Archive for August, 2019


Over several weeks, many have queried about why I haven’t sought additional treatment. It’s a fair question that often has nuanced answers. Probably the best answer I heard comes from Andrew Luck.

Having worked in the medical field, many patients have chosen the quality of life over treatment. That choice can be hard for family and friends, but for the most part, people who can make decisions for themselves have the right to refuse any treatment. The reasons vary. For some, there are associated health problems with treatment. For others, it’s age. Others, it’s a moral decision. And so on.

Coming to the end of life, I had one goal: die in the least objectionable way. Of course, doctors have arsenals loaded with weapons against infirmities of the body. Unfortunately, medicine focuses on longevity, not quality. Need an example? Me. I take 13 different drugs daily, three are required before I’m able to get up change clothes. The rest are ingested via a carefully crafted schedule. As I told my mother, medical technology is terrific, but sooner or later, the body wins.

I’ve often said to my physicians, “We all know I’m going to die. Help me die in dignity.” Therein lay the truth; everyone knows I’m going dying. It’s just a matter of when not if.

During a recent walk with my parent’s dog, Skip trotted ahead. He looked back with sympathetic eyes that could only say, “. . . you look like shit.” Sometimes in my humorous way, I reflect upon Doc Holliday’s witty quip (Wyatt Earp 1994), “I wake up every morning looking in the face of Death, and you know what? He ain’t half bad.”

Why am I deciding now?

During the past 35 years, I’ve not known a day without pain. What I learned from the military, from football, and my ol’ man was to suck it up, take the pain, sacrifice the body for the good of the team, and if required, for the good of the country. I’m aware of the physical toll of that profession as well as the traveling of my business. Throughout years of travel, I fought through pain and injury while simultaneously remaining stoic. I felt breaking through the pain helped proved myself. I accumulated significant damage.

Like many sitting behind their desk right now, I silently “self-medicate” to keep fighting at peak performance. Pills hide the pain from 8 partial ligament tears in my left knee, with 6 in my right. I was partially paralyzed from a spinal injury nearly forty years ago; had bone chips removed from my spine; feet suffer from severe arthritis that sometimes the left foot locks; experienced two concussions; one eardrum tear that requires hearing aids; had a silent heart attack; cracked some ribs; fractured a wrist; suffered a shoulder separation; have cervical stenosis; lumbar osteoarthritis; and now a cervical spinal tumor, and multiple sclerosis.

Andrew Luck, the former first overall draft pick and one of the NFL’s league’s brightest stars, eloquently summarized my thoughts. When questioned this past Saturday about his surprise retirement, Luck stated he could no longer take the years of pain and rehabilitation from a host of injuries.

It was not the first time a professional athlete stepped away during the prime of their career, but Luck was one of the more vivid examples of a player weighing the consequences of continuing a career. His decision to retire didn’t occur in the limelight, in front of a cheering crowd. “I’ve been stuck in this process,” Luck said during his retirement press conference. “I haven’t been able to live the life I want to live. It’s taken the joy out of this game. It’s the hardest decision of my life. But it is the right decision for me.”

I echo the same thought; it’s a hard decision, but it’s the right decision. Thus, that’s where I’m at, stuck for thirty-five years. In truth, I have not lived the way I wanted to live. The decision to choose a treatment or not to choose treatment isn’t easy. My body is tired, and I’m tired. Eventually, technology loses – the body wins. The body always wins. Pain has devoured my body, my mind, and my soul.

All of us, at some time or another, will be at a similar crossroad. At some point, one will have to prioritize their health or personal well-being rather than the good of a team or a company. We have to learn to invest in ourselves.

I was having lunch with two friends yesterday.

How does one go on after suffering horrific loss?” a colleague sighed as she referenced gun violence.

The other colleague recalled a story from her days in Chicago.

“”I remember two WGN radio hosts, Kathy O’Malley and Judy Markey.  They were forced by management to end their radio show with no notice. O’Malley and Markey said they had known for weeks their show was ending, but administration forced them to tell their audience during that day’s show. It would be their last. The abruptness by which management forced them off the air caught listeners by surprise.

We’re all going to be OK, and we’re all going to put on our big-girl panties and deal with it,” O’Malley told listeners.””

In other words,” my colleague stoically noted, “. . . Put your panties and deal with it. Life demands we move forward. ‘This day’ will always become another tomorrow.

As a Buddhist, I might have stated the world is full of causation, meaning that the whole universe is a web of interrelated causes and effects. To those who suffered a significant loss, such a statement would be ideological. However, such sentiments offer little to those who’ve lost much.

The Washington Post performed an analysis of recent high-profile mass shootings. Their report suggests that interest in combating the problem tapers out after about three weeks. Thus, by pulling up our pants and getting back into the world, it is the survivors who must make meaning out of the misery. Our presidential and legislative leaders only look to ‘run out the clock.’

And how does one run out the clock? Just do what Sen. Rob Portman, R-Ohio did. After the Dayton, Ohio shooting, Sen. Portman diplomatically referenced the NRA playbook.

“These senseless acts of violence must stop. While we are still learning more about the details of this tragedy in Montgomery County, we are praying for the victims and their families and thank the officers who responded so quickly and bravely. I am talking to local leaders and law enforcement officials this morning. First and foremost, let’s get all the facts and help the community heal.”

Need an interpretation? First, pray for the victims. Second, thank first responders. Third, talk to leaders and law enforcement. Fourth, help the community heal. Fifth, get facts. What Portman won’t tell you is that he’s running out the clock. Portman knows all he needs is three weeks–three easy weeks.

Portman understood playbook, the five steps. And each sound great, and that’s what voters want to hear. However, Portman also knows it will take months, if not years. Thus, all he’s doing is putting lipstick on a pig.

The Washington Post outlines the strategy.

“This is often the unstated goal of gun rights advocates. Allow the passion that immediately follows the attacks to cool, often demanding that politics wait until an appropriate mourning period has passed. Weeks later, most people have moved on to other issues — including members of Congress.

Trump claimed Wednesday that some background checks were still possible. Maybe. But there’s an established pattern of elected officials whose politics align with Trump’s merely wait out the energy and passion that inevitably follows mass shooting incidents.

Usually, by about now (three weeks later), people have moved on.”

Here’s my colleague’s message.

Every year brings forth a new set of survivors. They come from nearly every race, religion, and socioeconomic background. These otherwise ordinary heroes come from Parkland, Florida; Aurora, Colorado; and scores of towns whose names were chiseled into our minds. These tragedies go against everything we’ve been taught: that we live in a just world, and if we make the right decisions, we’ll be safe. Still, any of us could experience such deep, profound tragedy. With the help of those around us, we can turn fear into purpose.

Parkland survivors worked together and called for changes to prevent similar tragedies from recurring. In essence, they put their panties on, confronted lawmakers, rallied others, took to the streets of Washington, DC, put on the March For Our Lives, and made impassioned pleas for reform. They were able to put anger into activism, interrupted the typical narrative, and refused to let the news cycle or the country move on. They did not allow others to forget.

These same stalwart young activists are providing witness that if you want nationwide healthcare, put your panties on.

You want infrastructure building programs? Put your panties on. Do you want a national healthcare program for Alzheimer’s? Put your panties on. Do you want real gun reform? Put your panties on. Do you want decent childcare and early childhood education system? Put your panties on.

The list is endless.

These are the real changes Dr. Martin Luther King, Christ, Buddha, and so many others would have fought for.

I am not a fan of Walmart management. However, I read this morning that the El Paso, Texas Walmart, where 22 people were killed earlier this month, will be remodeled and reopened. According to news reports, the renovated store will include an on-site memorial honoring victims and recognition of the El Paso and Ciudad Juarez “binational” relationship. And that’s what should be done.

So, you, the one reading this blog post, do you want change? If so, put your panties on.

Five years ago, just before Thanksgiving, I had a colonoscopy.

For those unfamiliar with the procedure, a colonoscopy is a medical test that examines your colon for abnormalities and disease, mainly cancer. For new patients, a physician might show a color diagram of the colon. Such visuals are like AAA roadmaps that appear to go everywhere. Mine looks like the Louisville Kennedy Interchange, an intersection of Interstates 64, 65 and 71. Anything passing out of that whizzes past Lexington and jams up in the foothills of the Blue Ridge Mountains. The physician will state that a long flexible tube (colonoscope) is inserted into the rectum and the video camera allows clinicians to view the inside of the entire colon. Often, digital photographs are taken, none of which should be shared at family get-togethers.

I was amazed at the precision by which this procedure gets completed. Like flights landing and taking off from your local airport, patients are moved through the various stages: pre-op, operation, post-op, recovery, doctor’s summary, exit.

What most hate is preparation. It begins during the previous night and involves chugging a gallon size concoction that tastes similar to a dishrag and cat saliva. If you’re lucky, one might get a hint of strawberry. Most times, one is not so fortunate. Instructions forewarn said participant that ‘loose, watery bowel movements may result.’ May result? For me, ‘loose watery bowel movement‘ resembled ‘Old Faithful,’ with timely eruptions occurring every 20 minutes.

I overheard two clinicians saying they know of patients putting a shot or two of alcohol in the prep.

Damn,” I thought. “Why the hell didn’t I think of that?

Recovery resembles ‘America’s Got Talent.’ A group of clinicians gather around their scoreboard (x-rays and pictures), point, “Hmm” in unison and shake their heads. Awaiting my ‘Golden Buzzer’ or dreaded rejection, I overheard one patient-doctor conversation. The woman was given the sad news of a stage 3 tumor.

Hard to imagine: In less than a minute, someone went from Thanksgiving festivities to cancer patient.

In 2011, Vietnamese Buddhist monk William Tran went to the dentist for inflammation in his gums. Antibiotics did not help, and when the dentist saw him again, he was so concerned that he took Tran to the emergency room. There, Tran was diagnosed with acute myeloid leukemia and told his disease might not be cured. Tran went from monk to a cancer patient.

Writing previously, my diagnosis never came via a patient-doctor visit. I read about it from the online patient portal.

“. . . tumor in neck measuring 4.1 x 2.3 in transaxial dimensions and 3.7 cm in height (1.6 inches x .9 inches x 1.4 inches), surrounding the spinal cord and C5-C6. Preliminary indication benign. Requires biopsy. Metastatic or secondary tumors may spread from another site. Delicate neural structures will complicate treatment, resulting in nerve compression, spinal deformation and compromised bone strength.

I remember these stories as I learned of a friend who, in a matter of minutes, went from vibrant mother, wife, and business owner to cancer patient.

I am lucky. Years of work in the healthcare industry provided some tools to meet the requirements of my illness, its treatment, and when I could, the compassion to be patient with myself and others. In many ways, I revealed how I applied spirituality and or humor in many difficult situations. I always hope my experience would be of use to someone walking the same hallway.  As noted, I am not a spiritually mature person. As noted in my blog, I fail often but succeed as well.

My years in the healthcare industry has provided a general understanding of life and the body’s capability.

One such lesson: Spirituality, whether Buddhist, Christian or other, will neither prevent anything nor will it shield us from anything. Faith can soften the blow and open us to meet everything coming forth. A patient could spend the rest of their life thinking about treatment, without looking at the nature of their mortality and meaning in their life. Therefore, it is essential to have the courage to live a life true to yourself, not the life others expect. When people realize their life is almost over and look back, it is easy to see how many dreams go unfulfilled. Most have never honored even a quarter of their goals.

Remember to honor some dreams along the way. If not, from the very moment you lose that thing defined as ‘health,’ it’s too late. Health is a freedom seldom appreciated until no longer available.

Plowshares

When asked about my disease, my comparison is root rot. Yeah, true. Webster’s Dictionary will define root rot as a condition in which the roots of a plant begin to decay, but that’s where I’m at. My days are composed of overcoming various problems: stiffness, numb hands, dropping things, sporadic tremors, and so on. The latest issue is extreme neck numbness accompanied by full neck lock.

Several nights ago, while sitting in a comfortable chair watching the Cubs lose, I suddenly became unable to turn my neck. I quickly downed some essential medication. After an hour, little relief was achieved and grabbed my one form of ‘use at last resort’ medicine, a muscle relaxer, and pain blocker. By night’s close, I drifted off to beautiful sleep.

At dawn’s early light, I stumbled from the bed, showered, drank a cup of coffee, downed a batch of morning medications, dressed and reached for my Smith and Wesson 351PD.

Before this weapon, the only gun I ever owned was a Lone Ranger toy gun received from my Uncle at years for Christmas. Of course, I grew into a trained sniper and handled many weapons during my time in the military, yet I hadn’t owned a gun until 2017. Ownership came after being robbed while coming from a department store. And Smith and Wesson became my choice for personal protection. The 351 PD I carried provided me with a sense of security. With it, merely flashing the weapon to another would-be robber was all required to dispel an attack,

From there, I somehow acquired 8.

Strangely, in spite of everything, I could still shoot. My military instructors would be damn proud. I put in countless hours at the range, and in spite of my root rot, I could shoot nearly as good as some competitors.

Still groggy from the previous night’s medication, I flipped the cylinder open to ensure proper loading, spun the cylinder for the hell of it, handle in right-hand, barrel resting in my left, while and carefully checked the trigger.

The trigger slipped — a rookie mistake made by a professional.

Surprisingly, the. 22 caliber bullet provided little recoil. Amazingly, the bullet travel between my index finger and middle finger touched neither. Best I can tell, the shot angled through the drywall, wedging in a wall stud.

The explosion still resonates in my ear today. Suffice to say; it was huge. It was the first time I heard a weapon discharge so close to my ear. My ear still rings. That sound is forever etched in my mind. I’ll never forget it.

For the first time in my life, I understood the fear of gun violence; it’s sound and the fear of being shot. I could have been seriously wounded. Under different circumstances, I could have seriously injured a loved one or bystander.

The hundreds of hours spent in training is futile when one is slightly groggy. At that moment, I became a threat.

I was blinded to the real possibilities of killing someone. The idea to purchase the weapon was to feel safer. In a split second, I realized just how idyllic and self-delusional. I wasn’t warped by NRA, by some fancy salesman, by the notion of the second amendment. I had distorted by a belief that a weapon would make me safer.

I broke my honor, and the Buddhist precept of Ahimsa, do not harm. The real villain in this story is not the man who robbed me years ago. It’s was neither media nor gun rights advocates. The real villain was ignorance — my ignorance. I projected my fear unto a dreamlike state of peace that could never be created. Personal peace via a weapon cannot be attained.

Late afternoon, I gathered my weapons and handed them over for destruction.

I ended the fantasy.

————————

. . . and they shall beat their swords into plowshares . . .

Isaiah 2:4

Told To Leave

I was having with a newly diagnosed cancer patient about, what if, anything I learned that could be of value. Our conversation wavered to other topics. When she stated her concerns about healthcare coverage and the attempts by the current administration to dismantle healthcare, an elderly woman sitting near us interrupted.

If you don’t like America leave?

Without batting an eye, perfectly calm, I responded, “Where to?

Well,” she started . . .

Ah,” interrupting. “You raise a valid point.

A quizzical look began to envelop her.

Where to?” querying myself. Placing my hand underneath my chin, “Where to? . . . Yes ma’am. Ah, where to?” looking at her.

Well . . .” she started.

Cutting her off, “Yes indeed. So, my father has German heritage. My grandfather was German born, but immigrated to Canada in his youth. Should I move to Canada or Germany?

Beginning to become flustered, “Well . . .

However,” I pointed. “My mother’s side is Scottish. And although my grandmother is Scottish, she was born in Ontario, Canada. Yet, my mother was born in Chicago. So, should I return to anything, should I move to Scotland, Germany or Canada? Germany might be hard though, for I speak no German. Do you think they’ll accept me regardless?

Well . . .” she started.

But you know,” cutting her off and turning to my friend, “I have other issues. I was born near Chicago. Yet, I lived for a year-and-half in Toronto, Canada. I also lived for a year in London. And I lived for a year in Toyko, Japan.” Quickly pivoting back to the women, “Do I need to also consider Japan and the U.K.?

Ah . . .” she gasped.

Wait. Wait. Wait.” shaking my head. “Damn. I forgot I worked in 33 different countries, including, Chile, Brazil, Mexico, Peru, Columbia, Australia, New Zealand, China, Philippines, South Africa, United Arab Emirates, Switzerland, Sweden, Taiwan, Costa Rica, Venezuela, Ecuador, Saudi Arabia, France, Portugal, Spain, India, Ireland and a bunch more. Should I count any of those?”

Ah . . .

So,” I interrupted. “Why don’t you just go back to your table. I will buy you another cup of coffee, and you can debate all that shit and let me know.

Well, I never,” she gasped.

I agree,” responding tersely. “You never should have.

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