The Christmas Poster

We have one more task to complete now that the holidays are behind us.

Several years ago, we began a post-holiday tradition. As we look at the greeting cards for the final time, we gather all of the photos together. The pictures are trimmed and glued to a poster board. We focus on the faces of friends and family. Amazingly, each year the photos we receive just barely fill up the poster board. The board is hung on its own nail on a door in the kitchen where it will stay until the next Christmas.

Represented on the board are relatives from all around the country. There are several current and dearly missed former neighbors. There are friends and aquaintences from school and work. There are several people we haven't seen in years and pictures of many kids that we have never met. To be honest, there are some people pictured that we might not even stop and see if our travels took us through their towns. On the other hand, there are many people with whom we would love to see again and get lost in a long all-night conversation.

A couple of times each week throughout the year, I scan the photos on the board. Sometimes, a relative or friend will come up in conversation and we will look at their photo. Sometimes, I just like to remind myself of how fortunate I am to have known some terrific folks.

Each photo evokes a distinct memory or sentiment. I am so grateful for these people and enjoy having their images close at hand year round.

Llamas

For many years, I cared for a gentle and generous man who lived most of the year in Peru. He served as a teacher in a school for indigenous people. On most of his visits back to the States, he would bring small souvenirs.

On one occasion, he presented me with a small bronze statue of a llama carrying hoppers full of copper. The little creature has lived in my office ever since, proudly standing among several other mementos from patients. I smile and remember my patient and his stories whenever I see the llama.

Recently, I was honored to be given a "Golden Llama Award" by Dr. Rob at Musings of a Distractable Mind. Golden Llamas are awarded because...well, um...just because. I was surprised and delighted to be recognized.

So, now I have two llamas, one bronze (pictured here) and one gold (on the sidebar). Both are fun and both are very much appreciated. Thanks to my patient and thanks to Dr. Rob.

Faked Memoirs

Disappointing.

At the bottom of the sidebar to this blog is a list of books that I have enjoyed. One of them is "Left to Tell," an amazing story of survival and forgiveness in Rwanda during and after the 1994 genocide. I was moved by the story as I prepared to visit Tanzania in March.

A wonderful blogger and MCW graduate, Mary Rose Buckler, MD, brings some insight into the story...turns out much of the book is fabricated. Her post delicately hints at the details.

How sad! Just like the recent pulling of the faked memoir "Angel at the Fence," I would like to think that "Left to Tell" was written to make a point and to bring hope, rather than to cash in on an opportunity. It is hard to believe that there wasn't a story that would have moved people without fabricating any of the details.

Other recent fraudulent memoirs are listed here.

None of us is perfect, our cultural standards of "truth" differ, and our memories are subject to erosion. Still, as a person who writes a bit, I feel nothing but sadness for these discredited writers whose hard work went to waste.

Call for Submissions: SurgeXperiences 214

I am honored to be the host of the next edition (214) of SurgeXperiences! This is a “Blog Carnival” of blog postings that are related, however tangentially, to surgery and the surgical experience. The post will go live on January 4, 2009.

Everyone is welcome to submit, whether you are a physician, nurse, technologist, videographer, quilter, llama lover, patient, or friend of any of the above.

I will host SurgeXperiences on Reflections in a Head Mirror.

I will try to be a clever host, but, given the holidays and the need to recover from all of the potential meals and celebration, we will just have to wait and see what happens. If you want to submit, click on this link to go to the submission page.

Submission deadline: Saturday, January 3, 2009

I will put this message on my main blog next week, but wanted to give my three readers a heads up.

Passwords and the Aging Process

I am clearly aging. When I started working at my present job in 1987, our department had no computers at all, and, therefore, no password-protected security. Back in those days, I had no problem learning and recalling strings of numbers (credit card numbers, ID numbers, etc.) and adjusted quickly when a number changed. I chortled when the professors balked.

Security in those days depended much less on technology. When I started, the three keys I carried (office, clinic, outside door) provided all of the security the department needed. There were no electronic strips in name badges, no passwords, and none of the ubiquitous cameras. A few doors had punch-button codes that everyone knew. The most secure areas on campus could be accessed by calling a friend and being "buzzed" through a door.

Security has changed; many systems now require passwords. For example, to get to the first screen of our new medical record system, I sometimes need to log in three separate times using two different log in/password combinations. Every important website I visit requires a different password. And, of course, just when I finally get them all in sync, a screen pops up that requires me to change one of them. I currently carry a list of over 70 log in/password combinations. Too often, I forget to write down a new password and get locked out after making too many attempts to access a site.

Fortunately for me, one bit of security has never changed. When I walk into the operating room dressing area to prepare for surgery, the lock on my OR locker is the same one that I used in high school gym class from 1968 to 1972. The lock still works fine. And, best of all, I can remember the combination.

I know I am getting older. I can no longer remember new log in/password combinations when they crop up. I write them down and hope I can find my list when I need it.

But, the day I can not get into my OR locker because I can't remember the combination will be different. That event will be mark the day when I realize it is time to call it quits.

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.

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!

-BHC

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.

To learn more please go to http://www.facebook.com/l.php?u=http://www.engagewithgrace.org.

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