Saturday, September 12, 2009

Early Afternoon

Today has been a wonderful day and it's only early afternoon.

I awoke to a foggy morning overlooking "our" lake.
I scratched my Shar Pei's back like I do each morning.
He talked to me, like he does each morning.
I breathed the wonderful aroma of fresh coffee.
I sat while the "house" slept thinking of love.
I smiled wide.
I listened to "young kid's" music of now-a-days.
I listened to a different beat, a different tempo...but same message.
I watched my young adult son walk down from an unburdened sleep.
I thanked GOD.
I listened to his words.
I felt a humbled pride in the man that he has become.
I walked down to the lake.
I took several pictures of a Wolf Spider and his intricate home.
I wondered how I could later cut the grass without disturbing him/her.
I thanked GOD.
I walked on a knee that everyone but a few questioned it's future.
I thought of the upcoming NFL season and remembered excitement.
I dressed in nice clothes after a hot shower.
I drove with the windows down and the radio off.
I sang.
I sat with a woman as she left this world and entered Heaven.
I thanked GOD.
I watched an elderly man in bed smile as his wife entered the room.
I watched an elderly woman beam joy when he said, "Good Morning Honey!"
I thanked GOD.
I saw a little lady cry in bed.
I prayed with her for the safety of her grandchildren.
I handed her a tissue.
I handed me one too. :)
I witnessed an old man sitting next to his sister who was asleep in her bed.
I found that his name was Frank and that he has a Nissan that he didn't really like.
I listened to the hurt in his voice go away for 15 minutes.
I prayed for him to be comforted.
I prayed for the Nissan's windshield wipers to work again.
I watched a little lady play with her oxygen tubing trying to figure out what it was.
I saw a handmade beaded cross sitting on her pillow.
I held it out in front of her.
I watched her smile and reach for it instead.
I thanked GOD.
I read words of love from the woman that loves me.
I thanked GOD.
I smiled a lot today.
I thanked GOD that it was only early afternoon.

An Excerpt from "Pure and Good" Copyright 2009

Monday, July 27, 2009

Pure and Good...

I witnessed love again tonight at the Hospice House.

A man sat tirelessly at the bedside of his wife of 47 years. He held her hand the entire time I was in the room. The nurses later revealed to me that this was his customary pose.

I watched as we talked. His wife was semi-conscious with occasional episodes of wakefulness. The entire room revolved around this special lady, her love for him and his for her. Well rehearsed stories of how they met, times of exceeding joy and how she would, still to this moment in time, look him square in the eyes and say, "What did you say??? You don't know what the Hell you are talking about!" He then would laugh and squeeze her hand tightly..."She's still here."

She then would weakly but peacefully open her eyes to see who stood before her and then drift back into her dreams of Angels, Heaven and everything that surrounds Goodness. The moment her eyes would open, he would jump to his feet, approach closely but gently and gaze deeply into her eyes. Their eyes would finally lock...her's sleepy and his wishful. She would then smile the most beautiful smile that immediately transformed her face from that of the dying, to a face of joy, a face of laughter, a face of unconditional love. A face that he swore he would never stop seeking...if it was only one more time.
In was quite transparent that her contagious smile was the creator of every hope and every dream that he knew to exist.

I found myself smiling...larger than I had smiled all day. I felt warm and full of a love that radiated from deep inside of them, to deep inside of me.
Contagious, it was.

I am so Blessed.

An excerpt from "Pure and Good" Copyright 2009

Sunday, June 28, 2009

Be Still

I know...I know...I've left you all hanging so long...sorry...the rest is yet to come.

But for now...

Just wanted to begin sharing. Like many of the wonderful blogs that I read...I'm going to try to write less words...same content...but more frequently. I still will include the occasional excerpt from "The Journey Learned" but...I'm feeling a need to communicate with the masses!!!

Life happens all around us...when we are too busy to slow the pace...breathe the air...and as an insightful new friend reminded me just recently...Be Still.

Today my wife and I visited Mill Creek's Riverside Gardens to escape into the sea of roses...we spent over an hour walking, talking, sharing and smelling a bouquet of the sweetest aromas. We sat on a shady bench, held hands and watched a hummingbird claim it's bounty amidst red velvet pedals. We whispered each other's love often without voicing a single word. I held her hand and she laid her hand on my weary back. The sun was warm and the breeze quenching. It was a perfect afternoon.

As we were leaving the garden I realized that I felt...Still. I'm sure that some of you know what I mean when I refer to...Still. I wasn't hurried, preoccupied by someone else's needs, my soul was quiet and I relaxed. I pointed toward a second bench and offered it to my wife. We sat again...this time amidst a different bouquet.

Across a large water fountain a man sat alone on an opposing bench...he cradled in his hands a store bought cup with a lid as if from a gas station. He occasionally lifted it and took a quenching sip. I suspected that it was coffee as I think that he mirrored the contented expression that I have after a sip of my favorite coffee. I did wonder if he was truly...alone. If so why and how. I tried to see in his face if he had suffered loss. I couldn't. I tried to see if he looked sad, happy or looked any particular way at all. Succeed again I didn't because his expressions changed. Sometimes he looked sorrowful but then would interrupt this expression with a soft smile. Sometimes he appeared to be deep in thought...he would stop fidgeting with his "coffee" cup and hold it still as his eyes pierced a blank stare. He would then slowly begin to roll the cup between both hands and break the trance. He did appear to be watching others...just like I was. Still.

On a bench opposite ours but also slightly to the right were two ladies. They were truly enjoying each other's company. They each took turns telling stories and...were very animated as well. This was very entertaining. I couldn't, and didn't really want to, hear the content of their stories. It was obvious, because of their likeness, they were sisters or at least closely related. Maybe it had been years since they had the opportunity to share each other face to face. Sharing each other they were. They each possessed a very discerning and jovial laughter. Their laughter made me smile. I thanked them silently for the refuge.
To our left walked a young couple. They looked to be in their 30s and atop Dad's shoulders was perched the cutest little girl with unkept "Toe-Head" hair. They looked both happy and tired at the same moment. I chuckled thinking of, not so many years ago, when I was half of a young couple chasing my kids around at the exact same rose garden. I also remembered that contented, exhausted feeling after finally getting them back home and to bed.

It was also quite noticeable that this little girl was the mirror image of her mom. I'm sure Dad was reminded of that every moment that he looked at her...kinda like "Love at First Sight"...time and time again. They made my heart warm.

We finally felt that it was time to make our way out of the gardens and up to our car out in the parking lot. I voiced out loud that I really didn't want to leave but also realized that we couldn't stay much longer. We left our bench and I quickly gave them all one last glance...just to make sure I hadn't missed anything. I whispered a quick prayer for all of them and turned and walked away. We walked up a neatly placed stone path and it was there that I received the greatest gift of the afternoon.

I first noticed her walking up in the distance. She walked with a stooped posture and a shuffling gate. Her hair was as white as many of the prettiest roses in the garden. Her legs were swollen and she wore support stockings. Because of this, her legs must have gotten hot on the warm summer day. Her pant legs were rolled up to just below her knees, very evenly I must say. I had to look close to realize that they were indeed long pants rolled up. This actually made me chuckle. She was walking very slow and it looked mildly painful to take each step. For this I immediately felt sadness.

She wasn't alone. He was very tall and possessed hair equally as white. His gait was much more steady but not swift on any account. He looked at her with almost every step they took. His features were more animated and hers were petite. She held his arm and he supported her failing steps with the perfect balance of strength and tenderness. With what then appeared as our youthful pace, we quickly caught up to them.

I greeted them with a comment about the beautiful day and they both quickly agreed. We exchanged niceties and I found myself slowing down for them just in case she stumbled. He began telling us about the wonderful events that had taken place at the Gardens yesterday...

5 weddings!!! He began describing what everyone was wearing and how nice they looked. He talked about how each bridal party had dressed the same...."They all must have been members of the same club or something"!! We all chuckled.

We slowly walked with them out to our cars and I watched as he helped her get into the passenger side..."She's 90 years old you know"!! I waited to see if she was going to give him the elbow for revealing her age. She did not. I guess there is a time in everyone's life that age is an accomplishment and not necessarily a secret. I still thought to myself...I'll never do that.

I looked into my mirror to make sure that she got into the car safely and then pulled away. I thought of a life spent together...57 years he admitted both braggish and prideful. She still looked as beautiful as the day they met I imagined.

I questioned if they would reach 58 years. I found myself wondering who would have to be alone then I quickly had to stop thinking about was too painful to think about...leaving the other....alone.

We then drove away. I snuck a glance at my wife and her at me. We didn't have to talk about our afternoon...but I did find myself holding onto her hand just a little tighter.

Be Still.
Excerpt from "Pure and Good" Copyright 2009

Wednesday, April 15, 2009

Feel free to check a good friend of mine, "Dr. Anonymous", and myself on his radio show Thursday (4-16) at 9:00PM. We will be discussing Palliative Medicine, Hospice Care, passions of the heart and probably sharing a few tales (some true) about our days in Medical School together.
Hope you can join us!!!
Dr M

Monday, March 2, 2009

Raymond and Eloise
~A Lesson of Love~

Today is February 14th, Valentines Day. I awoke early, unable to stay away from my writing…for I have a Valentines Day story to tell.
A true love story that quietly unraveled before my eyes.
Eloise appeared even smaller in stature than the last time I saw her. This was difficult to imagine for I have never met a tinier lady. She weighed 85 lbs and was well under 5 foot tall. Her advanced osteoporosis caused a posture to be stooped forward and stiff in her movements. This is the posture that is so common in the elderly but now physicians attempt to prevent. Her walk was more swift than expected and mostly steady. Despite this, I still found myself walking close to her in case she stumbled and offering a hand to help her on and off the exam table. She dressed neatly in older but well cared for slacks with a matching pastel sweater that had been worn many times before but still appeared new. Her hair was clean silver, short and well groomed. She later told me that she made herself get out to the hair dresser regularly.
Eloise had been coming to my office now for about 4 years. Today was different than all the previous times.
Today, Eloise was alone.
For the past 4 years, they presented to my office together…Raymond and Eloise. I list his name first for this was how one would see them.

Raymond was a large man even in his advanced age. He was well over 6’ 4” and carried himself even taller. He wore a barrel chest and carried strong, square shoulders that were relaxed like old mountains. His build was stocky with a slight relaxed belly but not considered overweight by any standard. His arms were longer than expected until you noticed the length of his legs. Then you realized that this was just Raymond. He had thick hands with long meaty fingers that made yours feel inadequately small when you shook his hand. He possessed a man’s grip reaffirming his size.
Echoing his physical attributes was his baritone voice. He was loud and assuming. When Raymond spoke, you couldn’t help but listen for it was impossible to talk over him. Everything about Raymond was that way….not to be ignored.
Early on, during our initial office visits, I received the impression that he was feeling me out. He would study me as I entered the exam room as a father would a suitor calling on his only daughter. He monitored the way I held myself and studied my movements looking for any sign of insecurity.
He would, of course, dominate the interview with questions that deserved answers and then sit tall and await my response. He asked many questions. Sometimes the questions were very direct requiring direct answers while other times he would lead me into a conversation just to listen to what substance “The Doctor” possessed. No matter how he was doing it…he was looking to see if I possessed the qualities that he expected from his new doctor. I must have passed.
I would meet with Raymond and Eloise every few months and help them as they navigated through old age. Oftentimes they would present for check ups to monitor their blood pressure, heart rate. Weight, etc. It never ceases to amaze me the therapeutic effects of having your vitals checked by the nurse and hearing from the doctor that everything looks to be going along as expected. These visits are indeed…a strong medicine.
Sometimes Raymond and Eloise would come in between their scheduled office visits with various questions or ailments that were plaguing them. Thankfully the questions weren’t too difficult and the ailments not so serious…just valid concerns that arise from a slowly failing body. I counseled on hurt knees, rashes, backs that were stiff and the never ending insurance questions that my wife, Sandi, was capable of answering in more detail than myself. We adjusted “non-generic” medication to “generic” to allow a shared retirement pension to stretch just a little bit further. The generic meds were always less expensive by an oftentimes significant amount. We tweaked Raymond’s blood pressure medication, mostly under his guidance instead of mine, to where he was only taking one sixth of a the smallest milligram tablet available twice a day. This amount was difficult to imagine but he assured me that his measures were accurate. He stated that he was overly sensitive to all medication and anymore would make him dizzy. Every appointment, every treatment was a compromise…a compromise between my recommendations and his willingness to listen to them…or not to.
Please do not get me wrong. It wasn’t that I didn’t try. Early on I would become frustrated with Raymond’s visits and insist that he heed my advise for after all…I was his doctor. He would give me the floor, allow me to give him my spiel of why I think that he should do this and shouldn’t do that. He then would acknowledge that he knew that I was the doctor and that he certainly was not. He then would, in a polite, very “matter of fact” manner, would educate me on what he was willing to do and what he wasn’t willing to do. He certainly was a challenge. It would have been much easier to just dismiss him as a cantankerous old man who was stubborn and set in his ways…but to do this I realized that he would leave and not follow up with any other physician. What good would that do for him? At least he was coming in and listening to me though be it only sometimes. It wasn’t until much later that we found common ground that we could together stand upon.
But common ground we found. All in all, his blood pressure was controlled and his aches and pains responded adequately to the fragments of medications that he would allow me to supply him. Despite the fact that he challenged me in about everyway possible, I truly began enjoying his visits and found myself especially respectful even with his desire to supersede my advice and direct his own care. After all…I could see myself being the same way. Maybe he knew that of me and that’s why I “passed”.
Raymond disliked testing and hospitals more than he disliked medications. It was here that was another area we would find ourselves butting heads. He often complained of chest pain and difficulty breathing with physical activity on more than one occasion. This is what upset me the most for I knew that symptoms such as these denoted serious heart problems until proven otherwise. That’s just what he wouldn’t let me do…prove them otherwise.
On every visit after he mentioned these symptoms I would question him and his willingness to allow me to run some tests and if positive send him for treatment. I offered many different levels of attention from going to the ER enabling us to receive diagnosis and treatment almost immediately to working this up as an outpatient by getting some bloodwork, stress test, etc. full knowing that if I could get him to set foot in an emergency room, he would be admitted secondary to his complaints and immediate attention, treatment provided.
I know now that he trusted and respected me, for after months of pleading with him, he finally gave in…at least in part. Raymond agreed to see a cardiologist. He met with a respected local cardiologist and listened to what he had to say. I don’t know what the exact interaction was like that took place in the cardiologist’s office but could imagine that Raymond wasn‘t at all impressed. Sure he was polite and respectful but sure he wasn’t going to do much of what the cardiologist had to say. Bloodwork and an EKG was agreed upon but the Stress Test was definitely out of the question. I even met with Raymond and reviewed and concurred with the doctor’s recommendations. In perfect Raymond fashion, he respectfully declined a further work-up despite the knowledge of further heart damage and even death.
Over the next few years our office visits continued. Physician continued to navigate patient through the aging process. Like a path of fallen leaves, old age continued to reveal to them a direction they were destined to follow but with often uncertain footing.
It is here the story takes an expected and tragic twist.
Like many mornings, I arrived at my office and was greeted by our staff with an update of what labs and tests are back for my approval as well as who was seen in the emergency room and who of them were admitted. The news of Raymond’s heart attack was part of this morning’s report.
Apparently they were in Columbus at his daughters, and he became lightheaded with increasing shortness of breath. These symptoms must have been worse than previous or his daughters were better “doctors” than myself for they transferred him to the local emergency room where he was admitted.
The only other details that were given to me that day was that it was here that Raymond died.
Eloise appeared even smaller in stature than the last time I saw her. This was difficult to imagine for I have never met a tinier lady. She weighed 85 lbs and was well under 5 foot tall. Her advanced osteoporosis caused a posture to be stooped forward and stiff in her movements. This is the posture that is so common in the elderly but now physicians attempt to prevent. Her walk was more swift than expected and mostly steady. Despite this, I still found myself walking close to her in case she stumbled and offering a hand to help her on and off the exam table. She dressed neatly in older but well cared for slacks with a matching pastel sweater that had been worn many times before but still appeared new. Her hair was clean silver, short and well groomed. She later told me that she made herself get out to the hair dresser regularly.
Eloise had been coming to my office now for about 4 years. Today was different than all the previous times.
Today, Eloise was alone.
An excerpt from "The Journey Learned" copyright 2009
To be continued...soon.

Monday, January 19, 2009

The Party's Over...

Where have the last 2 months gone??? The Christmas Tree was up one minute, down the next....the Christmas ornaments await their 11 month slumber.
Much good has occurred in our lives over the past months. We were blessed to have our "German Son" with us over the Holidays, witness the miracle of life as we watch our daughter's belly grow awaiting the birth of our first grandchild and prepare for the "Big Move" into our lake house. There is something to be said about the phrase, "We haven't used that in years...let's get rid of it!".
Hope I find you and your's happy, healthy and anticipating a 2009 full of life and laughter.
Dr. M