Saturday, November 20, 2010

Where I Live

This is my view, my window to the world.

I live in a small efficiency apartment a stone’s throw away from the classroom. The unit is about 450 square feet. It has a full bath and a separate kitchen. It’s clean and comfortable. I like it. Both the bath and the kitchen are on the back side of the building and have windows. I can see across the top of downtown Portland and over to Mt. Hood and Mt. St. Helens on clear days. When I look out of my back windows, I can see the Science building through the trees.

On cloudy days I can see the layers of grey form and slide across the earth as they envelope the city and dim its lights at night. Some days I wake up, and the fog and mist have crept up our little valley. It obscures all but the closest trees that I can barely discern as thin, black fingers in winter. On sunny days, especially after a rain, the air is remarkably clear as the moisture settles the dust and pollution and allows the sun to penetrate every living thing. Colors are made bright and vibrant. There is also a skybridge that connects the main hospital to the VA hospital. It presents a phenomenal view of the mountains to the east. On clear mornings, it is filled with nature lovers who remark on the sunrise over coffee and scones.

Some would say my home is cramped, but I have room for all I need. I fold up my futon bed every day to make a comfortable couch and view powerpoints on a big screen TV hooked up as a monitor for my computer. I’m very thankful to have this new set-up. I had been having terrific headaches last year, and I seem to have been successful at narrowing the main source of my headaches to being bent over desks made too low for tall folks as I studied. My headaches occur a tenth as much as before. Pretty much everything is up on the screen now – controlled by a wireless mouse and keyboard.

I see people pass by when the front shades are open. They walk along the road that is about 30 feet from my front door. It’s not a busy road. I imagine that they are all affiliated with OHSU in some way, but I know that many aren’t. Most of them look like science people to me. They look like they like to work in labs or at tasks that engage them completely. They look like they would be happiest observing and thinking and synthesizing data.

The neighbors have been noisy. Thank goodness the noisy girl next door has gone. Unfortunately, the new girl upstairs walks heavily on her heels at a rapid pace. It echoes through the wood floors and reverberates in the walls. I’m pretty sure she crossed the floor over a hundred times in 45 minutes this morning. Doesn’t seem particularly efficient to me. Maybe it was too cold to walk outside this morning. I can hear her phone vibrate from where it sits on a table or chair, and the sound is transmitted to me when it is finally released from my ceiling.

I eat simply. Cereal and oatmeal with fruit in the morning. I take juice and donuts to class to snack on while I enjoy the show. I suppose popcorn would be more appropriate, but it doesn’t taste as good as donuts do and there are some bizarre chemicals in microwave popcorn. Even the unbuttered stuff, I think… Donuts are pure and wholesome. Sometimes I eat microwave dinners. They have too much salt. I like salads and tomatoes and bananas and whole wheat bread. I eat turkey and ham with too many nitrates (and too much salt, too). I have eggs every once in a while. I don’t cook much. Just keep it easy and try not to kill myself all at once.

I run 4 miles a few times a week and do calisthenics when I don’t run. I wish I would do more, but I need to study and am getting older. My strength is declining and my endurance continues to require greater effort. I do love to exercise. Am pretty sure I wouldn’t be here if I didn’t. Looking around, I seem to have more capacity than my same-age peers, and my energy levels drop quickly (within weeks) when I don’t maintain a workout schedule. I definitely look forward to including regular exercise in my life. I truly wouldn’t be happy any other way.

Friday, November 12, 2010

VA Adventure

So, you may be wondering how things went at the VA (alluded to in the previous post).

All in all, it went quite well. I was able to shake the hands of and say 'thank you' to 50 or 60 veterans. Spent about 3 and a half hours over there. I just started at the downstairs lobby and worked my way up a floor at a time until I got to the top of the building. I met folks who were well and heading home and some who appeared to have no idea that I was attempting to speak with them. Some were having new parts put on. Some were having old parts taken out. Some were sad and afraid of dying. Others felt restored and ready for the next big thing. All seemed grateful for the hospital and the caregivers who were providing so well for them. My old school chum Allen joined me for the last hour or so.

I met a Pearl Harbor vet who wasn't able to talk much. One fellow told me about his post-military CIA adventures. Another described the way Agent Orange melted the scenery, and how he and another crew member were the only two who survived their exposure to it. Everyone else died within a few months. He says he figures the mask he wore to maintain commo is probably what saved him. He builds "motorsickles", now.

I met pilots and boat drivers and truck drivers and pen-pushers and crew chiefs. All were glad to be remembered. None really had anything they cared to complain about. Even the ones who were actively dying. They were accepting life as it came at them. They made me proud to call them brothers and sisters. They are part of the best stuff this country possesses. They rose to the challenge. They answered the call. They lived without holding too tightly, giving so much of what they had and believing they could be of good use. They touched my heart and reminded me of why I'm here. I hope I did them as much good as they did me.

Good people, man. Good people.

Veterans Day Note to Class

Hello Classmates

Most of you know today is Veterans Day. We don’t make much noise about it here, so I wanted to raise some awareness and make a request.

At OHSU we have a large, blue building filled with 303 beds just for veterans, and the main road that courses through our campus is a reminder of these special persons in our midst. They come from all walks of life. For the last forty years or so, they have all been volunteers. They almost all begin their service as young, idealistic women and men who desire to serve their fellow citizens in a deeply personal manner. They literally sign their lives away and stand ready to place themselves in harm’s way believing it may be the only means by which we might protect our freedoms, our families, and the ideals that bind us together. They then carry these experiences of sacrifice in their hearts and minds until they lay themselves down for a final rest. They are worthy of our thanks.

Indeed, they are not unlike all of you. They choose to serve others. They hope that they will make a difference in the lives they touch. They press on with courage and honor and a sense of duty knowing that giving our best for the people around us is what makes us unique on this earth. They put hands and bodies into motion for the sake of persons who are weak or hurting, fearful or oppressed.

In that we are all the product of the intentions of those who come before us, and we are currently in a relative state of safety, free to speak our minds, provide well for our loved ones, and gather as good people, please take a moment today to remember the best intentions of our veterans. If you know one, give them a call. If you see one, say ‘thanks’. I’m headed to the VA today to do just that. Maybe I’ll see you there.

Thanks for your thoughts and service,

Paul Reynolds
SOM MS1

Saturday, November 6, 2010

Lifeline

My oldest and best friend has been watching his mother die slowly over the last few years. His Mom has been obese most of her life. Diabetes has stolen her energy, freedom, and eyesight. Each year she is carried to the hospital one more time than the year before. She really didn’t think she would make it to last Christmas. Now she is approaching another.

She has refused all meds but comfort care meds. No more insulin, heart pills, or drugs for hypertension. Just the fentanyl, an antiemetic, and something for acid reflux. She lies in bed and mostly sleeps. She has a bowel movement once a week, or they induce with a suppository. She doesn’t want my friend to clean the mess it makes because she says it affords her some dignity.

I talked to my friend last night. He said he was exhausted. He said he was more tired than he can ever remember being. He said he knew what it was going to be like when she died, but I wondered how anyone could know. He hoped for the best goodbye possible and some quality moments in her final days. I wondered how he would live in the vacuum that would exist after she is gone. He seemed to distract himself with the busy-ness and final details of death. I wondered when the moment would come for him to stop and come to grips with what was happening, ask himself how he fit into two lives that were such a part of one another.

He worried about her when she was in the assisted living apartment and spent most of his time there when she was ill with an infection or a complication of her condition. His sister died a few years back from an overdose. His brother is in town but has only dropped by once last week to see his Mom because they thought it was the end. His Mom and Dad have been divorced for over 20 years. His Dad is in town, but he doesn’t come by to see the grand-kids much.

She got out of the hospital a couple of weeks ago for a drug-resistant infection. The doctors thought she was going to die because she had stopped her meds, so they allowed her to move into a hospice facility. A day or so after she got there, her condition improved. The pain meds seem to lower her blood pressure, and she began to be more alert for more hours of the day. The doctors said she would have to move out of the hospice facility. In the state where they live, you only have five days to die.

If she doesn’t die fast enough, my friend will have to move her from hospice to his one-bedroom apartment. She will stay in the living room. He will have to get her hospital bed back out of storage and get it over to his place. He says at least he can sleep at night because he can check on her easily and not have to travel to her old place and spend the night in a chair.

The way we live affects the way we die. Our culture and society, the choices we make, and the hand we were first dealt all impact our dying. My friend hasn’t been a saint by any means, but he keeps trying to be the best person he can. He has been obese for many years and wants to get his weight down to something manageable. His wife is divorcing him after 20 years. It should be finalized this month. He’s in between jobs. He has three daughters. The oldest will be out of high school next year. I wonder how he will die, and who will be there to take care of him. I hope it’s me.

Before our parents die, we grieve knowing we will miss them. When they die, we have to experience it. We remember how we’ve lived our lives. We ponder what these people who’ve cared so much about us may have wanted for us - and maybe from us. We realize that in the same way we hope for our children, they hoped for us. Death certainly provides perspective.