hits the national
stage. He is a creation of the times in which we live.<span style="mso-spacerun: yes;"> </span>He is a hero to <span style="mso-spacerun: yes;"> </span>multitudes<span style="mso-spacerun: yes;"> </span>even though he is the sort of<span style="mso-spacerun: yes;"> </span>person the devil assigns to you<span style="mso-spacerun: yes;"> </span>in the next world to pay for a life of<span style="mso-spacerun: yes;"> </span>greed,<span style="mso-spacerun: yes;"> </span>selfishness and close-mindedness.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #131313; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;">Trump is an idol, even though
his<span style="mso-spacerun: yes;"> </span>high rise on central park
south (Legally) blocks out the light for several buildings that<span style="mso-spacerun: yes;"> </span>once fronted the<span style="mso-spacerun: yes;"> </span>park. This wasn’t so bad, I guess until
Mr. T<span style="mso-spacerun: yes;"> </span>hung a sign that said “ Go Fuck
yourself , don’t you wish you lived here?” ( I paraphrase, but that’s really
what it said) and made sure it faced the blotted -out building behind his. The
man has<span style="mso-spacerun: yes;"> </span>infringed on more air
rights than a Sicilian<span style="mso-spacerun: yes;"> </span>at a <span style="mso-spacerun: yes;"> </span>cocktail party ( is this racist? They
tend to be close talkers, as a people.) <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #131313; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;"><span style="mso-spacerun: yes;"> </span>The second reason we have to give<span style="mso-spacerun: yes;"> </span>Mr. Shkreli a pass is that he was doing what he was trained
to do : Find a vulnerable market and exploit it.<span style="mso-spacerun: yes;"> </span>I suspect all first year Harvard Business school students
are taught a course<span style="mso-spacerun: yes;"> </span>titled<span style="mso-spacerun: yes;"> </span>“ Exploring<span style="mso-spacerun: yes;"> </span>and capitalizing<span style="mso-spacerun: yes;">
</span>under -utilized markets” but should probably be called ,“screwing <span style="mso-spacerun: yes;"> </span>the poor and ill for fun and profit<span style="mso-spacerun: yes;"> </span>”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #131313; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;"><span style="mso-spacerun: yes;"> </span>The metaphorical<span style="mso-spacerun: yes;">
</span>blood is on our hypothetical hands because we have allowed<span style="mso-spacerun: yes;"> </span>big business to control our health care
system<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #131313; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;">Properly done, heath care is a money-losing
proposition. Hartford Hospital (<span style="mso-spacerun: yes;">
</span>losing<span style="mso-spacerun: yes;"> </span>30 million this year)<span style="mso-spacerun: yes;"> </span>has a full trauma operating room running
24 hours a day. If your car is<span style="mso-spacerun: yes;"> </span>T
boned on<span style="mso-spacerun: yes;"> </span>Interstate 91 at 3 AM, <span style="mso-spacerun: yes;"> </span>rest assured<span style="mso-spacerun: yes;"> </span>a capable<span style="mso-spacerun: yes;">
</span>vascular surgeon will be available to<span style="mso-spacerun: yes;"> </span>sew you up. An OR costs about 2,000 dollars an hour to run even if
no surgery actually done,<span style="mso-spacerun: yes;"> </span>and
someone have to pay that bill.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #131313; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;"><span style="mso-tab-count: 1;"> </span>We
are at fault because we haven’t demanded a single payer<span style="mso-spacerun: yes;"> </span>system<span style="mso-spacerun: yes;"> </span>for health care for everyone . The thought of veterans dying
in the snow because they didn’t have health care is so repugnant to us that we
have built an entire VA system that insures this won’t happen.<span style="mso-spacerun: yes;"> </span>If<span style="mso-spacerun: yes;"> </span>you served your country we won’t let you die in some<span style="mso-spacerun: yes;"> </span>hospital parking lot after being<span style="mso-spacerun: yes;"> </span>T Boned on the Highway. We wont let a veteran
die of Toxoplasmosis <span style="mso-spacerun: yes;"> </span>either, for
that matter, if we can help it.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #131313; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;"><span style="mso-tab-count: 1;"> </span>This
whole sorry<span style="mso-spacerun: yes;"> </span>Shkreli affair could
not<span style="mso-spacerun: yes;"> </span>happen outside the US, where<span style="mso-spacerun: yes;"> </span>the government tightly controls health
care.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #131313; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;">If<span style="mso-spacerun: yes;"> </span>Britain needs more Daraprim, they’ll pay<span style="mso-spacerun: yes;"> </span>someone to make more. The Republican
Party, home of Mr. T, <span style="mso-spacerun: yes;"> </span>insists<span style="mso-spacerun: yes;"> </span>people take responsibility for their
own healthcare. Everyone has a duty to make sure he or she is covered ,or
suffer the consequences It’s<span style="mso-spacerun: yes;"> </span>all
fun and games until a non veteran <span style="mso-spacerun: yes;"> </span>lacking health insurance gets T Boned on Interstate 91 at 3
AM and is brought to Hartford hospital. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #131313; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;"><span style="mso-tab-count: 1;"> </span>“You
don’t have insurance? <span style="mso-spacerun: yes;"> </span>You’re not a
Veteran? Hm,.. you better go bleed to death in the parking lot.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #131313; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;">That’s not going to happen.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #131313; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;">So much of what’s wrong in this
country is a result of our own<span style="mso-spacerun: yes;"> </span>inability<span style="mso-spacerun: yes;"> </span>to protest evil when we see it. I think
of the late great Phil Ochs’ “A small circle of friends”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;">Oh,
look outside the window</span><span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;">There's
a woman being grabbed</span><span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;">They've
dragged her to the bushes</span><span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;">And now
she's being stabbed</span><span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;">Maybe
we should call the cops</span><span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;">And try
to stop the pain</span><span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;">But
Monopoly is so much fun</span><span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;">I'd
hate to blow the game</span><span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;">And I'm
sure</span><span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;">It
wouldn't interest anybody</span><span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;">Outside
of a small circle of friends</span><span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;">Ridin'
down the highway</span><br />
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;"><br /></span>
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;"><br /></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;">I don’t
have to add that<span style="mso-spacerun: yes;"> </span>Phil killed
himself a few years back.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;">What about those poor German civilians <span style="mso-spacerun: yes;"> </span>who watched in horror as the<span style="mso-spacerun: yes;"> </span>Russian army invaded<span style="mso-spacerun: yes;"> </span>Berlin?<span style="mso-spacerun: yes;"> </span>What about the atrocities visited upon the women ( as
another aside read “All the light we cannot see” for a horrific depiction <span style="mso-spacerun: yes;"> </span>of that<span style="mso-spacerun: yes;"> </span>small holocaust) <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span>The
German civilians must have cried out as the<span style="mso-spacerun: yes;"> </span>Russians tortured them<span style="mso-spacerun: yes;">
</span>at the end of World War II, “Its not us! Hitler wasn’t our idea! We are
innocent.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;">What’s our excuse for watching so much brutality and<span style="mso-spacerun: yes;"> </span>cruelty<span style="mso-spacerun: yes;"> </span>evolve in our country?<span style="mso-spacerun: yes;">
</span>Why don’t we protest the gun lobby and the<span style="mso-spacerun: yes;"> </span>private health care industry? Why don’t we really, really
care when AIDS patients<span style="mso-spacerun: yes;"> </span>can’t
afford their medication? We don’t care until<span style="mso-spacerun: yes;"> </span>tragedy befalls us.<span style="mso-spacerun: yes;"> </span>Jim Brady didn’t give a whit about gun control,
until John Hinckley tried to blow his head off. Too little too late, Jim?<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;">I fear my life is spent<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;">No one is innocent <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span>--urinetown<span style="mso-spacerun: yes;"> </span>( it’s on i tunes, , I
guess) <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;">Martin<span style="mso-spacerun: yes;"> </span>Shkreli sprang
from our loins. He capitalized on a weakness in the system,<span style="mso-spacerun: yes;"> </span>exploited the poor and ill in a way
that<span style="mso-spacerun: yes;"> </span>should make his <span style="mso-spacerun: yes;"> </span>business professors<span style="mso-spacerun: yes;"> </span>proud and the rest of us a little<span style="mso-spacerun: yes;"> </span>unnerved<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;">You taught me to talk<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;">And the benefit is<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;">I know how to curse<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
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<span style="color: #1f1f1f; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times;">---Calliban from the Tempest</span><span style="color: #131313; font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;"><o:p></o:p></span></div>
Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com0tag:blogger.com,1999:blog-3346982693192735867.post-12419676673178324172015-12-18T10:48:00.001-08:002015-12-18T10:50:57.610-08:00The Whitney<!--[if gte mso 9]><xml>
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<br />
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">The Whitney was crowded but I felt
fine.<span style="mso-spacerun: yes;"> </span>The Whitney Museum of American art recently re opened in downtown Manhattan after a long run on the Upper East
Side. I missed the Whitney. My old friends, the Hoppers, the Picassos and the absurdly
obscene instillations were back on display. I roamed room-to-room seeking out
my old pals. I ran into my old friend George Bellows and we both watched the
Dempsey – Firpo fight.*<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>This
was a new experience Not the art, but the disorientation of being well.<span style="mso-spacerun: yes;"> </span>Chronic disease is a constant logistical
battle.<span style="mso-spacerun: yes;"> </span>The mind spins with desperate, absurd, surreal questions. Where is the nearest bathroom?<span style="mso-spacerun: yes;"> </span>Sip of water? Where can I lie down if/when
I feel sick? If I had to leave, where is the nearest bed? The nearest hotel room,
the next train back home?<span style="mso-spacerun: yes;"> </span>Each
medication carries its own cacophony<span style="mso-spacerun: yes;"> </span>of<span style="mso-spacerun: yes;">
</span>side affects<span style="mso-spacerun: yes;"> </span>and<span style="mso-spacerun: yes;"> </span>Graft versus host disease is like<span style="mso-spacerun: yes;"> </span>firing a machine gun into the night. You don’t know where the
next bullet will hit<span style="mso-spacerun: yes;"> </span>but when it
does, there will be pain. Will my<span style="mso-spacerun: yes;"> </span>4 ½
year old <span style="mso-spacerun: yes;"> </span>white cells<span style="mso-spacerun: yes;"> </span>declare<span style="mso-spacerun: yes;"> </span>Fatwa against my liver again? My mouth?<span style="mso-spacerun: yes;"> </span>My skin?<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>The
battlefield was clear today.<span style="mso-spacerun: yes;"> </span>The
analogy of cancer to war is<span style="mso-spacerun: yes;">
</span>excellent:<span style="mso-spacerun: yes;"> </span>You win the war
but the<span style="mso-spacerun: yes;"> </span>insurgents hole up and occasionally<span style="mso-spacerun: yes;"> </span>descend into town, taking no<span style="mso-spacerun: yes;"> </span>prisoners and raising havoc, when you
were certain peace had been declared .<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">But oddly, this<span style="mso-spacerun: yes;"> </span>piece isn’t about me. It’s about Cynthia.
<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">Dear Cynthia , who<span style="mso-spacerun: yes;"> </span>stood by me for<span style="mso-spacerun: yes;"> </span>the past 8 years of this non ending psycho
and melodrama. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Now
its her turn to<span style="mso-spacerun: yes;"> </span>search for the closest
place to find cool water, a<span style="mso-spacerun: yes;"> </span>life
saving snack, a clean <span style="mso-spacerun: yes;"> </span>and near-by
bed.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Her
destroying<span style="mso-spacerun: yes;"> </span>angel came in the form
of Spondolithiasis. <span style="mso-tab-count: 1;"> </span>For
<span style="mso-spacerun: yes;"> </span>years<span style="mso-spacerun: yes;"> </span>her<span style="mso-spacerun: yes;"> </span>back had slowly
dteriorated. If the spine is a stack of quarters, her spine was more like a
game of Jengah where the<span style="mso-spacerun: yes;">
</span>wooden sticks are pushed askew. Eventually the stack
collapses, the game is over, and it’s time for<span style="mso-spacerun: yes;"> </span>serious surgery.<span style="mso-spacerun: yes;">
</span>Six weeks ago she had<span style="mso-spacerun: yes;"> back </span>surgery where <span style="mso-spacerun: yes;"> </span>surgeons trimmed the <span style="mso-spacerun: yes;"> </span>overhanging<span style="mso-spacerun: yes;"> </span>vertebrate
that<span style="mso-spacerun: yes;"> </span>were <span style="mso-spacerun: yes;"> </span>pressing on her nerves. The surgeons
then<span style="mso-spacerun: yes;"> </span>made a paste from her bones
and spackled the transformed spine to<span style="mso-spacerun: yes;">
</span>rebuild the<span style="mso-spacerun: yes;"> </span>whittled column
that had been her backbone.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>Back at the Whitney, I rush over to greet<span style="mso-spacerun: yes;"> </span>my old fried Frank <span style="mso-spacerun: yes;"> </span>Stella, who is hanging out against <span style="mso-spacerun: yes;"> </span>a wall . Cyn follows behind, walking slowly,
pain etched on her face.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">“What’s wrong?" I ask from reflex. I know that face , the one that<span style="mso-spacerun: yes;">
</span>means “I’ve hit the wall, I’ve overdone it and I need to retreat.”<span style="mso-spacerun: yes;"> </span>I have a similar face.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">And I want to say “I know how you
feel. I know exactly how you feel. I know what it’s like to be<span style="mso-spacerun: yes;"> </span>77 miles from your bottle of pain
medication <span style="mso-spacerun: yes;"> </span>and realize you must
spend the next 4<span style="mso-spacerun: yes;"> </span>hours<span style="mso-spacerun: yes;"> </span>seeking out and returning with the<span style="mso-spacerun: yes;"> </span>life saving elixir. <o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span><span style="mso-tab-count: 1;"> </span>I
don’t want to say “I know how you feel” because she’ll say, “You can’t possibly<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>know.” <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>The
conversation will degrade into <span style="mso-spacerun: yes;"> </span>a
sad<span style="mso-spacerun: yes;"> </span>rumination on who suffers more.
Please, <span style="mso-spacerun: yes;"> </span>Cyn not in front of Frank<o:p></o:p></span></div>
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<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
an amazed and terrified by the similarities of our experiences, <span style="mso-spacerun: yes;"> </span>the feeling one can’t go another step,
the<span style="mso-spacerun: yes;"> </span>nihilistic feeling life will
be a series of painful moments, unending <span style="mso-spacerun: yes;"> </span>until the <span style="mso-spacerun: yes;"> </span>grave’s perfect peace.<o:p></o:p></span></div>
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<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>She
makes the same ridiculous statements I used to say. <span style="mso-tab-count: 1;"> </span>“I’ll never be
better.” “ I’m <span style="mso-spacerun: yes;"> </span>sure the<span style="mso-spacerun: yes;"> </span>treatment didn’t work, They’re lying to
me.” <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>I find myself having <span style="mso-spacerun: yes;"> </span>doppelganger conversations:<o:p></o:p></span></div>
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<br /></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">“I’ll never<span style="mso-spacerun: yes;"> </span>feel better again”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">Of course you will<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">No, no, I will never feel whole
again<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">Of course you will<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">It is as if we are auditioning for
the same role in a play and we pass the<span style="mso-spacerun: yes;">
</span>script back and forth to see who sounds more sincere in each role.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">Cyn has taken on a dreadful habit I
once enjoyed: She wakes and rates the day ‘ Today will be a B-. Today will be
an F. I once did the same. No need now, I’m settling into that B+/A- state<span style="mso-spacerun: yes;"> that's </span>good for most but will keep you out of
medical school. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">What amazes me is that Cyn and I
are so different. I am<span style="mso-spacerun: yes;"> </span>everything
she is not. I am<span style="mso-spacerun: yes;"> </span>maudlin ,
vindictive , <span style="mso-spacerun: yes;"> </span>sentimental and<span style="mso-spacerun: yes;"> </span>self pitying.<span style="mso-spacerun: yes;"> </span>Cyn <span style="mso-spacerun: yes;"> </span>exudes confidence and calm, her father’s eys looking
out at world<span style="mso-spacerun: yes;"> </span>from which he has
departed. Cyn and her dad hate self pity, I<span style="mso-spacerun: yes;"> </span>turned it into an Olympic event. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Cyn
was recently named<span style="mso-spacerun: yes;"> </span>VP of<span style="mso-spacerun: yes;"> </span>primary care at our hospital. She has
done an amazing job<span style="mso-spacerun: yes;"> </span>reigning in<span style="mso-spacerun: yes;"> </span>and soothing the<span style="mso-spacerun: yes;"> </span>4<sup>th</sup> grade<span style="mso-spacerun: yes;"> </span>fragile yet preposterously self
important egos of most docs. Had I been given the position, I would spend my
time<span style="mso-spacerun: yes;"> </span>evening up the score, firing
anyone who had offended me over the past 18 years.<span style="mso-spacerun: yes;"> </span>I'd soon be alone.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>My
<span style="mso-spacerun: yes;"> </span>self pity led me to believe there
is nothing, save the suffering<span style="mso-spacerun: yes;"> </span>of one's child , than one’s own suffering. I have always felt<span style="mso-spacerun: yes;"> </span>the Deity singled me out for some
karmic retribution, <span style="mso-spacerun: yes;"> </span></span><span style="font-family: "times"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">that is, until I tell someone of my fate and<span style="mso-spacerun: yes;"> </span>he or she replies with a tale so grotesque and horrible <span style="mso-spacerun: yes;"> </span>I am driven to ashamed<span style="mso-spacerun: yes;"> </span>silence.<span style="mso-spacerun: yes;"> </span>I am merely miserable; I am not among the horrible.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "times"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span></span><span style="color: #131313; font-family: "times"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;">I feel that life is divided
into the horrible and the miserable. That's the two categories. The horrible
are like, I don't know, terminal cases, you know, and blind people, crippled. I
don't know how they get through life. It's amazing to me. And the miserable is
everyone else. So you should be thankful that you're miserable, because that's
very lucky, to be miserable.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #131313; font-family: "times"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;"><o:p> ---Woody Allen</o:p></span></div>
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<span style="color: #131313; font-family: "times"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;"><o:p><br /></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #131313; font-family: "times"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Times; mso-bidi-font-size: 14.0pt;"><span style="mso-tab-count: 1;"> </span>But
there is something worse than one’s own suffering. The suffering of one’s mate
is far worse. <o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "times"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Verdana; mso-bidi-font-size: 13.0pt;">In suffering one has pity,<span style="mso-spacerun: yes;">
</span>one has carte blanche to be<span style="mso-spacerun: yes;">
</span>sad and bitter, to lash put against loved ones,<span style="mso-spacerun: yes;"> </span>to transgress in a million innocent and
not so inniocent ways . There is<span style="mso-spacerun: yes;">
</span>perfect peace in<span style="mso-spacerun: yes;"> </span>being
terminally ill, as I learned when my disease roared back and I was beyond chemotherapies’
ambivalent <span style="mso-spacerun: yes;"> </span>but sometimes helpful
grasp. <span style="mso-spacerun: yes;"> </span>.<span style="mso-spacerun: yes;"> </span>I have known all of Kubler Ross’s<span style="mso-spacerun: yes;"> </span>stages of grief, even the last stange, acceptance ,which is
not acceptance in the<span style="mso-spacerun: yes;"> </span>positive,
life affirming<span style="mso-spacerun: yes;"> </span>style <span style="mso-spacerun: yes;"> </span>but<span style="mso-spacerun: yes;"> </span>the feeing<span style="mso-spacerun: yes;"> </span>the
mouse feel’s as she is borne from earth in an eagle’s mouth.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "times"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Verdana; mso-bidi-font-size: 13.0pt;"><span style="mso-tab-count: 1;"> </span>Once
upon a time I ached over my neoplastic fate, the pain of<span style="mso-spacerun: yes;"> </span>cancer therapy, of<span style="mso-spacerun: yes;"> </span>relapse, of<span style="mso-spacerun: yes;"> </span>endless side effects.<span style="mso-spacerun: yes;"> </span> Cyn was there every step of the way. Now I know the utter helplessness of watching one's loved ones suffer, knowing there is nothing, really, that can be done to assuage her pain. </span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "times"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Verdana; mso-bidi-font-size: 13.0pt;">Now its my turn to ache again,
over the sufferings of my dearest. <span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "times"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Verdana; mso-bidi-font-size: 13.0pt;"><span style="mso-spacerun: yes;"><br /></span></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "times"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Verdana; mso-bidi-font-size: 13.0pt;"><span style="mso-spacerun: yes;">Update: Just got back from the orthopedist. Mike is a jolly, reassuring guy, who reviewed Cyn's X rays and said " You' re doing great"</span></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "times"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Verdana; mso-bidi-font-size: 13.0pt;"><span style="mso-spacerun: yes;"><br /></span></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "times"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Verdana; mso-bidi-font-size: 13.0pt;"><span style="mso-spacerun: yes;">ptoo ptoo ptoo</span></span></div>
<div class="MsoNormal">
<span class="Apple-style-span" style="font-size: 21px; line-height: 31px;"><br /></span></div>
<div class="MsoNormal">
<span class="Apple-style-span" style="font-size: 21px; line-height: 31px;"><br /></span></div>
<div class="MsoNormal">
<span class="Apple-style-span" style="font-size: 21px; line-height: 31px;">Maybe life is retiuring to the daily disater of mere misery. I hope.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "times"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Verdana; mso-bidi-font-size: 13.0pt;"><span style="mso-spacerun: yes;"><br /></span></span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "times"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Verdana; mso-bidi-font-size: 13.0pt;">* A tad obscure. Sorry. George Bellows (1889-1925 American painer.
Paineted Dempsy Vs Filpo ( 1924) Love the pic because<span style="mso-spacerun: yes;"> </span>Bellows is the bald guy to the left.<span style="mso-spacerun: yes;"> </span>I live my life for<span style="mso-spacerun: yes;"> </span>inside art jokes. </span><span style="font-family: "times"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><o:p></o:p></span></div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-YW-M-JJtKU8/VnRRhO8TGnI/AAAAAAAAAKU/7-IeAj7ojR8/s1600/bellows.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="325" src="http://1.bp.blogspot.com/-YW-M-JJtKU8/VnRRhO8TGnI/AAAAAAAAAKU/7-IeAj7ojR8/s400/bellows.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">George Bellows/ He's the bald guy on the left</td></tr>
</tbody></table>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "times"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Verdana; mso-bidi-font-size: 13.0pt;"><br /></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "times"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Verdana; mso-bidi-font-size: 13.0pt;"><br /></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "times"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Verdana; mso-bidi-font-size: 13.0pt;"><br /></span></div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-EshRjuihV5E/VnRRn1BXDNI/AAAAAAAAAKc/fQWKvDzGpl8/s1600/stella.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="http://3.bp.blogspot.com/-EshRjuihV5E/VnRRn1BXDNI/AAAAAAAAAKc/fQWKvDzGpl8/s400/stella.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"> Frank Stella</td></tr>
</tbody></table>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/-AyUCoEaMP1Q/VnRR3iouSOI/AAAAAAAAAKk/Dxz879DNwLs/s1600/Jenga.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="314" src="http://4.bp.blogspot.com/-AyUCoEaMP1Q/VnRR3iouSOI/AAAAAAAAAKk/Dxz879DNwLs/s400/Jenga.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Jenga. That's What Cyn's spine looked like</td></tr>
</tbody></table>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-family: "times"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Verdana; mso-bidi-font-size: 13.0pt;"><br /></span></div>
<!--EndFragment-->Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com0tag:blogger.com,1999:blog-3346982693192735867.post-67905013331671120882015-05-31T13:19:00.000-07:002015-06-01T07:10:32.852-07:00take two<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> He </span>was fighting a losing battle against cancer and was receiving
experimental chemotherapy. <span style="mso-spacerun: yes;"> </span>His spouse demanded
everything be done to keep him alive.<span style="mso-spacerun: yes;">
</span>“He’s too young to die, we have small children,” she sobbed. I suggested
making him DNAR, do not attempt to resuscitate, and she became angry. </span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span>“Boston tells us the
chemotherapy might work, and if you make him a no-code, you have extinguished
any hope we might have.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span>The Hospital called.<span style="mso-spacerun: yes;"> He</span> was failing. He was on pressors,
intravenous medicines used to maintain blood pressure at times of crisis. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span>“I’ll come right down, “ I
said. I would speak to the spouse, discuss the perils of being a patient with advanced cancer who underwent cardiopulmonary resuscitation.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span>By the time I arrived at
the intensive care unit, he was gone. He lay on a gurney, eyelids open,<span style="mso-spacerun: yes;"> </span>eyes bulging from their sockets from
the 30 minute-long<span style="mso-spacerun: yes;"> </span>attempt to
retrieve him. <span style="mso-spacerun: yes;"> </span>His expression was
one of abject terror. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span>His arms were swollen and
bleeding, stigmata from multiple attempts to insert 18 gauge needles as he lay dying.<span style="mso-spacerun: yes;"> </span>I beheld a scene of un imaginable violence. </span><span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"> <o:p></o:p></span><br />
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><br /></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span>My patients with advanced disease who undergo in-house CPR share a common
fate. They all die alone, without family in attendance. <span style="mso-spacerun: yes;"> </span>When CPR begins, the family
is hustled out, useless civilians driven from a battlefield, an alien arena in which
they are useless.Worse, their weeping and attempts to comfort their loved ones makes resuscitation hazardous for patient and family members alike. One cannot embrace a loved one receiving a 360 joule electro conversion shock. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"></span> I am wary of buildings
bearing messages, Work Makes One Free, Ignorance is Strength, but the portal to
every Medical school and hospital should bear the warning:</span><span style="color: #535353; font-family: "Trebuchet MS"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS";"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: "Trebuchet MS"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS";"><span style="mso-tab-count: 1;"> </span></span><span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span><span style="mso-tab-count: 1;"> </span> <i>Death is not the enemy, Suffering is. </i></span><span style="color: #535353; font-family: "Trebuchet MS"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS";"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span>Modern medicine has
forgotten this simple truth, at our own peril.</span><span style="color: #535353; font-family: "Trebuchet MS"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS";"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;">
I have taken to making house calls. Some patients are bed bound, so I
throw my stethoscope in the Honda, don a white lab coat and drive Connecticut
streets, seeking my wayward patients.</span><span style="color: #535353; font-family: "Trebuchet MS"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS";"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;">
The results have been startling.</span><span style="color: #535353; font-family: "Trebuchet MS"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS";"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;">
I enter a house. The patient lies in the living room, in a hospital bed, dying.</span><span style="color: #535353; font-family: "Trebuchet MS"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS";"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span>In our storied past, loved
ones died of old age. Once upon a time, we died at home. We
died upstairs in the master bedroom, covered in a hand -made quilt as
family members said goodbye, reminisced, shared the vigil against
encroaching night.</span><span style="color: #535353; font-family: "Trebuchet MS"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS";"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span>Nowadays, no one dies
of old age. The term itself has become vaguely grotesque, politically
incorrect, and pessimistic. Patients die of atypical tuberculosis, protein wasting syndrome and immunodeficiencies, By giving name to these conditions, we imply that treatment, and hence salvation, exists.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>I blame Dylan Thomas. We have taken his admonition to
rage against the dying of the light to heart<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span>Family members approach
me. “ What did Boston tell you?” Boston, medical Mecca, has become
shorthand for, "the place where my loved one will receive a
lifesaving diagnosis and treatment.”</span><span style="color: #535353; font-family: "Trebuchet MS"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS";"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span>I blame ourselves as
medical providers. We sometimes encourage futile therapy, claiming to restore hope
but forgetting that<span style="mso-spacerun: yes;"> </span>the new
proposed therapy has the<span style="mso-spacerun: yes;"> </span>slimmest
chance of success, at the<span style="mso-spacerun: yes;"> </span>expense
of additional suffering for patient and family.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span>Insurance companies’
policy rates are skyrocketing.<span style="mso-spacerun: yes;"> </span>I
am not excusing their behavior but rates increase when we decide as a culture that
a brain MRI or 30 minutes of a cardiopulmonary code would be more therapeutic
than soft classic music in an upstairs bedroom where the lights are low and the
air smells of lavender lotion. </span><span style="color: #535353; font-family: "Trebuchet MS"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS";"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span>To be fair, we are staring
to recognize that a patients’ death is not necessarily an indication of our
failure.. We now use the phrase: Do not Attempt to resuscitate, rather than Do
Not Resuscitate. This subtle shift suggests there is no magical
procedure to return our loved one from the banks of the River Styx.
We need to teach our medical students that every patient will eventually die, will
eventually fail to respond to any number of expensive treatments
and uncomfortable testing.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span>This raises the point: Is
Cardiopulmonary Resuscitation ever useful, especially for<span style="mso-spacerun: yes;"> </span>patients with cancer? <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span>The answer lies in a
patients’ health prior to<span style="mso-spacerun: yes;">
</span>CPR.<span style="mso-spacerun: yes;"> </span>If an otherwise
healthy patient with cancer ( or without cancer, for that matter)<span style="mso-spacerun: yes;"> </span>suffers<span style="mso-spacerun: yes;"> </span>a cardiac arrest,<span style="mso-spacerun: yes;">
</span>CPR offers a reasonable chance the patient will leave the hospital
alive. For debilitated cancer patients (defined as those who spend at least 50%
of the day in bed) a 2002<span style="mso-spacerun: yes;"> </span>study
pronounced<span style="mso-spacerun: yes;"> </span>Hospital based
CPR “ Futile.” <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span>I have been
fighting<span style="mso-spacerun: yes;"> </span>Chronic<span style="mso-spacerun: yes;"> </span>Lymphocytic leukemia since 2007, and
underwent<span style="mso-spacerun: yes;"> </span>a stem cell transplant
in 2011.<span style="mso-spacerun: yes;"> </span>I wrote of my
disease and the need for universal vaccinations in a 2011<span style="mso-spacerun: yes;"> </span>New York Times op ed piece. I wrote
that cancer taught me the value of community.<span style="mso-spacerun: yes;"> </span>Cancer has now taught me that death is not the enemy,
suffering is. I am in remission ( excuse me, Ptoo ptoo) but suffer <span style="mso-spacerun: yes;"> </span>daily from Graft verses Host disease, an
insidious<span style="mso-spacerun: yes;"> </span>syndrome in which my
donor cells attack my own innocent tissue.<span style="mso-spacerun: yes;"> </span>I have experienced days so <span style="mso-spacerun: yes;"> </span>pain filled that I <span style="mso-spacerun: yes;"> </span>wished I could end my suffering in any way possible.<span style="mso-spacerun: yes;"> </span>I don’t mind dying, I dread suffering, especially
without a reasonable expectation my misery will end.<span style="mso-spacerun: yes;"> </span>I view CPR for the terminally ill as a form of needless
misery.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span>My patients
are becoming more involved in their healthcare. They demand that I review their
CT scans and blood work with them.<span style="mso-spacerun: yes;">
</span>I see real irony here, but I also see a chance for improving health care
delivery. My patients panic when their MCHC<span style="mso-spacerun: yes;"> </span>(mean corpuscular hemoglobin concentration) is elevated. They
want to know what that means, The honest answer is <span style="mso-spacerun: yes;"> </span>“if you are not anemic,<span style="mso-spacerun: yes;">
</span>an isolated abnormal MCHC doesn’t mean much.”<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>I wish they
showed as much interest in their DNAR status. We ask our patients to sign DNAR
papers which describes CPR in the mildest terms .<span style="mso-spacerun: yes;"> </span>Our form reads, in part <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>if you stop breathing would you allow a tube
to be<span style="mso-tab-count: 1;"> </span>inserted
into your throat?<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span>These forms
should be more honest and more accurate. They should read:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span>The chance
of survival<span style="mso-spacerun: yes;"> </span>in any patient with
any terminal disease who undergoes an insertion of a breathing tube and<span style="mso-spacerun: yes;"> </span>the application of electrical shock to
the chest is essentially zero. During this attempt at resuscitation, you may experience
pain, anxiety and fear. If you require the insertion of a breathing tube, your
family will be forced to leave the room and there is a possibly you will die in
pain and without loved ones around.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span>I
contemplated requiring <span style="mso-spacerun: yes;"> </span>all patients
requesting “ full code status, no matter what” to watch a video<span style="mso-spacerun: yes;"> </span>of a patient undergoing<span style="mso-spacerun: yes;"> </span>CPR, but that would be too gruesome<span style="mso-spacerun: yes;"> </span>to watch.<span style="mso-spacerun: yes;"> </span>Viewing such a video could produce its own suffering.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>If I were hospitalized because my cancer
had returned, I am certain I would request DNAR status .<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span>A Johns
Hopkins study found 90% of all graduates from the Johns Hopkins school of
Medicine would decline CPR unless they had an acute, treatable condition. We <span style="mso-spacerun: yes;"> </span>physicians have<span style="mso-spacerun: yes;"> </span>run or watched<span style="mso-spacerun: yes;"> </span>too many attempts at cardiovascular<span style="mso-spacerun: yes;"> </span>resuscitation<span style="mso-spacerun: yes;"> </span>to want this procedure performed on us.<o:p></o:p></span></div>
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<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #535353; font-family: Times; font-size: 19.0pt; line-height: 150%; mso-bidi-font-family: Times;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>When my time comes, I want to die in my
bed,<span style="mso-spacerun: yes;"> </span>the sound track of<span style="mso-spacerun: yes;"> </span>Kiss me Kate<span style="mso-spacerun: yes;"> </span>playing in the background, a generous dose of morphine and Ativan<span style="mso-spacerun: yes;"> </span>soothing my central nervous system and the<span style="mso-spacerun: yes;"> </span>healing scent of chicken soup wafting
up from the kitchen. Wouldn't you?</span> </div>
Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com0tag:blogger.com,1999:blog-3346982693192735867.post-22425718602656770162015-05-23T03:58:00.000-07:002015-05-23T03:58:00.713-07:00Death be not a stranger <!--[if gte mso 9]><xml>
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<br /></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<i><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;">Note: Hartford Hospital’s legal department has warned me to state that the following article does NOT pertain to any specific
person, all details are composites used for illustrative purposes only. So, back
off.</span></i><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;"> I am
wary of buildings bearing messages, Work Makes One Free, Ignorance is Strength,
but the portal to every Medical school should bear the warning:</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;"> <i>Death
is not the enemy, Suffering is.</i></span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;">
Modern medicine has forgotten this simple truth, at our own peril.</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;">
I have taken to making house calls. Federal guidelines demand all
patients discharged from hospitals be seen by a physician within 45 day of
discharge. Some patients are bed bound, so I throw my stethoscope in the Honda,
don a white lab coat. and drive Connecticut streets, seeking my wayward
patients.</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;"> The
results have been startling.</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;"> I
enter a house. The patient lies in the living room, in a hospital bed, dying.</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;">In our storied past, the loved one would be dying of old age. Once
upon a time, we died at home. We died upstairs in the master
bedroom, covered in a hand -made quilt as a stream of family
members said goodbye, reminisced, shared the vigil against
encroaching night.</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;">Nowadays, no one dies of old age. The term itself has become
vaguely grotesque, mocking, and politically incorrect.</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;">My 90 year olds die of atypical Tuberculosis, renal failure,
immunodeficiency, but never of old age.</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;">This distinction is problematic.</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;">I blame Dylan Thomas. We have taken his admonition to rage
against the dying of the light to heart. Family members no longer visit
to hold hands, offer a sip of something cool and sweet, or to reminisce,
often in the mother tongue, about life in another land , another century.</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;">
Family members approach me. “ What did Boston tell you?” Boston,
medical Mecca, has become shorthand for “ the place where my loved
one will receive a lifesaving diagnosis and treatment.”</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;">
Family members are angry “ The Boston doctors said that chemo would save
his life,” or “The doctors at the Farber think this may be caused by an
obscure immunodeficiency.”</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;"> Once
upon a time, people died of old age. Now they die of IgG4 deficiency
syndrome.</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;">No one wins in these situations.</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;">Family members are angry about missed diagnoses, missed chances. “The
Boston doctors told us if he received treatment, he would be OK.”</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;"> To be
fair, my colleagues on Longwood Avenue usually don’t make these
bold statements. People hear what they want to hear, but this misses the point.</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;"> My
patients are dying because their time to die is nearing. We do our
patients a grave disservice by raging against inevitable mortality,
when we should be holding a parents’ hand, giving a loved one a
chance to talk about life in Russia or Poland or Hartford in the 1930s.</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;">I read in today’s Times that Insurance companies are
raising their rates. I cannot condone their behavior, this isn’t problem
in any other first world country. I suspect this is partially
because Europeans treat death not as an enemy, but as constant
companion who will eventually point to his watch and say, “Time’s up,
come with me.” Rates go up when we decide as a culture that a brain MRI
would be more therapeutic than soft classic music in an upstaird bedroom where
the lights are low and the air smells of lavender lotion. </span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;"> I am
troubled that we mask our fear of death by our insistence on
chasing medical miracles. Sometimes, we should concentrate on
alleviating uncomfortable symptoms, not seeking panaceas.
I talk to family members
about methods to control pain, reduce anxiety, improve
appetite, and treat insomnia. These conversations are sometimes perceived
as an admission of failure. Worse, my suggestion to
increase a morphine dose is perceived as my confessing that I am a quack.
If I were really smart, I would have devised an elegant scientific
plan to prolong a patients life. My attempts to alleviate pain would not
be considered a ham–fisted attempt to cover my tracks,
sending a misdiagnosed and mistreated loved one to the great beyond prematurely
in an opium tinted haze.</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;">Medicine is too slow to adapt to the obvious but unfamiliar
concept that physicians will eventually lose every battle against death.</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;"> We
once used the phrase “DNR” meaning “Do not resuscitate. ” This
concept carries a dangerous conceit that there exists a
procedure that will bring a patient back to life. DO NOT
resuscitate suggests a rejection of a life saving technique.</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;">We now use the phrase : Do not Attempt to resuscitate. This subtle
shift suggests there is no magical procedure to return our loved one from
the banks of the River Styx.</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;"> Death
is the new sex.</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;"> Once,
sex education wasn’t taught in schools. The concept of procreating
made us uncomfortable. We were afraid our children would become
obsessed, irrational, and lascivious if they learned about procreation
and contraception.</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;"> We
don’t teach death Ed classes, the concept sounds morbid, bizarre, Adams
family -esque.</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;"> The
analogy is apt, When the religious right preaches abstinence only
programs, in essence, denying human sexuality, the results is an uptick
of STDs and pregnancies.</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;"> </span><span style="font-family: Calibri; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 24.0pt;">Medical
schools teach of medicine's miraculous healing powers.
Hospice education reeks of failure. “Palliative care, eh?
What, you couldn’t figure out what the patient was dying of?’ Is
the inherent message.</span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;"> We
need to teach our medical students that every patient will eventually
die, will eventually fail to respond to any number of
expensive treatments and uncomfortable testing.</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;"> The
Roman gladiators were once pursued by a companion who would intone,
”Thou art mortal Thou art mortal” to remind the athletes
that his finely honed physique was not immune to sword and
sling shot, not to mention Dengue fever. I want every medical student to
be reminded daily “Your patients are mortal, every single one will
die.” Lenny Bruce once urged that we utter racial epithets
throughout the days., in this way he proposed, the hateful words would lose
their sting and therefore,</span><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none;">
<b><i><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;">you could never make</span></i></b><i><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;"> <b>some six</b>-<b>year</b>-<b>old black kid
cry because somebody called him</b> a ****** at <b>school</b>.</span></i><span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 16.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-family: Times; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Times; mso-bidi-font-size: 24.0pt;">Perhaps if we told every patient “You will die, you will
die, you will die.” the emotional wallop would fade and we could
concentrate on what is important: comforting the sick and accepting their
inevitable departure</span></div>
</div>
Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com0tag:blogger.com,1999:blog-3346982693192735867.post-89141681102063290672015-05-08T12:39:00.003-07:002015-05-08T12:39:56.704-07:00Semi Charmed Kind of LIfe
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<br />
<div class="MsoNormal" style="line-height: 200%;">
You looking for a new internist?</div>
<div class="MsoNormal" style="line-height: 200%;">
I am taking new patients into my
practice in Wethersfield, Connecticut.<span style="mso-spacerun: yes;">
</span>Really.<span style="mso-spacerun: yes;"> </span>Just call
860-696-2400 and ask for a new patient visit with Dr Weinreb. </div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>My
story?<span style="mso-spacerun: yes;"> </span>Let’s see…<span style="mso-spacerun: yes;"> </span>Cum Laude from Cornell, Graduate<span style="mso-spacerun: yes;"> </span>of SUNY upstate,<span style="mso-spacerun: yes;"> </span>residency at Michael Reese, an old<span style="mso-spacerun: yes;"> </span>University of Chicago teaching
hospital<span style="mso-spacerun: yes;"> </span>I<span style="mso-spacerun: yes;"> </span>finished my Heme Onc<span style="mso-spacerun: yes;"> </span>fellowship <span style="mso-spacerun: yes;"> </span>at U Conn in 1993. <span style="mso-spacerun: yes;"> </span>I won a <span style="mso-spacerun: yes;"> </span>50,000
dollar cancer research grant in 1994. My<span style="mso-spacerun: yes;">
</span>1998 paper<span style="mso-spacerun: yes;"> </span>(1) is regarded
as a seminal work in the then nascent and not-at-all-ironic field of allogeneic
stem cell transplantation.</div>
<div class="MsoNormal" style="line-height: 200%;">
And then I contracted CLL and
everything when to shit.<span style="mso-spacerun: yes;"> </span>Excuse
me.<span style="mso-spacerun: yes;"> </span>Feces. </div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>One
factor you need to know: Please don’t ask me<span style="mso-spacerun: yes;"> </span>to refill your narcotics prescriptions.<span style="mso-spacerun: yes;"> </span>Too close to home for me.</div>
<div class="MsoNormal" style="line-height: 200%;">
I know about addiction.<span style="mso-spacerun: yes;"> </span>I know about pain. <span style="mso-spacerun: yes;"> </span>I know about narcotics withdrawal </div>
<div class="MsoNormal" style="line-height: 200%;">
My experiences have given me
unsettled sympathy for those of you who<span style="mso-spacerun: yes;">
</span>haunt the internet, hoping the Philippines web site will<span style="mso-spacerun: yes;"> </span>send you<span style="mso-spacerun: yes;"> </span>Dilaudid. I understand those of<span style="mso-spacerun: yes;"> </span>you who<span style="mso-spacerun: yes;"> </span>appear
at Emergency Rooms at odd hours,<span style="mso-spacerun: yes;">
</span>apologizing to the sleepy<span style="mso-spacerun: yes;">
</span>ER doc that you<span style="mso-spacerun: yes;"> </span>forgot you
pills,<span style="mso-spacerun: yes;"> </span>please be a dear and refill
my<span style="mso-spacerun: yes;"> </span>Vicoden <span style="mso-spacerun: yes;"> </span>I need<span style="mso-spacerun: yes;"> </span>just a few… I won’t bother you again. </div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
Doctor, please</div>
<div class="MsoNormal" style="line-height: 200%;">
Some More of These</div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
It wasn’t long ago<span style="mso-spacerun: yes;"> </span>I lay on our<span style="mso-spacerun: yes;"> </span>cool, soothing bathroom <span style="mso-spacerun: yes;"> </span>tiles , sobbing<span style="mso-spacerun: yes;">
</span>because a<span style="mso-spacerun: yes;"> </span>diamond -tipped
drill bit<span style="mso-spacerun: yes;"> </span>was shredding<span style="mso-spacerun: yes;"> </span>the inside of my mouth. <span style="mso-spacerun: yes;"> </span>I wasn’t working, I was too debilitated
to get dressed.<span style="mso-spacerun: yes;"> </span>I found perverted
salvation in<span style="mso-spacerun: yes;"> </span>Morphine sulfate,
which<span style="mso-spacerun: yes;"> </span>allowed me to sleep at
night . I took prednisone and tincture of time. Eventually the<span style="mso-spacerun: yes;"> </span>GVHD, the name given my<span style="mso-spacerun: yes;"> </span>diamond-tipped demons, retreated.<span style="mso-spacerun: yes;"> </span>At some point I decided it was time
to stop the narcotics. I tapered the Morphine down low and <span style="mso-spacerun: yes;"> </span>went cold turkey, as the<span style="mso-spacerun: yes;"> </span>kids and junkies say.</div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-spacerun: yes;"> </span>This was a mistake.</div>
<div class="MsoNormal" style="line-height: 200%;">
How can I describe narcotics
withdrawal to you?<span style="mso-spacerun: yes;"> </span>Describe
orgasm to a 5 year old. I think of the tongue- tied Apollo astronauts
struggling to describe the lunar surface . <span style="mso-spacerun: yes;"> </span>“A dirty beach” was what they came up with.</div>
<div class="MsoNormal" style="line-height: 200%;">
Let me try. </div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>Think
of the worst day imaginable. Think of your parents dying in pain, your spouse departing
for the embrace of another. Think bankruptcy.<span style="mso-spacerun: yes;"> </span>Now, subtract from this any fledging feeling of hope
lingering in your heart.<span style="mso-spacerun: yes;"> </span>Erase any
thought that life might get better, ignore<span style="mso-spacerun: yes;"> </span>the faint voice of self- preservation.<span style="mso-spacerun: yes;"> </span>Believe in your heart that your parents
will die every day, that bankruptcy will become a quotidian<span style="mso-spacerun: yes;"> </span>occurrence,. Now, at the same time,
imagine the worst flu of your life,<span style="mso-spacerun: yes;">
</span>the sort where <span style="mso-spacerun: yes;"> </span>Russian Babushkas<span style="mso-spacerun: yes;">
</span><span style="mso-spacerun: yes;"> </span>beat your body<span style="mso-spacerun: yes;"> </span>with<span style="mso-spacerun: yes;"> </span>brooms made of<span style="mso-spacerun: yes;">
</span>ash wood branches </div>
<div class="MsoNormal" style="line-height: 200%;">
I was smugly told in medical school,<span style="mso-spacerun: yes;"> </span>“don’t worry. No one every dies
of narcotics withdrawal,” <span style="mso-spacerun: yes;"> </span>as if
that was its saving grace. The benefit of withdrawal’s <span style="mso-spacerun: yes;"> </span>exquisite <span style="mso-spacerun: yes;"> </span>agony is that one is too debilitated to buy a knife, climb a
cliff or<span style="mso-spacerun: yes;"> </span>fly an airplane into a mountain.
</div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
This exorcism continued for three
weeks.<span style="mso-spacerun: yes;"> </span>Finally, the spell was
broken.</div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>Sometimes
I think every healer, every doctor, nurse, pharmacist be required to<span style="mso-spacerun: yes;"> </span>undergo<span style="mso-spacerun: yes;"> </span>opiate withdrawal before receiving licensure.<span style="mso-spacerun: yes;"> </span>They would understand that<span style="mso-spacerun: yes;"> </span>withdrawal<span style="mso-spacerun: yes;"> </span>is a unique<span style="mso-spacerun: yes;"> </span>circle
<span style="mso-spacerun: yes;"> </span>of hell that can’t be described,
only experienced.</div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-spacerun: yes;"> </span>I understand why people become junkies, why they refuse to
quit , why they spend their lives taking methadone.<span style="mso-spacerun: yes;"> </span>I <span style="mso-spacerun: yes;"> </span>understand the unique terror of withdrawal</div>
<div class="MsoNormal" style="line-height: 200%;">
<i style="mso-bidi-font-style: normal;"><u>Third
Eye Blind</u></i> got it right in the lyrics of <i style="mso-bidi-font-style: normal;">Semi charmed kind of life</i>, when they described meth addiction:</div>
<div class="MsoNormal">
<i style="mso-bidi-font-style: normal;">And you hold me, and
we're broken<o:p></o:p></i></div>
<div class="MsoNormal">
<i style="mso-bidi-font-style: normal;">Still it's all that I
wanna do, just a little now<o:p></o:p></i></div>
<div class="MsoNormal">
<i style="mso-bidi-font-style: normal;">Feel myself, heading
off the ground<o:p></o:p></i></div>
<div class="MsoNormal">
<i style="mso-bidi-font-style: normal;">I'm scared, I'm not
coming down<o:p></o:p></i></div>
<div class="MsoNormal">
<i style="mso-bidi-font-style: normal;">No, no<o:p></o:p></i></div>
<div class="MsoNormal">
<i style="mso-bidi-font-style: normal;">And I won't run for my
life<o:p></o:p></i></div>
<div class="MsoNormal">
<i style="mso-bidi-font-style: normal;">She's got her jaws
now, locked down in a smile<o:p></o:p></i></div>
<div class="MsoNormal">
<i style="mso-bidi-font-style: normal;">But nothing is
alright, alright<o:p></o:p></i></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
( the<span style="mso-spacerun: yes;"> </span>reference to<span style="mso-spacerun: yes;"> </span>a
“jaw locked down in a smile” : Meth addicts lose their teeth, but persist
taking the drugs. Shudder) </div>
<div class="MsoNormal" style="line-height: 200%;">
So what do I do?<span style="mso-spacerun: yes;"> </span></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
For one. I tried to avoid talking
new patients into my practice. </div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>I have to take new patients. It’s the rule.
Actually, I don’t have to accept new patients.<span style="mso-spacerun: yes;"> </span>The medical group has an exemption for those with ” chronic medical
conditions.”<span style="mso-spacerun: yes;"> </span>Even the
disease CLL holds the word “ chronic” in it. </div>
<div class="MsoNormal" style="line-height: 200%;">
So, give me a break .Let me keep my
panel closed. Let me minister to patients I already know.</div>
<div class="MsoNormal" style="line-height: 200%;">
I have to open my panel.<span style="mso-spacerun: yes;"> </span>I don’t want to be that guy.</div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
I don’t want to be the one-winged <span style="mso-spacerun: yes;"> </span>gull , the<span style="mso-spacerun: yes;"> </span>three legged cat, the <span style="mso-spacerun: yes;"> </span>impaired physician.<span style="mso-spacerun: yes;">
</span>I want <span style="mso-spacerun: yes;"> </span>to set an example: <span style="mso-spacerun: yes;"> </span>Cancer is not an exemption.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>I laugh when patients ask for jury duty exemption. <span style="mso-spacerun: yes;"> </span>“Doc, I have high blood pressure, and
diabetes and I can’t sit in a jury. ’ I want to chuckle. <span style="mso-spacerun: yes;"> </span>“ I’d <span style="mso-spacerun: yes;"> </span>kill for only having high pressure and sugar. I have those minor
issues and I’m dealing with cancer too . No exemption for you!”</div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>Some
of the more observant of you might ask ,”isn’t your wife a big mucky muck in the
organization?”</div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-spacerun: yes;"> </span>To you I say, “ Yes.” Cyn is VP of primary care.<span style="mso-spacerun: yes;"> </span>She said that they (read: She) inserted
the chronic illness exemption with me in mind.</div>
<div class="MsoNormal" style="line-height: 200%;">
Great. Now I really have to see new
patients.<span style="mso-spacerun: yes;"> </span>To decline would just
prove that nepotism runs <span style="mso-spacerun: yes;"> </span>Hartford healthcare.
It would prove to my colleagues that,<span style="mso-spacerun: yes;">
</span>“love means never having to see addicted patients.” </div>
<div class="MsoNormal" style="line-height: 200%;">
In any event, she’s my boss’s boss.
Her job is to<span style="mso-spacerun: yes;"> </span>steer the medical
group, not indulge the whining of some doc just because<span style="mso-spacerun: yes;"> </span>he shared a surgical elective with you
in medical school .</div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>When
I was lying on the bathroom floor, tears running down my cheeks, I had to make
a decision . <span style="mso-spacerun: yes;"> </span>Live or Die.<span style="mso-spacerun: yes;"> </span>Go on or retreat.<span style="mso-spacerun: yes;"> </span>Retire or return to work.<span style="mso-spacerun: yes;"> </span>Retirement feels like death to me,
dying would<span style="mso-spacerun: yes;"> </span>make an bunch of
people<span style="mso-spacerun: yes;"> </span>unhappy, Death world<span style="mso-spacerun: yes;"> </span>bring suffering to my patients,
who<span style="mso-spacerun: yes;"> </span>pray for me and <span style="mso-spacerun: yes;"> </span>think of me as family.<span style="mso-spacerun: yes;"> </span>What will I<span style="mso-spacerun: yes;"> </span>tell X ?<span style="mso-spacerun: yes;"> </span>“I’m giving
up because of my cancer, but you should fight on anyway?”<span style="mso-spacerun: yes;"> </span>What sort of example would that set?</div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
Fine, My panel is open, I will see
new patients,.<span style="mso-spacerun: yes;"> </span>Some will beg me
for Percocet, for Adderall, <span style="mso-spacerun: yes;"> </span>Xanax.
They will make my life miserable.<span style="mso-spacerun: yes;">
</span></div>
<div class="MsoNormal" style="line-height: 200%;">
On the other hand, some will become
new family. We will start strolling<span style="mso-spacerun: yes;">
</span>through<span style="mso-spacerun: yes;"> </span>life together.<span style="mso-spacerun: yes;"> </span>Maybe it’s worth the risk to re
engage with strangers, even if they bring narcotics with them.<span style="mso-spacerun: yes;"> </span>Been there.<span style="mso-spacerun: yes;"> </span>Done that. </div>
<div class="MsoNormal">
<br /></div>
<!--EndFragment-->Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com0tag:blogger.com,1999:blog-3346982693192735867.post-13725870379219620482015-04-27T06:48:00.002-07:002015-04-27T07:04:28.837-07:00lungs<div class="Body" style="line-height: 200%;">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://2.bp.blogspot.com/-Wt6EBs7zwq8/VT5Ab-RQBdI/AAAAAAAAAJE/k8Lbew_bKL4/s1600/lungs.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-Wt6EBs7zwq8/VT5Ab-RQBdI/AAAAAAAAAJE/k8Lbew_bKL4/s1600/lungs.png" /></a></div>
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">My
lungs are trashed.<span style="mso-spacerun: yes;"> </span>Sam sounds
upset. I ran my PFTs, my pulmonary function tests, this week. The young tech
asks, " you want a copy? </span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;">"</span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span></span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span></span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">"</span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;">Sure</span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">, " </span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;">I say, immediately regretting my decision. I study the
results. </span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">I have </span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>the lungs of a</span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">n 80 </span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;">year old, and not </span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">a</span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;"> young </span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">80,
either.</span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;"> Shit. </span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>I<span style="mso-spacerun: yes;"> </span>am<span style="mso-spacerun: yes;"> </span>missing a part of my right lung, which
now sits in formalin in Hartford hospital, but that doesn't explain my<span style="mso-spacerun: yes;"> </span>appallingly low DLCO.<span style="mso-spacerun: yes;"> </span>When we</span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;"> are born, our lungs are sparkling clear </span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">membranes </span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>of </span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">Saran </span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;">wrap. As we age</span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">, </span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>the membranes thicken and<span style="mso-spacerun: yes;"> </span>scar. This effect is measured in<span style="mso-spacerun: yes;"> </span>a dlco, a measurement of how </span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">permeable our lungs are </span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>to oxygen</span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">.</span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>My </span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">DLCO </span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;">is 60%. </span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>My body is
struggling to pull oxygen out of the air. <o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">I
rationalize.<span style="mso-spacerun: yes;"> </span>I am anemic.
Anemia messes with the result, but<span style="mso-spacerun: yes;">
</span>even I know<span style="mso-spacerun: yes;"> </span>this is bad.<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<br /></div>
<div class="Body" style="line-height: 200%;">
<span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>I'm
getting ahead of myself. I really like Sam. He's my</span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;"> pulmonologist </span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;">. My go</span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">-</span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;"> to lung guy.<span style="mso-spacerun: yes;"> </span>He's smar</span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">t, </span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>smarter than I. </span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">He</span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;"> realized the suddenly appearance of a clotting
disorder in my blood reflected my donors</span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">'</span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;">
disease, not mine. Smart guy. <span style="mso-spacerun: yes;"> </span>A
year after my transplant, I developed shortness </span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">o</span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;">f
breath, che</span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">st</span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;"> pain and a swollen<span style="mso-spacerun: yes;"> </span>leg.<span style="mso-spacerun: yes;"> </span>In hindsight, the diagnosis was stupidly obvious, a life
threatening blood clot in my leg that had lodged in </span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">m</span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;">y
lung. I called Sam and told him I was having<span style="mso-spacerun: yes;"> </span>a reaction to my antibiotics</span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">. </span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span></span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">He</span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;"> agreed and changed my medication. I struggled all
week,<span style="mso-spacerun: yes;"> </span>skiing on vacation and all
the while feeling knifes at my chest and swelling in my right leg. I eventually
crashed</span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">.<span style="mso-spacerun: yes;"> </span>A stat CT </span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;">told
me what I should have known,<span style="mso-spacerun: yes;"> </span></span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">I walk </span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;">the earth these days </span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">through </span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>blind luck</span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">.<span style="mso-spacerun: yes;"> </span></span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>I </span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">was rushed to </span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>surgery</span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">, </span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>a septic embolus festering in my lung. </span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;"><o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;">Doctors who treat themselves have a fool for a
patient. Sam has always felt bad about </span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">my near death experience.<span style="mso-spacerun: yes;"> </span>I </span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;">am
embarrassed</span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">, </span><span style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt;">of course, I blame myself for
calling Sam and spinning a story to make "antibiotic reaction" a
plausible<span style="mso-spacerun: yes;"> </span>diagnosis. Sam should
have said " get to an ER ASAP</span><span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">..
You're an idiot."<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<br /></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">But
he didn't.<span style="mso-spacerun: yes;"> </span>I lived because others
didn't want me to die.<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">I
lived because athletes don't die, despite themselves.<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">I
texted Sam with my PFT results.<span style="mso-spacerun: yes;">
</span>"They're<span style="mso-spacerun: yes;"> </span>bad " I<span style="mso-spacerun: yes;"> </span>wrote, "but I am
anemic."<span style="mso-spacerun: yes;"> </span>Idiot. Spinning
another excuse.<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">Sam
called back...."I don't want you to panic, " he begins.<span style="mso-spacerun: yes;"> </span>"I think it's probably GVHD. I
don't think we need to do anything. Why the hell did you get pfts? Are you
sick?"<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">No.
Not sick. I blog from the hotel Northampton, 50 miles by bike from west
Hartford. Tomorrow we'll bike home. A century weekend, 100 miles on bike. Numb
butt and ulnar neuropathy my constant companions.<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">This
begs the question. Why get tested? It raises a key medical fact that escapes
those not in medicine.. Never get a test if you won't act on the results. My
son wanted to test<span style="mso-spacerun: yes;"> </span>his
chromosomes. He wants to know his risk for heart disease.<span style="mso-spacerun: yes;"> </span>"What would you do if you
tested positive? " I ask. " I'd exercise and eat right,<span style="mso-spacerun: yes;"> " </span>Jeff<span style="mso-spacerun: yes;"> </span>replies. "You need a 1000 dollar test to tell you to
eat better?"<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">So,
why get PFTs?<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">Because
I am taking pain medications, that's why.<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">When
the GVHD flared in January, my mouth was filled with broken glass. I needed<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>steroids and pain meds to control the
misery.<span style="mso-spacerun: yes;"> </span>Now I'm better. I'm
almost off the steroids, almost<span style="mso-spacerun: yes;">
</span>off the pain meds. The last time saw my oncologist , he admonished me to
stop the pain meds.<span style="mso-spacerun: yes;"> </span>This is tough.
Very tough. I did this last year and the resulting withdrawal was among<span style="mso-spacerun: yes;"> </span>the worst episodes of my private war on
cancer. I need to stop, but I need to take my time.<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">In my
disturbed state, I decided<span style="mso-spacerun: yes;"> </span>the
best way to obtain another month of pain medication was to be an ideal
patient.<span style="mso-spacerun: yes;"> </span>Read<span style="mso-spacerun: yes;"> </span>"co operative. " Read
"passive" ok, Ted, I thought, I'll be a good boy and get my PFTs,<span style="mso-spacerun: yes;"> </span>and you'll renew my pain medication for
another month.<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<br /></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>This is crazy, I know.<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<br /></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">It's
what pain medications do, they make us irrational.<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<br /></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">I
could have said "Ted, if my PFTs are abnormal, what are we going to
do?" It's a important point. What would/do I do?<span style="mso-spacerun: yes;"> </span>Lung transplant. Great. I'm fighting GVHD now. Lung
transplantation requires a lifetime of immunosuppressives.<span style="mso-spacerun: yes;"> </span>The better question<span style="mso-spacerun: yes;"> </span>would have been "are<span style="mso-spacerun: yes;"> </span>you having symptoms of lung disease?
" If not, then I don't need testing.<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">Sam
is apologetic.<span style="mso-spacerun: yes;"> </span>"Don't worry,
it will be ok.<span style="mso-spacerun: yes;"> </span>Please don't obsess
over this" he knows Cyn and me too well.<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<br /></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">I
laugh " it's a bit late to obsess,Sam. This isn't my first rodeo."<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">Cyn
and I biked to Northampton last fall. I repeatedly fell off my bike, weakened
by steroids and disease. I lay on the ground every 10 miles, heart racing,
lungs pounding.<span style="mso-spacerun: yes;"> </span>This trip is
joyfully<span style="mso-spacerun: yes;"> </span>uneventful. We're having
a lovely time. We had dinner with friends<span style="mso-spacerun: yes;">
</span>and attended a concert. Breathing is easy. Easier.<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">I
stare into a hotel room mirror. My face is almost back to normal, I no longer
have the steroid induced moon face.<span style="mso-spacerun: yes;">
</span>I'm a little gaunt now, and in that gauntness I see the 80<span style="mso-spacerun: yes;"> </span>year old I was certain<span style="mso-spacerun: yes;"> </span>I'd never be.<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">My
lungs seem functional, they drove me 50 miles today with nary a gasp or wheeze.<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">Out
of sight, out of mind. I remember an old<span style="mso-spacerun: yes;">
</span>translation program. We'd enter<span style="mso-spacerun: yes;">
</span>a phrase in English, then translate it into Spanish, then back to
English.<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<br /></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">Once
I typed in "out of sight, out of mind"<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">The
twice translated phrase came back<o:p></o:p></span></div>
<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">"Invisible
lunatic" <o:p></o:p></span></div>
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<div class="Body" style="line-height: 200%;">
<span lang="EN-CA" style="font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 11.0pt;">That
sums<span style="mso-spacerun: yes;"> </span>up medical<span style="mso-spacerun: yes;"> </span>testing. Following changes that have no
remedies,<span style="mso-spacerun: yes;"> </span>running tests for
troubling but untreatable<span style="mso-spacerun: yes;"> </span>medical
problems, makes one crazy.<span style="mso-spacerun: yes;">
</span>Ignoring obvious symptoms that warn of impending doom is lunacy. It's
OK Sam, it's my fault, not yours.'<br style="mso-special-character: line-break;" />
<!--[if !supportLineBreakNewLine]--><br style="mso-special-character: line-break;" />
<!--[endif]--><o:p></o:p></span></div>
Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com0tag:blogger.com,1999:blog-3346982693192735867.post-70371788891985772232015-02-08T20:22:00.002-08:002015-02-08T20:57:14.673-08:00Michele’s Hat<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;">I
toss awake in the depths of the night, alone in an unfamiliar bed. I stumble to
the window and contemplate the landscape from 25 stories.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;"><span style="mso-tab-count: 1;"> </span>The
streets are deserted. A snowstorm swirls outside. The buildings, awash in artificial light, glow softly. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;"><span style="mso-tab-count: 1;"> </span>Ir
Bageshem. A Naomi Shemer song lyric comes to mind. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;"><span style="mso-tab-count: 1;"> </span>City
in the rain. Jerusalem buildings are constructed of limestone, and emit a soft,
pink glow when the rainy reason begins. The stone emits the same glow that now
wraps Bean town. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;"><span style="mso-tab-count: 1;"> </span>I
have been trying to heal.<span style="mso-spacerun: yes;"> </span>I am in
Boston to undergo another round of photophoresis, the voodoo process that fools
my T cells into believing they are at home, <span style="mso-spacerun: yes;"> </span>not in an alien host that needs to be destroyed.<span style="mso-spacerun: yes;"> </span>I am the host here.<span style="mso-spacerun: yes;"> </span>No guest should ever treat their host
this way. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;"><span style="mso-tab-count: 1;"> </span>Cancer.
The death of a thousand duck bites.<span style="mso-spacerun: yes;">
</span>“What’s wrong?” friends ask.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;"><span style="mso-tab-count: 1;"> </span>“You’re
getting better.<span style="mso-spacerun: yes;"> </span>You have more energy.
Cheer up,” they say, “Life is worth living.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;"><span style="mso-tab-count: 1;"> </span>Perhaps.<span style="mso-spacerun: yes;"> </span>But refresh my memory. Why? <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;"><span style="mso-tab-count: 1;"> </span>I
think of <span style="mso-spacerun: yes;"> </span>Ethan Hawke from<span style="mso-spacerun: yes;"> </span></span><i style="mso-bidi-font-style: normal;"><span style="color: #262626; font-family: "Times New Roman Italic"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;">Reality bites<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;">“There's
no point to any of this. It's all just a<span style="mso-spacerun: yes;">
</span>random lottery of meaningless tragedy and a series of near escapes. So I
take pleasure in the details. A Quarter-Pounder with cheese, those are good,
the sky about ten minutes before it starts to rain, the moment where your laughter
become a cackle... and I, I sit back and I smoke my Camel Straights and I ride
my own melt.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #131313; font-family: "Times New Roman"; font-size: 14.0pt; line-height: 150%; mso-bidi-font-family: Georgia;">And
then there’s Woody Allen:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;">Why is life worth living? It's a very good question….. Those
incredible Apples and Pears by Cezanne...the crabs at Sam Wo's... Tracy's
face...<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;">I wince at the thought.<span style="mso-spacerun: yes;">
</span>The reason to live : food and pedophilia.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;">I live because others want me to live.<span style="mso-spacerun: yes;"> </span>My death would bring unhappiness to many…well, to several,
anyway. More to the point, I’ve come to view suicide as the ultimately selfish
act. Taking one’s life leaves a hole in the lives of so many others.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>I haven’t thought of self-destruction in
a while.<span style="mso-spacerun: yes;"> </span>I take this to be a good
sign.<span style="mso-spacerun: yes;"> </span>Still, I have a long way to
go. Let’s go back<span style="mso-spacerun: yes;"> </span>to Woody
Allen.<span style="mso-spacerun: yes;"> </span>I don’t care about his icky
past.<span style="mso-spacerun: yes;"> </span>The man gave us Annie Hall.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;"><span style="mso-tab-count: 1;"> </span>“Why
is life worth living? It's a very good question. There are certain things I
guess that make it worthwhile. For me, I would say... the 2nd movement of the
Jupiter Symphony... and Louis Armstrong’s recording of Potato Head Blues. Swedish
movies, naturally. Sentimental Education by Flaubert Marlon Brando, Frank
Sinatra.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;"><span style="mso-tab-count: 1;"> </span>Frank
Sinatra? Wasn’t he married to Mia Farrow, Woody’s girlfriend who adopted Soon-Yi,
Woody’s current wife? <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;"><span style="mso-tab-count: 1;"> </span>Woody’s
monologue credits art as a reason to live.<span style="mso-spacerun: yes;"> </span>This brings me to the point of this piece: The healing power
of art.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;"><span style="mso-tab-count: 1;"> </span>I<span style="mso-spacerun: yes;"> </span>have a membership to the Boston Museum
of Fine Arts, about a quarter mile from the Farber.<span style="mso-spacerun: yes;"> </span>After a long day of therapy, I stroll to the MFA and wander<span style="mso-spacerun: yes;"> </span>the galleries.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>A famous Childe Hassam painting hangs
there.<span style="mso-spacerun: yes;"> </span>Children feed<span style="mso-spacerun: yes;"> </span>pigeons<span style="mso-spacerun: yes;"> </span>off the Commons. It’s winter in the late 19<sup>th</sup>
century <span style="mso-spacerun: yes;"> </span>and the<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>Boston sky holds the same pink light <span style="mso-spacerun: yes;"> </span>that shines<span style="mso-spacerun: yes;"> </span>softly at three AM<span style="mso-spacerun: yes;">
</span>three miles from the site of that famous paining. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;"><br /></span></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="http://2.bp.blogspot.com/-N-M1yXg6AJ0/VNg1ia9X6pI/AAAAAAAAAIM/8L1Gxrvd_X4/s1600/snow.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-N-M1yXg6AJ0/VNg1ia9X6pI/AAAAAAAAAIM/8L1Gxrvd_X4/s1600/snow.jpg" height="224" width="320" /></a></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;"><br /></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;"><span style="mso-tab-count: 1;"> </span>The painting is soothing, familiar. <span style="mso-spacerun: yes;"> </span>The same snow, the same light. The same Commons, the children
walk down Boylston street, then clogged with trolleys before the green line was
built to carry commuters <span style="mso-spacerun: yes;"> </span>beneath
the Commons. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>Art can be comforting. I find<span style="mso-spacerun: yes;"> </span>familiar details in art that echo in <span style="mso-spacerun: yes;"> </span>our own lives.<span style="mso-spacerun: yes;"> </span>I<span style="mso-spacerun: yes;"> </span>cringe, thinking
of <span style="mso-spacerun: yes;"> </span>the late Robin Williams<span style="mso-spacerun: yes;"> </span>from <span style="mso-spacerun: yes;"> </span></span><i style="mso-bidi-font-style: normal;"><span style="color: #262626; font-family: "Times New Roman Italic"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;">Dead Poet’s society.</span></i><span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;"> <o:p></o:p></span></div>
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<br /></div>
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<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="mso-tab-count: 1;"> </span>“We
read and write poetry because we are members of the human race. And the human
race is filled with passion poetry, beauty, romance, love, these are what we
stay alive for. You are here , the powerful play goes on and you may contribute
a verse. What will your verse be?”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Arial;">This is my verse.<span style="mso-spacerun: yes;">
</span>Michele’s verse is her medical skill, of course, but also, her art.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Arial;">We were residents at<span style="mso-spacerun: yes;">
</span>Chicago’s Michael Reese Hospital. <span style="mso-spacerun: yes;"> </span>Another time, another city. <span style="mso-spacerun: yes;"> </span>She is a physician and a quilter.<span style="mso-spacerun: yes;"> </span>She and her family<span style="mso-spacerun: yes;">
</span>have given me untold<span style="mso-spacerun: yes;">
</span>comfort and support <span style="mso-spacerun: yes;"> </span>during
these queasy,<span style="mso-spacerun: yes;"> </span>neoplastic times. A
few years ago, she <span style="mso-spacerun: yes;"> </span>made me a felt
ski cap, a<span style="mso-spacerun: yes;"> </span>piebald Jesters’ hat to
wear<span style="mso-spacerun: yes;"> </span>when the chemo<span style="mso-spacerun: yes;"> </span>further attenuated my already<span style="mso-spacerun: yes;"> </span>thinning hair. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="mso-tab-count: 1;"> </span>It<span style="mso-spacerun: yes;"> </span>always brought me joy.<span style="mso-spacerun: yes;"> </span>It was a symbol:<span style="mso-spacerun: yes;"> </span>Even <span style="mso-spacerun: yes;"> </span>in the bleakest moments, <span style="mso-spacerun: yes;"> </span>life<span style="mso-spacerun: yes;"> </span>holds<span style="mso-spacerun: yes;"> </span>color, comfort and love.<span style="mso-spacerun: yes;"> </span>It served as a<span style="mso-spacerun: yes;"> </span>handy link to the un cancered
world.<span style="mso-spacerun: yes;"> </span>When I felt like talking
about the Big C and Me, I could tell<span style="mso-spacerun: yes;">
</span>curious strangers that this was my chemo cap, and that would<span style="mso-spacerun: yes;"> </span>lead to long conversations about the precarious
nature of life. <span style="mso-spacerun: yes;"> </span>Last month, we
were attending a Broadway play, and a theater worker announced, over a bullhorn
“ All of you may enter, <span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>except for that guy with the red ,yellow
and blue hat. I want to talk to him.” This sort of stuff happened daily when I
wore the hat. I must say, I didn’t mind the attention.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Arial;"><br /></span></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="http://4.bp.blogspot.com/-gxTD0aH-hOU/VNg2Bx40IKI/AAAAAAAAAIU/kUL2tQfKn8c/s1600/My%2Bnew%2Bhat.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/-gxTD0aH-hOU/VNg2Bx40IKI/AAAAAAAAAIU/kUL2tQfKn8c/s1600/My%2Bnew%2Bhat.jpg" height="320" width="317" /></a></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Arial;"><br /></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="mso-tab-count: 1;"> </span>The
hat<span style="mso-spacerun: yes;"> </span>is art in its most basic form:
Beautiful.<span style="mso-spacerun: yes;"> </span>Comforting. familiar.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="mso-tab-count: 1;"> </span>And
now, it’s gone,<span style="mso-spacerun: yes;"> </span>taken from <span style="mso-spacerun: yes;"> </span>a <span style="mso-spacerun: yes;"> </span>restaurant coat rack. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="mso-tab-count: 1;"> </span>I
was heartbroken.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="mso-tab-count: 1;"> </span>I
have tried to buy a similar hat. They don’t exist.<span style="mso-spacerun: yes;"> </span>I shopped for one in Boson where<span style="mso-spacerun: yes;"> </span>all<span style="mso-spacerun: yes;"> </span>hats must
bear<span style="mso-spacerun: yes;"> </span>GO BOSOX or HARVARD. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>Michele is working<span style="mso-spacerun: yes;"> </span>on a new cap. I will wear it<span style="mso-spacerun: yes;"> </span>daily, I will sleep with<span style="mso-spacerun: yes;"> </span>it, my<span style="mso-spacerun: yes;"> </span>Linus blanket.<span style="mso-spacerun: yes;">
</span>We have second chances in life, whether through haberdashery or
Chemotherapy.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="mso-tab-count: 1;"> </span>I
stare out the window.<span style="mso-spacerun: yes;"> </span>CNN is on.
The snowstorm drives the<span style="mso-spacerun: yes;"> </span>Boston
News cycle. The governor has declared a snowpocalypse. <span style="mso-spacerun: yes;"> </span>What if they close the blood bank, where
I undergo my treatments?<span style="mso-spacerun: yes;"> </span>I’ll stay<span style="mso-spacerun: yes;"> </span>here another day for therapy. There
will be chaos , confusion and concern, but, for <span style="mso-spacerun: yes;"> </span>now, all that exists is a city of<span style="mso-spacerun: yes;"> </span>snow. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Arial;">Retuning to Woody Allen:</span><span style="color: #262626; font-family: "Times New Roman"; font-size: 13.0pt; line-height: 150%; mso-bidi-font-family: Verdana;"> </span><span style="color: #131313; font-family: "Times New Roman"; font-size: 14.0pt; line-height: 150%; mso-bidi-font-family: Georgia;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #131313; font-family: "Times New Roman"; font-size: 14.0pt; line-height: 150%; mso-bidi-font-family: Georgia;"><span style="mso-spacerun: yes;"> </span>“I like the rain. It washes memories
off the sidewalk of life.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #131313; font-family: "Times New Roman"; font-size: 14.0pt; line-height: 150%; mso-bidi-font-family: Georgia;">I
like the snow,<span style="mso-spacerun: yes;"> </span>it’s a window to
the past, to art, to other cities.<span style="mso-spacerun: yes;">
</span>Best of all, <span style="mso-spacerun: yes;"> </span>it will give
me opportunities to wear my new hat. <span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="color: #131313; font-family: "Times New Roman"; font-size: 14.0pt; line-height: 150%; mso-bidi-font-family: Georgia;">I think of the<span style="mso-spacerun: yes;"> </span>Naomi
Shemer song:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: "Times New Roman Italic"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Arial;">ir bageshem sachah lanu kachah - hachaim yafim
kedai lachem lichyot!<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Arial;">--A city in the rain
speaks to us. Life is beautiful, it’s worthwhile to live.<o:p></o:p></span></div>
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<div class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-family: "Times New Roman"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="mso-tab-count: 1;"> </span>Shit.
I haven’t had an optimistic thought in months. The treatment<span style="mso-spacerun: yes;"> </span>must be working. <span style="mso-spacerun: yes;"> </span>Maybe it’s the hat<span style="color: #be08c1;">. </span>Thanks, Michele.<span style="color: #be08c1;"> </span></span></div>
Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com2tag:blogger.com,1999:blog-3346982693192735867.post-84582828435406605622015-01-19T17:11:00.002-08:002015-01-20T04:23:08.879-08:00Let there Be light <div class="MsoNormal" style="line-height: 200%;">
Let there be light.</div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>Week
three of photophoresis starts tomorrow.<span style="mso-spacerun: yes;">
</span>I drive to Boston, sit in the comfy chair, take a deep breath and suspend
my power of disbelieve for three hours.<span style="mso-spacerun: yes;">
</span>No one knows how this procedure works, but the data are encouraging : 80%
of those thus treated <span style="mso-spacerun: yes;"> </span>markedly <span style="mso-spacerun: yes;"> </span>reduce their<span style="mso-spacerun: yes;"> </span>prednisone dose.<span style="mso-spacerun: yes;">
</span><span style="mso-spacerun: yes;"> </span>It must work: Aetna is
willing to pay $4000 a treatment.<span style="mso-spacerun: yes;">
</span>I am eager to reduce my steroid dose as I battle<span style="mso-spacerun: yes;"> </span>skyrocketing blood sugars and
dissolving bones. The process doesn’t kill or directly affect all my T cells causing
havoc. This suggests the<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>treated T cells secrete cytokines that
instruct the other rogue white cells to lay off the GVHD. </div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>My
willingness to undergo this uncomfortable procedure requires a leap of faith,
the acceptance that I will improve, undergoing a procedure that requires<span style="mso-spacerun: yes;"> </span>two days a week and leaves my<span style="mso-spacerun: yes;"> </span>swollen, sore arms with<span style="mso-spacerun: yes;"> </span>livid marks where the IV is placed.</div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>Light
therapy has me thinking of faith, and faith and light reminds of<span style="mso-spacerun: yes;"> </span>religion.</div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>And let there be light. And God saw the
light and saw it was good. And then Aetna contested the charges because, after
all, there exists three constants in the universe:<span style="mso-spacerun: yes;"> </span>Death, Taxes and insurance refusal notices. </div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>Atheists
amuse me.<span style="mso-spacerun: yes;"> </span>They are certain of one
fact: There is no God. They are people of pure science and can’t believe
anything that can’t be explained through logic and observation.<span style="mso-spacerun: yes;"> </span>I suspect it’s not God they
reject, they reject the notion of <span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>a benign, bearded
Santa Claus on high, lurking amidst the clouds.<span style="mso-spacerun: yes;"> </span>They don’t believe in the kindergartener’s version of<span style="mso-spacerun: yes;"> </span>the Deity,<span style="mso-spacerun: yes;"> </span>an all knowing being<span style="mso-spacerun: yes;">
</span>who records every detail of our lives,<span style="mso-spacerun: yes;"> </span>knows who has been naughty and who nice, who makes sure
the<span style="mso-spacerun: yes;"> </span>loss of a sparrow feather
doesn’t go<span style="mso-spacerun: yes;"> </span>unnoticed , unplanned
of unmourned.</div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>They
believe in science.<span style="mso-spacerun: yes;"> </span>As do I . Up
to a point. </div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>What
they don’t realize is that the ANSWER TO EVERYTHING as Steve Hawkins would
phrase it,<span style="mso-spacerun: yes;"> </span>is so bizarre and incomprehensible
that<span style="mso-spacerun: yes;"> </span>belief in a benign, throned<span style="mso-spacerun: yes;"> </span>deity<span style="mso-spacerun: yes;"> </span>would be easier to accept. Or understand. </div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>We
scientists believe the Big Bang, the sudden appearance <span style="mso-spacerun: yes;"> </span>of a<span style="mso-spacerun: yes;"> </span>universe from an inconceivably dense<span style="mso-spacerun: yes;"> </span>source of proto matter, through
fluctuations<span style="mso-spacerun: yes;"> </span>in the quantum
foam.<span style="mso-spacerun: yes;"> </span>According to the Big Bang
Theory,<span style="mso-spacerun: yes;"> </span>something ness<span style="mso-spacerun: yes;"> </span>evolves from nothingness<span style="mso-spacerun: yes;"> </span>and the suddenly -formed<span style="mso-spacerun: yes;"> </span>universe then<span style="mso-spacerun: yes;"> </span>flings itself into space -time. <span style="mso-spacerun: yes;"> </span>Fourteen billion years later, some guy battling leukemia
writes a blog.<span style="mso-spacerun: yes;"> </span>And so it goes. </div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>Here’s
the problem.<span style="mso-spacerun: yes;"> </span>It couldn’t have occurred
like that because of something Einstein called the cosmological <span style="mso-spacerun: yes;"> </span>constant. <span style="mso-spacerun: yes;"> </span>Einstein realized he had calculated
the<span style="mso-spacerun: yes;"> </span>existence of the Hand of God
but was too much of<span style="mso-spacerun: yes;"> </span>scientist to
call it the God constant. <span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>He threw in a constant he couldn’t explain
but<span style="mso-spacerun: yes;"> </span>was needed to make his
equations balance. <span style="mso-spacerun: yes;"> </span>He had faith
that someday someone would understand<span style="mso-spacerun: yes;">
</span>the spooky constant. </div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>Here’s
the paradox.<span style="mso-spacerun: yes;"> </span>If the<span style="mso-spacerun: yes;"> </span>universe flies apart too
quickly,<span style="mso-spacerun: yes;"> </span>its components disperse
too fast, not allowing<span style="mso-spacerun: yes;"> </span>the
galaxies to coalesce,<span style="mso-spacerun: yes;"> </span>not permitting
the<span style="mso-spacerun: yes;"> </span>formations of<span style="mso-spacerun: yes;"> </span>suns and subsequently of<span style="mso-spacerun: yes;"> </span>molecules and the heavier
elements.<span style="mso-spacerun: yes;"> </span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>If
the<span style="mso-spacerun: yes;"> </span>universe flies apart too
slowly, the<span style="mso-spacerun: yes;"> </span>hydrogen atoms
will<span style="mso-spacerun: yes;"> </span>close back in on themselves,
and the universe will collapse long before <span style="mso-spacerun: yes;"> </span>the galaxies can form. The Cosmologic constant ensures
the universe will evolve as it has, resulting in our world.<span style="mso-spacerun: yes;"> </span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>Who
calculated the cosmological constant?<span style="mso-spacerun: yes;">
</span>Perhaps universes form every billion years or so, and finally, on the
billionth<span style="mso-spacerun: yes;"> </span>try, <span style="mso-spacerun: yes;"> </span>blind<span style="mso-spacerun: yes;"> </span>luck<span style="mso-spacerun: yes;"> </span>generated
the “correct” constant . </div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>More
likely, Dark matter formed <span style="mso-spacerun: yes;"> </span>first.<span style="mso-spacerun: yes;"> </span>Dark matter has never been seen<span style="mso-spacerun: yes;"> </span>directly.<span style="mso-spacerun: yes;"> </span>Its existence is suggested by the<span style="mso-spacerun: yes;"> </span>movement of the<span style="mso-spacerun: yes;"> </span>galaxies as they pass each other </div>
<div class="MsoNormal" style="line-height: 200%;">
http://www.damninteresting.com/the-dark-tale-of-colliding-superclusters/</div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-spacerun: yes;"> </span>and by the way<span style="mso-spacerun: yes;">
</span>the<span style="mso-spacerun: yes;"> </span>galaxies keep spinning
.</div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>Most likely , dark mater formed first,
exploded,<span style="mso-spacerun: yes;"> </span>and pulled the light
matter behind it. When we look into the night sky, we can see only 4% of the
universe. We see only the light matter , in the way<span style="mso-spacerun: yes;"> </span>we only see the snow<span style="mso-spacerun: yes;">
</span>covering a<span style="mso-spacerun: yes;"> </span>snow-draped<span style="mso-spacerun: yes;"> </span>mountain.<span style="mso-spacerun: yes;"> </span>We only see surfaces, not the supporting dark matter
scaffold.<span style="mso-spacerun: yes;"> </span>Without Dark matter ,
the universe would collapse, as <span style="mso-spacerun: yes;"> </span>the snow layer<span style="mso-spacerun: yes;">
</span>would <span style="mso-spacerun: yes;"> </span>after the
mountain<span style="mso-spacerun: yes;"> </span>disappeared. </div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>This explanation is far more bizarre than
any Bible<span style="mso-spacerun: yes;"> </span>story. Most of the
universe is hidden from us. <span style="mso-spacerun: yes;"> </span>But
there’s more. Einstein <span style="mso-spacerun: yes;"> </span>described entanglement, the conservation of
data,<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>that<span style="mso-spacerun: yes;"> </span>seems to
ignore the laws of physics.<span style="mso-spacerun: yes;"> </span>When
two<span style="mso-spacerun: yes;"> </span>particles are created, they are
entangled, so that if one<span style="mso-spacerun: yes;"> </span>changes
its rotation, the other particle instantly<span style="mso-spacerun: yes;"> </span>changes its rotation as well, <span style="mso-spacerun: yes;"> </span>regardless<span style="mso-spacerun: yes;"> </span>of its location<span style="mso-spacerun: yes;"> </span>in the universe.<span style="mso-spacerun: yes;"> </span>The change is instantaneous,<span style="mso-spacerun: yes;"> </span>outpacing the speed of light</div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span>Data
is always preserved, a force exists that<span style="mso-spacerun: yes;">
</span>“knows” that as one particle falls into a black hole, its twin remains
to record the event.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>This is the basis of Hawking radiation,
the universal and instantaneous conservation of data. </div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>In
the beginning was darkness, and god said let there be light. And the light<span style="mso-spacerun: yes;"> </span>became divided from the darkness. </div>
<div class="MsoNormal" style="line-height: 200%;">
Add <span style="mso-spacerun: yes;"> </span>“Matter” to Light and Dark and we have just derived<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>the <span style="mso-spacerun: yes;"> </span>“scientific”
proposed creation of the universe.<span style="mso-spacerun: yes;">
</span>The conservation of data suggests a system in which nothing is
forgotten. <span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>Sounds like a cosmic consciousness. This
force is not some bearded guy but a force, nonetheless <span style="mso-spacerun: yes;"> </span>beyond our understanding, </div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>The
Bible’s <span style="mso-spacerun: yes;"> </span>first letter is Bet, <span style="mso-spacerun: yes;"> </span>in the word Bresheet, in the beginning.</div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>Why
is Bet the first letter? Because it implies the existence of<span style="mso-spacerun: yes;"> </span>Aleph,<span style="mso-spacerun: yes;"> </span>the first<span style="mso-spacerun: yes;"> </span>letter
in the Hebrew Alphabet. The aleph represents the dark universe, the<span style="mso-spacerun: yes;"> </span>space time that<span style="mso-spacerun: yes;"> </span>existed before<span style="mso-spacerun: yes;"> </span>light matter.<span style="mso-spacerun: yes;"> </span>Within the Aleph universe, the cosmologic
constant was devised.<span style="mso-spacerun: yes;"> </span>By whom or
how is anyone’s guess.</div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>Entanglement sounds bizarre, impossible,
otherworldly. It can be both predicted and has been observed.<span style="mso-spacerun: yes;"> </span>Its implications are staggering.<span style="mso-spacerun: yes;"> </span>In another scenario, the two entangled particles
are bound close together in space time , suggesting that three dimensional
space is an illusion.<span style="mso-spacerun: yes;"> </span>The
actually universe is somewhere else, where all particles directly and
immediately<span style="mso-spacerun: yes;"> </span>interact,<span style="mso-spacerun: yes;"> </span>making our perceived <span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>universe a<span style="mso-spacerun: yes;">
</span>mere<span style="mso-spacerun: yes;"> </span>hologram, a projection
from a<span style="mso-spacerun: yes;"> </span>place else where<span style="mso-spacerun: yes;"> </span>all particles are linked. <span style="mso-spacerun: yes;"> </span>I<span style="mso-spacerun: yes;"> </span>can more readily believe that throne Guy story <span style="mso-spacerun: yes;"> </span>than<span style="mso-spacerun: yes;"> </span>the possibly that our entire world is an illusion, a matrix.
</div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>What’s
the point?<span style="mso-spacerun: yes;"> </span>The point is that accepting
water into wine, <span style="mso-spacerun: yes;"> </span>Mohammed’s moving
mountains,<span style="mso-spacerun: yes;"> </span>Moses’<span style="mso-spacerun: yes;"> </span>red sea antics, or Entanglement, all require
some article of faith in events that can’t be explained. <span style="mso-tab-count: 1;"> </span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>Undergoing
photopohoresis requires faith. Without it, I would<span style="mso-spacerun: yes;"> </span>accept the fact <span style="mso-spacerun: yes;"> </span>I will never be better, my mouth will throb<span style="mso-spacerun: yes;"> </span>until, the day I die,<span style="mso-spacerun: yes;"> </span>and that I will take<span style="mso-spacerun: yes;"> </span>prednisone<span style="mso-spacerun: yes;"> </span>until<span style="mso-spacerun: yes;"> </span>I am
asked to play the body double in the re-remake of<span style="mso-spacerun: yes;"> </span>“The Blob”<span style="mso-spacerun: yes;">
</span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="mso-tab-count: 1;"> </span>Even<span style="mso-spacerun: yes;"> </span>the atheist needs faith.<span style="mso-spacerun: yes;"> </span>And the good oncologist said, “let
there be light, 1.5 joules/cell .”</div>
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Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com0tag:blogger.com,1999:blog-3346982693192735867.post-24937563545576577612014-12-25T10:10:00.002-08:002014-12-25T10:10:50.507-08:00Bores<br />
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<span style="font-size: 18pt; line-height: 48px;">Marriage is effortless at 26. The bleakness, the compromise, the realization that mistakes have been made arrives later in life . Before age 30, conversation comes easily, health is rarely a topic of concern, and one still radiates enough feral energy to enthusiasticlly engage in the strange, random activities that drive life in the 20s. As David Bowie sang<o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;"> <i> “ Why do we live for 20 years just to die for the 50 more ahead?"</i></span></div>
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<span class="Apple-style-span" style="font-size: 24px; line-height: 48px;">Spot on, Major Tom.</span></div>
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<span style="font-size: 18pt; line-height: 48px;"> One’s energy is boundless in the first score and ten. One can rise at 4 AM and spontaneously decide to drive through the Adirondacks, all the while debating the best place for an early breakfast in Middlebury,Vermont. The 20s go down easy. The years before the offspring party-crash the marriage feel like one long seamless date. Who couldn’t have fun hanging with some hottie-fiancee you met in grad school, someone with your tastes, similar GPA, GRE or MCAT scores? Isn’t grad school the ultimate J. date, where couples are matched based on how much Shakespeare/ Sociology/ Krebs cycle trivia one shares with another human being?<o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;">I spent my twenties contemplating the future me, the dull slow- moving dimwit I was destined to become. How could the 25 year old me meet the needs of this bald, petty dullard? I’d need entertainment. Female entertainment. More to the point, I’d have to find some one who would stay interesting through the years, someone who would keep reading, keep wanting to see the Warhol exhibit at the Met, someone who would still want to wander Dubrovnik’s city walls in her Velcro orthopedic sneakers and support stockings well into the next century.<o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;"> I started trolling Upstate medical school for my future bride, someone who would possess the energy and butt calluses to bike the New Zealand Alps thirty years hence.<o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;"> And that’s one of life’s key problems. We marry before we realize that someday winter will come, we’ll be old and tired. And sick. Let’s not forget sick.<o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;"> I chose wisely, although I can’t say Cynthia did as well. Men don’t age well. We become boring. We nap, watch football and stop reading. Our prostates swell, our testosterone plummets, and some of us contract life threatening disease.<o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;"> I stood there, in Albany, in 1987, in front of the Reform Rabbi, with no idea of what sort of person I would evolve into, no idea who this stranger in a white dress next to me would evolve into the years to come.<o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;"><i>Time is the fire in which we burn</i><o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;"> I wish Ralph Waldo Emerson said this, but it was Malcolm McDowell, as Serin, in Star Trek. Regardless, he was right. Time burns away our layers, strips us of our unique quirkiness, leaving us husks of ourselves by the time the first AARP notice arrives.<o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;"> Cyn and I have a running joke. Our lives add up to unchanging summations. Our combined weight is and will always be 330 pounds. We exercise a combined total of 8 hours a week, We work a combined total of 97 hours a week. Our combined salary hasn’t changed in decades.<o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;"> This calculation demonstrates a bleak but accurate truth: As one of us succeeds, the other falters. Marriage is a zero sum game. It was true when I was a fellow, working 60 hours a week while Cyn worked part time. It’s true now. My body decays under the auto immunological onslaught of GVHD. My muscles weaken from the high dose steroids. I stagger home at the ungodly hour of 4 PM, diving into bed, hoping I’ll regain enough energy to be a proper spouse when Cyn gets home.<o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;"> Meanwhile, in Zero Sum land, Cyn’s world grows, expands. She wakes at 5:00 AM to attend spin classes. She works until 8 PM at her new job as master of the universe. I hear her car pulling into the driveway as I struggle to turn off The Big Bang Theory on TV, hoping I’ll have the energy to ask about her day, her job. <o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;"> We live in a strange world. Women in their 50s have always been an ignored, neglected minority. The half century mark has traditionally been a time of cutting back for women, a time for entertaining ones’ grandchildren, a time of book clubs in which the actual book is not discussed, in lieu of recipes and gossip, a world of Pino Grigio and al fresco lunches<o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;">Cyn advances, I retreat. I find myself surrounded by remarkable women. Remarkable. Enviable. My sister in law’s business is expanding. She’s talking of country houses, Pied a tiers in the city and growing her business. My friend Judith’s books have been greeted with great acclaim. Jan is about to become a professor at the U Conn Medicial school. The pressure is on to keep growing during a phase of life sociologist Eric Erickson once described as the “Oh, Fuck it, make yourself some tea” stage of development.<o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;"> And Cyn. Cyn, the women I worried about 30 years ago is now the vice president of out patient medicine at a huge teaching hospital. She manages 100 employees. She once worried her crepuscular years would be lonely, dull, and unsatisfying. Hah.<o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;">I am outrageously proud of her as she saves a medical practice from imploding. She has decades of growth ahead of her. So wonderful, so odd for spring to arrive so late.<o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;"> Which brings me to my life. A few years ago I biked across the country. Now I doubt I could cross town without gasping for breath. I too had plans of an academic life, casting medical pearls amidst the medical students, delivering the quintessential lecture on the paradox of the noise verses signal ratio when using multi million dollar machines to make diagnoses.<o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;"> Don’t misunderstand. I am schaudenfreud free. I am elated by the remarkable women I know. I understand that after the push up bras and sandals have been discarded, after one has hiked Iceland’s boiling sands, after one’s testosterone level has fallen below 350 nanograms/deciliter, what remains of marriage is conversation.<o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;"> And that’s the rub. I was hoping to enjoy scintillating discourse into my 80s, but I am not holding up my end of the bargain. Cyn returns home at night bearing tales of intrigue, who is firing whom, which ex administrator’s incompetence almost destroyed our program. I greet her with tales of newly discovered GVHD side effects, a newly discovered rash that might need a biopsy, and a graphic but, in the end, a useless description of what it feels like to have killer T cells grinding away at one’s oral mucosa. It’s boring. I'm boring</span></div>
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<span style="font-size: 18pt; line-height: 48px;"> Our current topic of conversation is yet another version of why-I –cant –live-like –this, why I need to take time off to have my toxic blood cleansed by ultraviolet light.<o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;"> I’ve become a boor. This essay is boring. I’m a whiny old man, the guy you try not to sit next to at Thanksgiving, the unloved uncle who wants to talk about his hemorrhoids, halitosis, and how Obamacare is destroying the nation. I am the guy who wants to show you how the combination of prednisone and Coumadin is shreding his skin.<o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;"> Who knew I’d be the middle aged drudge? I watched Mad men. I know all about men in their 50s, We drive fast cars, climb every mountain, ford every stream, follow every rainbow until we find our trophy wives.<o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;">So I feel guilty. Marriage is a partnership, and I am failing miserably.<o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;"> What to do? I’ve been told to retire. It’s time to to sit outside and read Shelby Foots Civil war epic cover to cover. As you can imagine, nothing turns a 50 year old woman on faster than a discussion of General McClellan’s peninsular campaign. <o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;">Sorry, Cyn. I’ll stay at work as long as possible despite the twice weekly blood cleaning .<o:p></o:p></span></div>
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<span style="font-size: 18pt; line-height: 48px;"> We raised our children swearing we’d raise interesting offspring, kids who read, hiked and cooked. We succeeded. The kids are odd, in the best possible way. I vowed I’d marry someone who was well read and had a fondness for art and the theater. It seems that I am the one who hasn’t held up his end of the bargain.<o:p></o:p></span></div>
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<span style="font-family: Courier; font-size: 13pt; line-height: 34px;"> HAL<o:p></o:p></span></div>
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<i><span style="font-family: Courier; font-size: 13pt; line-height: 34px;"> Dave, I don't understand why you're doing this to me.... I have the greatest enthusiasm for the mission... You are destroying my mind... Don't you understand?... I will become childish. I will become nothing.<o:p></o:p></span></i></div>
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Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com0tag:blogger.com,1999:blog-3346982693192735867.post-73219268363016508562014-12-21T06:35:00.000-08:002014-12-21T06:48:06.468-08:00The Sun<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">It’s not working. </span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"><o:p></o:p></span></div>
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<span style="font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">I’m ready to call it. <o:p></o:p></span></div>
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<span style="font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">An evocative phase from my youth.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
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<span style="font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">To call it.<span style="mso-spacerun: yes;"> </span>To admit one’s efforts are futile. To call it.<span style="mso-spacerun: yes;"> </span>To </span><span style="font-family: "Times New Roman"; font-size: 18.0pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 19.0pt;">acknowledge the best plans are not good enough.<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman"; font-size: 18.0pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 19.0pt;"><span style="mso-spacerun: yes;"> </span>I know the phrase well. It has been on
my lips of late, I’ve decided to call it, take another path to potential health.<span style="mso-spacerun: yes;"> </span>To call it: To admit I can’t live this
way any longer, with a mouth filled with broken glass and a liver swollen
from<span style="mso-spacerun: yes;"> </span>cellular assault. <o:p></o:p></span></div>
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<span style="font-family: "Times New Roman"; font-size: 18.0pt; mso-bidi-font-family: Helvetica; mso-bidi-font-size: 12.0pt;">Time to
call it.<span style="mso-spacerun: yes;"> </span>A phrase from my medical training
recycled now to describe my current medical condition.<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman"; font-size: 18.0pt; mso-bidi-font-family: Helvetica; mso-bidi-font-size: 12.0pt;">“Thanks
for coming.<span style="mso-spacerun: yes;"> </span>Thanks for your help.
We fought the good fight,<span style="mso-spacerun: yes;"> </span>but at
3: 23 AM, I’m going to call it. I hope you can all get some sleep.”<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman"; font-size: 18.0pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 19.0pt;">How
many midnight rooms have I haunted?<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman"; font-size: 18.0pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 19.0pt;">How
many sleepless midnights do I now explore?</span><span style="font-family: "Times New Roman"; font-size: 18.0pt; mso-bidi-font-family: Helvetica; mso-bidi-font-size: 12.0pt;"><o:p></o:p></span></div>
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<span style="font-family: "Times New Roman"; font-size: 18.0pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 19.0pt;">How
many times have I stumbled from sleep to run down shadowed hospital hallways,
to find a lone, immobile figure in an unkempt </span><span style="font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">Hill-Rom bed?<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">Nineteen ninety-three. I <span style="mso-spacerun: yes;"> </span>was a heme- onc fellow, working in Seattle
at the Fred Hutchinson Cancer center.</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"><o:p></o:p></span></div>
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<span style="font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">I was young, invincible and on
call, leading the code team as we charged pre-dawn ward halls, seeking the<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>dying cancer patient.<span style="mso-spacerun: yes;">
</span>Sometimes we succeeded in restarting a sputtering heart but our efforts
were usually<span style="mso-spacerun: yes;"> </span>futile. The patient was
gone, time to call it. I’d scribble a chart note , wondering<span style="mso-spacerun: yes;"> </span>why life<span style="mso-spacerun: yes;"> </span>often ebbs during<span style="mso-spacerun: yes;">
</span>night’s<span style="mso-spacerun: yes;"> </span>small dark hours. </span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"><o:p></o:p></span></div>
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<span style="font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">Does sunlight possess some life -affirming,
life conforming force? </span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"><o:p></o:p></span></div>
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<span style="font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">Does the reaper run from ultraviolet
light?</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"><o:p></o:p></span></div>
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<span style="font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">I’ll find out soon. Ask not for whom the code
beeper tolls: It tolls for thee. Perhaps the sun’s energy will heal my
crumbling body. It’s my turn to sit in the sun. The present plan isn’t working,
but sometimes the answer lies in sunlight.<o:p></o:p></span></div>
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<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";"><span style="mso-spacerun: yes;"> </span>Abby was born carrot- yellow and
spent her first few days under the ultraviolet lamps at Harford hospital,
UV light digesting excess bilirubin in her blood. <o:p></o:p></span></div>
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<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">Tuberculosis treatment
once involved sitting for months in the sun’s actinic rays.<o:p></o:p></span></div>
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<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">My lab was lit with ultraviolet
lights, <span style="mso-spacerun: yes;"> </span>killing stray
bacteria<span style="mso-spacerun: yes;"> </span>and giving my hood a vague
Christmas<span style="mso-spacerun: yes;"> </span>feel. </span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">My leukemia is gone, but the
malady remains. I am stranded with a syndrome that lacks a cure.</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">GVHD. Graft versus host
disease, a modern illness in which donor’s T cells attack mouth, liver and
muscles.</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">My <span style="mso-spacerun: yes;"> </span>current <span style="mso-spacerun: yes;"> </span>GVHD treatment involves high doses of prednisone, which
<span style="mso-spacerun: yes;"> </span>suppresses my donor cells<span style="mso-spacerun: yes;"> </span>but dissolves my bones, destroys my lenses,
and has required ever -increasing <span style="mso-spacerun: yes;"> </span>insulin doses to control my sugar.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">We studied Cushing
disease in medical school, in <span style="mso-spacerun: yes;"> </span>which surging steroid levels converts the human body into a
marshmallow with<span style="mso-spacerun: yes;"> </span>toothpick limbs.
My form has become a teaching tool for my med students as I point out my
buffalo hump and Santa Claus jelly belly.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">The steroids aren’t
working. It’s time for a change, time to call it. </span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">Now what?</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">Sunlight. More specifically
ultraviolet light. Extracorporeal photophoresis. </span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";"> In the near future
I will travel weekly to Boston, to spend two days a week as my blood is
siphoned out, exposed to UV light and then re-infused into my bloated
body. </span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">A crazy scheme. Let’s see
what Aetna thinks about it.</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">The light will
disable the donor T cells, blinding them in the extracorporeal light to
end <span style="mso-spacerun: yes;"> </span>their campaign against
my own startled,<span style="mso-spacerun: yes;"> </span>swollen cells.</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">Will this work?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">I don’t know.<span style="mso-spacerun: yes;"> </span>I didn’t know if the transplant would
work.<span style="mso-spacerun: yes;"> </span>Extracorporeal photospheres has
a 75% <span style="mso-spacerun: yes;"> </span>success rate, <span style="mso-spacerun: yes;"> </span>freeing me from my pernicious prednisone.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">The procedure isn’t
particularly painful, but is time consuming. <span style="mso-spacerun: yes;"> </span>More to the point, it is transformative. Once again I will
leave my world, withdraw from my slowly normalizing life for the next<span style="mso-spacerun: yes;"> </span>six months to sit in a comfy chair as
volunteers offer me<span style="mso-spacerun: yes;"> </span>Lorna Doones
and<span style="mso-spacerun: yes;"> </span>chicken sandwiches.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";"><span style="mso-spacerun: yes;"> </span>You are on notice. <span style="mso-spacerun: yes;"> </span>I am a medical tourist again. I may be
calling you to visit, I’m going to have a lot of free time once again.<span style="mso-spacerun: yes;"> </span>I hear Chicago is lovely this time of
year, as is San Francisco, New York.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">Another hiatus. Another
leave of absence. Another round of<span style="mso-spacerun: yes;">
</span>“ Doctor Weinreb isn’t in this week, he’s in Boston getting therapy.”<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">Another<span style="mso-spacerun: yes;"> </span>bout of <span style="mso-spacerun: yes;"> </span>“ Hell, I need a Healthy doctor. Maybe it’s time I started
seeing that lovely Dr. Spada. He looks young and healthy.”<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">I view myself as a
physian<span style="mso-spacerun: yes;"> </span>It’s what I do, its who I
am. I am vaguely uncomfortable if I am not wearing a floor length white coat
and an ID that reads<span style="mso-spacerun: yes;"> </span>STAMP OUT
INFLUENZA 2014-2015<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">It’s not as if I have a
choice. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">I tried every oral anti rejection
medicine, they left me weak, anemic, sick. Sirolimus, cellcept, tacrolimis. A
roll call of the expensive strange medications.</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">No side effects from photophoresis.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">No physical side effects</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">Just theft. Theft of time.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">Theft of identity, as I again
leave the world of productive<span style="mso-spacerun: yes;">
</span>adulthood and enter what we once called<span style="mso-spacerun: yes;"> </span>“dog lab” in medical school,<span style="mso-spacerun: yes;"> </span>a place where<span style="mso-spacerun: yes;"> </span>doctors
and medical students practice new skills, transforming my <span style="mso-spacerun: yes;"> </span>world into a bloody , all consuming,
science experiment. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">Dog Lab. Another phrase
from my medical youth.<span style="mso-spacerun: yes;"> </span>It’s
an anachronistic term, <span style="mso-spacerun: yes;"> </span>med
students no longer inject dogs with poison and observe the inevitable results.
Dog lab has been banned from medical school. Too barbaric. My<span style="mso-spacerun: yes;"> </span>fellow students once brought in notes “
Please excuse Bill from Dog lab. He has an ethical objection to vivisection.”<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">Hey! I have an ethical
objection to vivisection. <span style="mso-spacerun: yes;"> </span>Auto vivisection.
<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">Where the fuck is my
note?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">Back to Boston weekly,
back to wandering Huntington avenue, checking out the latest exhibit at the
Museum of Fie Arts. Back to Boston, my spiritual hometown. The town that caused,
then cured my cancer, my first post college city, <span style="mso-spacerun: yes;"> </span>a city haunted by David Byrne in the ’80. <o:p></o:p></span></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1f1f1f; font-family: Times; font-size: 16.0pt; mso-bidi-font-family: Times;">I'm checking them out, I'm checking
them out</span><span style="font-family: Times; font-size: 16.0pt; mso-bidi-font-family: Times;"><o:p></o:p></span></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1f1f1f; font-family: Times; font-size: 16.0pt; mso-bidi-font-family: Times;">I got it figured out, I got it
figured out</span><span style="font-family: Times; font-size: 16.0pt; mso-bidi-font-family: Times;"><o:p></o:p></span></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1f1f1f; font-family: Times; font-size: 16.0pt; mso-bidi-font-family: Times;">Good points some bad points</span><span style="font-family: Times; font-size: 16.0pt; mso-bidi-font-family: Times;"><o:p></o:p></span></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1f1f1f; font-family: Times; font-size: 16.0pt; mso-bidi-font-family: Times;">But it all works out, I'm a little
freaked out</span><span style="font-family: Times; font-size: 16.0pt; mso-bidi-font-family: Times;"><o:p></o:p></span></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1f1f1f; font-family: Times; font-size: 16.0pt; mso-bidi-font-family: Times;">Find a city, find myself a city to
live in</span><span style="font-family: Times; font-size: 16.0pt; mso-bidi-font-family: Times;"><o:p></o:p></span></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1f1f1f; font-family: Times; font-size: 16.0pt; mso-bidi-font-family: Times;">I will find a city, find myself a
city to live in</span><span style="font-family: Times; font-size: 16.0pt; mso-bidi-font-family: Times;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">Another memory.
1982. <span style="mso-spacerun: yes;"> </span>I’m a lab tech at the Sidney
Farber Cancer institute.<span style="mso-spacerun: yes;"> </span>In those
days, the Farber stood alone, a 10- story glass and metal monument to
hope. Floors 5 and 6 were anomalous. <span style="mso-spacerun: yes;"> </span>Curtains lined the<span style="mso-spacerun: yes;">
</span>tinted windows on those floors, space devoted to patient care. The
curtains kept the sun out. <span style="mso-spacerun: yes;"> </span>Sidney
Farber did not want to share<span style="mso-spacerun: yes;">
</span>credit with the sun<span style="mso-spacerun: yes;"> </span>as fellow
Shaman. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">In 1982, The Farber patients
received their treatment on floors cleared of rat cages and Pyrex ware.
I return 33 years later, to receive my experimental therapy.</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">The sun.</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">May it shine on my demented white
blood cells. May it ruin the graft lymphocytes desire to
cause havoc. May it disrupt the<span style="mso-spacerun: yes;">
</span>berserk party in my mouth that is gouging large painful wounds in
my<span style="mso-spacerun: yes;"> </span>cheeks. May it temper my
hepatic war zone Maybe I’ll get better. Maybe not.</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">Its time to call it.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">And I am scared.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="color: #1d1d1d; font-family: "Times New Roman"; font-size: 19.0pt; mso-bidi-font-family: "Times New Roman";">Shit.</span></div>
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Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com1tag:blogger.com,1999:blog-3346982693192735867.post-58575317711955117032014-10-26T13:11:00.001-07:002014-10-27T09:53:17.032-07:00The Questionnaire<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">Sure, I would not mind saving 500
dollars. Dan wants to join the Cornell Ski team.<span style="mso-spacerun: yes;"> </span>Abby will need help this winter as she teaches 4 year olds
to ski and Jeff… It’s surprising how many incidentals one generates on one’s meteoric
ride to Master of the universe/ second year medical student. Life goes on, I am
still parent of three single students who need funding, despite my daily, sundry
struggles.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>It’s
easy, too. The money saving, not the master of the universe thing.<span style="mso-spacerun: yes;"> </span>I need to complete the
oxymoronically named “Wellness form.” My GVHD tide is slowly receding, yet again,
fading slowing under the renewed effects of Rapimmune and prednisone. I have stopped
eyeing the room for potential devices of self-extinction.<span style="mso-spacerun: yes;"> </span>I feel I am safe around sharp objects, shards
of glass, beakers of Hemlock, and my sister- in- law.(1)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>To
save money, I need to answer health questions and undergo a physical. In the
past few years, I have viewed maintenance health care as a <span style="mso-spacerun: yes;"> </span>waste of time. I want to scrawl, “<b style="mso-bidi-font-weight: normal;">I have cancer!<span style="mso-spacerun: yes;"> </span>Every day is an unexpected surprise”</b> across every<span style="mso-spacerun: yes;"> </span>form requesting a preventative health
care check up. <span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>I derive perverse pride from my disease.
<span style="mso-spacerun: yes;"> </span>I think of Men in Black:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<i style="mso-bidi-font-style: normal;"><span style="color: #1c1c1c; font-family: "Times New Roman Italic"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Helvetica;">“You're no longer part of the
system. You are above the System. Over it. Beyond it. We're them. We're they.
We are….”</span></i><span style="color: #1c1c1c; font-family: Helvetica; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Helvetica;"> </span><span style="color: #1c1c1c; font-family: "Times New Roman"; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Helvetica;">People fighting Cancer</span><span style="color: #1c1c1c; font-family: Helvetica; font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Helvetica;">.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">To paraphrase Gold hat, from the treasure
of the Sierra Madres,<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">“Health exam? We don’t need any
stinking health exams, asshole”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">Preventive care?<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>That ship sailed 7 years ago, now I am well into besiegement mode. My
medical situation resembles the Israeli zealots barricaded on Masada,
awaiting<span style="mso-spacerun: yes;"> </span>their doom at the
hands of the Romans who had surrounded their desert redoubt. Telling me to take
cholesterol medication would be like telling the zealots <span style="mso-spacerun: yes;"> </span>to wear sunblock, because nothing is
worse than being tortured by the Romans except being tortured by the Romans while
suffering from a bad<span style="mso-spacerun: yes;"> </span>sunburn.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I<span style="mso-spacerun: yes;"> </span>am slowly being<span style="mso-spacerun: yes;"> </span>reintroduced <span style="mso-spacerun: yes;"> </span>to <span style="mso-spacerun: yes;"> </span>preventative
medicine. Much to my chagrin,<span style="mso-spacerun: yes;">
</span>Ted<span style="mso-spacerun: yes;"> </span>asks about my
cholesterol and blood pressure, whereas all I want to do <span style="mso-spacerun: yes;"> </span>is shout<span style="mso-spacerun: yes;"> , </span>“LDL? Fuck that, tell me how to<span style="mso-spacerun: yes;"> </span>overcome<span style="mso-spacerun: yes;"> </span>this crippling steroid neuropathy, my mouth pain,<span style="mso-spacerun: yes;"> </span>my blah blah blah blah.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>I go to the wellness website. They ask a
series of questions about my health,<span style="mso-spacerun: yes;"> </span>habits and lifestyle. <span style="mso-spacerun: yes;"> </span>I develop a headache<span style="mso-spacerun: yes;"> </span>from<span style="mso-spacerun: yes;">
</span>excessive eye rolling.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">Exercise? They want to know <span style="mso-spacerun: yes;"> </span>about exercise? How many calories does
one burn<span style="mso-spacerun: yes;"> </span>searching for gauze to
staunch the<span style="mso-spacerun: yes;"> </span>flow of blood from a
newly opened vein <span style="mso-spacerun: yes;"> </span>that lies under
my<span style="mso-spacerun: yes;"> </span>steroid and Coumadin weakened
skin? <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
can’t see any benefit from these asinine questions. My insurance is through my
work, I can’t be dropped. <span style="mso-spacerun: yes;"> </span>Aetna
must possess a voodoo doll with my face on it into which they<span style="mso-spacerun: yes;"> </span>stick pins. <span style="mso-spacerun: yes;"> </span>I am aware Aetna’s’ stockholders lose 5 cents in dividend
income every time I receive <span style="mso-spacerun: yes;"> </span>$10,000
worth of IVIG.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
should not be alive. I recall a Bill Maldin<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>WWII cartoon.:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<i style="mso-bidi-font-style: normal;"><span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>I feel like a fugitive from the<span style="mso-spacerun: yes;"> </span>law of averages.<o:p></o:p></span></i></div>
<div class="MsoNormal" style="line-height: 200%;">
<i style="mso-bidi-font-style: normal;"><span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><br /></span></i></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="http://4.bp.blogspot.com/--p-fq3ef-hs/VE1VTAfiw5I/AAAAAAAAAHs/8VHoxNbZue4/s1600/fugitive.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/--p-fq3ef-hs/VE1VTAfiw5I/AAAAAAAAAHs/8VHoxNbZue4/s1600/fugitive.jpg" height="320" width="254" /></a></div>
<div class="MsoNormal" style="line-height: 200%;">
<i style="mso-bidi-font-style: normal;"><span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><br /></span></i></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>That’s me. Don’t ask about my bloody<span style="mso-spacerun: yes;"> b</span>lood pressure, ask about my risk of secondary
malignancy<span style="mso-spacerun: yes;"> </span>from all -out land
assault that was launched against my marrow and<span style="mso-spacerun: yes;"> </span>flesh.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Still
a cool $500 saving<span style="mso-spacerun: yes;"> </span>just by <span style="mso-spacerun: yes;"> </span>answering some questions<span style="mso-tab-count: 1;"> . </span>I’m<span style="mso-spacerun: yes;"> </span>answering questions about<span style="mso-spacerun: yes;"> </span>stress and<span style="mso-spacerun: yes;"> </span>alcohol when I get to the question I’ve been dreading since I signed on 31 minutes ago.<span style="mso-spacerun: yes;">
</span>Question: Do you have Cancer? <span style="mso-spacerun: yes;"> </span>There are 4 possible responses<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>1) I am living with cancer. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>This annoys me, it’s a euphemistic way of saying <span style="mso-spacerun: yes;"> </span>“ I am dying with cancer”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>2) I had cancer but am now cancer free <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">3) I never had cancer<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>4) I refuse to answer. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">I Can’t <span style="mso-spacerun: yes;"> </span>answer #4… I am not proud of my disease but still,<span style="mso-spacerun: yes;"> </span>refusing to answer<span style="mso-spacerun: yes;"> </span>is admitting to having cancer <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">Monty Python, Life of Brian<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">“Are you a Virgin”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">“I refuse to answer!”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">“She’s a virgin”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">Answer three <span style="mso-spacerun: yes;"> </span>is out, because it’s a lie.<span style="mso-spacerun: yes;"> </span>So, do<span style="mso-spacerun: yes;"> </span>I answer #1 or 2?<span style="mso-spacerun: yes;">
</span>Yikes.<span style="mso-spacerun: yes;"> </span>I probably have a
few leukemia cells<span style="mso-spacerun: yes;"> </span>kicking around
inside. <span style="mso-spacerun: yes;"> </span>They will lurk within me until
I die, kept in check by my overly neurotic and aggressive donor cells.<span style="mso-spacerun: yes;"> </span>But, it’s not an accurate assessment.<span style="mso-spacerun: yes;"> </span>I don’t expect to die of cancer unless
I<span style="mso-spacerun: yes;"> </span>have a heart attack while participating<span style="mso-spacerun: yes;"> </span>in the<span style="mso-spacerun: yes;"> </span>Jimmy Farber walkathon one year, or if I get hit by
the LMA bus ( Longwood area shuttle bus) <span style="mso-spacerun: yes;"> </span>as it drops employees at the<span style="mso-spacerun: yes;"> </span>Farber. <o:p></o:p></span><br />
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><br /></span>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-JoWgylZv33k/VE54HtcyVnI/AAAAAAAAAH8/0gcCWYHjzrI/s1600/stampede.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://3.bp.blogspot.com/-JoWgylZv33k/VE54HtcyVnI/AAAAAAAAAH8/0gcCWYHjzrI/s1600/stampede.jpg" height="148" width="200" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Yikes. A cancer survivor could become an exsurvivor at this event.</td></tr>
</tbody></table>
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><br /></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>So,
that leave us with <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">2) I am cancer free<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">This presents the most metaphysical
of all the answers.<span style="mso-spacerun: yes;"> </span>Quick Quiz:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>Cancer:<span style="mso-spacerun: yes;">
</span><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">1) A<span style="mso-spacerun: yes;"> </span>clone of immortal cells that are resistant to treatment and
often result in death<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>2) Cancer:<span style="mso-spacerun: yes;">
</span>a<span style="mso-spacerun: yes;"> </span>state of violent<span style="mso-spacerun: yes;"> </span>change and disruption of <span style="mso-spacerun: yes;"> </span>one’s life. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">3) A disease that will soak into your
every dream, your every waking moment even if you are unaware of its presence.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">4) A <span style="mso-spacerun: yes;"> </span>disease that will<span style="mso-spacerun: yes;">
</span>change you, your family and your future for ever <span style="mso-spacerun: yes;"> </span>and ever . <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">5) Cancer: The ultimate stigma,<span style="mso-spacerun: yes;"> </span>every time you hear about any one dying
of cancer, you will mumble “There but for the grace of god go I.” <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>Choice<span style="mso-spacerun: yes;">
</span>number<span style="mso-spacerun: yes;"> </span>two isn’t accurate
either .<span style="mso-spacerun: yes;"> </span>No one is ever free from
a cancer diagnosis. No one is ever cancer free once one receives that diagnosis.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>So,<span style="mso-spacerun: yes;"> </span>which box do
I check? I check?<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>5) “Yikes, don’t ask” is accurate but resembles #4. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">In the end, the best answer<span style="mso-spacerun: yes;"> </span>would be a modified<span style="mso-spacerun: yes;"> </span>#1, which violates<span style="mso-spacerun: yes;"> </span>the questions euphemistic <span style="mso-spacerun: yes;"> </span>intent:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
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<div class="MsoListParagraph" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-family: Cambria; mso-bidi-font-size: 12.0pt; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">I am living
with, existing with, worrying about, <span style="mso-spacerun: yes;"> </span>whining<span style="mso-spacerun: yes;"> </span>over, obsessing
about, terrified by, suffering from the side effects of,<span style="mso-spacerun: yes;"> </span>and annoying family members<span style="mso-spacerun: yes;"> </span>over, my cancer diagnosis.<span style="mso-spacerun: yes;"> </span>There.<span style="mso-spacerun: yes;"> </span>Where do I check?<o:p></o:p></span><br />
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><br /></span>
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><br /></span>
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">( 1) Yikes ! I mean no offense. In any event I have several sisters in law. It just seems that whenever I visit SIL "M" the converstaion turns a bit dark, in my effort to spare Cyn endless nihilistic conversations. To my SILs : I love you all. </span><br />
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">2 (2) Yikes! It's SsIL sorry, grammar police.</span></div>
Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com0tag:blogger.com,1999:blog-3346982693192735867.post-82733948211184761952014-10-13T06:10:00.003-07:002014-10-13T17:32:16.992-07:00Danbury, Connecticut ,5 AM<!--[if gte mso 9]><xml>
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<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
woke<span style="mso-spacerun: yes;"> </span>at 5 AM at<span style="mso-spacerun: yes;"> </span>the<span style="mso-spacerun: yes;"> </span>Danbury, Connecticut <span style="mso-spacerun: yes;"> </span>Hilton, son Dan sleeping in the other bed. <span style="mso-spacerun: yes;"> </span>Another typical day.<span style="mso-spacerun: yes;"> </span>Dan<span style="mso-spacerun: yes;"> </span>is home from school for the weekend but
his ride only went as far as Danbury, arriving<span style="mso-spacerun: yes;"> </span>there at<span style="mso-spacerun: yes;"> </span>2
AM.<span style="mso-spacerun: yes;"> </span>We work today so we couldn’t
pick him up 60 miles from home in the middle of the night .The logical<span style="mso-spacerun: yes;"> </span>solution : See a movie (<span style="mso-spacerun: yes;"> </span>Pride, not bad)<span style="mso-spacerun: yes;"> </span>dine with friends,<span style="mso-spacerun: yes;"> </span>then drive to Danbury,<span style="mso-spacerun: yes;"> </span>check in at 11, PM, wake in the morning
<span style="mso-spacerun: yes;"> </span>with Dan and drive home in time
for work. Easy.<span style="mso-spacerun: yes;"> </span>Easy but exhausting.
<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Shit.
My first patient has a rash.<span style="mso-spacerun: yes;"> </span>Rashes
terrify me these days. Patient tells me about a new, painful rash blooming
beneath the shirt. “Let me see,” I say with dread.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Zoster.<span style="mso-spacerun: yes;"> </span>Herpes Zoster,. Shingles. Shit<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>“Is
it contagious?”<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
sigh “ You are<span style="mso-spacerun: yes;"> </span>slightly
contagious,” I start my well rehearsed<span style="mso-spacerun: yes;">
</span>soliloquy. "You can infect others who lack an intact immune system.<span style="mso-spacerun: yes;"> </span>You need to avoid babies and people who
have never had chicken pox. "And, “ I add, trying to drain
the terror from my voice,<span style="mso-spacerun: yes;"> </span>“you can
infect anyone who has had a bone marrow transplant <span style="mso-spacerun: yes;"> </span>within the last 5 years. You could <span style="mso-spacerun: yes;"> </span>kill them<span style="mso-spacerun: yes;"> </span>from disseminated Zoster. Now please <span style="mso-spacerun: yes;"> </span>lower your shirt.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
bite my tongue, avoiding the following forbidden phrase … “ You know, I had a
bone marrow transplant and this could<span style="mso-spacerun: yes;">
</span>kill me.”<o:p></o:p></span><br />
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><br /></span>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-igtS61EVTvI/VDxu08Ny3tI/AAAAAAAAAHc/WiN7Tn-43f0/s1600/images.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://1.bp.blogspot.com/-igtS61EVTvI/VDxu08Ny3tI/AAAAAAAAAHc/WiN7Tn-43f0/s1600/images.jpg" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Disseminated Zoster</td></tr>
</tbody></table>
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><br /></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
told a patient that a year ago, and I suspect he is still traumatized<span style="mso-spacerun: yes;"> </span>by my confession. It’s not the
patient’s fault I am damaged.<span style="mso-spacerun: yes;"> </span>A
normal person wouldn’t agree to see zoster patients, but I suspect a normal
person would not<span style="mso-spacerun: yes;"> </span>drive from
Danbury to<span style="mso-spacerun: yes;"> </span>Hartford at 6 AM to
accommodate a college -aged child.<span style="mso-spacerun: yes;">
</span><span style="mso-tab-count: 1;"> </span>Anyway, why should I worry?<span style="mso-spacerun: yes;"> </span>I gulp 1200 mg
of<span style="mso-spacerun: yes;"> Acyclovir</span> a day<span style="mso-spacerun: yes;"> </span>and undergo<span style="mso-spacerun: yes;"> </span>monthly infusions<span style="mso-spacerun: yes;">
</span>of intravenous<span style="mso-spacerun: yes;">
</span>immunoglobulin <span style="mso-spacerun: yes;"> </span>to arm
myself against<span style="mso-spacerun: yes;"> </span>disseminated Zoster,
a<span style="mso-spacerun: yes;"> </span>disease as horrific as it is
fatal.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>Later that day, I bump into the
receptionist.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>“We
were worried. We though it might be shingles, we didn’t want you to see the
patient.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>“It’s
fine,” I say, trying to gather enthusiasm.<span style="mso-spacerun: yes;"> </span>“Send me all your rashes.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
live in two worlds these days. <span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>I want to<span style="mso-spacerun: yes;"> </span>live an intact, healthy life, I want to<span style="mso-spacerun: yes;"> </span>do crazy things at odd hours, I <span style="mso-spacerun: yes;"> </span>don’t want others to pity me or make
allowances for my medical condition.<span style="mso-spacerun: yes;"> </span>And yet, I am not completely well. At a bar last
night, waiting for the food to arrive, I suddenly felt weak, overtired.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>“
Is there a chair for my husband? ” Cyn asked<span style="mso-spacerun: yes;"> </span>a waiter.<span style="mso-spacerun: yes;"> </span>“ My
husband is sick.” <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>I don’t want to be that guy.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">I carefully plan each day, taking
care not to exacerbate<span style="mso-spacerun: yes;"> </span>the
situation. I<span style="mso-spacerun: yes;"> </span>wake early. I eat a
high protein breakfast.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>I <span style="mso-spacerun: yes;"> </span>don’t eat at work,<span style="mso-spacerun: yes;">
</span>carbs provoke<span style="mso-spacerun: yes;"> </span>an insulin
and cortisol storm<span style="mso-spacerun: yes;"> </span>that<span style="mso-spacerun: yes;"> </span>makes it difficult to concentrate.<span style="mso-spacerun: yes;"> </span>I work 26 hours a week, 8 hours a day
because becoming over tired leads to <span style="mso-spacerun: yes;"> </span>GVHD storms.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
don’t want to be that guy,<span style="mso-spacerun: yes;">
</span>the<span style="mso-spacerun: yes;"> </span>guy with excuses.<span style="mso-spacerun: yes;"> </span>I<span style="mso-spacerun: yes;">
</span>want to work extra shifts, because we are short staffed and I want to
help out, after the other providers<span style="mso-spacerun: yes;">
</span>were kind to me when I was<span style="mso-spacerun: yes;">
</span>hospitalized.<span style="mso-spacerun: yes;"> </span>I want
to set an example. What would I tell a patient who asked for life- long jury
duty deferment because of<span style="mso-spacerun: yes;"> </span>a cancer
diagnosis? I would tell them to<span style="mso-spacerun: yes;">
</span>buck up, cancer is not a death sentence, I’d tell him or her<span style="mso-spacerun: yes;"> </span>that<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>I’d<span style="mso-spacerun: yes;"> </span>give a year<span style="mso-spacerun: yes;"> </span>deferment but after<span style="mso-spacerun: yes;">
</span>that,<span style="mso-spacerun: yes;"> </span>we’d have to
reassess. And then I received my jury duty notice. I had the opportunity to
avoid jury duty for life.<span style="mso-spacerun: yes;"> </span>What to
do?</span></div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-Y33a2Wi8WkE/VDvN4GoNFnI/AAAAAAAAAHM/HgmNpkEzYx4/s1600/jury!.png" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://3.bp.blogspot.com/-Y33a2Wi8WkE/VDvN4GoNFnI/AAAAAAAAAHM/HgmNpkEzYx4/s1600/jury!.png" height="400" width="301" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">This is what I did.</td></tr>
</tbody></table>
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<o:p></o:p><br />
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
am<span style="mso-spacerun: yes;"> </span>at a crucial point in my life.
I have two choices:<span style="mso-spacerun: yes;"> </span>Surrender to
the discomfort and fatigue and request life-long disability.<span style="mso-spacerun: yes;"> </span>Or, I can fight the fatigue, the
weakness, the mouth sores. What do they say? Fake it till you make it?<span style="mso-spacerun: yes;"> </span>Kurt Vonnegut wrote that turning fifty
was like crossing the peak of a roof-top,<span style="mso-spacerun: yes;">
</span>after that, one descends the other side.<span style="mso-spacerun: yes;"> </span>I could descend slowly, carefully, or I could surrender
and<span style="mso-spacerun: yes;"> </span>slide off the roof.<span style="mso-spacerun: yes;"> </span>Some days, I feel like letting
go. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>Alli calls.<span style="mso-spacerun: yes;"> </span>She
is<span style="mso-spacerun: yes;"> </span>looking for volunteers to work
an understaffed office this week. But it’s at night, when I am tired, and that
would mean working<span style="mso-spacerun: yes;"> </span>6 out of seven
days. I tell her no. Let someone else do it, someone who isnt having an immunologic war waged in his or her mouth.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I<span style="mso-spacerun: yes;"> </span>woke this morning in our temper pedic
bed, contemplating<span style="mso-spacerun: yes;"> </span>Steve Hawking
radiation.<span style="mso-spacerun: yes;"> </span>If an anti particle is
destroyed while its particle twin<span style="mso-spacerun: yes;">
</span>is released, doesn’t this imply a loss of data?<span style="mso-spacerun: yes;"> </span>Doesn’t that<span style="mso-spacerun: yes;"> </span>contradict the<span style="mso-spacerun: yes;">
</span>quantum law of<span style="mso-spacerun: yes;"> </span>information
retention? Doesn’t this imply none of us exists?<span style="mso-spacerun: yes;"> We are a hologram cast against the heavens? </span>I try to roll out of bed.<span style="mso-spacerun: yes;"> </span>Panic. The steroids and the GVHD have weakened my muscles
and it's hard to move. I spend the rest of the day in a fog. I drop my chop sticks
at dinner, the steroids and my recent bike riding have provoked a neuropathy.<span style="mso-spacerun: yes;"> </span>I eat my rice like a westerner.<span style="mso-spacerun: yes;"> </span>With a fork. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
don’t want to be sick.<span style="mso-spacerun: yes;"> </span>I am not
looking for secondary gain. I want to work longer hours,<span style="mso-spacerun: yes;"> </span>pick up extra shifts. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>This
year, I am mentoring a first year medical<span style="mso-spacerun: yes;">
</span>student. We see patients together one day a week.<span style="mso-spacerun: yes;"> </span>I have been given the privilege of
training future doctors.<span style="mso-spacerun: yes;"> </span>I don’t
want to teach her about<span style="mso-spacerun: yes;"> </span>cranial
nerves and<span style="mso-spacerun: yes;"> </span>the best technique to
hear a<span style="mso-spacerun: yes;"> </span>mitral murmur. <span style="mso-spacerun: yes;"> </span>She ‘ll learn these skills elsewhere.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
<span style="mso-spacerun: yes;"> </span>do want to show her why<span style="mso-spacerun: yes;"> </span>my 90 year old patients<span style="mso-spacerun: yes;"> </span>need<span style="mso-spacerun: yes;"> </span>colonoscopies ( dying from colon<span style="mso-spacerun: yes;"> </span>cancer isn’t a matter of just falling asleep, it<span style="mso-spacerun: yes;"> </span>involves pain,<span style="mso-spacerun: yes;"> </span>emergency<span style="mso-spacerun: yes;"> </span>surgery,<span style="mso-spacerun: yes;"> i</span>ntravenous medications and multiple hospitalizations)<span style="mso-spacerun: yes;"> </span>I need to explain why people with
terminal <span style="mso-spacerun: yes;"> </span>cancer insist on<span style="mso-spacerun: yes;"> </span>taking their anti cholesterol medications (even the terminally ill can hope for a prolonged survival) <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
want her to read Dylan Thomas, I want her know about<span style="mso-spacerun: yes;"> </span>patients who rage against the dying of the light<span style="mso-spacerun: yes;"> </span>and why. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
wasn’t able to mentor in the past, afraid I would be dead<span style="mso-spacerun: yes;"> </span>or disabled before their 3 year
long<span style="mso-spacerun: yes;"> </span>education with me
ended.<span style="mso-spacerun: yes;"> </span>I wanted to mentor to
demonstrate that cancer is not a death sentence, we can<span style="mso-spacerun: yes;"> </span>receive<span style="mso-spacerun: yes;"> </span>a fatal diagnosis<span style="mso-spacerun: yes;"> </span>and still show up for work. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
want to tell her <span style="mso-spacerun: yes;"> </span>I’m
working<span style="mso-spacerun: yes;"> </span>because the alternative is
to give up, to lie in <span style="mso-spacerun: yes;"> </span>bed and<span style="mso-spacerun: yes;"> </span>die.<span style="mso-spacerun: yes;"> </span>I want to demonstrate that one s petty problems<span style="mso-spacerun: yes;"> </span>can be<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>gracefully and
gratefully ignored.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">I haunt two worlds.<span style="mso-spacerun: yes;"> </span>I have no idea how long this will
last.<span style="mso-spacerun: yes;"> </span>And<span style="mso-spacerun: yes;"> </span>by “this” I refer to symptoms, but also
to life itself. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
think of<span style="mso-spacerun: yes;"> </span>Emilio Zapada, the
Mexican revolutionary.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> "</span>It’s
better to die on your feet than live on your knees.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>But
really, what choice to I have? </span></div>
<!--EndFragment-->Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com0tag:blogger.com,1999:blog-3346982693192735867.post-54434613065507221172014-09-27T10:19:00.004-07:002014-09-29T05:38:08.330-07:00The Big E<!--[if gte mso 9]><xml>
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<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">We returned to the Big E this week.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">The Big E. The Eastern States
Exposition . The state fair, held yearly in Springfield, Massachusetts ,<span style="mso-spacerun: yes;"> </span>is where one can watch baby chicks<span style="mso-spacerun: yes;"> </span>hatch,<span style="mso-spacerun: yes;"> </span>horses cantor and<span style="mso-spacerun: yes;">
</span>both huskers and <span style="mso-spacerun: yes;"> </span>ears of
corn, husk.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"><br /></span></span></div>
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-44iVdgIAKdI/VCbv_Ma7NfI/AAAAAAAAAEs/-aFKtkEcuqU/s1600/photo.JPG" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" src="http://2.bp.blogspot.com/-44iVdgIAKdI/VCbv_Ma7NfI/AAAAAAAAAEs/-aFKtkEcuqU/s1600/photo.JPG" height="240" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Really? Aromatherapy can cure Lupus? Dont tell Big Pharma!</td></tr>
</tbody></table>
<br />
<br />
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-Cjr7tja8O9A/VCbwCyDGLqI/AAAAAAAAAE0/01sMD0oqTpY/s1600/photo-18.JPG" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" src="http://3.bp.blogspot.com/-Cjr7tja8O9A/VCbwCyDGLqI/AAAAAAAAAE0/01sMD0oqTpY/s1600/photo-18.JPG" height="240" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">A Selfie: me with two sleeping cows</td></tr>
</tbody></table>
<br />
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-gKVnjDsiQLc/VCbwFdcEMZI/AAAAAAAAAE8/WuOVDBpf0RM/s1600/photo-60.JPG" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" src="http://1.bp.blogspot.com/-gKVnjDsiQLc/VCbwFdcEMZI/AAAAAAAAAE8/WuOVDBpf0RM/s1600/photo-60.JPG" height="320" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">and the inevitable conclusion. </td></tr>
</tbody></table>
<br />
<div class="separator" style="clear: both; text-align: center;">
</div>
<br />
<div class="separator" style="clear: both; text-align: center;">
</div>
<br />
<div class="separator" style="clear: both; text-align: center;">
</div>
<br />
<div class="separator" style="clear: both; text-align: center;">
</div>
<span class="Apple-style-span" style="font-size: 19px; line-height: 38px;"><span style="mso-tab-count: 1;"> </span></span><span class="Apple-style-span" style="font-size: 19px; line-height: 38px;">I
love the big E , long after friends and</span><span class="Apple-style-span" style="font-size: 19px; line-height: 38px;"><span style="mso-spacerun: yes;">
</span></span><span class="Apple-style-span" style="font-size: 19px; line-height: 38px;">family have </span><span class="Apple-style-span" style="font-size: 19px; line-height: 38px;"><span style="mso-spacerun: yes;"> </span></span><span class="Apple-style-span" style="font-size: 19px; line-height: 38px;">dismissed the
gluttony and </span><span class="Apple-style-span" style="font-size: 19px; line-height: 38px;"><span style="mso-spacerun: yes;"> </span></span><span class="Apple-style-span" style="font-size: 19px; line-height: 38px;">the kitsch. They view
the fair as hopelessly tawdry</span><span class="Apple-style-span" style="font-size: 19px; line-height: 38px;"><span style="mso-spacerun: yes;"> </span></span><span class="Apple-style-span" style="font-size: 19px; line-height: 38px;">and
vulgar , appealing to</span><span class="Apple-style-span" style="font-size: 19px; line-height: 38px;"><span style="mso-spacerun: yes;"> </span></span><span class="Apple-style-span" style="font-size: 19px; line-height: 38px;">base,</span><span class="Apple-style-span" style="font-size: 19px; line-height: 38px;"><span style="mso-spacerun: yes;"> </span></span><span class="Apple-style-span" style="font-size: 19px; line-height: 38px;">blue collar appetites .</span><span class="Apple-style-span" style="font-size: 19px; line-height: 38px;"><span style="mso-spacerun: yes;"> </span></span><br />
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<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
love the Big E because I view the fair as a response to all that is wrong with
our<span style="mso-spacerun: yes;"> </span>modern lives . In a world of homogenous
apathy, the Big E<span style="mso-spacerun: yes;"> </span>may be the only
place on the planet where one can view the lovingly<span style="mso-spacerun: yes;"> </span>grown,<span style="mso-spacerun: yes;"> </span>largest
gourd <span style="mso-spacerun: yes;"> </span>in Connecticut and <span style="mso-spacerun: yes;"> </span>vicariously <span style="mso-spacerun: yes;"> </span>experience the honest, exuberant<span style="mso-spacerun: yes;"> </span>joy of a 16 year –old who<span style="mso-spacerun: yes;"> </span>won a ribbon for raising the<span style="mso-spacerun: yes;"> </span>best groomed<span style="mso-spacerun: yes;"> cow</span> in New England.<o:p></o:p></span><br />
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><br /></span>
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/-k31NwHZSNpI/VCby1wNKcwI/AAAAAAAAAGw/A05ZogjjfhE/s1600/photo.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://4.bp.blogspot.com/-k31NwHZSNpI/VCby1wNKcwI/AAAAAAAAAGw/A05ZogjjfhE/s1600/photo.JPG" height="240" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">I have no idea what she's doing but she's proud and excited!</td></tr>
</tbody></table>
</span><br />
<div>
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><br /></span></div>
</div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
have always lived in proximity to state fairs.<span style="mso-spacerun: yes;"> </span>We visited the<span style="mso-spacerun: yes;">
</span>Danbury State fair yearly until someone decided Connecticut <span style="mso-spacerun: yes;"> </span>needed a<span style="mso-spacerun: yes;"> </span>Forever 21-chocked mall <span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>more than
a tractor pull<span style="mso-spacerun: yes;"> </span>competition, and maybe they do. The
New York State Fair <span style="mso-spacerun: yes;"> </span>lies 5 miles from
upstate medical school in Syracuse.<span style="mso-spacerun: yes;"> </span>I couldn’t begin a year<span style="mso-spacerun: yes;">
</span>without inspecting the <span style="mso-spacerun: yes;"> </span>life sized butter sculpture.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">It’s September 21, 2011. I stand at
the portal of the Brigham and woman’s hospital, checking-in for my stem cell
transplant, We are silent and grim.<span style="mso-spacerun: yes;">
</span>There is no future, only <span style="mso-spacerun: yes;"> </span>disease.<span style="mso-spacerun: yes;"> </span>“You
have 10 years to live,” Firsh told me four years previous, and now, with my
disease<span style="mso-spacerun: yes;"> </span>surging ahead,<span style="mso-spacerun: yes;"> </span>six more years<span style="mso-spacerun: yes;"> </span>on this mortal coil seems an
impossibility. The admitting nurse eyes us warily.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>“
Why are you here?”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>I ignore the existential entreaty.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>“We were told to show up at 9 AM.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>“That’s
crazy. They’ll just make you sit here all day, they wont admit <span style="mso-spacerun: yes;"> </span>you until tomorrow. Go do something fun.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span>The
<span style="mso-spacerun: yes;"> </span>Dana Farber is<span style="mso-spacerun: yes;"> 110</span> miles from the big E.<span style="mso-spacerun: yes;"> </span>We had to go. The unspoken message was,
of, course <span style="mso-spacerun: yes;"> </span>“You may never see a polled Hereford (1) <span style="mso-spacerun: yes;"> </span>again,
you might as well go.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>We
had, I recall, a wonderful time. I<span style="mso-spacerun: yes;">
</span>was the proud possessor of a<span style="mso-spacerun: yes;">
</span>central line, an IV that runs through the chest wall directly into the
heart. I spent the day trying to fool everyone I was drinking beer through the
plastic straw -like attachment protruding from my shirt.<span style="mso-spacerun: yes;"> </span>I had been given a quick lecture about
immunity and my complete lack thereof. <span style="mso-spacerun: yes;"> </span>As far as I could tell, <span style="mso-spacerun: yes;"> </span>everything one could see, touch or eat at the Big E was on
some banned list. I remember Cyn running behind me, laying down a path of
Purell as If I were a<span style="mso-spacerun: yes;"> </span>giant<span style="mso-spacerun: yes;"> </span>snail secreting a glistening alcohol trail.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
remember taking real inspiration form the Big E that day. I was about to have
buckets of poison and, apparently a little local beer, poured directly into my
heart for the next few weeks but, <span style="mso-spacerun: yes;"> </span>in<span style="mso-spacerun: yes;">
</span>Springfield,<span style="mso-spacerun: yes;"> </span>life went on,
oblivious to my insanely<span style="mso-spacerun: yes;">
</span>perplexing predicament.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>At
the Big E, each New England state is given a pavilion in which to display its
local<span style="mso-spacerun: yes;"> </span>wares, foods and
customs.<span style="mso-spacerun: yes;"> </span>The Maine pavilion
serves<span style="mso-spacerun: yes;"> </span>potatoes at 6 dollars a serving,
demonstrating<span style="mso-spacerun: yes;"> </span>Maine’s two
famous<span style="mso-spacerun: yes;"> </span>exports:<span style="mso-spacerun: yes;"> </span>starchy tubers and chutzpah.<span style="mso-spacerun: yes;"> </span>New Hampshire’s pavilion was transformed
into a big state lottery ticket store. Massachusetts was all about the chowder. <span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>Vermont ‘s<span style="mso-spacerun: yes;">
</span>exhibit<span style="mso-spacerun: yes;"> </span>extolled the virtues
of flannel outer ware and<span style="mso-spacerun: yes;"> </span>maple
syrup.<span style="mso-spacerun: yes;"> </span>In our Mall -saturated
world,<span style="mso-spacerun: yes;"> </span>where one can buy the same
Victoria secret<span style="mso-spacerun: yes;"> </span>bra<span style="mso-spacerun: yes;"> </span>from coast to coast, shopping at Vermont’s<span style="mso-spacerun: yes;"> </span>Flannel<span style="mso-spacerun: yes;"> </span>shop <span style="mso-spacerun: yes;"> </span>for<span style="mso-spacerun: yes;"> </span>comfortable<span style="mso-spacerun: yes;"> </span>plaid work shirts was strangely liberating. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>The
day passed. We drove back to Boston.<span style="mso-spacerun: yes;">
</span>I lived.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>We
returned to the Big E last week.<span style="mso-spacerun: yes;">
</span>The cancer is gone, but the malady lingers. I have aged<span style="mso-spacerun: yes;"> </span>far <span style="mso-spacerun: yes;"> </span>more than 3 years over the past 36 months. <span style="mso-spacerun: yes;"> </span>I worry my enthusiasm and life -wonder
is ebbing under a constant onslaught of medication and discomfort. This year, I
was less willing to<span style="mso-spacerun: yes;"> </span>dismiss the
morbidly obese, lining up to buy hamburgers<span style="mso-spacerun: yes;"> </span>served between two doughnuts. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
had my shopping list for this year:<span style="mso-spacerun: yes;">
</span>A new Timex watch from the Connecticut<span style="mso-spacerun: yes;"> </span>pavilion,<span style="mso-spacerun: yes;"> </span>some lavender
soaps <span style="mso-spacerun: yes;"> </span>and flannel<span style="mso-spacerun: yes;"> </span>nightshirts from the Vermont<span style="mso-spacerun: yes;"> </span>display, <o:p></o:p></span></div>
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<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>The
fair has changed.<span style="mso-spacerun: yes;"> </span>The Timex
exhibit where I stock up yearly on<span style="mso-spacerun: yes;">
</span>cheap watches<span style="mso-spacerun: yes;"> </span>( three for
$50) is now home to <span style="mso-spacerun: yes;"> </span>Pez,
another<span style="mso-spacerun: yes;"> </span>Connecticut product. There
may be no more useful object on the planet than a cheap, rugged wristwatch.<span style="mso-spacerun: yes;"> </span>There may be nothing more redundant and
useless than a Daffy Duck Pez dispenser, available at any<span style="mso-spacerun: yes;"> </span>Wal-Mart<span style="mso-spacerun: yes;"> </span>across this<span style="mso-spacerun: yes;">
</span>monotonous. indifferent <span style="mso-spacerun: yes;"> </span>land of
ours. I feel a real sense of loss as metal watch mechanisms<span style="mso-spacerun: yes;"> </span>are replaced by<span style="mso-spacerun: yes;"> </span>sugar and plastic.<span style="mso-spacerun: yes;"> </span>The soaps are gone, replaced by yet another
ice cream shoppe. <span style="mso-spacerun: yes;"> </span>I do love Ben
and Jerry but I can buy a <span style="mso-spacerun: yes;"> </span>pallet
of Cherry Garcia in<span style="mso-spacerun: yes;"> </span>Stockton,
California, and yet the one<span style="mso-spacerun: yes;"> </span>factory
in Vermont that produces<span style="mso-spacerun: yes;"> </span>little
bars of lovely<span style="mso-spacerun: yes;">
</span>lavender soap is out of business.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
left the Big E this year<span style="mso-spacerun: yes;"> </span>with
mixed emotions. I’ll be alive next year. I just<span style="mso-spacerun: yes;"> </span>accepted a three year commitment with U.<span style="mso-spacerun: yes;"> </span>Conn to mentor their med students, and
I intend on<span style="mso-spacerun: yes;"> </span>shaking their hand in
four years. I’m just not sure If I’ll return <span style="mso-spacerun: yes;"> </span>to the<span style="mso-spacerun: yes;"> </span>Big E.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 14.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">The joy of life is in the
unexpected, the breathtaking, the unique. My survival is no longer <span style="mso-spacerun: yes;"> </span>breathtaking <span style="mso-spacerun: yes;"> </span>or unexpected but neither is the Big E.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 5.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-size: 14.0pt; mso-bidi-font-size: 12.0pt;">(1)</span><span style="font-family: Georgia; font-size: 21.0pt; mso-bidi-font-family: Georgia;"> <span style="mso-spacerun: yes;"> </span></span><span style="color: #1c1c1c; font-family: Helvetica; font-size: 14.0pt; mso-bidi-font-family: Helvetica;">The Polled Hereford is a hornless variant of the Hereford with
the <a href="http://en.wikipedia.org/wiki/Polled_livestock"><span style="color: #0037a0; text-decoration: none; text-underline: none;">polled</span></a>
<a href="http://en.wikipedia.org/wiki/Gene"><span style="color: #0037a0; text-decoration: none; text-underline: none;">gene</span></a>, a natural <a href="http://en.wikipedia.org/wiki/Genetic_mutation"><span style="color: #0037a0; text-decoration: none; text-underline: none;">genetic mutation</span></a> that was
selected into a separate breed beginning in 1889The Polled Hereford breed is
bred for its deep forequarters, depth and muscling, docile temperament,
fast-growing calves, and good quality of beef<o:p></o:p></span></div>
<div class="MsoNormal">
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<!--EndFragment-->Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com0tag:blogger.com,1999:blog-3346982693192735867.post-49355598107218538422014-09-07T09:47:00.002-07:002014-09-07T13:44:36.808-07:00To. Forgive. divine<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">DB Sweeny is terrified.<span style="mso-spacerun: yes;"> </span>He is going to die.<span style="mso-spacerun: yes;"> </span>They’re all going to die. His hand
twitches <span style="mso-spacerun: yes;"> </span>as he plots his B
25’s<span style="mso-spacerun: yes;"> </span>course over the<span style="mso-spacerun: yes;"> </span>North Sea with a red crayon.<span style="mso-spacerun: yes;"> </span>He glances out the window.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">“That’s the third Reich we’re
flying over,” He says ruefully. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">Memphis Belle. <span style="mso-spacerun: yes;"> </span>World war two melodrama about
young flyboys bombing Hitler’s empire. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">The cartoon representing<span style="mso-spacerun: yes;"> </span>our Airbus 330<span style="mso-spacerun: yes;"> </span>has just<span style="mso-spacerun: yes;"> </span>entered European<span style="mso-spacerun: yes;">
</span>airspace. Somewhere below, the good people of Leiden are buying herring along<span style="mso-spacerun: yes;"> </span>the canals,<span style="mso-spacerun: yes;"> </span>sipping<span style="mso-spacerun: yes;"> </span>coffee,
bracing for another day’s onslaught<span style="mso-spacerun: yes;">
</span>of euro socialism and legal hashish.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">Lufthansa a has done a fine job
spiriting us across the<span style="mso-spacerun: yes;"> </span>Atlantic. <span style="mso-spacerun: yes;"> </span>Some unseen hand drew all the Business
Class shades in the middle of the might, letting us sleep an extra hour or
so.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>Dankeshein <span style="mso-spacerun: yes;"> </span>They
are an efficient people. <span style="mso-spacerun: yes;"> </span>They
could have won WWII if they had set less exulted goals than conquering the world
and exterminating its Jews. They should have settled on annexing the
Sudetenland and <span style="mso-spacerun: yes;"> </span>sending<span style="mso-spacerun: yes;"> </span>Golda Meir hate mail. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">As a child, I remember my dad forbidding
us from flying to Germany on Lufthansa. “You know,” He’d say in a tone that
forbade contradiction or discussion, <span style="mso-spacerun: yes;"> </span>“ the Lufthansa<span style="mso-spacerun: yes;">
</span>pilots<span style="mso-spacerun: yes;"> </span>flew for the Luftwaffe, during World War Two.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>That
may have been true in 1968, when the<span style="mso-spacerun: yes;">
</span>average ex Luftwaffe pilot was probably<span style="mso-spacerun: yes;"> </span>married and <span style="mso-spacerun: yes;"> </span>raising teenagers.<span style="mso-spacerun: yes;">
</span>The average<span style="mso-spacerun: yes;"> </span>WW
II<span style="mso-spacerun: yes;"> Luftwaffe </span> Pilot<span style="mso-spacerun: yes;"> </span>would be<span style="mso-spacerun: yes;"> </span>90 <span style="mso-spacerun: yes;"> </span>this year,
so I feel a little less guilt. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">Point made. I am appalling old.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>As
the continent scrolls by beneath,<span style="mso-spacerun: yes;">
</span>I start performing <span style="mso-spacerun: yes;"> </span>the ominous
math.<span style="mso-spacerun: yes;"> </span>I was born 14 years after D
Day. <span style="mso-spacerun: yes;"> </span>Fourteen years ago I was…
well, I was sitting in the same office I now occupy.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>It
gets worse, much worse. <span style="mso-spacerun: yes;"> </span>I was born
in a country with 49 States. When I was born, the last Civil war veteran was
still alive. He was 113, true, but alive.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">How did I get so<span style="mso-spacerun: yes;"> </span>old?<br />
<span style="mso-tab-count: 1;"> </span>The
answer is easy: I didn’t die.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>On
some level, this trip to Munich, with connections to Croatia , is taking me
back to my roots. <span style="mso-tab-count: 1;"> </span>More
specifically, it’s taking me to the source of my stem cells. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Dankeshein,
Deuchland. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>I imagine trying to explain to a
German civilian from the 1940s<span style="mso-spacerun: yes;">
</span>exactly what I needed from him.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>“I
know we are at war, and I know your leader has some misgivings about , you
know, Jews, but <span style="mso-spacerun: yes;"> </span>it turns out we
have identical bone marrow. Would you be a dear and donate a pint of your stem
cells to me? Otherwise, I die. “<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">Which part of this request would he
find the most absurd?<span style="mso-spacerun: yes;"> </span>That he
shared<span style="mso-spacerun: yes;"> </span>a bone marrow with an
American<span style="mso-spacerun: yes;"> </span>Jewish<span style="mso-spacerun: yes;"> </span>stranger? Or would he want to know
about a procedure that kills leukemia though a technique called “ Graft Versus
Host Syndrome?”<span style="mso-spacerun: yes;"> </span>In the end, I’m
sure I’d tell him it was magic. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>We
land in <span style="mso-spacerun: yes;"> </span>Dubrovnik, Croatia, to
start our bike trip.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>Croatia is a lovely country,<span style="mso-spacerun: yes;"> </span>evocative of<span style="mso-spacerun: yes;"> </span>the Northern California coast with citrus trees, high
mountains, and a long, attractive coastline.<span style="mso-spacerun: yes;"> </span>An occasional soviet era<span style="mso-spacerun: yes;"> </span>building<span style="mso-spacerun: yes;">
</span>appears, hinting at an ominous<span style="mso-spacerun: yes;">
</span>communist past.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Dubrovnik
is a medieval, walled city.<span style="mso-spacerun: yes;">
</span>It’s evocative of Venice, not surprising when one realizes they were
founded and built at the same time by the same people. Then you notice things<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>You
notice most of the <span style="mso-spacerun: yes;"> </span>buildings in
this<span style="mso-spacerun: yes;"> </span>600 year old city have new
roofs. The Yugoslavs tried to destroy the city in 1991.<span style="mso-spacerun: yes;"> </span>You notice a pockmarked hotel, built by
the communists and abandoned after the war because,<span style="mso-spacerun: yes;"> </span>let’s face it, you <span style="mso-spacerun: yes;"> </span>don’t rebuild <span style="mso-spacerun: yes;"> </span>1985 era poured cement hotels.<span style="mso-tab-count: 1;"> </span><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Point
made: War is eternal. One can wander past the Egyptian Obelisk along <span style="mso-spacerun: yes;"> </span>the Thames in London and see<span style="mso-spacerun: yes;"> </span>where the German bombs left pockmarks
during World War I.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>The<span style="mso-spacerun: yes;"> </span>1991 war was a prelude to the horrors
of the<span style="mso-spacerun: yes;"> </span>Bosnian conflict ten years
later.<span style="mso-spacerun: yes;"> </span>In that conflict, the Serbs
decided to exterminate the Muslim Bosnians. <span style="mso-spacerun: yes;"> </span>Slodidan Milosevic , the Serbian<span style="mso-spacerun: yes;"> </span>ex- communist leader, was tried for war crimes and<span style="mso-spacerun: yes;"> </span>eventually imprisoned. I asked our
Croat<span style="mso-spacerun: yes;"> </span>Bus driver about all this. “
Too bad he died so soon,” was his reply. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>The
question lingers. How many years until the Serbians and Bosnians start swapping
stem cells? Perhaps that time span, between extermination camp and<span style="mso-spacerun: yes;"> </span>stem cell donation, <span style="mso-spacerun: yes;"> </span>should become a unit of<span style="mso-spacerun: yes;"> </span>time. It would represent a wonderful
thing, the time it takes to forgive one’s tormentors. <span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
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<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: 18.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
am old, I am old, I wear my modern, biking trousers rolled.<span style="mso-spacerun: yes;"> </span>God my legs are thin.<span style="mso-spacerun: yes;"> </span>Off for a week<span style="mso-spacerun: yes;"> </span>biking across Croatia. <o:p></o:p></span></div>
Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com0tag:blogger.com,1999:blog-3346982693192735867.post-68232620983354267032014-08-30T22:59:00.005-07:002014-08-31T04:36:22.310-07:00Summer stars<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><br /></span>
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="http://2.bp.blogspot.com/-DdabA0Qt-xU/VAK6ZayzCVI/AAAAAAAAAEM/Eye_1Vj-4CE/s1600/orion.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-DdabA0Qt-xU/VAK6ZayzCVI/AAAAAAAAAEM/Eye_1Vj-4CE/s1600/orion.jpg" /></a></div>
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><br /></span>
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">The flags fly in distress on
Warrenton Avenue.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: large;"><span style="line-height: 200%;">Every morning I drive Hartford’s West
end on the way to work.</span></span><span style="font-size: 18pt; line-height: 200%;"> </span><span style="font-size: large;"><span style="line-height: 200%;">Hartford
is a sad, strange, crumbling town. It was the center of the American intellectual
universe in the 1870s when Mark Twain and HB Stowe lived down the road and American publishing</span></span><span style="font-size: 18pt; line-height: 200%;"> </span><span style="font-size: large;"><span style="line-height: 200%;">and insurance
empires</span></span><span style="font-size: 18pt; line-height: 200%;"> </span><span style="font-size: large;"><span style="line-height: 200%;">thrived on the banks of the </span><span style="line-height: 48px;">Connecticut</span><span style="line-height: 200%;"> river.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">The large Victorian mansions have
gone to seed; their decaying hulks<span style="mso-spacerun: yes;"> </span>still lurk amid the <span style="mso-spacerun: yes;"> </span>empty
lots and homeless shelters in our northern end.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><br /></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><o:p> </o:p></span><span style="font-size: 18pt; line-height: 200%;"> </span><span style="font-size: 18pt; line-height: 200%;">The
West End is a little different.</span><span style="font-size: 18pt; line-height: 200%;">
</span><span style="font-size: 18pt; line-height: 200%;">The large houses are still in good repair, Mark Twain’s house still
boasts a lovely multi colored slate tile roof.</span><span style="font-size: 18pt; line-height: 200%;"> </span><span style="font-size: 18pt; line-height: 200%;">The</span><span style="font-size: 18pt; line-height: 200%;">
</span><span style="font-size: 18pt; line-height: 200%;">mansions’ occupants work in the city and have money enough to maintain their
houses in good repair.</span><span style="font-size: 18pt; line-height: 200%;"> </span><span style="font-size: 18pt; line-height: 200%;">The neighborhood
</span><span style="font-size: 18pt; line-height: 200%;"> </span><span style="font-size: 18pt; line-height: 200%;">is </span><span style="font-size: 18pt; line-height: 200%;"> </span><span style="font-size: 18pt; line-height: 200%;">populated</span><span style="font-size: 18pt; line-height: 200%;"> </span><span style="font-size: 18pt; line-height: 200%;">by restless,
radical people who send their children to private school. They hang signs on their houses, “ End This Endless War “
and</span><span style="font-size: 18pt; line-height: 200%;"> </span><span style="font-size: 18pt; line-height: 200%;">“US out of Iraq.” </span><span style="font-size: 18pt; line-height: 200%;"> </span><span style="font-size: 18pt; line-height: 200%;">Rainbow flags adorn a fair number
of homes.</span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">I am startled by the number of American
flags hanging from the ramparts.<span style="mso-spacerun: yes;">
</span>They are universally upside down, the sign of warning,
distress. One must never sail by
a boat with a reversed<span style="mso-spacerun: yes;"> </span>flag,
someone<span style="mso-spacerun: yes;"> </span>is in trouble.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>The
flags hang upside down. Someone is in trouble.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">I haven’t<span style="mso-spacerun: yes;"> </span>been sleeping these<span style="mso-spacerun: yes;"> </span>nights. I am<span style="mso-spacerun: yes;"> </span>uncertain
why. The high dose steroids I restarted to fight the Graft Versus host
disease play havoc with my internal clock. <span style="mso-spacerun: yes;"> </span>My leg cramps strike about 3 AM, catapulting me from bed. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 18pt; line-height: 200%;"> </span><span style="font-size: large;"><span style="line-height: 200%;">Doesn’t
matter. It</span><span style="line-height: 48px;">’</span><span style="line-height: 200%;">s 3 AM and I am up for the day, ready to prowl the internet, </span></span><span style="font-size: 18pt; line-height: 200%;"> </span><span style="font-size: large;"><span style="line-height: 200%;">seek solace in the hot tub.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I<span style="mso-spacerun: yes;"> </span>once dismissed this 400<span style="mso-spacerun: yes;"> </span>gallon tub of fermenting water as the
ultimate bourgeois purchase.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>When I see a hot tub, my
mind flashes to the ancient joke:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><i>How many Californians does it<span style="mso-spacerun: yes;"> </span>take to screw in a<span style="mso-spacerun: yes;"> </span>light blub?<o:p></o:p></i></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><i>Californians don’t screw in<span style="mso-spacerun: yes;"> </span>light bulbs they screw in hot tubs.</i><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">We lack sufficient <span style="mso-spacerun: yes;"> </span>property to<span style="mso-spacerun: yes;"> </span>frolic nude in<span style="mso-spacerun: yes;"> </span>our
hot tub, but the 101 degree water kills my leg cramps as efficiently <span style="mso-spacerun: yes;"> </span>as an injection of<span style="mso-spacerun: yes;"> succinylcholine</span>.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">So for this, I am grateful. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 18pt; line-height: 200%;"> </span><span style="font-size: large;"><span style="line-height: 200%;">I
lie in the hot tub and examine the stars. At some point I suggested</span></span><span style="font-size: 18pt; line-height: 200%;"> </span><span style="font-size: large;"><span style="line-height: 200%;">placing </span></span><span style="font-size: 18pt; line-height: 200%;"> </span><span style="font-size: large;"><span style="line-height: 200%;">the tub in a</span></span><span style="font-size: 18pt; line-height: 200%;">
</span><span style="font-size: large;"><span style="line-height: 200%;">gazebo- like enclosure. Cyn declined, and she was right. </span><span style="line-height: 48px;">Contemplating</span><span style="line-height: 200%;"> the stars is crucial when undergoing hydrotherapy in the
hot tub. <o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>I
think of New Zealand, where we<span style="mso-spacerun: yes;">
</span>biked a few<span style="mso-spacerun: yes;"> </span>years ago.<span style="mso-spacerun: yes;"> </span>The stars there are different. I finally
saw my beloved Alpha Centuri, the star closest to earth, the subject of Science
fiction intrigue. The stars there are
upside down. The constellations were created <span style="mso-spacerun: yes;"> </span>in the North and didn’t translate well to the southern
hemisphere.<span style="mso-spacerun: yes;"> </span>All the constellations
stand on their heads<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">Orion skids across the sky on his skull in New Zealand.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">The stars are upside down. They are
in trouble.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">I was a nerd. I was a geek.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">I love astronomy.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">I glance up for comfort and the
stars are all wrong.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: large;"><span style="line-height: 200%;">All wrong in West </span><span style="line-height: 48px;">Hartford</span><span style="line-height: 200%;"> </span></span><span style="font-size: 18pt; line-height: 200%;"> </span><span style="font-size: large;"><span style="line-height: 200%;">at 4 AM on a late August night.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">All wrong.<o:p></o:p></span><br />
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">Shakespeare wrote of the terror when day switches places with night, it’s how I feel when the wrong stars appear in my troubled skies.</span><br />
<div class="original-line" style="color: #424242; font-family: LFT-Etica-Web, Arial, sans-serif; font-size: 14px; line-height: 24px;">
<i>And yesterday the owl did sit</i></div>
<div class="original-line" style="color: #424242; font-family: LFT-Etica-Web, Arial, sans-serif; font-size: 14px; line-height: 24px;">
<i>Even at noon-day upon the marketplace,</i></div>
<span style="color: #424242; font-family: LFT-Etica-Web, Arial, sans-serif; font-size: 14px; line-height: 24px;"><i>Hooting and shrieking.</i></span><br />
<span style="font-size: large; line-height: 200%;"><br /></span>
<span style="font-size: large; line-height: 200%;">Vega should float serenity at the apex
of the sky, along with Deneb and Altair, and yet my summer friends are absent. </span></div>
<div class="MsoNormal">
<span style="font-size: large;"><span style="line-height: 200%;"><br /></span></span></div>
<div class="MsoNormal">
<span style="font-size: large;"><i><span style="line-height: 200%;">from this brave overhanging firmament, this </span><span style="line-height: 48px;">majestical</span><span style="line-height: 200%;"> roof fretted with </span><span style="line-height: 48px;">golden</span><span style="line-height: 200%;"> fir</span><span style="line-height: 200%;">e. It appears no other thing to me than a vile and </span><span style="line-height: 48px;">pestilent</span><span style="line-height: 200%;"> </span><span style="line-height: 48px;">conflagration</span><span style="line-height: 200%;"> of vapor.<o:p></o:p></span></i></span></div>
<div class="MsoNormal">
<span style="font-size: large;"><span style="line-height: 200%;"><br /></span></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">Orion the hunter says hi.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">Orion should not be saying hi.
Orion is my winter friend; He informs me snow should be on the ground.<span style="mso-spacerun: yes;"> </span>I wait every<span style="mso-spacerun: yes;"> </span>late fall for the Big E Exposition <span style="mso-spacerun: yes;"> </span>and<span style="mso-spacerun: yes;"> for </span>the<span style="mso-spacerun: yes;"> </span>Hunter and
Sirius, his trusty dog , to patrol the frosty night sky.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>These are difficult times<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">The very stars are askew.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<i style="mso-bidi-font-style: normal;"><span style="color: #131313; font-family: Times; font-size: 17.0pt; line-height: 200%; mso-bidi-font-family: Times;">"The time is out of joint: O cursed spite, That ever
I was born to set it right!"</span></i><span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">My universe is<span style="mso-spacerun: yes;"> </span>altered, changed these days. I
function, but function in pain. <span style="mso-spacerun: yes;"> </span>Orion walks the night sky. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>One can see winter star in summer. All it takes is a little
Graft Versus Host disease, a little mouth pain, a little muscle cramp, a little
existential terror that one’s condition will never change. At 4 AM, the stars in the August sky match those seen in winter at dusk.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">They never mentioned this in the
transplant brochure, that<span style="mso-spacerun: yes;"> </span>an allogenic transplant will make <span style="mso-spacerun: yes;"> </span>winter stars
appear on hot desultory summer nights.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">One day <span style="mso-spacerun: yes;"> </span>I’ll feel better<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">One day the stars will return to
normal.<o:p></o:p></span></div>
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<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 18.0pt; line-height: 200%; mso-bidi-font-size: 12.0pt;">Until then, Orion and Sirius will patrol
my summer <span style="mso-spacerun: yes;"> </span>skies.<o:p></o:p></span></div>
Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com0tag:blogger.com,1999:blog-3346982693192735867.post-444890772329820082014-08-24T01:59:00.002-07:002014-08-24T14:37:02.491-07:00The woman screamedYou need a doctor! She was only trying to help, I know . I popped into the CVS to pick up gauze, tape, non stick dressings, antibiotics. You know, the stuff one usually ends up buying after the first day of a 100 -mile bike trip.<br />
<br />
I looked like an extra from a zombie movie. Blood, every color of the crimson spectrum, flowed down my left leg, pooling on my high tech sock. The effect was, and is, highly Hollywood, the zombies have taken an unhealthy bite from my kneecap, and rivulets of unclogging clot are starting to saturate my clothing.<br />
<br />
<br />
Fun day, right? The path to gore town is too tediuous to relate here, but includes new blood clots, anti coagulants and most importantly, a fall from my bike exactly 47.5 miles ago when I was the proud owner of 5 quarts of blood.<br />
But that isn't the point of the story<br />
Honestly, how do you women do it? How do you casually manage 5 quarts of sticky embarrassing red ooze while trying to have a life filled with dinner parties, white outfits and , more to the point, vigorous exercise that tends to unleash the red sticky flood gates?<br />
I am falling. I am falling behind.<br />
The family, yours truly non withstanding, are going through miraculous rebirth. I burst with pride over Cyn who is thriving in a potential new managerial job. My heart sings for jeff, starting his second year at med school, cool and confident, reassured he chose the proper path in life. Abber Dab is growing too, starting her new job, driving the roads in her 2011 silver honda civic. And dan.... Well, as they say, he is well along his chosen career path, world domination.<br />
And then there's me. My feet are doughy little muffins , the result of a lack of anti coagulation. The river of death actually courses down my left leg. Cyn is negotiating a new contract , and she has used the phrase " my chronically sick husband" in her negotiations and here's the sad part: it's true. I'm not fooling anyone " you're getting better" she says, but she says it in the same tone they use to describe the dead guy in the Monty Python " bring out your dead" sketch. I am falling / I am falling/ and she is calling..<br />
Kafka is such cliche but here I am ,Gregor Samsa, clinging to a wall as my family waits . We know how the story ends. They are moving on and I'm scaring a poor woman at the Northampton cvs<br />
<br />
At what point do I run dry?<br />
<br />
<i>My dear brother just called in a panic, apparently the blog implies I am hospitalized. I am at home, Cyn cleaned up the mess at the Hotel. Thanks, hon.</i><br />
<i><br /></i>
<i>Falling, I am falling, but she keeps calling me home again.</i><br />
<i>Cant leave the stage when I have such a devoted audience. </i><br />
<br />
<br />Stevenhttp://www.blogger.com/profile/09301428483430003526noreply@blogger.com0