Helen of Marlowe's Blog

The World Has Become Too Complicated for Me

Posted in "North Carolina" by helenofmarlowe on February 24, 2013

I do not like my new cell phone. I plan to either take it back to Target or put it under the wheel of the car before I back out.

I can remember when no one had to learn how to use a telephone. You’d pick up the receiver and dial a number, pulling the dial to the right and letting it go. You’re four when you see your big brother do that, and you instantly catch on. Later, when dials were replaced by buttons with numbers on them, the learning curve wasn’t too steep for me. I caught on to that right away.

Now, the whole world is changing faster than it took that rotary dial to fall back into place. And the smarter my phone gets, the more my brain cells deteriorate. There is a direct correlation between the birth of new electronic devices and the death of synapse connections in my central nervous system.

I liked the cell phone that I laundered last night. It had buttons that push.  I could press left and right and up and down and feel the tactile response. I could text with my thumbs almost a quarter as fast as my granddaughter, and I never type u for you.  This new one  has no tactile feedback. It wants me to slide my fingers across a screen.

I also liked the cell phone that I laundered before I laundered this one, but that was months ago and I am no longer mourning it. See, I can move on, when practicality requires it.

The second time I left a cell phone in my pocket and ran it through the laundry (no, not this time, this is the third) I bought a tiny sd card, put all my contact info on it, and thought I was ensuring that I would not have this aggravation again. I put the sd card safely away, and I even remembered where I put it. It turns out the sd card is not something that I can slide into the new cell phone and lo and behold, there are all my people. No, the contact info is on the sd card, but either my new phone does not know how to sort it back into usable data or I don’t.

So if you, gentle reader, are one of the people inadvertently washed away, you might send me a text with your name included, and I will start to rebuild my data.

If the world continues to change at this pace, I won’t even know how to get up on the right side of the bed by next winter. Because there will actually be a wrong side. Or maybe there already is.

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About Living Wills and Dying When the Time Comes

Posted in "North Carolina", Health by helenofmarlowe on February 22, 2013

What do the physicians know about all this that the rest of us don’t?

A couple weeks ago, I was listening to Radio Lab, about a study done at Johns Hopkins.

In a precursor study, 1337 medical students agreed to be examined physically and to answer questions about habits, about anxiety, exercise, diet – and about death.

These former students are now doctors. And they’re responding to questions again.

The doctors are asked to imagine they have brain disease that can’t be cured and to indicate their wishes.  Before the time comes that they can’t make decisions. If they are in a life-ending situation, do they want IVfluids? Feeding tube? Breathing machine? CPR, surgery, dialysis, antibiotics?

Radio Lab asked a random sampling of people on the street, and almost all people said yes to almost all interventions.

But get back to the doctors, and the answers are strikingly different. Most physicians prefer for themselves and their family an advanced directive stating that they want only pain medication. That’s it. Just pain medication.

And 60% of the physicians say they do not want even antibiotics. Not even antibiotics? That’s what they say.

Why is there such a gap between doctors and patients, as to how they want to be treated at the end of life? What is it that doctors know that the rest of us don’t?

When asked this question, the doctors respond that CPR, for example, is pretty terrible. It doesn’t work very well. But most people just don’t believe that.

On TV shows, people survive CPR.; 75% of the time, people in TV shows are revived and it works. But in the real world, the actual number is about 8%. Eight percent live a month after receiving CPR. And it’s worse than that. Often ribs are cracked and this leads to other complications. In a study of 95,000 cases, 3% had a good outcome. Meaning a return to a meaningful life after CPR. Three percent.

And breathing machines – doctors don’t want that for themselves or their families. I learned from this program that when you are put on a breathing machine, it breathes for you, but you fight it. So you’re paralyzed so you can’t fight it, but you’re not asleep, you’re just completely helpless. And aware. And many doctors say the treatment is worse than whatever you’re dying from, and the prolonged life is a miserable life.

Many doctors wear medallions that say No Code. Many have DNR tattoos. Doctors don’t want to die in a hospital. When the time comes, they want to die at home or wherever they are. Radio Lab reported that frequently, doctors who are tending to patients who are dying will say to their colleagues,  If you ever see me like this, kill me. And they are not kidding.

Pain medication? Yes. But nothing else.

A doctor interviewed in the program said, When you ask people, they say they want to die peacefully, quickly, without pain. And yet, when the time comes, we do everything to keep that from happening.

It’s reported that most doctors have a directive authorizing the withholding or withdrawing of artificially provided food, intravenous fluids, or other nourishment.

But unless there is a legal directive, doctors, the doctors themselves say, have to work to prevent a good death! Listen to http://www.radiolab.org/ It’s the one called The Bitter End. It’s more complicated than I’ve described, but I think I have it pretty close.

And all this leads me to another question. My husband and I have the advanced directive, I think it’s called a living will. But we don’t carry them around in our pockets. So if we’re in an accident hundreds of miles from home, what happens?

By the time the medics have learned that we don’t want CPR, we’ve already had it? By the time someone finds the living will, we’re already in a hospital fighting a breathing tube?

For whatever it may be worth, I hereby state that if I’m found in a situation in which medical intervention is required to keep me alive, I do not want that. Pain medication, yes. That’s all.

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We all do that? Really?

Posted in "North Carolina", Winston-Salem by helenofmarlowe on February 17, 2013

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Oh Jeez we’ve done it again.

See previous post here.

Last night it was Vincenzo’s.  The spinach ravioli there is wonderful, and the music is not too loud for conversation.  A very pleasant and comfortable place for dinner. We’ve just returned from about two weeks in Florida (eating in restaurants for two weeks, so naturally we came home and had to eat out again).  This time it was a neighborhood (sort of) Italian locally-owned restaurant.

So when we made our unhappy discovery, I went to Richard, the impeccably dressed owner, and said,  I hope you remember us.  He smiled and said yes, of course.   And that we’ve been coming here for 20 years … He nodded, yes …  And we live close by …  He didn’t know that I’m sure but he smiled and nodded …  and my husband left his wallet at home, and I never carry a purse, or almost never …

He laughed, said no problem, we all do that.  Richard is always gracious.

We offered to come back before they close at midnight, and he said that would be fine, or we could just call in a credit card when we get home.   That’s what we did.

We were too embarrassed to ask for our senior discount, so we just said add a 20% tip for the waitress.

Someone, I forget who, said  Old age ain’t for sissies.  If I were younger, I would remember who said that.

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Florida Freeways

Posted in Ecology by helenofmarlowe on February 11, 2013

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They stand, patient sentinels, dressed to pass muster

Never stepping out of line (unless forced by some disaster)

Miles and miles of unbroken lines unnaturally arranged in rows

Tall they stand, never leaning over to scratch an ankle or rest a foot

Surely bored by the unceasing sight of cars all day and all night,

All going in the same direction, year after year.

Proud they stand, but they’re never heard to say, We were here first.

In Florida storms, they lean into one another over I-95 and whisper

Perhaps repeating the tales of their ancestors, cut by the Spaniards to make bayonets.

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Tears in Palm Beach

Posted in Ecology by helenofmarlowe on February 9, 2013

In  West Palm Beach, the morning is warm.

Too warm, some say.

I walk around the lake and fall painfully in love with the Muscovy ducks.

Four Muscovies  rest  under a bottle brush tree.

In the shallows of the shore, a red-faced Muscovy swims with seven black chicks trimmed in yellow

and one yellow chick trimmed in black.

An egret stands apparently on the water.

But with my cynical nature I suspect there is a rock just under the surface.

Or a stump.  A stump would do.

The chicks scamper around their mother on the shore

while someone’s grandchild tosses pinches of white bread into the water.

There are tears.  There are tears.

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