A NEW ATTITUDE

A NEW ATTITUDE

I had thought for quite a while now that there is nothing new in the area of feelings and attitudes, now I am not so sure that what I knew to be true is so. Here is what has happened so far:

Until about two weeks ago it looked as if I could expect to live another three or four years; this is from the statistics for people who have what I have, and is a number not too far from the average expectancy for all men in this country. I am well aware that these statistics imply and I intend to do anything that I can to come out on the far side of that bell-curve; I also found the study that found people with heart failure often over estimate how long they have to go. I had asked a few medical people, found more than a few articles online that all said about the same thing. My chore had been to get my head around that notion, to accept what was and then to get on with my life.

As I wrote a week or so ago I had an appointment with someone who discovered that I have severe apnea, but that with treatment I can expect to add perhaps four years to this cruise that I am on. And one other thing, he now has probable cause for something that I had been told many times was idiopathic. Treatable and redeeming–quantity and quality.

In effect I have just have just been offered a doubling of my expectancy; this idea is taking a while to root in my cranium and germinate, but it will. There are events and situations all through life that cause feelings and attitudes; except that this business is different, what I am feeling and how I am seeing the world is not quite like any I have ever experienced. I am not ready to say that this is unique, it might just be a variation on one or more, I just can’t say yet.

Obviously I am happy with the news, I have long ago discarded any wish to be dead notions; have reached the conclusion that whatever pains and discomfort come along, no matter how intense, they cannot overwhelm that of being, of becoming. This new thing is a testimony to perseverance, to scratching at the tunnel face until the gold vein is completely discovered; and for that I am relieved, perhaps more than a bit smug. This that I have just received is a gift, more to God than from; but it is such an overwhelming gift that no words are appropriate. Perhaps it would be as if someone gave me a new car–then I see that it is a brand-new Rolls convertible; what the hell do you do with such a thing! A great problem to work at as I go on.

I may write more about this as I figure it out and believe it would be of interest to someone, anyone else. Let me add one more thing: To say that this is more a gift to God than from God is because I know that without man God is irrelevant; He is what we are about, that makes us what we are.

Persistence pays

It is right to say something as I accept that I have added years to my life expectancy by following a string as far as it goes; and I admit that that is what I have realized this week.

I have been told perhaps a dozen times that my heart condition was idiopathic (the word idiot always came to mind), that I should live carefully and not worry about the cause, just the relief that all these medicines provide. Being a good patient that is just what I have been doing, as I was wrapping my mind around living in this new and limited body I kept asking unresolved questions about fatigue and all that it was doing to me and my life.

The pulmonary doctor finally said that all of my lung conditions had disappeared and that there was no need to return; I pushed the fatigue question yet again and so she ordered a sleep study which showed minor apnea that she wanted reviewed by a sleep specialist anyway. Reluctantly I made the appointment with just the thoughts of pacemaker and transplant as all the arrows left in my quiver–neither of which I was anxious to launch from my bow.

The sleep doctor pointed out that I have severe apnea, that waking those hundreds of times a night each sending a jolt to the heart telling it to wake up and to increase pressure; and that this constant bombardment by a hormone leads to the heart breaking down. That’s the short answer of the little I remember: except that here was cause for which there is a cure; a CPAP machine will control the apnea, allow the heart to get a night’s rest, help control my weight and mood. Pretty much everything except squeeze oranges for juice in the morning. Oh yes—looking at some of the online studies it looks as if I may have increased my life by a number of years—No Shit!

I didn’t put the meager medical details down as guide for others because I don’t know anything at all about medicine; but I do know that if I had not kept asking the question until I found someone who had an answer that made sense I would continue declining with the shorter life expectancy. There ain’t no guarantees that continued searching will bring resolution to all problems, no guarantee at all, and in that case acceptance is the right road to follow. But I know that not looking around for answers means that none will ever be found.

I could express this in a few other ways, with more precision and wisdom but this is just some information from a guy who had something going and pursued the string to the end.

John Updike existentialist

FEBRUARY 24, 2009 WEBLOG

There is a lighted sky after five in the afternoon.

Snow and ice are gradually being reduced as the mercury peeks above freezing now and again.

People are responding to these changes even though February isn’t quite finished.

I awoke about four this morning feeling that abysmal dread that can arrive at that hour; a void that is filled with the blackest of blacks, and from which there seems to be no way out. As this despair swept over me I knew that I could avoid the strongest of what was to come by getting out of bed, turn on the television or go check the computer; I also knew that it was and is an honest feeling that is appropriate especially now.

I have an elderly patient in the hospital for whom I have consented to do medical approvals which are coming daily. I received lab results on tests I had done last week; I entered them manually in Google Health and noticed where they lay in their respective ranges. A very good friend who has agreed to do some things for me has just moved in a couple of blocks away; and I have another test this week.

All these combined as a perfect wave of anxiety that carried me upward to despair at that blackest hour; and today I read a review of John Updike’s life in the NYRB, how he recognized and handled the existential anxiety that he recognized early on and grew to be his muse. Reading that article meshed with what was going on with me, what goes on with anyone who will avoid the computer and television when it arrives. I didn’t get out of bed but lay there feeling and examining the great truth of meaninglessness that this despair brings.

And today the sun is shining through a thinly clouded sky, there are paths down most sidewalks that are free from snow; people are pleased to be experiencing these days because they have gone through a hard winter, a winter which tests but cannot destroy.

A Short Follow-up

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February 11, 2009

This is the third day of my ‘five minute a day writing exercise’ which I hope will graduate into something more, different, better. The first challenge is the subject and if the right one is found everything follows well from there. The post of yesterday could be thought of as heavy and even morbid, that is not an unknown criticism. Heavy? Yes, the topic of what goes on in the very center of a soul can’t be anything but heavy, except when it is frivolous; morbid? I don’t think so because it was a fine lines describing the utmost in living, in being. Remember that shying away from something means that I never get to know and enjoy it. For reasons that aren’t all that clear I do enjoy untangling the knots that are at the edge of my reason, my emotions, my spirituality.

I am going to leave this here.

My Old Pal Ben

FEBRUARY 10, 2009 Just as I was about to sit and start my five minute daily writing exercise I received a phone call from the social worker of St. John’s hospital. After introducing herself she asked a few questions to make sure that she had the right person on the phone, then she asked about my old pal Ben. Ben had been hospitalized a couple of days previously with pneumonia; he doesn’t exercise much if at all so I wasn’t surprised that what might have been a chest cold became something else; but that wasn’t her concern. Does Ben have any relatives that I know of, any friends whom she might contact, was there anyone else? The answer to all of these is no Ben has no one in his file except my name and number because I have been visiting him for a couple of years; not as a hospice patient, just as an elder who received the occasional visit. Ben has had dementia from the beginning although recently it has become severe, he no longer recognizes my face, never mind my name. Ben lives in the here and the now, can’t look backward and is frightened to look forward, although he sometimes does talk about that. It has become difficult to visit Ben and the others since I had the heart experience, not that I am near being a candidate for either a home or hospice, just that I sailed a little closer to that shoal than was comfortable. If I go over and see Ben tonight I will have to introduce myself, expect that nothing we have said previously is remembered, and that as soon as I leave all is forgotten. Why go?—- To give a guy the few minutes of conversation and maybe a joke or two that will be all he gets in the course of a day; and immediately forgotten. The reason that it is more difficult to make visits is that it forces me to face the meaningless of all of this, that nothing one accomplishes means anything other than at the time and place; that whether we are or whether we vanish is irrelevant, except that we need to do whatever it is that we are about in order to be complete. This is the fucking paradox that has been giving people headaches and into arguments for thousands of years; and in the end it is about visiting Ben for a few minutes.

Surprise 2

I had intended writing about my recent heart failure adventure more than that first chapter “Surprise”; for some reason my several attempts just wouldn’t get off the ground, it was as if I had put everything I knew into that first one, there was nothing more to say; that the attitude of rationally handling the situation was said and shouldn’t be belabored.

This morning as I was taking off the electrodes that have been monitoring my heart for the last couple of days it came to me what was blocking my writing; I had been avoiding being scared, perhaps denying that I was frightened. It was that handling the situation was right at the time, that allowing the screaming heebie jeebies to fly around unchecked wouldn’t have helped what was going on either at the hospital or the first week alone at home. There had been a good chance that I could have stroked-out; there was a reason that all of those scans for clots was ordered, that the four times a day blood samples were taken, that the monitor had been on my chest for almost two weeks continuously.

Last week I was talking with a guy who had been in a situation where he couldn’t move or talk for two days, he was aware of everything going on but was unable to respond; to me that would be what it would be like to have a stroke, or one possibility. Strokes frighten me: the inability to respond, to indicate, to act and yet still be aware is horrible. That I had a high chance of a stroke for a while is a different fear than death, death has no content, it would be a brief experience before zero. Being in a stroke would mean not typing whatever I want onto this screen and then blurting to the web-ether.

So as I was in the shower, washing the adhesive from the electrodes off of my chest I let that horrible fear scream and fly around the room, felt the aloneness of not being able to do anything while yet aware of everything. This was the time to let that gremlin out to exasperate and then to evaporate.

There will be other threads of existential emotion that come from the experience, this is just the first; and each will be allowed its minute or two of power.

What was the question?

WHAT WAS THE QUESTION AGAIN?

I was feeling unsettled over something or other, and decided to drive over to Peet’s for a coffee; I don’t know what made me think of doing this, I have the same coffee at home, and the traffic on North Avenue is always to be avoided, especially on my day-off. There was nobody I knew at Peet’s, but there was a dozen people burbling on cell phones; I took my coffee and walked up past the Whole Foods store, questioning as I always did what it was that there business is about, it isn’t just good and pure food, we have always had sources for that, it is that they promise something else, something philosophical or spiritual and pseudo-scientific, I can’t put my finger on their message; but it certainly is successful, their message resonates, especially among a certain group. Could it be that people believe that if one ate just the right combination of foods there would be a special reward? That their food should be thought of as some sort of prescription that will ward off evil spirits and give eternal life; is this what Ponce De Leon had sought and never found?

I stopped in front of Transitions Bookstore , a “new age”café and store with a display of books and lecture announcements all of which seemed to be offering the one true answer, the one right path, the secret of the ages. If there was but one true answer, one great secret–why is it in any number of different books? Why isn’t it taught to every school child in the world? Why would the one important truth in life be limited to these “New York Times bestselling authors”?

I walked on through the stream of pedestrian robots with earpieces supplying the necessarily constant and deadening music, reminding me of Aldous Huxley. Next is this large store with a name that is made-up, selling makeup, that is successful, and not only with women. A lot of people paying a lot of money to pretend to not look or smell as they really do; factor that notion in if you can.

None of these observations are new, none are unique to me; but there is something more going on here, there is something behind all of this avoidance and denial.

In my work I occasionally drive people whose names are familiar, who employ people to make sure that their names and faces are familiar; I drive these people to a place, wait for them to do their thing, then drive them back to the other place. If it is a nice day I often stand outside the limousine and read a book while wait, or just stand and enjoy the passing parade; part of the parade is the awe that comes over people when they think they may be in the presence of someone famous; people who are famous for being famous.

I am far from the first person to witness and note this effect; but what is it that is going on here? How does this relate to what I was noticing at the mall.

The day after my walk through the mall on North Avenue I paid a visit to Bert in the home: He is looking even more drawn than before, I imagine the cancers in there doing their nasty work; the colors on his face and hands becoming more a patchwork of grays and whites, the food stains on his shirt more noticeable because he has just finished lunch, and more lunch is dropping from his slack mouth.

I say hello, he looks up into my eyes, after a few seconds there is a recognition, I say my name, he smiles and moves his hand in an attempt to raise it, I take hold of that cool hand, not too energetically or forcefully I give him a handshake. He is sitting in the hallway, there are about eight of them lined up in the hallway, all in wheelchairs; I pull up an empty chair in order to sit beside Bert. I ask that question that always makes me feel really stupid, I ask him how is it going? What kind of question is that to ask a dying man? What else is there to say? my options are limited here. He gives me a smile and says “oh, you know, it goes”. I ask if he is in pain, that is a required question, one that must be answered on the report form; no he is not in any pain—-good, very good.

There is one question that always brings a wry smile “well, what’s new at this place?” Boredom is the universal among the elderly and the dying, so I try and make some sort of joke about the obvious.

We sit for a while, I make my usual comment about watching the parade go by, I say it because it always makes us both smile. I ask what he had for lunch, less than an hour previous, he can’t remember; did his daughter visit on Sunday, he can’t remember. I sit, he sits, we sit, the lineup of wheelchairs sit in the hallway, near the nurses’ station where they can all be seen in a glance by the always busy nurses and aides.

I stay for about another fifteen minutes, it seems forever; there is nothing here other than hello, a few smiles, a waiting; I can’t stay there longer than that, it becomes pointless, it borders on being depressive, I feel out of place.

I fill out the necessary form, leave a copy on the nurses’ desk, say goodbye to Bert, then I say goodbye to a few others who have come to recognize me over time. One woman takes my hand and compliments me on my new hat, tells me it makes me look good, that she is glad that she got to see this great hat. There is a guy in one of those padded chair/beds that are used for people who have little or no control; I think that he is looking at me, I say hello, he makes a noise, I smile and then move on to the elevator.

On the ground floor, near the elevator, there is a drinking fountain where I always stop and take a long drink; there is something about spending time up there that makes me want to have a long drink of cool water. Then I leave, or do I escape?

My mind wants to make a connection between the questions raised at the mall and the experience of sitting with this dying man who is my good friend, who doesn’t know my name; there is something that is in the back of my mind, it is yelling something in my ear. I refuse to understand what it is that I am being told.

At the mall are offered answers to unasked questions, to made up questions, to stupid questions—–at the home there is no answer, no question, no worthy comment. There is just sitting in the hallway waiting.

I was about to make some comment on what other people are looking for, what is missing in their lives, what keeps them from being right here in the present and not in denial; then I realized that that would be going down the conservative way of blame and criticism, change direction. All that I observed and wrote down here is part of my trying to figure out what I am about, the only person of whom I have any knowledge or control. So what do I think that I am missing, what is absent from this life of mine, what answers will make it all right?

There is nothing missing.

This is it, complete and understandable.

If I sometimes forget this, remind me.

Out of beans

I went out for coffee this morning; it was my habit to go to Peet’s every morning, did this for several years until I realized that firing up a cold car on a winter morning for a drive of less than three miles wasn’t quite right just for a cup of coffee. Today I was out of beans so I had this morning’s coffee there and bought a pound of Sumatra; I had a chance to say hello to most everyone who goes there in the morning.

Eric came in on his way to take his dog to the beach, he is about finished his police training, something he had wanted for years, now he has it. I asked if he is learning not to talk to civilians, he agreed that he is learning to stay clear of people who are not cops, people who want to talk to him, ask him, about everything in the world, or out of it. I also asked him if he was carrying, he allowed as he was; there are some crazy guys who hang around the beach where he exercises his dog, you can’t be too careful. Eric has become the attitude of the weapon: have a gun because you might meet up with a crazy guy while at the beach with your dog—–that sums it up.

I was reading that great article by Elizabeth Drew in this week’s New York Review of Books, the one analyzing the state of the political race. Steve came in, Paul came in: all three of us agreed on who should step down, why it should be soon, that the heavyweights of the party need to step in and settle things. There came out again that thing about the need for an idea that will lift us from where we are right now.

I went for a walk afterwards, stopped at Transitions Bookstore to see what books were in their window display, Transitions is a new-age store, a store that sells books at list price, that is success. All of the titles and blurbs offer an answer, the answer; you can tell the really important answers because they are endorsed by Deepak or Oprah, who are the Housekeeping Seals of Approval for answers to your life.

Yesterday I was reading Tillich’s Courage to Be, the part where he writes that faith is being grasped by that that carries you where you ought to be (the book is in the car, so the quote may not be exact).

The thread here is that every single one of us is looking for an answer, a guide, a direction: so you can spend some money to have a certified author tell you what you are missing; next month you can spend money for that month’s certified author to tell you what you are missing. Or you can wait for a political leader to become a national leader, to become an international moral leader to tell you what you need to be, to become. There seems no end of options of answers to what you need.

On the other hand Tillich leaves his answer as “that that grasps you”, you can’t be less specific than that; but he is right, just as Jesus was right when he suggested that whatever I require I already have. If I would only accept that I have it all I could stop searching, why do I hesitate?

It takes a whole bunch of courage to look deeply, to examine clearly each brick of my foundation, to know what it is that I am about, to peek at pillars that are usually left in the dark; a truly scary experience.

It’d be so much better to open a beer, watch some television, read a new book, work a little bit longer; that would be so much easier.

I visited Bert in the home yesterday, he was hospitalized earlier, now his agitation is so strong that he can’t talk about anything other than a single idea, he cycles it again and again, there was nothing to do but leave—nothing that I could do but to leave him. That is hard idea to accept.

There are more than a few hard ideas to accept, but I bet that I can.

Why do I do it?

Several friends recently have suggested that visiting the old and the dying is something I do because I have a big heart, implying that I have more of something or other than anyone else:—that is going down the wrong road, it says something about where they are coming from, doesn’t say much about me. I began visiting the dying out of fear, a fear of mine that I would end up on a gurney, in a hallway at Cook County Hospital; that image scared the hell out of me for a long time.

I really don’t like living with fear, I have found that it isn’t a great diet, is a poor exercise companion, is an all around unpleasant thing to keep in my belly: so I decided to get rid of this big one. The best recipe for eliminating any kind of fear is, of course, to go right up to it, look it right in the eye, smell its breath, listen to it gasp; and then realize that it ain’t so scary after all, that fear evaporates, my stomach becomes unclenched, I can get on with other business. So, in order to get rid of that dying fear I took a close look at it, got as close to the experience as possible, and did it again, until that fear became a memory.

The reason I continue is the friendship I experience, friendship is a rare and valuable thing; especially one that has no agenda, no history, nothing to be gained or owed, there is just being there with someone, watching the parade go by.

I visit these people for selfish reasons, the best of selfish reasons, and I hope that I will continue to listen to my belly when it signals that fear has taken up residence, listen and go on from there.

Visiting Bert

I didn’t visit Bert in the home last week; my fibromyalgia was acting up and I wasn’t moving around very much, it is now under some control, the pain level is low. I went out to see him this morning during the daily ‘activities period’ that I describe recently; he wasn’t sitting in the circle nor out in the hall watching. I found the floor nurse who told me that he was resting and shouldn’t be disturbed, she also told me that he had just returned from the hospital. She then told me that she was busy and had to cut our conversation short.

One of the toughest parts of hospice work is that I am not in the circle of knowledge, by law I am not entitled to read a chart, ask about the state of health of a patient, nor am I in ordinary contact with relatives. This anonymity leaves me in the dark here; my friend Bert has had something happen that required a hospital stay, and I am left to speculate without any other information. What if he is close to the end? When should I return? Aren’t I entitled to know something about my new friend?

The answer to the latter is I am not entitled. As for the other two questions I have no guidance. This has been a difficult morning.

I was talking to a priest last week, we were discussing doing hospital and hospice visiting: he said that he found that going home alone made the visitation work impossible for him, so he found other things to do. I am not about to give this work up, but I sit here alone knowing just what he meant.

There is a local rumor: spring may come. Rumors should always be taken with a touch of skepticism, this year the skepticism has more than a touch of cynicism to it; spring ordinarily lasts about 72 hours here in Chicago, then we have full blown humid summer; this could be an even shorter spring season.

My landlord had me remove the bird feeder, he doesn’t want to attract birds onto his little part of the world; the feeder was fun while it lasted, I was able to write about it occasionally, I will find something else to write about.

I have started to write stories; I have put down a number of ideas for them, have started one that is about being a chauffeur; writing stories is slow and difficult work, especially when I want it to flow naturally and seem easy.