The Dread Protocol

   Having had a "procedure" two days ago, I just received a call from SMH (not shaking my head) checking on my welfare. I feel fine, and the staff was fine also. That's what they wanted to know.  I was there at 7 as requested, for a 7:30 procedure. I remember hearing that the doctor was there and the last time I looked at the clock it was  7:45.  I arrived home about 10 after 10, after stopping at Dunkin's for a coffee cake muffin, actually was gifted with 2 of them, lunch and dinner.
    Since I don't remember being oblivious for more than a few minutes at most, and didn't fall asleep afterwards, I was hopeful that Versed, that fearsome amnesia drug, had been administered at  lesser strength and therefore didn't destroy as many brain cells as usual, so I looked up the usual dosage from my formidable array of downloaded health records and saw that the dosage was the same. Maybe I've maxed out on dispensable brain cells.
    Googling will attest to the fact that there are many who believe Versed has caused them unimaginable grief, with all types of detrimental and long-lasting effects. But doesn't life do that to you anyway?
   

...continued (Technical error)

My computer is inexplicably dysfunctional.  It has lost the ability to scroll, or I have anyway.
  ,,,the car approaching me just before I reach my house is flashing its lights,  I slow down.  There is a fairly large birch tree across the road, blocking one lane completely and part of the southbound lane.  I drive into that lane to pass the obstruction, and I'm home before 9 in plenty of time for that conference call.

And it's not yet 9:00 A.M.

  The bus driver said he'd pick up at 7:00 A.M.   So I was up before 6 because it's a long process to be curbside that early in the morning, and besides, the driver is invariably early, as indeed he was this morning, pulling up to our driveway at 10 of 7.  I'd turned on the TV to hear reports of  the approach of a devastating windstorm and potential power outages.  So my first reaction was to turn on the dishwasher.  Who needs to be in a cold house with a bunch of dirty dishes.  I needed to do a load of laundry, including bedsheets, so I waited until after the fill cycle of the dishwasher stopped and ran, rather walked, downstairs to the washing machine, hoping the laundry could be dried before the sky fell, Chicken Little that I am.
    It's still early.  I am scheduled to participate in a Conference Call at 9:30 this morning from the V.A.  I opted not to be there in person. It is with Palliative Care. Not to be confused with Hospice Care.  The goal is to relieve pain and ease the suffering and discomfort. Through what, I can only imagine, its being an arm of social worker services.  Neither of us is enduring physical pain, and I have not much faith in the healing power of words, not words that people are paid for anyway.  But they make a big deal of it, so we agreed.  Anyway, I have a while before the scheduled appointment.
  The phone rings: a plaintive plea from the youngest who has left his lunch at home.  He says he doesn't need it soon. His lunchtime isn't until 12, he says.  I decide to deliver it at once, before the power cuts out and before the palliative care call.  The driveway is littered with broken branches. I pick up a few of the largest, and toss them down the bank behind the house.  The road to Schaghticoke is clear, if you don't count the garbage cans which are blown over treacherously close to the highway.  I deliver  the goods to the school, and make it almost to my house.  An approaching car blinks its headlights continuuously so I slow down

Health Care Crisis

   Well, sort of.  In the past year, 5 of my long time health care providers have left their practices:  Goldstein, Constantino, Pietracola, Griffin and now Mastrianni.  Two of them were courteous enough to send departure letters. Three have retired or so the story goes, one flew to another medical consortium, and the latest is leaving his practice and continuing his medical career with a combination of teaching and administrative work.  His letter cited our 14-year relationship. I've been seeing the 5 practitioners for quite a long time, ranging from about 7 to 20 years.  Only one of them was of typical retirement age, so the reason for  the mass exodus is a mystery, or maybe just  a coincidence.
    Likewise, there has occurred an acute shortage of home health aides or caretakers. Though we are deemed eligible for services, we cannot avail ourselves of them because no one is available, either from agencies or personal referrals. The media has addressed the situation, attributing it to increases in payment for fast food workers.  A friend just told me that he knows people who, in addition to paying generous salaries to their healthcare workers, also provide them health insurance and vacation pay.
   Replacing the ACA will do little good if the shortage of providers impacts the delivery of affordable health care.  Where is the focus on that problem?

Travail

"Between the dark and the daylight
When the night is beginning to lower,
Comes a pause in the day's occupation
That is known as (the tortuous hour.)
 ...
And there will I keep you forever.
Yes, forever and a day,
Till the walls shall crumble to ruin
And moulder in dust away."

"There, but for ..."

...not  but for  the grace of God--but for the potential humiliation of a missing-vulnerable-adult alert----go I.

"Ah, bitter chill it was"

The Eve of St. Agnes
Charles Anthony Madigan    January 20, 1966
  Gone now, for far longer than any of us knew him.  Rest in peace.

Occam's Razor

  Me and Occam are in the same boat.

December 29 Birthday

Dorothy Evelyn Rita Madigan  
December 29, 1939        June 1, 2011
   I remember both days, each day incomprehensible, the first unable to understand, the second, not wanting to.

   "The winter of our discontent
    Will smother the trees and flowers,
    But amidst the ice and biting frost,
    May reveal our finest of hours.
    Only in darkness does light exist;
    Only in love will our lives be missed."
                                                                  ---Anon, DSS     c.1991

                                                 

Thank you for your service

November 11, 2016

Rosebush a gift from Daisy and Carmen, about 2009

HINENI

"You want it darker."

So True

I just read on the news site that there is a fire in a crematorium.

The O.T. or How would you answer the question. Update 7-10-2020

   Granted, I don't think I've ever encountered an Occupational Therapist before, and definitely not in a professional capacity.  Plenty of Physical Therapists though, and I'm aware there is a distinction between  the services they provide.  Even so, I was not expecting the question the therapist posed, nor was I prepared for the answer it evoked.
    Addressing the patient, he asked, "What would you consider a good day?"  Almost without hesitation, the response was, "Yesterday my daughter and her 2 boys picked me up and we drove over to a fish fry place for lunch, and then we stopped at my brother's house.  She and the kids helped me up the steps and I sat and enjoyed a talk with him for a while."
   I don't know why this seemed so significant at the time, or why it still does, or for that matter why I'm writing this through tears, maybe effects of  the CMA.  I asked an old friend this question tonight and she replied, "To be in Paris without fear of terrorists."
   I contemplate how I would answer this question.  The odds of my ever being asked are infinitesimal, not being likely to ever receive  this type of therapy and even less likely that any other therapist  would ask that question.  Still my mind attempts an answer:  Is the good day one that's already passed, or one that's yet to come, is the day to be one that may be possible, or is it a day of fantasy and dreams.  My mind is essentially empty now, blocked by the unwanted answer to an impossible question, and struggles to leap over that chasm to an answer, any answer.  For now, the two choices are the same:  the reality scenario is just as much a fantasy as the other.  I decide my idea of a good day would to be able to decide how to answer, and to pretend there was the possibility that one could happen.

When to Call It Quits

    I don't have enough Kleenex in the house to watch much more of the Country Music Awards,  So I thought I'd turn to my faithful old blog, but I'm afraid the mood has been set.
     During the course of my lifetime, I've heard many people speculate about at what point they would no longer wish to live. A child I once worked with said he could not imagine a life without Reese's Peanut Butter Cups, and I recall Barbara Walters responding to that very question by answering that it would be when her friends were all gone.
     Offerings of a  variety of other reasons why life would not be worth living could fill a lot of pages: I've heard many, and if I were to comment on their validity, could say that over the years, people do change their minds.  The majority of people in their twenties probably look upon a life without sexual fulfillment as a  life unlived, but as time exacts its inevitable toll, that deprivation becomes---meh.   Suicides excepted, of the too many deathbeds I've been next to, the person struggles for every last breath of life, regardless of what they might have once thought they couldn't have lived without.
     The thought occurred to me today as I sat in an office, waiting.  I can do a crossword puzzle while I wait, or a Word Jumble, but I think if I ever reach the point where I carry a little book of Word Search puzzles, the time has come.

Fear and Loathing

    Sometimes, what you think is the right thing to do, or else the only thing you are capable of doing, makes you hate yourself.

The Dying Room

  She was in her 95th year and, against her wishes, found herself in the hospital, its saving grace, in her eyes, was that it was a Catholic hospital. The cardiologist on call said, based on their testing, that she would be a candidate for a pacemaker, for her irregular heartbeat.  But what about her kidney function was the other concern.  He quickly responded that would indeed be a consideration, but not in his area.  So the pacemaker was not installed.
    I think it was a Tuesday she was convinced to go to the hospital, which she reluctantly agreed to, with the condition she'd be checked out and could be home by Friday.
  Her condition did not improve after her diagnoses, such as they were.  She'd been on an IV, one which included a morphine drip, though she had not complained of pain, only extreme weakness.  I remember a nurse asking her what level of pain, and though she answered in the negative, the nurse administered more morphine.  This was over 20 years ago, and we were relatively naive about the workings of hospitals, had no reason to question their treatment.
    That became all too clear when, on the third day, they told us they would be moving  her from the room in the ward she'd been in to another, this one in a rather secluded area, by the door.  So she wouldn't be disturbed, they said.
    There were 3 of us family members with her at the time of the move, and the room was small, so we had to make way for their bringing her into the new room.  Two people stepped out into the hallway, but I was near the bathroom so I went in there to make way, apparently unnoticed.  There were 2 staff members arranging her transfer from the transport bed to her new bed, which was near the wall and in front of the bathroom where I was waiting.  The others were in the hall.  The nurses, or I suppose aides, wheeled her over to the bed and just dumped her into the new bed, like a sack of vegetables, or trash.  She, who was never one to complain, moaned at the shock and pain.  I stepped out of the bathroom, horrified,  and told them so.  Their response was that the room was so small they had no choice.
    So now she's in this small room, near the doorway, and the morphine drip has been increased.  She is lucid, but weak. She still has some appetite, says she wants to eat but can't think of any food that would be agreeable, and  requests a peanut butter sandwich from home.  Her niece brushes out her long thick hair and pins it up for her.  She hopes  her nephew will  give her dog a promised bath.    I stay with her that night, on a sleeping bag brought from home.  She has a tube in her nose, to help her breathe, she's told.  The nurse tells me to call them if anything happens, and not to touch anything.  I suddenly recall that when we first arrived, I had seen a stretcher with a covered figure being carried out of this very room.  Clarification sets in:  there is a reason for the location of this room, away from the others and near the doorway.  The dying room.
    Her breathing comes to an end that very night.  I dutifully notify the nurses' station, after I removed the tube from her nose. It was Friday, and she was leaving the hospital.
 

"Out, Out"

..."and they, who were not the one dead, turned to their affairs."

Tea and Sympathy

There are plenty of tea bags in the house.

"You Brought It Up"

   The doctor, a specialist, is so esteemed, erudite, and learned, therefore busy,  that a prospective patient needs a physician's referral as a first step.  Then the request for appointment is reviewed by a panel of nurses for consideration, and possible acceptance.  Yes, exactly, a "panel of nurses."
    The consult, finally granted, leads to his saying that, contrary to what you may think, the condition is not rare.  The "condition" being diagnosed as a part of a vast spectrum.  His mother has it, he states, has had it for a time.  I ask how she is doing.  "I don't like to talk about it," he says, "but I will if you want me to."
    "Sorry," is all I say, but he goes on to talk about it anyway, some details about both his parents.  He volunteers that if he himself were to seek assisted living, he would consider going to the Midwest, where the costs are much lower.  He mentions Milwaukee, a beautiful city.
     The next day we are in an attorney's office.  She is preparing for her son's wedding in Syracuse.  She will wear navy blue with silver accessories, though her favorite color is lavender, which would clash with the bridesmaid's dresses.
     The last day of the week finds me in an accountant's office.  I need a return appointment, but it will be delayed because his wife is to undergo eye surgery at Ellis Hospital.
    This comprises my entire social interaction for the week, nay, the month, oh, OK, the entire year, to date.

"Ethical and Religious Directives for Catholic Health Care Services"

    "A person has a moral obligation to use ordinary or proportionate means of preserving his or her life.  Proportionate means are those that in the judgment of the patient offer a reasonable hope of benefit and do not entail an excessive burden or impose excessive expense on the family or the community."
   Who writes this stuff?  So a billionaire in mortal physical distress would not have to worry about imposing an EXCESSIVE EXPENSE  on family or community, but the rest of us should take that into consideration, before, say, consuming an inordinate amount of antibiotics.  And who would "the community" be?  Since this was written before the GoFundMe sites, the community would most likely refer to the insurance companies or Medicare.
    I suspect the highly touted Advance Directives and Living Wills, etc. make little or no difference in the long run, except maybe for your choice of donating your body parts. The issuing of such may serve as further justification for the decision-makers.  Legal justification, that is; moral justification has no place in pragmatic statements.
        It's simplistic to define terminology:  if you need to explain what the subjective word "proportionate" means, just use other equally subjective words to define it.  Who can separate the concept of "hope of benefit"  from "reasonable hope of benefit" or determine what amount of expense is "excessive expense"?
   I see that the "judgment of the patient" is the deciding factor.  But then, at this time,  isn't someone else in charge of determining the patient's ability to make a rational judgment?