Posts

My Last Surgery Will Be a Lobotomy

I’m slated to have surgery soon on a particularly nasty fistula/hernia in a particularly unpleasant place (pelvis,butt). There’s a chance it won’t happen as I have an unusually nervous-about-lawsuits-PCP. She’s already expressed concern (liability risk) about my possible death on the table if she clears me. Sigh. While it’s frustrating (anger-producing) to have that possible decision in her hands not mine, a small part of me doesn’t actually care.

The irony here of course is the six-plus centimeters of bowel I sit on could blow open and kill me anyway even if I don’t have the surgery, but hey, I guess she’d feel vindicated! While I have spent several weeks fretting-and-stewing a good head of steam about it all, I’m beginning to be at peace either way. At least part of me is.

A New Medical Model

A few weeks ago I saw Dr Ezekiel Emanuel interviewed on a news show about a decision he’s personally made: to decline a good number of medical treatments and/or tests after hitting age 75. It sounded initially quite shocking to hear a world renowned oncologist and medical ethicist go public with his decision. But the more I think about it, the more understandable it might be, highly rational even!

Keeping people alive and doing whatever it takes, from carving up body parts to pharmaceuticals laced with life prolonging drugs is starting to feel crazier and crazier to me. I’ve had eight surgeries for a tumor that began in the rectum and traveled south to the anus, the body parts no one likes to mention. The whole problem began twenty-plus years ago though with far less invasive procedures. At some point however, and after two trans-anal surgeries, a zillion colonoscopies to scrape out double digit polyp growth, it had finally graduated to ever-greater proportions and invasions which, as night follows day, resulted in a permanent colostomy. The bag!!

After five years (which isn’t really all that long I suppose) of dealing with hernias and several complications such as a kinked colon, a skin separation that ended up with exposed flesh that then became necrotic (dead) and infected, etc. and now the worst complication of all in terms of discomfort and fright, there is a decision to make if not by my primary care doc, potentially by me. 

Expiration Dates

The lengths we go to in modern medicine to keep people alive is extraordinary and often wondrous. But it’s impressive and valiant efforts looking back seem more worthy of younger bodies sometimes. I’ll be 71 years old very soon and a part of me (if the decision is mine alone to make even) is inclined to let this ole’ animal let nature take its course. Dr Emmanuel’s cutoff is 75, I’ll be 71, both still arbitrary numbers.

I like to think in practical terms sometimes which can be disconcerting to many in the medical community. Most professionals are hard-wired to keep people alive. At whatever cost. While I too want to make prudent decisions to preserve life, including my own, at what point do we consider surrendering to the inevitable? And the inevitable for me does not include hastening death but does not include avoiding it either. I heard one doctor say that Medicare “requires keeping the patient alive.” I don’t know how it’s worded in the manual (do they have a manual?) but suffice it to say, we’re all caught between a perpetual rock-and-a-hard place loop of sorts.

(I told one of my doctors that I’ve had a “do not resuscitate” document signed for the past 10 years. He literally told me that in the OR, they’ll ignore it and try to resuscitate me anyway!)

Different Strokes for Different Folks 

My elderly friend Magie used to occasionally say to me “won’t this ever end?” She lived to be 96! My other elderly friend, Bennet, lived to be 94, which is nothing short of a miracle since he survived the holocaust which included several years of malnutrition (to put it mildly) while in the camps. But I think his drive to survive those years turned into an insistence on living well and long afterwards, a fierceness to go on with purpose and passion as an example of a different sort.

My role on the planet may be more nuanced. It may not require such heroic measures at all. Maybe, just maybe, letting the body run a natural decaying falling-apart course (which mine is clearly doing!) can also be an ethical example of not just choice or protocol but rather surrendering to the inevitable. I mean, come on!

Don’t misunderstand me: I don’t want to die at all, ever!! And actually because I believe in the eternal—of life before life as well as after death—my preference is to stay in this, oh-how-shall-I-put-this, “incarnation”. It’s all I know of me. But that does not mean there isn’t a “knowable me” in a different context, a different state of being. Just because I have no memory of existence other than the one I currently inhabit, doesn’t mean there isn’t one. How arrogant to think otherwise.

So I’m in a state at the moment that seems uncertain, to have this next abdominal surgery or not; to have doctors decide based on their best interests or mine. However it plays out, if the surgery does occur, I know one thing for sure it’ll likely be my last, or at least second to last. Unless of course there’s a lobotomy in the offing! I’d consider that!

/0 Comments/by

Covid-19 Rising

I sit here on a gloomy-stew Sunday, just me and the rain. It continues to feel like such a surreal existence, the social distancing, the subtle fear of others—could they have “it” or could I infect them, crossing my mind all too frequently. The odd wariness of people, be they strangers or even friends, it’s disconcerting, but a near curiosity nonetheless.

KEEP YOUR DISTANCE

Through no fault of their own, everyone is suspect, including myself. The rain makes me think the earth is weeping for us. But maybe not out of sadness. Maybe just maybe, it’s a way to cleanse the world and metaphorically, us in it. How many mistakes we  humans make. If I wasn’t so personally involved and engaged in the whole pandemic, from a distance it presents as a puzzle, curiosity about the human race, however briefly. Oh, the folly of us.

It’s impossible not to judge although as quickly as I do, I try desperately to chastise myself for doing it. I watch people walk around without any protection, though not too many of them, and marvel at governors who still don’t have statewide orders to social distance. They are making an assumption because they only have four people in the state who are infected, that they are exempt from tragedy somehow. Oh, the folly of human thought. And the arrogance.

I LOVE ME WHO DO YOU LOVE

Arrogance is as arrogance does, or so they say. So too ignorance, and too many Americans, certainly suffer from it. Sadly, both conditions are part of the human experience, part of each of us in unequal measure. We either think we know best, think nothing bad will ever really seriously happen to us, or believe in wacky political ideas that are naive at best, nefarious at their worst. 

Then there’s the greed and selfishness of people hoarding, sometimes out of downright fear I realize, but all too often out of a belief system that “I’ve got to get mine so I won’t lose out” mindset, strutting their behavior like terrified peacocks. I, I, I! It is the bane of our existence.

COVID-19 RISING

They say the next couple of weeks could be very grim with the contagion spreading like wildfire, infecting many more people, with a rising death toll as a result. It will be an uneven contagion no doubt, much like it has been to date. Still, there’ll be some in disbelief, denial. Still there’ll be people who think it’s a conspiracy, some absurd plot. For what end? What global purpose? Remarkably we still live in an age of the superstitious. Still!

And so we soldier on, trying as we might, to protect ourselves as best we can from “the others” be it person or germ. What lesson is it that we must individually and as a collective learn? What spiritual, ethical and social nugget have we yet to break open and discern? Can it result in a “dear God please let us be better than our former selves, please let us think of our brothers, please let us have compassion and caring,” at least those of us who are capable of it. To expand that intent and cover, not just this nation in an atmosphere of love, but indeed the entire world, is our mandate besides the practical behaviors we all must exercise. 

If only…

/0 Comments/by

Defending Your Life

 It is hard to make sense of things in the current situation with the COVID-19 pandemic. Especially when there’s no sense to be had. I’m not talking about all the instructions coming out from the CDC, Trump’s undermining of certain medical measures, and minimizing others, pitting constituencies against one another. Get a test, don’t get a test, etc. Open the markets, don’t open the markets ad infinitum.

Even in the best of times, let alone the worst of times, a new disease let loose on the population can certainly create their own contradictions when so much is unknown about the spread of it, how to contain it best. It is particularly challenging, however, when we have a president who has decimated certain aspects of critical governmental infrastructure ever since obtaining office.

THE DEEPER FISHERS

I don’t wanna talk about those. There will be time to do a postmortem after so much of the risk has passed. In the meantime, we are all challenged in the face of social distance, isolation, to reevaluate not just the bigger picture along with the key players. Just as importantly I suggest we look at our individual selves AND the aggregate of the same. It is an opportunity to go in. Not just to relieve anxiety, although that is true enough. But to really take stock of who we are, what we want, how we ferociously judge, what we value, and to look at what and how we want to be going forward.

Is there not a great possibility to consider the other person, to practice compassion and forgiveness even with those we can’t stand, not to let them off the hook for we can illuminate accountability later on. That has to happen. But just as importantly if not more so, we need to get micro as well as macro, to look at our own role and dare I say, responsibility to our neighbors as to ourselves. I know not everyone has the capacity to take this kind of self inventory, but those of us who can would be better served to examine ourselves and the society at large by taking a steely-eyed look at what we value and why. Who do those values hurt sometimes and who do they help, besides our own self-interest.

DELAYING GRATIFICATION 

We are a very spoiled nation in so many ways. What’s more, very few know it. How is it that too many grumble, unable to comprehend the concept “for the good of the whole.” When my son was in college and there just happened to be for the millionth time a flare up of tensions between Israelis and Palestinians he started a film treatment about God making both sides have a time out, effectively isolating them to opposite corners until they could think through the folly of their behavior, their untenable positionalities. 

I likened his idea in certain ways to Albert Brooks’ Defending Your Life film where Brooks’ character has to defend himself in the afterlife for being driven by fear, afraid to really love, afraid to look at the other. In his case it was fear of loving a woman, fearing a risk of rejection, an ultimate loss of himself in some way. As a collective, our American fear is about losing things, money, our precious comforts, possessions, status, power, whatever externals that too often drive us apart instead of together. 

LOVE IN THE TIME OF COVID-19

And now, through the pandemic we all are on the brink of possible redemption juxtaposed with destruction. Do we have the courage to take stock of our values and the fear that drives too many of us apart heretofore isolating from one another in other ways, suckling our precious opinions, greed, judgments, attachments to things or belief systems as our identity. The metaphor writ large NOW is being forced to isolate physically so as not to contaminate one another. Can we not see that we have been isolating ourselves by class, fear of otherness, fear of not keeping up, fear of losing power or influence—the list is endless but still all driven by fear. What a golden opportunity we have now to examine ourselves and what we truly value and exercise compassion and sacrifice. There are great examples in truckers, nurses, doctors, cleaners but they are not the end of it. We are called to make our own.

And so we continually stand on the precipice waiting for a collective aha moment. Otherwise, we will continue to repeat the same lesson through catastrophes such as this or others we can’t even imagine be they physical, financial, societal, political, whatever, until such time as we come to understand how we have created such incredible comfort and privilege – – even those of us in the middle class – – that this is just that: a privilege. But it is more than that. It is a responsibility. And to deny the least among us out of fear we might lose something at the expense of truly loving our brothers, our fellow countrymen, why, we’ll just keep having to repeat “4th grade” lessons of caring compassion, EQUITY, etc until we ultimately learn and live it. 

ON THE EDGE

Bizarrely, we have the choice right in front of us reflected in two “characters” that represent these options: the grotesque distortion of greed, deceit, and self-absorption in our current President on the one hand, and a compassionate scientist in Dr Fauci, looking out for the good of the whole on the other. One defends his “30 pieces of silver” like Judas while the other defends his love of life itself for the true good of all and asks us to do the same via social distancing. What will we do with this golden opportunity of a “time out”. Can we stand the individual discomfort for the good of the whole? We will all have to decide, for this problem runs far deeper than the current pandemic and will only resurface again and again until we truly move past the isolation of too many hearts and minds that exist in this country today.

/1 Comment/by