The Very Last One

I read in Wednesday’s paper where Florence Green died.  I didn’t know Florence Green. I don’t even know that I know anyone who knew Florence Green. I'm pretty sure I don't. Nonetheless, I felt a twinge of sadness at her passing. And a twinge of guilt.

Florence was born in London in 1901. Her death was reported as that of the last surviving World War One veteran. She entered the Women’s Royal Air Force in 1918 and enlisted in time to spend the last month of the war serving food.

My guilt stems from an episode my first year in practice as an orthopedic surgeon, 1990. I was fresh out, eager to work, but lacking the robust confidence and pure guts to simply dive into the most difficult cases. And so, wouldn't you know it, first month while on call I get a phone call from one of the really busy and cool family docs. He tells me that one of his patients has broken his hip and he wants me to take care of him. “And take good care of him. He’s a World War One vet. He even has a dent in his forehead where a German soldier hit him with the butt of his rifle. Don’t kill him!” he finished with a laugh. 

As you might not guess, with a lead in like that, I operated him without a problem. Unfortunately, about three or four days later the repair failed after I had already left the state for a beach trip to Oregon. My partners re-operated him a day or so after I had left. When I returned after a week-long trip to the Oregon coast I learned that he had, indeed, died a few days after the second surgery

As awful as that story sounds it is not a bizarre or entirely unexpected outcome. There was nothing lacking in his care. He was in his late eighties, poor quality bone, and the risk of death with hip fracture at that age is not insubstantial—even more so 20 years ago then perhaps now.

The hard part in all of that was the fact that this old barnacle of a veteran, a guy who survived a terrible war and survived getting bashed in the head with a rifle, lived long enough to break his hip and die after this newbie surgeon laid hands on him.  I couldn't help feeling I failed him as well as having failed in my duty. To this day I feel a little sadness in that sorry ending. It’s not an uncommon end for many elderly people but this one was an especially frustrating, sentimental, and sad demise.

I'm over it. Sort of. But reading about the passing of Florence Green kind of brought it all back once more. I wish he'd lived to be 110 as well.

No Apologies

I went and picked up one of those "days of the week" pill boxes last week. Actually, Tam picked it up because she knew I wanted one. I was tired of standing there looking at my Crestor bottle and asking myself, "Did I already take one today?" So, bless her heart, she picked one up for me while out running errands.

The thing is great. It may be an "old person thing" but I can hide it in the privacy of my medicine drawer at home. It's not like those loopy strands one uses to secure their glasses to their necks, those beaded strands that say, "Yep. I'd forget my head if it weren't attached to my neck! Yuk, yuk." And since I've started using it there is no more guess work. The only problem I've encountered is with Tam.  She has gone ahead and stuffed all her vitamin and calcium in along side my little Crestor pill making it a wee bit difficult to retrieve my pill without dumping the whole contents.

The little boxes have proved so useful I'm considering expanding the concept: I'm thinking about creating "days of the week" activity boxes. I envision a five foot by one foot cubby to sit on top of my kitchen bookcase. Each day would have its own compartment and a hinged lid with the day of the week, Monday through Friday. (Sorry. You're on your own for the weekend.) Every morning you just simply open the lid and there's your to do list. Maybe a pink slip that says "doctor at 10." Or a picture of an airplane that says, "Delta flight 1211, 5:30PM." Presto! No more annoying phone calendars and reminders. No. Everyday a concrete reminder of what's to be done that day.  All those sticky notes and scraps of paper like, "exterminator-- thursday 10" would no longer clutter your counter tops. No siree. They all get placed in their proper box. Just open the lid and get to work.

I know. Sheer genius. But don't even think about it. It's my idea. I've already got the call in to Ronco.

No Pills For You

I just want what's best for God and America, ladies.

The recent brouhaha over the Obama Administration's requirement that insurance  cover contraceptives without cost is a classic example of just how far politicians can go to distract, deceive, and defraud the American public. This recent report from NPR highlights just how much is being made out of how little.

The current "outrage" is being generated by those self-serving and self-righteous leaders and special interests who prey on the collective ignorance that infects this country. After all, it shouldn't be that easy to remake old policy, tried and tested in multiple courtrooms, into a red hot issue all these years later. It requires an uninformed public and a manipulative leadership.

The most significant impact of Obama's policy is that it has provided one more load of fuel for the obstructive opposition to the tall, skinny, east coast Ivy League liberal who must be a Muslim and probably wasn't even born in the US negro democrat in the White House who wants to destroy our traditional values and transform our Great Country into a Socialist Empire. That's all. They're just lookin' out for our best interest.

An Emotional Problem

I need to make a flip book of all my posts on this blog so that I can keep track of how many times I repeat myself. That said, one of my favorite gripes is about the downfall of humanity. Not the big theatrical collapse with earthquakes and open drunkenness and orgies like one sees in movies and in college, but the little peeks and snippets I glimpse so often in my practice.

Tuesday was classic: I saw a kid with whom my daughter went to high school.  Actually, I remember this kid from birth because both of his parents have been my patients and he was born with a birth defect requiring orthopedic care. The stunner came when the kid tells me he's on SSI. I ask, "Are you in school or what kind of work are you doing?" He responds, "Oh, I don't work. I'm on SSI," like it's a study abroad program or something. SSI is Social Security Supplemental Income which is provided to those who are disabled from work. "What's the source of your disability?" I have to ask. It might relate to my assessment of his condition. That and I always have just a bit of indignant curiosity as to what precludes a healthy looking young person from ever working. "I have an emotional disorder." Whaaat?? I had to know more. "Well, I have trouble emotionally adjusting to work."

Okay. Can I just stop there?! And you thought I was using hyperbole when I said the downfall of humanity.

More On Aging (Moron Aging??)

I've done it twice now in the past 7 days. I'm beginning to worry. In fact, if it weren't so funny I just might worry.

A few days ago I left the house before dawn and walked up to the hospital. Nothing unusual there: I do it several times a week.  Difference was, I decided to set the house alarm before walking out the door. It's dark at that hour and everyone is sleeping. Perhaps it's unreasonable but sometimes I worry if Evan were to get up unbeknownst to me and try to follow me outside. Not good when it's 20 degrees. So, I set the alarm. That way, should he try to open a door, the alarm goes off. Beep, beep, beep for a minute and then, bam! the big horn and the phone rings, etc, etc.

So I grab my x-rays, grab my little to-go bowl of cereal, bundle up, set the alarm, and head out the door-- the garage door so as not to wake anyone by slamming the front door. Walking up to the hospital I feel really good about leaving my wife and son safely asleep at home and turn into the hospital drive when I stop: My glasses! I left my damn glasses on the dresser in the bedroom. Idiot!

Sooo….I walk back down the hill, open the garage door, enter the house and, Crap!, race like crazy to silence the alarm before it wakes my sleeping wife and child with its staccato beeping. "Sorry. Forgot my glasses." Tam rolls over the other way.

Yesterday morning I once again left the house before dawn. I bundled up, grabbed my scarf--  woops, almost forgot to grab my cereal-- set the alarm and headed out through the garage and on up the hill. I even double checked: Yep. Even with my gloves on I could feel 'em: Glasses in coat pocket.  Arriving at the hospital I went to my locker, changed into scrubs, and grabbed my-- %#@&! Sunglasses!!! Where were my regular glasses?? I was certain I had grabbed them as well as the shades!

After racing to turn off the alarm Evan came walking out of his room, blanket in hand, wanting to know why I had on blue clothes.  "I'm just going to work sweetie. It's still night time. Go back to bed." "But I'm hungry." "Go back to bed, sweetie. I just forgot my glasses!" I was so disgusted with myself by the time I had grabbed my glasses from the counter-- where I had left them while packing up my cereal-- that I was ready to kick the dog (the dog I don't have and, which I should mention, is just one more reason not to have a dog).

I like my glasses. My glasses do good things for me. They look good on me. And, without a doubt, without them I feel really dumb. The worse part of it is I can't be certain: memory issue or distraction issue? If this happens again I'm not sure if I'll get another pair to leave in my locker at the hospital or an MRI to look for gray matter atrophy. For the time being, I'll just file these recent episodes under "humor." But I will have to give just a little thought to worry. If I can spare the gray matter.

Another Reminder

I called an old friend the other day. She and her husband and I go way back to our heady days as interns. We were fresh out of medical school with our eyes firmly fixed on surgical careers while trying to navigate the many threats and obstacles to be found waiting in an inner city hospital. We met feeling all grown up and ready to grab life by the horns, grew more, grew closer, grew older, and grew apart as we followed our work. And yet, we always maintained a bond, even years and many miles apart. It must have been the timing, the shared experience. We were only together for a few years but they were exceptional years of growing and experimenting and learning and playing. And after that I have always had a place for him. A bit of me owned by him.

She told me that she and her husband were getting a divorce. Worse yet, the reason for their demise was related to his addiction to alcohol. He, a bright, fast talking Texan with an easy laugh and a million stories, appears to be slipping away-- socially withdrawn and no longer practicing. I am terribly sad at the news because I fear for my friend and knew him well enough to think, although he may have lived at risk, he didn't have this coming. His humor, intelligence, and animation were an amazing source of energy and pleasure in my life. He and his wife were the closest I've ever come to knowing a real life Nick and Nora Charles.

Great lives and great friendships that run afoul of life's deep mud and sand traps: It makes a sad story for a family, for a beautiful quick-witted intelligent spouse, and for an old friend. For my friend's sake I can always hold out hope that a journey into the abyss will lead to a stairway back to a whole and social life. One never knows. For me the news serves as yet another reminder just how fragile life is, how close one sometimes gets to the edge, and how fortunate I am to have friends to hold close. Life is never so good that I can take it for granted.

Super Fumble

It should have been a harbinger: Out to breakfast late Sunday morning I have the urge to order a side of french fries with gravy on the side. First of all, I don't eat meat anymore and second, it's hard to do worse than order french fries with gravy. In spite of these compelling reasons to steer clear I dive in.

I survived the dietary fumble without any obvious ill-effects, but psychologically I had trouble forgiving myself. French fries with gravy? Seriously??

A few hours later I was back home in the kitchen whipping up queso, (fake) buffalo wing dip, getting stuff together for tacos, and helping cut up veggies for snacks. As it turned out our small party was a visit by one. Just Tam's mom came over and, other than having a refrigerator full of uneaten junk, that turned out to be a good thing. As a result I was finally able to get back on the right track and make a good choice. Free of any self-imposed obligation to watch the Super Bowl, I slipped out of the den and into the office where I actually used my time constructively. It was a great salvage after starting my day eating french fries with gravy, assembling piles of food that would not get eaten, and starting to watch a football game so immersed in hype as to test the depths of human gullibility.  It was nice to reach the moment when I finally said "no" and got something constructive done.

I did check in at halftime to watch Madonna. I should have left after her first number but I like Madonna and wanted to give her the benefit of the doubt. Turns out I gave her more than she gave me.  Maybe she had french fries with gravy for breakfast as well. And, too, maybe she got something constructive done after halftime as well-- like firing her producer and her wardrobe designer.

I have vowed that next year I will not waste even 1 hour on the so-called-Super Bowl. I will start that Sunday with a bowl of granola, go for a walk, and finish a novel. Unless, of course, the Lions are in.