Saturday, November 29, 2008

The Last Word

All would live long, but none would be old.
-Benjamin Franklin

I have known him for more than thirty years. Back then, he was a clever, accomplished 60-year-old. He was self-aware, well-versed, well-read, and well-travelled. He was rigorously honest, selfless in his actions, and generous with his time. He was engaged with friends and colleagues around the world. His self-deprecating humor was well known by his family and friends. At the time, he was about to finish a career which had combined his gifts as a beloved teacher, a respected leader, and a deeply spiritual intellect.

Just one thing annoyed me, though: It seemed that whenever a conversation had reached a stopping point and I had taken a couple of steps toward the door, he would invariably call out one more question. It happened all the time. With each question, I would turn back, finish the conversation again, and retreat out the door. Sometimes, this happened two or three times before he would let me go.

Over the years, I got used to this propensity of his. Sometimes, I found ways to distract him as I snuck out. (“Look! A huge bird! Right behind you!”) I am certain that, too many times, I rudely just mumbled an answer or pretended that I had missed the final question. I did not like being rude. Sometimes, though, it was the easiest way out.

Over the past year, however, Alzheimer’s disease has tightened its grip on him. He is pleasant and attentive. He can still play some card games with help. He answers questions appropriately when they allow an automatic response. His eyes still sparkle. He smiles when he gets a hug.

But - sadly - he no longer calls anyone back to ask just one more question.

Who would have thought that the loss of his spontaneity would be manifest by the loss of his ability to call someone back into conversation? Who would have thought that he would still be able to process and answer simple questions but no longer be able to create his own?

I think about what he has lost whenever we end one of our simple conversations and he sits quietly, watching me walk away.

Friday, November 21, 2008

Engage with Grace

Medical blog writers around the world will be including the message below for Thanksgiving this year. Please take a look and consider discussing these issues with your family. Happy Holidays!

We make choices throughout our lives - where we want to live, what types of activities will fill our days, with whom we spend our time. These choices are often a balance between our desires and our means, but at the end of the day, they are decisions made with intent. But when it comes to how we want to be treated at the end our lives, often we don't express our intent or tell our loved ones about it.

This has real consequences. 73% of Americans would prefer to die at home, but up to 50% die in hospital. More than 80% of Californians say their loved ones “know exactly” or have a “good idea” of what their wishes would be if they were in a persistent coma, but only 50% say they've talked to them about their preferences.

But our end of life experiences are about a lot more than statistics. They’re about all of us. So the first thing we need to do is start talking.

Engage With Grace: The One Slide Project was designed with one simple goal: to help get the conversation about end of life experience started. The idea is simple: Create a tool to help get people talking. One Slide, with just five questions on it. Five questions designed to help get us talking with each other, with our loved ones, about our preferences. And we’re asking people to share this One Slide – wherever and whenever they can…at a presentation, at dinner, at their book club. Just One Slide, just five questions.

Lets start a global discussion that, until now, most of us haven’t had.

Here is what we are asking you: Download The One Slide and share it at any opportunity – with colleagues, family, friends. Think of the slide as currency and donate just two minutes whenever you can. Commit to being able to answer these five questions about end of life experience for yourself, and for your loved ones. Then commit to helping others do the same. Get this conversation started.

Let's start a viral movement driven by the change we as individuals can effect...and the incredibly positive impact we could have collectively. Help ensure that all of us - and the people we care for - can end our lives in the same purposeful way we live them.

Just One Slide, just one goal. Think of the enormous difference we can make together.

This post was written by Alexandra Drane and the Engage With Grace team.

Wednesday, November 19, 2008

The Gastrocnemius Muscle and the Cat

All I do is eat and sleep. Eat and sleep. Eat and sleep. There must be more to a cat's life than that. But I hope not.

In early September, I walked into the bedroom just as the cat was leaving. I spotted a black item on the bedspread. This was upsetting to me. Our cat, who, by and large, is a well behaved, litter box-trained, somewhat autistic creature, has occasionally shown her displeasure with us by depositing evil things on the bed. It apparently had happened again.

I walked back to the family room looking for the perpetrator. There she was, looking innocent and resting (as always). "Bad kitty!" I announced. "Why do you do that?!" She regarded me coolly, refusing to make eye contact.

I bristled at her insubordination. I made a loud noise and moved toward her. She decided that I was a crazy person and took off toward the living room. I took a couple of quick steps after her in pursuit.

Suddenly, I felt a "pop" in the back of my right leg, as though something had hit me from behind. Then I felt the pain. Then I went to the floor.

I knew something was torn. I lay on the floor trying to self-diagnose the injury. One way or another, I knew I was going to be limping for a while. Kathi looked at me like the pitiable fool I can be and helped me into a chair. Ice, elevation, ibuprofen, rest. We knew the routine. This was not the first time I had done something stupid to my leg.

After I explained why I had been so upset with the cat, Kathi went to clean up the mess. She was back in a moment.



"The mess on the bed?"


"The thing on the bed was your pager. The cat didn't do anything."



I eventually forgave the cat but she, of course, did not care. I did notice that during my period of immobility, especially in September and early October, I had more time to write posts for this blog because, especially during those first six weeks, walking was uncomfortable and running was impossible. Now, ten weeks after the injury, I am just now using the treadmill in the bedroom.

Sometimes, when I am running, the cat comes to watch. I occasionally catch her looking smugly at the bedspread. I am certain that she is gloating.