“THERE’S A MASS ON YOUR THYROID . . .”

31 May
May 31, 2013

throid

The title constitutes six of the most frightening words in the English language.

A week and a half ago I am rushed by ambulance to the ER. It is 6:00 am and I’m having a great deal of difficulty catching my breath. At first, doctors think it is a flare-up of my CHF (Congestive Heart Failure). I am admitted late that morning.

St. Luke’s Hospital in Bethlehem, Pennsylvania is where people like me–who hate hospitals–go to be treated. The medical staff is consistently reassuring and dedicated and the Personal Care Attendants and CNAs are as good as you’ll find anywhere.

Day three: pulmonary specialists are called in for a consult and rule out CHF, based on a loud expiratory wheeze and other factors, and began to lean toward a COPD-Bronchitis-Asthma problem. To get a clearer look they order a CAT scan.

A radiologist says the scan reveals a grapefruit-sized “mass” on my thyroid gland that appears to be pushing against my trachea.

Could this mass be the culprit?

I meet with a team of pulmonary/thoracic surgeons. They opine that the mass should be removed in the OR, but first, they want a needle biopsy. In this procedure, a lump of cells are aspirated into a long needle that is placed into my chest with ultrasound guidance.

I have the ultrasound procedure, but the mass is too well-hidden inside my rib cage and scapula. The ultrasound image is essentially useless.

Twenty-four hours later, a new team of surgeons from the Radiation/Imaging Dept. tell me they will retry the biopsy, but this time using a CAT scan to guide the needle.

The first week is now “the past” and a thick porridge of melancholy sets in.

The next day is medically unremarkable and I am unprepared for the knock on my door as I fold the last of a Sloppy Joe bun into my mouth from the dinner tray.

A dark-skinned man of medium height introduces himself as an oncologist. Nice guy; Syrian. We talk about the world-as-it-is for a few minutes, then both settle into the business-at-hand. “I know you didn’t come here tonight to talk geopolitics. What’s up?”

“The original CAT scan revealed two lesions on your sternum.” he said.

A bead of cold sweat begins its journey from my left arm pit to my waist. “And you think it might be . . .” The sentence hangs in the air awkwardly.

“Myeloma,” he says, with just the slightest tinge of sadness in his eyes.

“What’s the next step?” I ask in a voice suddenly two octaves lower.

“A full-body panel of x-rays and blood work.”

I lay my head on the pillow and take a deep breath. “What does your gut tell you on this one?”

“You understand I have to rule it out,” he says, “but do I think you actually have myeloma?” Again, his eyes soften. “No,” he says, a smile accentuating a beneficence unusual in bedside consults..

Late that night I practice a technique I call “fall away,” in which I allow my body and mind to fall away in a total act of surrender. In the eye of the storm there is stillness and peace and I have my first good night’s sleep.

The next day I have the x-rays and blood work. It is negative.

In the interim, my lungs and their feeder tubes began to respond to the antibiotics, steroids and broncho-dilation breathing treatments. Although I still have a nasty cough, I am breathing easier, with less effort.

The next day seems to jump out at me. I shudder awake at 3:00 am, nervous and irritable about the CAT needle biopsy. The Transportation Unit parks a gurney outside my door precisely at 2:30 pm. and I’m wheeled down to Radiation/Imaging.

Twenty minutes later I am introduced to the physician who will perform the procedure and he explains in detail what will be expected of me. The thought of being inside a CAT machine for thirty minutes has very little appeal, but I have no choice.

At that precise moment, the Universe intervenes.

“I’m not so sure I want to subject you to this procedure today, before first obtaining the results of the PET scan of your neck five years ago in New York,” the physician says. (I had completely forgotten about the PET scan). “Once we have those records, we can chart its rate of the growth just by eye-balling the two radiographs. It looks to me like calcification is present to some degree, which means it’s likely been there for some time. Let’s get the records. I still may end up recommending the biopsy after I see the PET scan, but in the meantime, there’s not a whole lot we can do.

The next day couldn’t get here fast enough. After almost two weeks, I’m going home.

Suzanne and Carol, the two senior administrators of the assisted living community I live in, along with a handful of residents, are there to greet me.

By most standards, a modest Welcoming Committee, but to me it’s like a ticker tape parade. Martin Bayne

Zen Master Narrates A Story From My Most Recent Book

29 May
May 29, 2013

rm_haryo-222x300ORDER OF BUDDHIST CONTEMPLATIVES

The Head of the Order is respected as the most senior member of the Order, and is a key figure in the functioning of the Order. The Head of the Order serves both as the spiritual leader of the Order, providing a critical refuge point for all who practice within the Order, monastic and lay alike, and also as, in conjunction with the Order officers and the senior monks of the Order, its administrative center. His function and range of authority are defined in the Rules of the Order.

Rev. Master Haryo Young is the current Head of our Order.Ordained in 1972, Rev. Master Haryo is a senior disciple of Rev. Master Jiyu-Kennett and served as one of her assistants for many years.

He was elected by the senior monks to succeed Rev. Master Daizui McPhillamy who died in 2003. Although Rev. Master Haryo travels extensively as part of his role, his primary residence is in North America.

Here is a link to an essay on practice written by him and published in the OBC Journal. The Truth of Being  And another about the path to monasticism: Why Monasticism?

THE YING AND YANG OF PERSONAL CARE ATTENDANTS

18 May
May 18, 2013

 

images543

YING

There is an immutable truth that goes something like this: industries tend to have within their ranks, a single group that does most of the “heavy lifting.” Here’s an example: within the life & health insurance industry, the sales agents do most of the heavy lifting. They not only bring in all the premium dollars, but they are the interface the public sees. In fact, it’s unusual for a policyholder to ever come face to face with anyone BUT the agent. Here’s another, in Microsoft, it’s not Bill Gates that does the heavy lifting, it’s the line-workers who build the computer chassis and mother boards, and the “code jockeys” that translate the binary ones and zeroes that make up an instruction set, to the operational program.

YANG

And then, there’s the example of what happens when heavy-lifters are mistreated, neglected or forced to live on substandard compensation. In this dynamic, we start with a gaping loop-hole in a 1974 federal bill that allows a small handful of industries to dodge minimum wage guidelines.

In English please!                OK – the bill says a handful of industry CEOs can pay their employees less than they pay their baby-sitter.

Personal Care Attendants in the Long-Term Care Industry are in that handful.

Assisted living care givers, also known officially as personal and home care aides, provide help in both private and public institutions where patients require care and assistance with daily tasks such as bed-making and meal preparations. These assisted living institutions can include mental retardation residences, long-term care wings at general medical hospitals, and sometimes even the patient’s personal home. The average salaries earned by these care givers can vary depending on factors like work environment and geographic location.

The Long-Term Care(LTC) industry is in crisis. But the average American doesn’t understand or see the problem. What most see are the manicured lawns of assisted living facilities; the bus load of CCRC(Continuing Care Retirement Communities)residents en route to a swank casino, or the upgraded menu at a skilled nursing facility.

What they don’t see are the biweekly payroll stubs of the Personal Care Attendant who works in these facilities. Most are also unaware the average Personal Care Attendant is a woman of color with at least one child and no post-secondary education. Most training is on-the-job and minimal.

Job security and future job opportunities are abysmal.

These are the people who comfort our father with Alzheimers and feed our 96-year-old aunt who is dying of cancer. They bathe our grandmothers and often provide emotional support at 3:00 am for a stranger they’ve never met.

And they deserve better. Starting with a living wage.

 Is that really asking too much?

BOOK REVIEW

14 May
May 14, 2013

Book Review

419qjI0DgvL._SL160_PIsitb-sticker-arrow-dp,TopRight,12,-18_SH30_OU01_AA160_

 

What Aging Men Want
By John Robinson

What an interesting title: What Aging Men Want. Don’t they just want to retire, play golf and fish, travel and see the grandkids? What more could they want? And anyway, don’t most retired guys say they’re busier and happier than ever? Not quite. Not according to psychologist, minister, author and aging Boomer, John Robinson.

John tells us that the transition from busy middle-aged family man and hard worker to enlightened elder is much more complicated that it looks, and he describes its steps and stages with the help of an ancient myth: The Odyssey by Homer. As you may recall, this myth tells the story of aging warrior coming home from the Trojan War to his wife, son and estate. What should have been a pretty simple and straightforward journey takes him ten years! Why? Because there is so much to learn in this new “coming of age.”

Likening aging men to tired warriors, John explains that each adventure Odysseus faces symbolically represents one of growth tasks confronting men in the transition of age. He explains, “Among other things, a man has to 1. Give up his habitual conquer-everything approach to life (The Raid on the Cicones), 2. Overcome the temptation to bury his angst with alcohol, drugs or mind-numbing activities (The Land of the Lotus Eaters), 3. Surrender his heroic male self-sufficiency (The King of the Winds), 4. Come to terms with the unresolved feelings about women (Circe the Witch), 5. Face the reality of death (Descent into Hades), 6. Consciously choose a real relationship over fantasy idealizations (Leaving Calypso), 7. Terminate a lifetime of warrior strivings still imprisoning his soul (Confronting the Suitors), 8. Reconcile with his family after years of emotional distance (Reunion with Penelope), 9.

What Aging Men Want, John argues, represents the Iron John for aging men. Continuing Robert Bly’s use of myth and fairy tale to symbolize psychological transformation, John deftly guides the reader on his journey home. He also provides ideas on how men can mentor each other, rekindle their passion for life, and create initiation rituals for this new time of life. With its increasing longevity, aging has literally become a new developmental stage in the human life cycle with its own unique meaning and growth tasks. Ignoring these tasks, however, often leads a man into hidden depression. Indeed, retiring “happily ever after” can be a dangerous fantasy for men because it glosses over the serious work of aging. Worse, the old model of masculinity directs men to conquer age with exercise, nutrition, attitude, travel and more work. That’s ok for a while, but it’s not the deep journey of understanding and transformation men need to reach home safely. If you are a man struggling with the passage of age, or know a man who is, take a look at this book.Accept the reality of old age (Visit with Laertes), and 10. Understand the spiritual work attending this final stage of life (Ritual for the Gods). No wonder it took Odysseus ten years to come home!”

What Aging Men Want is the third in a trilogy of aging books by John Robinson following The Three Secrets of Aging and Bedtime Stories for Elders: What Fairytales Can Teach Us About the New Aging. You can learn more about his work at www.johnrobinson.org.

May 2030–Rethought

10 May
May 10, 2013

NOTA BENE: Look I don’t know anymore about the future than you.  I can’t predict what’s going to happen in May of 2013 much less May 2030.  But I do know this, our planet’s in Congestive Heart failure; some days it’s a challenge just to balance the enormous amount of negative energy  from eight billion people and catch it’s breath while it watches it’s resources raped and pillaged by the infamous 1%.

Having said all of that let me go out on a limb to make a prediction.  There is a line we cross as human beings.  Most of us never see the line but I assure you it’s there.  It has no name and yet despite its anonymity it plays a surprisingly large roll when we cross it.  I call it the lifeline.  And for two decades using simple observation, stillness, and intuition I’ve watched many of my fellow residents cross the line.  Sometimes it’s dramatic, sometimes it’s not. But the outcome is certain, always the same. Death.  I’ve seen people cross the line at ten years old with leukemia, at 45 years old with MS, and at 60 years old well. . . you fill in the blank.  For human beings–and that’s the only race I can speak for, the desire to live to protect that spark of life within us for centuries has saved us in precarious situations, it would appear at times that we are all cats, or so we’d like to think.

But in truth, whenever I see and feel and hear a fellow resident cross that line I feel a twinge of sorrow knowing fully well what lies ahead.  Sometimes the end maybe months away, sometimes hours, but once they cross the line death chases them like a thief in the night and they are only too willing to oblige.

Now for the truly sad part.  I have watched planet earth cross that line as if she lived and breathed.  I saw her wipe back tears as she made the decision to let it be and now we are in free fall. plummeting toward the same earth that produces raspberries, cotton and healing herbs.

I hope I’m wrong. I hope it was all a dream, that people will somehow pull it together. Maybe Rodney King wasn’t so far off the mark after all.

Martin Bayne

MAY 2030

06 May
May 6, 2013

images

It’s 2030 and I just celebrated my 80th birthday in one of three resident lounges in AGCOM #43, an Aging Community in upstate New York, just south of the Canadian border. Unlike the assisted living and skilled nursing facilities of the past, with their manicured lawns, on-site and remote activities and 450 square-foot private rooms, today’s AGCOMs are managed by the US Dept. of Aging, and are little more than warehouses with two coats of paint. The building itself is an aircraft hanger-like structure with a corrugated steel roof, and the residents live four-to-a-room in 1,400 square-foot “quads” – each resident has 220 square feet of private space and shares a kitchen, bathroom, and living room with the three other residents.

Every quad also has an RC (Robotic Companion). RCs are the brainchild of Dean Kamen, the man who gave us Segways at the turn of the century. The Companion, made primarily of plastic and other cleanser-friendly materials, cooks, gives showers, cleans and assists with any Activity of Daily Living. Fully operational by voice command, the front of the RC can even fold out to provide an emergency wheelchair.

The conditions I described in the previous two paragraphs are the result of two dramatic changes in the American aging algorithm. Demographics coupled with a massive global financial depression in 2016 was the first. When the Euro finally caved in 2015, China called in a sizable chunk of US debt. And for the first time in this nation’s history, we were unable to meet our obligations. That set off a domino effect and within two weeks – after a sizable and very violent run on banks in this and other countries – most global stock exchanges halted trading indefinitely. The NYSE came back online three months later, but with massive restructuring.

The second change – and without doubt the most startling and dramatic – was the Timble Fergeson Act – named after the senators who introduced the bill when it became clear in 2017 that Medicaid and Medicare were nearly bankrupt. The situation called for drastic measures and Timble Fergeson narrowly passed in Congress.  Here are some of the most contentious (and most say) onerous provisions of the legislation.

Effective 12/4/2018 everyone 70 and over automatically was assigned a Primary Care Physician in a national managed care plan. ANY patient plan of  care, acute or protracted that was likely to cost over $5,000 was assigned a “cash transaction” status until an appeal could be filed. This, in effect, shut down the medical system for those 70 and older who were without financial means. A Congressperson from New Jersey said the Bill was “thinning the herd” and had an ulterior motive — to not only dramatically lower acute care costs, but also long-term care costs . . . to be continued . . .

The Grand Journey

28 Apr
April 28, 2013

In the assisted living community I call home, when a fellow-resident begins to physiologically “shut down” in preparation for death, I try — whenever possible — to visit the resident while they are still alive. I’ve never been big on post-mortem communications, regardless of how ethereal. When a person’s “essence” or soul moves on, so do I.

cemetaryI avoid sitting Shiva, wakes, funerals, burials, mortuaries, cemeteries, and cremations like the German Measles. And if that makes me insensitive, disrespectful, and socially crude, then so be it. The dead sure as hell don’t care, why should the living?

I pray our National Cemeteries, with row upon row of headstones as far as the eye can see, will be seen by future social anthropologists for what they truly are: fields of terror, pain and sorrow.

Last night I sat for an hour at the bedside of Father W, an ordained Franciscan priest. Father W is one of the kindest, most sincere and intelligent Catholic priests I’ve ever had the good fortune to know. He began his professional life as an engineer for Bethlehem Steel at their main plant and corporate headquarters in Bethlehem, Pennsylvania, and was in his thirties before he entered the seminary to study for the priesthood.

Now he lies, peacefully, in a coma, waiting for the first bus Home.

And If I know Father W, he’ll get a window seat; like any ten-year-old school boy, unwilling to miss a thing.

STILL RUNNING

27 Apr
April 27, 2013

evil

It’s a beautiful day in Boston, Jim. as our cameras pan the crowds that have lined the streets for this race, you can feel the excitement . . “

Jim?”

Bob, cue a 60-second spot and CUT the feed. NOW. “

“Jim, what the hell is wrong with you?”

Sorry, Richard, I was thinking about the airport”

What about the airport? God damn it, Jim, look at me when I’m talking to you — we’ve got 20 million viewers and you pick this morning to fall off the wagon?”

Bullshit. I haven’t touched a drop.”

Then tell me — what’s wrong with you?

The airport. . ..”

For the love of God, man, what about the airport?”

The passengers that flew out of Logan. They started the real race.”

Jim, what are you talking about?”

Nine-eleven was the real race day, but it’s not over yet. Not by a long shot.”

OK, that’s it. GET HIM OFF THE SET and don’t make me say it twice.

Ladies and gentlemen, we’re experiencing some technical difficulties, we’ll be right back . . .

I SAID I WANT HIM OFF THE SET. Bob, please: call security if you must, but get him off this stage.”

Richard, there’s no need for Bob to call Security. Just hear me out for two minutes, then I’ll leave peacefully.”

All right, Jim, you’ve got ONE minute, not two. That’s it.”

“lLogan was just a warm-up, Richard”

Yeah, right. You now have fifty seconds.”

It didn’t stop that day, did it Richard?”

What the hell are you talking about?”

They’re still running.”

Who are they?”

They. We. Us. We’re still running, aren’t we Richard?

I don’t know what you’re talking about.”

Suicide has surpassed car crashes as the leading cause of injury death for Americans. Even more disturbing, more U.S. Soldiers died in 2012 by suicide than in combat.”

Jim. Your point?”

As our churches empty and the the psychiatric wards and crack houses fill to capacity, we are in darkness. There’s no light. Look at the legacy we’re leaving our children.”

Times up. Enough bullshit. You want to believe the world’s in a dark place and our children will . . . [A tremendous explosion] WHAT THE HELL WAS THAT?”

[A second explosion from a pressure cooker bomb decapitates Richard.]

[Lying on the floor, covered with dust and glass, a camera man slowly makes his way across shattered equipment and broken bodies to Jim. “Who is it we’re running from?” he asks in a hoarse whisper.]

What difference does it make what you call him today. Like a virus, he’ll just mutate tomorrow”

The Devil?” he asked.”

Jim turned away and stared at a smoldering disconnected hand lying on a desk.

How do we find him?” the camera man said.

Just look in the mirror, friend. Just look in the mirror”

 

 

 

 

 

 

 

THE MACHINE THAT ATE MY GREAT-GRANDMOTHER

24 Apr
April 24, 2013

Lorna-Gobey_1589754c

I’m sure most of us have heard at least one grueling story recounting the horrors of an innocent farm hand who accidentally caught a loose piece of clothing in a hay baler or perhaps it was a seed planter built completely of Ginzu knives. The story invariably turns ugly in the second paragraph, and by the end — after thrashing, yanking and terrifying screams — we’re left with a shirt collar and a prequel for a recurring nightmare.

Thank God this is not one of those stories.

In fact, to be completely honest, my great-grandmother was not actually eaten by a machine. She died of complications of pneumonia and heart failure. But that makes for a slow-witted title and a bored reader.(Or a prospective reader who skips over my story entirely! I can assure you, this does not sit well with the Pulitzer Selection Committee.)

Fortunately, I’m a savvy, sophisticated writer, and, thus, am allowed to use bait-and-switch headlines. We call the pick-and-lock sets that give us that extra “literary license”: metaphor, simile, euphemism, and allegory.

Back to G-G. The last time I saw her — the woman who introduced me to incense, Pecan Sandies and comic books — she was in a skilled nursing facility — restrained in a crib-bed, with sunken eyes that reflected her pain and terror.

That experience haunted me for the next half-century. And then there was the diagnosis of Parkisons 19 years ago. This is my eleventh year as a resident in an assisted living community. I live every day surrounded by more death, despair, disability and depression that most see in a lifetime.

But the days of the patient restraints are all but over, and I honestly believe the quality of life in Institutional Aging Communities is improving every day.

Incremental victories. A future with hope.

 

DIVINE INTERVENTION?

17 Apr
April 17, 2013

 

 

 

10:46pmDiagram_of_the_human_heart_(cropped)

J. arrives for the 11-7 shift. Pokes his head in my room and says “hi” on his way to the private dining room – the “Operations Center” for the handful of Personal Care Attendants(PCAs) and Med Techs(they dispense resident’s meds) who will work the graveyard shift tonight at the assisted living community I am part of.

11:09pm

I look at J., “You don’t look your usual upbeat, Bob Marley wanna-be, self this evening. What’s wrong?

“I hope nothing,” he says, “but I’ve had a pain in the middle of my chest for most of the day . . .”

“Whoa. Back up.

Where exactly is the pain?” I ask, suddenly worried about my friend.

He points to a spot about 3 inches below the Sternal Notch.

Now, alarm bells are starting to go off in my head, but I’m in no mood to argue. I had my first round of physical therapy in three years earlier in the day, and I am one tired puppy.

“I’ll be fine he says,” and the day’s exhaustion finally catches up to me and I barely make it back to my room before sleep overtakes me.

5:00am

J. walks in my room. “Shower time.” he says. I rub my eyes for a minute or two and the previous evening comes rushing back at me like a large wave. “How is your chest pain?” I ask.

“It’s livable.” (that’s not the answer I’m looking for).

After the shower, as he begins to dress me, I notice a grimace on his face as he bends over to put my sneakers on. Then, the obvious physical manifestations of someone who finds it hard to breathe.

“That’s it,” I say, “time to call the ambulance.” But J is unmoved.

J.’s as stubborn as I am, and I’m afraid we may not have much time left

And then, a random thought/voice drifted through my pre-frontal cortex: “Find the PostEm note with ‘Carol’ written on it.”

Yesterday, as I was cleaning up, I came across the note with just “Carol” written on it and a phone number. I took a guess that maybe the number was Carol Bs’s. She’s the facility’s Director of Nursing. A tall, lithe woman who is efficient with her decisions and has a great sense of humor. Mind you, I didn’t actually know the number on the note was Carol Bs., but I knew I had to call it anyway. She had the juice to convince J. to call an ambulance.

Long story, short — it was Carol B’s number, I called her, and she convinced J. to call the ambulance.

Divine intervention?

You betcha’