Friday, February 22, 2013

A LIttle Diversion from Business as Usual

Cute, huh?
 Last July, the daughter of a friend brought forth triplets; she had carried them almost to term. After a day or so in a NICU, she and her husband brought them home to meet their big brother, then about 20 months of age.

Yes, that's four under 2. Mom had regaled her friends with pregnancy updates, including some unbelievable photos, pre-delivery. And she continues to post and blog when she has the time.

What a treat for me: I get to drop over from time to time. Most visitors are greeted by a smiling parent, most often holding one or two or three babies. It's not uncommon, after "Hi," to hear "Here."

So, yes, I get to hold a baby or a toddler.
Two babies and Mom

Now that they are almost mobile, the living room and family room have been transformed into a baby playland. Mom reports that big brother can 'read' to his brothers from books that he has memorized.

And, so far, no squabbles over who's grabbing who's blanket or toy.

Saturday, two of the babies were up and eager at 2 P.M. 
Getting mobile.

Sunday, February 10, 2013

Passing On

Have you ever considered how much of our everyday behavior is learned from someone else?  Most of the routine events in our lives require a previously programmed response.  All of us have learned how to react, get along, and behave in most social circumstances because we assimilated over time what was acceptable behavior.  That is, most of us learned…some better than others… I can assure you.  Step out of line and somebody will be quick to call it to your attention and will assuredly try to put you in your place.  Count on it.
Do you doubt me?  Let me give you a humorous (hopefully) example of what I am talking about.  Ladies, before I go further, let me challenge you to check out my example with the man of your choice.  I am certain that, after you stop laughing, you will find that I speak the truth.

Assume you are a male person who needs to urinate in a busy public place. Perhaps a large building, a convention center, an airport, a hospital or a courthouse.  You walk into the men’s room and are confronted with a row of ten urinals.  Let’s label them one through ten, starting on the left with one and ending on the right with ten.  “Four” is in use; the rest are unused.  Which urinal do you pick to do your business?  The possibilities theoretically are one through three and five through ten.  Simple enough, right?  WRONG!  The reality is that the possibilities are one, two and six through ten.  Given the scenario I have presented, no man I know is going to use three, four or five.  Why is this?  I do not know, except  to say that all men have somehow learned this. 

 Let’s take it a step further.  Suppose two, five, eight and ten are in use.  What now?  You have no doubt figured out that the point of my examples is that two guys are not going to stand next to each other and pee if it can be avoided. However, if the row of urinals is crowded, standing next to your fellow man is acceptable, providing you do not look around (certainly not down and/or to the left or right). Where and when did we men learn this?

 Doubt me?  Ladies, ask your guinea pig what would happen if in the first example he walked in and took the urinal on either side of four.  I can assure you that the user of four will zip up and be gone in seconds because that is weird behavior on your friend’s part, which will set off everyone’s alarm bells.  (Let’s not even consider where it is is permissible to look and what to say while peeing with your fellow man.)

The urinal example is just one small bit of learned behavior males seem to instinctively recognize.  I am sure ladies have your own unwritten rules that your momma taught you or that you picked up somewhere, so I will not comment on your rules, since I do not qualify as an expert. 

 On the other hand, all of us, both men and women, have been taught what to say when confronted with recurring behavior.  Let me give you another example.  You are at a party.  Your host or hostess hands you a drink, which you promptly spill because someone bumped you.  Do you get into a fight with the person who bumped you?  Of course not.  All of us would immediately begin to apologize to the host or hostess  and make an offer to help clean it up, which we know is going to be refused and is going to be met with the inevitable “it’s no big deal…the stain will come right out.”  Everyone has a part to play in this scenario and most of us know our parts perfectly.  And it is all learned somehow, from someone, somewhere.  Probably, we learned this programmed behavior from our parents, spouses, friends, at school or just by experience with what seems to work and the rules of common courtesy.  It is how we get along with other people and circumstances.

Most of us know how to behave at work, with the boss, with the spouse, with the children, with a new client, with our physician, with the coach, with the teacher or professor and with our parents and/or grandparents.  We have been well taught, mostly, and this shared, universal knowledge serves to take the rough edges off polite society.

But let me ask you this.  Has anyone given you instruction or advice on how to die?  Think about it.  Death is universal.  All of us will experience it eventually.  No exceptions.  Talk about recurring behavior!  Death is an experience that is unavoidable, all-encompassing, significant and totally inclusive.  It is going to hook every one of us.  As Mick Jagger said, “No one gets out of here alive.”

I have been thinking about this lately.  I cannot recall getting any advice or instruction on dying from anyone, including my dad, who had good advice on almost everything.  In fact, I cannot recall even a single discussion with anyone, ever, about how to die properly.  How does one go about dying properly?

As a precedent and side note, I was in my oncologist’s office the other day when I made the comment that dying of cancer was a “chickens—t” way for a real man to die.  She looked at me not understanding what I was saying.  When she asked what I meant, I said that a real man would die pulling eight g’s trying to outturn a SAM missile, or the wing would fold up on his airplane, or he would be a little hot in the turn on a motorcycle and hit a tree, or would be lost at sea on a solo voyage in his sailboat or would make one last charge at the enemy, having run out of ammunition. I commented that dying at home in bed, comatose from painkillers, having wasted away to nothing did not appeal to me.  She just shook her head.  Maybe she knows something about dying I do not know.  Since I know absolutely nothing, that is certainly possible, but she didn’t volunteer any inside knowledge or advice either, and I am sure that she, like my sister, a nurse practitioner, has seen hundreds of people die in a variety of circumstances.

What about the rules of dying?  Are there such rules?  If there are, where do we find them?  And if found, are they good rules?  I just do not know.

My wife and I recently had a discussion about dying. I told my wife that I wanted to die like “an officer and a gentleman,” whatever that was.  Smiling, she responded that in her view the goal should be to “die well.”  As usual she is right. I like that.  It sounds good, but what does that mean and, more importantly, how do you do that?  I am not sure, but I have been thinking about it.

A few of us are going to die violently and suddenly in car or motorcycle crashes or as victims of crimes.  But the majority of us are going to meet our end by heart attack, cancer or other disease, after a significantly long illness.  If that is what gets you, you might have a say in the place of your death. But probably not.  Any choice you might have comes down to whether you prefer a healthcare facility or your home.  The healthcare facility is not really a choice, because if you present yourself at the ER in the final stage of a terminal illness, someone is going to tell you, “There is nothing we can do for you.  Go home.” 

 I know this for a fact, because I have checked it out.  Show up with a few days to tough out before you die and you are going to get sent home to die.  Dying in a hospital has its benefits, to be sure.  It is clean, warm, nurses are there to take care of you, they can kill the pain and clean up your mess, if you can’t get out of bed.  Kind of like a hotel that you never check out of.  At least while alive.

On the other hand, if you die at home, presumably someone will be present to take care of you.  Maybe.  Maybe not.  Like the hospital, your bedroom will be warm and clean, and familiar to you, but there are no 24 hour nurses, and you will wait to get painkillers from a visiting nurse, providing she can get orders from the physician.  A precarious situation.  And someone has to clean up after you and give you a bath if you need it.  Gross.

If you want visitors, then home is probably a better place to be, providing they can be regulated by someone.  Chances are there are a few people you do not want to see.  Nurses can get rid of them in a hospital.  All you have to do is push the call button and ask for assistance.  But what about at home?  

How do you get rid of an unwanted family member?  We all have them, you know.  Particularly ones who may be concerned about the will.  I have been in a room where a person was dying and the relatives were openly arguing about who got what, totally oblivious to the not-quite-yet deceased.  Very grisly.

Suppose you are in extreme pain.  Most of us do not do well in pain.  We tend to be difficult, nasty and say unkind things to whoever happens to be standing there. At least I do.  I do not want to unload on or snap at some well-wisher who is there to pay his or her last respects.  Also, there is the privacy issue.  Most of us do not want people we care about to see us squirming in pain.  Most of us do not want to be seen having to deal with bedpans and urine bags either.  It is not dignified.  It is not how we want to be remembered by anyone.  So what do you do, tell them to get out?  I do not know.

I think most of us would like to be visited in our last days or hours by friends and loved ones who have enough sense to know when to leave.  But I think such people are rare. I think that I would like old friends and most, but not all, family members to hang out.  But it must be within reason.  I know some people who have actually ordered a pizza for themselves and ate it, washing it down with a few beers in front of the dying person.  Talk about no couth.  

The bedroom I have shared with Lynnie for thirty plus years, in addition to the king-sized bed, has three rocking chairs in it, along with my Ducati motorcycle, which is currently wintering next to our bed. Three rocking chairs means at least three visitors.  Or is that six with spouses?  Is some ignorant person going to sit on my motorcycle?  I have no doubt someone will try to buy it from Lynnie, just as soon as my last breath has slipped away.  Do we need to move some of the rocking chairs out of the bedroom, so people will have to stand and, therefore, will not stay long? Relocate silver Duckie? I just don’t know.  I suppose my wife will handle it.

Having thought about these problems and discussed them with my wife, I guess what I would like is to be comfortably lying in my familiar bed bathed in the morning sunlight, wrapped in my eiderdown comforter, warm and toasty, pain free or gently floating on morphine, being held in my Lynnie’s arms and with the Iverson resting her chin on my chest, with quiet music playing and a few much appreciated friends quietly rocking away my final moments.  I think that would be “dying well” by anyone’s standards. It appeals to me. Perhaps there will be a smile on my face when I take that last look at my Lynnie and begin to hear the music.  I think maybe this is doable.  I shall see soon enough.

Mike out.

Friday, February 8, 2013


Thursday night, we had dinner guests.

KHS has a new program that markets our brand of 'American education' overseas. Something like 20 students are studying this year, from Asia and Europe.

Last summer, I read what we were planning and frankly, I was skeptical. The corporation purchased a dilapidated building near the downtown middle school and renovated it into a dorm for the male students. 15 seventeen-year-olds would be moving in, living there, going to school, and certainly improving their English. Of course, that includes all sorts of colorful swear words, expressions like "I finna go" and the variety of slang that exists here.

No matter. From what I can see, they are a fresh additional to our school and with busy house parents, the dorm thing is working out OK. A few bugs --- first year, after all -- but OK.

Last semester, I had one guy, Santiago, in class. He hails from southern Spain, the son of two chiropractors. THIS semester, my classes include Santi, plus Miguel (Mexico), Kata (Japan) and "Fan" (China). Their presence is a plus for my other students. Among their assignments, they hand in written responses, double-spaced, and I correct/improve their grammar and diction.

At any rate, Mike and I decided that we would entertain them so they joined us for a very American meal. I had mentioned to Santi that I was not a fancy cook.

"That's OK," he told me. "It will be better than dormitory food."

Anyone who has been away to college can understand that.

So, Mike drove over to the dorm and brought them to our home. After a quick tour, we sat down to
1) shrimp cocktail; 2) steak, baked potatoes and veggies; 3) bread and 4) sugar cream pie. And a lively conversation.

 Fan, whose English is improving, asked many questions. He held up pieces of flatware and inquired about their uses. He said that when he was preparing to come to America, he had learned about 'dinner' and 'supper' but did not understand. He asked if he should removed his shoes. (no)

Then, after dinner, Mike drove them back. I had the place almost cleaned up by the time he got home.

Since he's been off Xeloda, I see some  positives.....Mike is getting some sleep at night and he's not exhausted when I come home from school. I don't know if it's just that omission, but I'm all about seeing positives.

Next Monday, Mike will get some blood tests and then meet with his doctor. We will discuss what, if anything, the newest treatment is doing. We will have some lunch and make some decisions.

So, we ask you, specifically, to pray for wisdom. We know you will. And we know God will provide.

Sunday, February 3, 2013

A Scene from the Chemotherapy Room

I’m back taking one last shot of chemotherapy.  Two hours on Monday, followed by two more hours on Tuesday every two weeks.  Why do it, you ask?  Because I would like to attend the fifth annual “I’m not dead yet” party at Winona Lake the last weekend before Labor Day.  Can I make it?  Not likely, but you never know.  As my oncologist told me Monday, “Mike, none of us gave you more than ninety days and here you are four years later.  Who can say how long you have left?  But you won’t make May, if you do nothing.  What have you got to lose?”  Good point.

So there I was reclining in my leather chemo chair getting poisoned, when a young lady about four cubicles down came out into the chemo room, pulling her tower of heart monitoring equipment and the chemo apparatus.  I could tell that she was using a permanently installed port in her chest, to receive the needle.  Not a good sign.

She was wearing a university warm-up suit (the kind you earn, not buy) and appeared to have been very physically fit…at one time. I could immediately tell that she was probably a track person by her coordinated walk, although she was walking bent over slightly, as she headed for the bathroom, probably to throw up.  Her mother was helping to guide her by holding her by the elbow and with an arm around her waist.  It was slow going.  Her mom was gently encouraging her to take each unsteady step.

She had beautiful natural blond hair and blue eyes and had a nice figure at one time.  You could tell she had been a looker.  She wore a simple gold necklace and a hair ribbon sweeping her lovely hair back into a pony tail  that still bounced as she trudged down the hallway, shaky on her feet.

The thing that got me was the look on this once beautiful young woman’s face.  It was strained, tired, and worn-out.  I could tell that she was in pain and significant discomfort.  Each small step was hurting her and she was bravely trying to get through it and not let her mom know how bad it was. But she couldn’t hide the agony twisting her face.

 She was breathing in small, short gasps, probably because of the pain.  Her mother sensed how much pain her daughter was in and was whispering quietly to her words that I could not hear.  The mother’s face was withered with utter despair, but to her credit she was putting on a brave front for her daughter.

My cold, hard, lawyer’s heart broke as I was witness to this monumental, silent struggle being waged by mom and daughter against this terrible, relentless, almost always victorious disease. 

My nurse walked over to my recliner as mom and daughter went into the bathroom together.  Another bad sign.

I said to my nurse, “That beautiful girl can’t be 25.  Right?”

She replied, “She’s only 22 and just graduated from college.”

I said, “I hope she has something that is curable or at least treatable for years.”

She said, “I wish that were true, but it is not.  She is terribly sick.”

I said, “Some things are just not right in this world.  I’ve had most of my life.  A little short, but she has not even got started.  It is not right.  I hate this disease.”

“So do I, Mike.  I just hate what it does to my patients and their families.  The patient dies, but what few people understand is that a piece of the family dies, too.  It is tragic.  I hate it and there is not much we can do so often.  We try to manage the pain and make the patients more comfortable, but that’s it much of the time.  I do not know how the families deal with it.”

I cannot imagine how that mother will deal with her beautiful daughter never being married, never having grandchildren, never again using that marvelous athlete’s body.  She will have to try to be strong and supportive, while witnessing her daughter day-by-day lose her long-term struggle. And then she will have to bury her daughter.  Also into the grave will go a piece of mom’s heart, torn out by this disease, never to be healed. 

 It is just not right.  It is just not right.

Mike out.