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St. Gerardus Majella

I do not make a very good blogger as one of the rules is to actually write.

A few weeks ago, I stumbled across my medical record from an accident I had when I was four years old. The neurosurgeon who saved my life has passed away, and I knew him not well, other than as a patient as a young boy, and one more time, as a young man. I wish I could visit with him now. I remember sending for the records in Feb. of 2002, and receiving them in the mail on a busy day in which I glanced through them and tossed them in a safe place. A place so safe that I lost them for the next ten years.

When I read them this time, from front to back in the quiet of my office, I then realized what a gift these past 46 years have been.

I read all of the 25 pages, 46 years after this man, whose name begins with Christ, gave me life. Hence, the title for my June contribution to NWTC newsletter, What’s Cooking, was initially the same as my post, St. Gerard, but, I changed it to The Circle of Willis, thinking that there may be some objection from a secular college. It was difficult for me to write of it in less than 800 words. There is so much more to recollect, to feel, to share; nonetheless, here it is.

 

St. Gerard

My life began when I was four years old with the weight of St. Gerard filling my hand, pushing it to the linen sheet as hooded and masked people wheeled me into the operating theater with whispered assurances that all would be well, the familiar still forms of my mother and father disappearing behind the pneumatic hiss of double doors closing on one world and opening on another. That was my most poignant memory of my life that came after the day I lay on the street, four months earlier, my life leaking out of me. The neurosurgeon told my parents then that the prognosis was poor, that I had suffered a severe open brain injury from which a full recovery would be difficult to realize; but that he would do his best; that it was in God’s hands.

In the hours that followed my first operation, mother and father waited in the chapel, praying, and years later my father told me that it was only when he told God that it was okay if He took me home that he knew I would be okay. Shortly after that, Dr. Christoferson walked into the chapel with a tired, cautious smile and said that I would live, but that I may still have a significant neurological deficit. He told them that after he removed the depressed bone chips and debrided the devitalized brain tissue, when he ligated the bleeding vessel in the right side of my brain, he saw new vessels grow before his eyes, feeding the brain that had been cut off. He told them that it was a miracle.

I didn’t recognize St. Gerard when my father placed him in my hand in November of 1966. I only knew that the two-and-quarter-inch metal figurine was somehow connected to God, going to church on Sundays, and the prayer that started with “Our Father who art in heaven.” It felt heavy cool and warm all at the same time, and I kept it near, in a safe place for years after where it remained only as a memory until one day when I found it again, this time an adult, approaching the point of having barely more life in front of me than lay behind me when first I held it in my hand.

For decades, in the rare and occasional glimpses of the statue in the bottom of a safe box or in the back of a dresser drawer, I hadn’t picked it up and held it close to read the faint inscription inscribed on the base, assuming instead that it was St. Francis of Assisi because Make Me a Channel of your Peace was my father’s favorite gospel song, and because St. Francis was the only other saint I knew of outside of the Apostles. I remembered that the lettering started with a “G” and that there was an “M” and that it didn’t look anything like “St. Francis,” but I figured it must Latin, and after all, it looked like St. Francis, except that he wasn’t holding a lamb.

The years of the miniature Saint’s sequestration coincided with my years of immersion in science during which I learned about the chemistry and biology of life, and the Circle of Willis. Dr. Carlson, who was my neuro-anatomy professor in medical school sketched it out on the board in chalk, and I copied it down in red ink in my notes because red was for arteries, blue for veins, and green for nerves. He told us how, if the Circle of Willis was good, you could tie off a main artery to the brain on one side, and the arteries from the other side would fill the parts of the brain cut off from artery that was tied off because the two arteries going to the frontal lobes and the main one going to the posterior occipital lobes were connected by communicating branches that formed a generous circle in the deepest part of the brain.

So then I began to think that maybe it wasn’t a miracle. Maybe all these years of being told it was a miracle that I was alive was not true and the only reason was because I had a good Circle of Willis. Then, ten years later I sent for the medical record from The Neuropsychiatric Institute in Moorhead, MN, and ten years after that I actually read it from front to back; and, as a surgeon, having the benefit of a unique perspective on the biology of life, bearing witness on a daily basis to something that is so obviously more than the sum of its parts, I decided that it was a miracle.

St. Gerardus Majellus is what the inscription says. He is the patron saint of children, and he is with me now at work, a daily reminder of the man, whose name starts with Christ, who gave me my life in May of 1965.

The above isn’t what exactly what was submitted to NWTC. I did remove a few religious references.

Paranoia

This is my October contribution to the NWTC Newsletter, What’s Cooking. Since it is October, I saw no harm in a little morbidity.

We’re all gonna die! Someday. That’s an obvious given, a constant, the elemental fact of life with which we will be confronted. One day. That momentous day, in which the age-old question that has plagued mankind subsequent to the onset of sentience is answered—is there a God; is there a spiritual realm in which I will have an awareness of; will I find St. Augustine’s Eternity? The problem is; you won’t be able to tell anyone else the answer. No, that glorious answer belongs to you alone, and all the antecedent arrivals to the hereafter.

The Mayan “Long Count” calendar wraps up a 5,126 year era on 21 December, this year, in a few months, and is supposed by some to mark the end of the world as we know it. How the end comes is anyone’s guess; perhaps it’s a collision with a planet called Nibiru  en route from the star V838 Monoceros;

Monocerotis, from where Nibiru is coming (courtesy of NASA)

or, perhaps it’s a collision with one of a thousand (that we know of) Near Earth Objects (NEO) that are already in the neighborhood. Well, 5000 years doesn’t seem all that significant against the backdrop of a 4.5 billion year-old earth, and the chance of a planetary collision is less likely than me winning the Powerball, and what do a bunch of extinct old Mayan’s know anyway. Therefore, before sinking into the Paranoia of these end-of-the-world scenarios, perhaps we should focus on the more common causes of our material end.

I knew a neurosurgeon where I trained who never drank out of an aluminum can because he thought he’d get Alzheimer’s despite the lack of medical evidence for a causal relationship—but, he is a neurosurgeon, which makes one go…hmmm. After all, Alzheimer’s is the eighth most common cause of death in the U.S., which makes that frosty can of MGD on a blistering summer day behind a fishing pole on a stone beach radiating shimmering waves of heat look less appealing…okay, not really—but then, I’m not a neurosurgeon either. Alright, let’s consider causes  of death one, two and three; heart disease, cancer, and cerebrovascular disease (stroke), which accounted for 60% of all deaths in 2000. Let’s further consider some of the most common causes of cancer; breast, colorectal, endometrial, kidney, ovary, lymphoma, and pancreatic, the first three for which a link to obesity has been firmly established, and the remainder for which there at least seems to be an association.

The sixth most common cause of death is diabetes mellitus of which type II is also strongly associated with obesity. The fifth most common cause of death are unintentional accidents, an example being like going for an innocent bike ride on a beautiful day and suddenly finding yourself launched head-first into space with the overwhelming thought…is this my day? (Ahem…true story—last Memorial Day)

So, it is clear that there’s plenty to be paranoid about, if not fearful, unless you face the thought of death with the equanimity of a saint, unless you are a saint. Not being a saint, I admit to finding myself a few degrees to either side of fearful, depending on the day, my mood, and whether or not I’ve attended church lately. But, if you want to exert a force towards longevity and delay of that momentous day, it is clear where your efforts should be focused—not on avoiding beverages in aluminum cans, but on defeating obesity, given the well-documented link between it and heart disease, diabetes, cancer and stroke; and by only riding your bike on flat grassy fields.

Now all those things seem rather mundane and common (maybe because they are), and much less dramatic than a planet called Nibiru colliding with the earth; but at least they are things we have some control over. Still…I’ve noticed that my exposure to aluminum cans has fallen, and I did notice a particularly bright star in the sky the other night, and I do have a Mossberg 12 gauge leaning in the corner with four shells in the tube, and a pile of nonperishable food in the basement next to my beer-fermenting carboyl for December 21st when the world goes crazy because I’m no saint, and don’t plan on going gentle into that good night.

Mossberg 12 ga.

And you thought I was kidding.

 

Remembering Helen

“Remember Helen?”

“Yes. I remember Helen very well. I’ll never forget her.”

“Yeah,” he says with a softly rising inflection that seems to add finality. “I pray the rosary for her every day.” His eyes look through me to a different time when the carpeting is not beige and a little slip of a girl with curly red hair skips from the kitchen, licking a smudge of powdered sugar and milk from her upper lip. He does not know me anymore although I’ve been a part of his family over the past thirty years. The living room looks to me much as it had twenty years ago, with the same velour-print sofa, against the wall, across from a picture window that looks out on the afternoon sun and an electrical substation on the other side of the street.

“Remember my dad?”

“Yes, I do…George–wasn’t it?”

“Yeah,” he nods again, speaking more to himself than to me. “He’s not here anymore.”

“No. He’s in that better place, Clem, where we’ll all go someday.” I wanted to say in Heaven, but I’d already said that and it felt so cliché-ish. It’s what everyone says. It’s what you tell your child when their goldfish dies.

“Yeah.”

I saw him last four or five months ago when he still knew me. He had taken me out to the garage to show me how he had organized and labeled everything so that he might better find something he’d need and I helped him replace a broken latch on the screen door leading out of the sunroom. I remembered the previous summer when he’d taken apart an electric power washer and then forgotten how to put it together, and how he smiled two hours later after I’d somehow managed to reassemble it. That long weekend visit was punctuated by card games and reminiscing around the kitchen table. He remembered Helen then too, but with more clarity, such that he could understand why he was crying.

When I saw him two nights ago, just before one in the morning, after a 13 hour drive across three states, he was walking from the bathroom to the bedroom at the end of the hall. His steps were short and unsteady behind the walker as he was helped along by his wife. Shirtless, with disheveled hair of that iron-grey that is more black than white, and a face more unlined and clear than one would expect after eighty years, he looked at me with eyes so empty of recognition that I was startled, and wished I were somewhere else.

This morning, when I came up from the basement where I’d slept in Jimmy’s old bedroom, I found him sitting at the kitchen table with a pile of coins that he was trying to count, moving them into a plastic bowl one by one. He looked up and I said good morning to him and he replied in kind. I greeted him by name and reminded him who I was, “Shaun—Suzy’s husband,” and he nodded, repeating it after me, just like he had the previous morning; each day as though it were the first. After a few minutes of counting, and my one-sided conversation about Jimmy’s little boy, he looked up at me, blinking back tears, and asked, “Remember Helen?”

It’s ninety degrees outside, but with the air conditioning the sun through the picture window feels good on my arms. He’s sitting in the electric recliner to the side of the picture window, angled so he can see out the window, and I’m sitting on the other side of the window in a high backed chair that was more comfortable than it looked, my feet up on a matching ottoman.

He leans forward and looks into the sky. “It’s going to rain,” he says. I twist around to see a couple of tall wispy clouds above the distant horizon in a clear blue sky otherwise so devoid of clouds that the two that are there seem anomalous. That evening there’s thunder, lightning, and the following morning three quarters of an inch in the rain gauge.

The skin on his forearms is loose and I remembered the time I was on the roof helping him wrap some decorative tin around the chimney flue. He’d cut the tin with the snips, then took the two sharp edges in his bare hands and tore the rest of the strip in two. I remembered how he could take a tiny screw in thick fingers and make it go in a small hole in a deep dark place that I didn’t understand.

He sinks back into the chair, then looks over at me and asks, “Remember Helen?”

“I do, Clem. I’ll always remember her.”

“I pray the rosary for her every day,” he says.

“I know you do. We all pray for Helen, Clem.”

“Yeah.” He wipes the tears from his eyes, the memories more distant week by week such that he understands less and less why he feels such grief, only knowing that he does.

_______________________________________________________________________________

Dementia is a terrible and all too common illness that affects 5-8% of people over the age of 65, and that number doubles every five years. There are many causes of dementia although the most common seems to be Alzheimer’s. Most forms of dementia are degenerative (irreversible) and manifest themselves by decreasing cognitive function over time.

Some causes of dementia are reversible (metabolic, some medications, normal pressure hydrocephalus, brain tumor, vitamin deficiency, chronic alcohol abuse); so, it is important to see your physician to rule out these causes that can be addressed; and also for consideration of treatment with medications that can slow down the progression of the disease.

Many famous people have suffered from dementia, perhaps most famously, Ronald Maximus.

Dementia is, I think, more difficult on the loved ones of those so affected as the patient themselves are largely unaware of their deterioration, other than in the initial stages.

For those diagnosed with dementia, know that there is help and treatment, so take hope, and treasure the time with family and loved ones, as we all should be doing anyway.

For those family members and loved ones of the affected individual, know that there is help and treatment available (and actually partake of it for respite), so take hope, and treasure your loved one all the days of their life, as we all should be doing anyway.

 

If I die before I wake, I pray the Lord my soul to take.

I wrote this post on 1/14/2010 for my old site, following a trip home for my sister-in-law’s funeral. I’m going to transfer the domain ‘melarvie.com’ to the Relativity wife for her own site (under developement).

I’m not sure if it was the bison beef sticks or the fact that it was the tail end of a crazy five days culminating in a twelve hour drive across the midwest stopping only to pee and buy more diet coke (and not the caffeine free kind, because that kind of defeats the purpose). Perhaps it was the stress of a funeral, too little sleep, and boat loads of unhealthy food: whatever the cause, it came to pass that when my head hit the pillow at 11 pm Tuesday night, my chest grew strangely light. My heart felt like a butterfly trapped in a cage, and it wanted out; its soft wings battering the inside of my ribs, bouncing off my sternum, and flying crazy loopy-loops from one side to the other.

I recognized atrial fibrillation for what it was, irregularly irregular, and indeed it was. I laid on my right side, hooked up to my CPAP machine like a corpse on life support, counted my pulse and did the math. Around 25 beats in 15 seconds added up to about a hundred beats a minute—hmmm—could be worse. I held my breath strained, coughed, and rubbed my neck (carotid body). Nothing changed, still had the butterfly. I was freezing. I thought that maybe if I exercised I’d snap out of it, but I was bone tired, so I took a hot shower, except it wasn’t as hot as I would have liked because of some stupid safety feature I tried to undo a few months ago, but couldn’t. After a long very warm (but not hot) shower, I was still freezing, so I climbed into some flannel pajamas that must’ve had an R value of about 40. Finally, I was warm, but I still had the butterfly.

I laid on my back and did some more math. I figured if I went to the ER, I’d be admitted and monitored because it was so damn late. Morning-time would come and I’d convert medically, or electrically, and no matter what, I’d miss the talk I was supposed to give Wed. morning at 9:45 am. Well, I really didn’t want to do that, and, well, I’ve been in A-fib before, and lots of people live with A-fib (like Bill Bradley); but, true, many of them were on coumadin, which I of course was not; but, then lots of times patients come off of their coumadin for a few days before a surgical procedure; so, it’s not like I absolutely had to go in.

Besides, did I say I was bone-tired? And if I was bone-tired, Sue was even more bone-tired (boner-tired?). She didn’t even stir with all my grunting, coughing, neck rubbing, and rolling around in general, feeling sorry for myself. I wasn’t sure if having my heart history was comforting or not. It’s not like I had a heart monitor at home. I mean, it felt like atrial fibrillation; but what if it was V-tach with some PVC’s messing up the regularity? What if it was only irregular and not irregularly irregular?

I laid on my back, done with all the math, not sure if the butterfly would let me sleep. It was 12:04 am. My CPAP was strangely comforting, and unlike years before, when I wondered how I could ever sleep with it, I now wonder how I could ever sleep without it. As I lay there, the possibility of not waking up did occur to me, and for some reason, I did not find that thought particularly frightening. I imagined myself in a casket, wearing my dark navy suit with a white shirt and blue-striped tie; skin smooth and unblemished, hands folded, left third finger graced with the second of my three wedding rings. I suppose my thoughts were secondary to the visitation and funeral we had just attended over the four preceding days. It didn’t seem so bad—to be on the other side, I mean. So, I lay there, my butterfly fluttering quietly, and I prayed, If I die before I wake, I pray the Lord my soul to take.

When I next opened my eyes, the clock read 6:22 am, and my butterfly whispered from inside my chest, Good morning sunshine.

PTD #8

This morning was the first day I awoke without anything hurting, which I wasn’t expecting, as last night it seemed impossible to fall asleep because everything was. Whether related or not, it all began after eating the second Corsica bread stick while sitting, stretched out on the back seat of Sue’s car, on a “get-me-the-hell-out-of-the-house drive ‘up north’.” For those not familiar with Corsica bread sticks; which I recommend most highly, other than more than one at a time, especially on an empty stomach, they are pretty much saturated with olive oil, a mono-unsaturated fat notable for its cardiovascular benefit–as often is the case, too much of a good thing can, at times, be a bad thing.

A few minutes ago, my son and his girlfriend stopped by, following a trip “up north” with a gift of Corsica bread for dinner. They knew not of my over-indulgence yesterday, but, being fully recovered; I find myself looking forward very much to dinner, with a modest serving of the heart-healthy bread.

I’ve been a week on my back now, and have yet to write anything productive (blogging doesn’t count). I’m not sure where all the time goes. I sleep about twelve hours a day; still, the twelve remaining hours are considerable. I need to spend less time getting to the end of the Internet, but I’ve been so hooked on reading/listening/watching all that I could about Jason, now that he’s a celebrity: and of course there’s always the news–but, that’ll always be there, so Monday I think I’ll re-engage with my productive side.

The swelling is down significantly from this photo from PTD 5

Stigmata

Sue said that the foot looks like it should have a toe-tag on it, and I’d have to agree, and in fact, it very well may have given the mechanism of injury. During the dressing change last night, with the foot bare, open to air, our friend, Jan, who was helping (it’s easier with two people) said, “Jesus…it looks like a nail.”

I said, “it is; the only thing missing is the wood of a cross.” And as a point of further clarification, I added, “the only difference is that I’m no Jesus, and the only stigmata this is is the stigmata of stupidity.”

I can easily say this because if I’ve learned anything, I’ve learned that I’m a sinning, faulted, imperfect man, and humility comes quite easily to me. I’m also more convinced, than I’ve been in the past, of the existence of two worlds, those being the material and the immaterial or spiritual world.

The beauty of the material world: the milky-way of stars against a moonless night; the varying shades of azure surrounding the white sands of a tropical island, turning to the deep blue of the deep; the scent of roses in bloom on a trellis; the taste of honey; the sound of Pachabel’s Canon in D, all this beauty is accessible to any observer; but is rather meaningless to those observers who are not present in the immaterial world as well. And I don’t mean a “secular” immaterial world, because there is no such thing. I mean, truly, the spiritual/immaterial world–the other, eternal world, where He is.

By “present in” I mean to say having belief in the existence of God, and the moral values that implies, for that is what separates us from the other denizens of the earth. By “meaningless” I mean to say that what makes beauty remarkable is the awareness and appreciation of it, and if there is not that, what does it matter–kind of like–if a tree falls in a forrest, and no one is there to hear it, does it really make a sound. What lends meaning to beauty is the Wisdom to comprehend it, with the understanding that the Wisdom is in his image, and a part of the eternal, which is within us. 

Knowledge and intelligence are not synomonous with wisdom; they are the in the domain of animals as well as of man; whereas Wisdom is soley within the domain of man. So, when an atheist, such as Richard Dawkins, a most intelligent and knowledgable man all would agree, gazes upward, on a dark night, at a limitless haze of stars, it is meaningless, negated by his denial of the Wisdom within; he may as well be a chipmunk.

What’s that?

Oh, Dinnertime; gotta go.

Just the Facts, Please

The below is my monthly contribution the the NWTC Newsletter.

We live in a universe defined by mathematical law of such symmetry that to suppose it is merely accidental defies logic. For example, Kepler’s 3rd law of planetary motion tells us that the square of the time it takes for a planet to orbit its sun is directly proportional to the cube of the longest radius of its elliptical orbit. The value of pi is an infinite number that starts with 3.14… Planck’s constant is an infinitesimally small number commonly applied in quantum mechanics. Energy cannot be created or destroyed, and energy is equivalent to mass multiplied by the speed of light, squared. One pound of fat contains 3500 calories. The three macronutrients; carbohydrate, protein, and fat contain four, four, and nine calories per gram respectively.

Our corporeal existence is dependent on a tight range of values: a core temperature of 98.6 +/-5, a serum sodium concentration of 135+/-10, a blood pH of 7.4+/-0.3, and so on, and so on, ad infinitum. There are so many physiological “requirements” that I consider everyday begun with opened eyes a wonder. All of these numbers have a meaning, a reason for being what they are that rarely penetrate ones veil of consciousness, remaining forever just a number, a target, a value to be attained. Take, for instance, your blood pressure of around 128/76. Perhaps it’s higher. Perhaps it’s lower. Perhaps you take a medication, or two, or three, to bring it down to a certain number. But, what does that mean? All most people know is that the top number is supposed to be higher than the bottom; and the higher it is, the worse it is; and the lower it is, the better; unless, of course, it’s too low, then that would be bad.

The top number of your blood pressure is the systolic pressure, which is the maximal aortic pressure that results from the contraction of the left lower heart chamber (ventricle) as it sends oxygen-laden blood throughout the body.  Simultaneously with the contraction of the left ventricle is the contraction of the right ventricle, which sends oxygen-deprived blood, returned from the bodily tissues, into the lungs to allow the exchange of carbon dioxide for oxygen across the cellular membranes of the 300 million or so alveoli of each lung.

The bottom number of your blood pressure is the diastolic pressure, which is the lowest pressure in the aorta that occurs just before the ventricle contracts again a second or so later. The difference between the upper and lower number, in our example 52 (128-76), is called the pulse pressure, and the time that the pressure takes to fall from 128 to 76 comprises the time that the heart has to re-fill with blood to eject with the next heartbeat, and the one after that, and the one after that, and so on, and so on, for a lifetime…lub-dub, lub-dub, lub-dub.

A heart contracts, blood is ejected into the aorta at 128mm Hg, the arteries elastic walls expand, decreasing the resistance to flow, and the blood courses throughout the body as the pressure rapidly decreases to 76 mm Hg in the aorta. Out in the venous system, the pressure approaches zero as it is ultimately returned to the right side of the heart. Knowing this, it is easy to understand the significance of plaque build-up in the arteries, which results in constriction of flow, loss of elasticity, and increased resistance, which makes the heart work harder and decreases the flow of oxygen to the tissues that need it. And knowing this, it is easy to understand the significance of obesity, which predisposes one to the development of the metabolic syndrome, diabetes, and the associated cardiovascular disease, leading of course to high numbers.

And that’s just your blood pressure!

So, I can tell you that this number means that; that number means this; and that all life came from the ancient seas, from a slimy green unicellular organism washed one day upon an ancient shore; but I can only tell you so much before I would be forced to say something along the lines of…”and then He said, ‘Let there be light’.”