S.T.

June 10, 2023 by EDWIN LEAP


All around us, every day in medicine
SNIPPET:

While some hospitals have more of the ‘exciting stuff,’ than others, much of what I and my amazing colleagues do is treat the injuries and illnesses of a rapidly aging population.

Although that may sound mundane it really isn’t. As humans live longer and medical science advances, managing the infections, heart disease, lung disease, stroke, fractures, head injuries and other assorted travails of the elderly becomes ever more complicated. Indeed, we’re getting better at it. We’re just not so good at adding quality of life to quantity, but that’s another discussion for another day.

We also do more than manage the medical issues. Every day, every night hospitals have to deal with the social crises associated with aging and infirmity. Whether it’s how to arrange home health after a broken arm, or where to place the confused and violent patient with dementia, there are few easy answers as skilled nursing beds fill up, neurologists and psychiatrists are few and far between and perhaps most poignant of all, men and women are aging all alone.

Whether this happens because they had no children, lost their children to disease or injury, or are estranged from their families, it comes to the same. Many seniors with disability or chronic illnesses have no advocates and little hope of flourishing in their later years. 😞


As I was contemplating this I had a minor epiphany. And since it’s almost Sunday, I’ll throw in some James 🕊️ (brother of Jesus).

“Religion that God our Father accepts as pure and faultless is this: to look after orphans and widows in their distress and to keep oneself from being polluted by the world.” James 1:27

That seems fairly 🕊️ straightforward.  It’s a statement free of politics. (Unlike so much that comes from my fellow 😒 believers in these dark days.)

But as I thought about my aging mother, my aging in-laws, the men and women I see in the ER, confused and frightened, lonely and without help or hope, I realized what I was missing.

Full article: 
https://edwinleap.substack.com/p/a-different-kind-of-orphan/

td

LYNN PARRAMORE / INSTITUTE FOR NEW ECONOMIC THINKING

JULY 19, 2023


In "The Measure of Our Age," elder justice expert M.T. Connolly offers both a warning and challenge about our eldercare systems.
SNIPPET:

We’re not ready for old age. Not as individuals, not as a society. That’s the sobering news from lawyer M.T. Connolly, former coordinator of the Elder Justice and Nursing Home Initiative at the U.S. Department of Justice. In her new book, The Measure of Our Age: Navigating Care, Safety, Money, and Meaning Later in Life, she outlines how our institutions, laws, and cultural practices have failed to keep up with our amazing advances in longevity over the last century. As a result, many, if not most of us, are spending our final years with far less security, health, purpose, and joy than we could be having. (Americans have been falling behind peer countries on mortality rates in recent years).

We aren’t prepared to care for people living longer, either. As many a midlife person can tell you, I’ve found my own journey through the land of caring for an elderly parent to be difficult in ways I never anticipated—often unnecessarily so. Gaps and ambiguities in the law made it hard to figure out who could decide and do what, despite my mother’s diligent planning. Well-known financial institutions my family had trusted for decades turned out to be predatory—with whole divisions set up to take advantage of an aging population. Help was hard to come by, as was knowledge of how to navigate confusing systems of insurance, home care, and the constantly-shifting needs of a person with diminishing capacity. All of it was crushingly expensive—and my mother was one of the lucky ones of her generation, reaching old age with a pension and educated children to help oversee her medical needs and combat the scammers that seemed to lurk around every corner, some wearing handyman overalls, others in suits and ties.

Connolly has written a book not just to warn us, but to prepare us and to offer insight into the changes and adaptations we must make in order not just to live longer, but to live longer better. She spoke to the Institute for New Economic Thinking about what prompted her to take on the challenge of aging and what she envisions for a final stage of life that is healthier and happier.

Lengthy article:

https://www.truthdig.com/articles/why-is-getting-old-so-hard-and-expensive-in-america/

July 27, 2023 by EDWIN LEAP



Bessie, some three score and ten years old, lay on the backboard motionless.  Her old, gray head was surrounded by great orange blocks of foam; her neck encased in a hard plastic collar.  Straps criss-crossed her body, as if she might make some miraculous attempt to escape.  As if we strapped her body down so it wouldn’t float away, though she was already floating, I suspect.  Oxygen passed into her lungs from the tube that protruded from her dry mouth.

She was found slumped in the floor of her nursing home. God bless those paramedics, whose skill revived her dying heart and who, with strong hands bound her top to bottom for her ride to the emergency room.  They snatched her from something; from death a while, from life a while.  But she arrived and she was ours.

Standard stuff.  No one knows quite what happened.  But we knew a few things.  She did not breath.  She did not wince from any pain.  She did not startle with any sound.  And she appeared as old as Methuselah.  Older than her years. ‘Older than her stated age,’ as we delicately say in medical charts.

I did have some information.  She was a long-time resident of a local assisted living center.  She was profoundly retarded and always had been.  She was blind.  And all she would do was suck her fingers and try to sing some hymns.  Maybe she mumbled ‘Amazing Grace’, or ‘On Christ The Solid Rock’, slurring words and verses, annoying some passersby, inspiring others.

It suddenly seemed so easy!  She had a cardiac arrest.  She was probably a ‘no code’.  She was going to die with no one around.  The nursing home would tell me, ‘she has no family.  Some old friends stop by sometimes, but no one checks on her.  Do what you think is best’.  All so easy.

Until they gave me that cussed (two syllables, please) phone number, and told me she was a ‘full code.’  No one had ever filled out the ‘blessed’ paperwork for this little old lady.  Fine.  I called her sister.  I expected more ease.  ‘No, I’m her only family.  I don’t want you to do anything.  I can’t come over.  Just call me when she passes’.

But to her credit, Bessie would not leave me alone.  Bessie had a message for me.  Bessie was speaking through her silence, through her loneliness, through her confusion and into my busy day.  Bessie was standing with one food in heaven’s gate, looking back and talking to me.  And laughing! What her sister actually said was, ‘I’ll come right over.  I’m calling her other sister, her brothers and her nieces.  We’ll be there as soon as we can.’

And they filed in, slowly, until they were all there.  All of her siblings were older.  All of them seemed weary, like this was just one more piece of sadness in a long sad story.  Any of them could have been lying on that backboard that day.  But they sat in assorted chairs and touched one another.  Their eyes swollen and red, tears on their sagging, age lined faces.  They sat there and looked at her.  They looked at her like she mattered.

I told them the score.  What I knew, by the time they arrived, was this: she appeared to be having a large MI, or heart attack.  But she also had experienced a large cerebral hemorrhage and her brain was already ‘herniating’; it was being pushed down through the base of her skull where her spinal cord and blood vessels traveled. This was a death sentence.  I wondered in physician fashion, ‘is it really an MI, or are the EKG changes from her brain bleed?  Or did she have an arrhythmia and then fall, hitting her head?’  And then I thought, ‘who really cares?’   Her family certainly couldn’t have cared less about the fascinating cause and effect of medical science, that thing that makes doctors call terrible events ‘interesting’.  I really didn’t care either.  It’s hard to care about things you can’t change.  I knew what had to be done.  I knew I would be her doctor, start to finish.

We took her off of the backboard.  I told her people everything. I told them she was going to die as soon as we stopped breathing for her.  They understood and waited for everyone to arrive.  They told me she was their baby sister. They said it like they remembered how precious she was, simplicity, drooling, singing and all.  They said it like she was worthwhile.  They all wanted to be with their old baby sister and hold her hand as she fell asleep the last time.

Finally, it was time to put an end to the futile.  With all her local kin at the bedside, I deflated that cuff and pulled out that tube and we put a little oxygen over her face and watched.  Tuned in to modern medical drama, her brothers and sisters and nieces and nephews watched the green blip of the monitor until I turned it off.  People have watched death far longer than there have been heart monitors.  None of us needed to see the plummeting oxygen saturations or the transformation of heart beats into flat lines.

Bessie never drew another breath.  Some three or four hours after she arrived, we let her walk on through the door to glory, where the hymns’ final verses are all written down.  She walked through smiling, blowing kisses at her family.  Baby sister, all grown up at last.  She walked from confused infirmity into forever perfection, waiting and hoping for them all to come to her in due time.

At least that’s what I believe.  I think it’s what they believed.  She left behind a place where some might have considered her pathetic, her life meaningless.  But in her years of hymns mumbled in the dark of her blindness, she focused the love of a family into rare clarity, and helped to teach us that what is worthless to some is a treasure to others.

She sang as she looked back, sang in a clear voice, eyes clear.  Maybe that last verse of ‘Amazing Grace’, ‘When we’ve been there ten thousand years, bright shining as the sun…’.

And we covered her old house in plastic and went our separate ways.
https://open.substack.com/pub/edwinleap/p/bessies-life-had-meaning

AGelbert COMMENT:

"She walked through smiling, blowing kisses at her family. Baby sister, all grown up at last. She walked from confused infirmity into forever perfection, waiting and hoping for them all to come to her in due time.

At least that’s what I believe."

I too firmly believe it with every fiber of my being.

“Every event which might claim to be a miracle is, in the last resort, something presented to our senses, something seen, heard, touched, smelled, or tasted. And our senses are not infallible. If anything extraordinary seems to have happened, we can always say that we have been the victims of an illusion. If we hold a philosophy which excludes the supernatural, this is what we always shall say.

What we learn from experience depends on the kind of philosophy we bring to experience.” C.S. Lewis

October 17, 2023 by EDWIN LEAP
For those readers who follow me at the SC Baptist Courier, this is my October column. I thought it was worth sharing widely.


Suggestions for navigating a dangerous world

Over the years I have seen treated many individuals who had been involved in violence. Most had violence inflicted upon them. But it was not uncommon for me to meet the alleged perpetrators, who sat on the ER stretcher in handcuffs.

Unfortunately, in these contentious times violence is not rare. So it’s probably good for us all to think about ways to avoid being involved in dangerous interactions. This is especially true for young men, who seem to find themselves in these situations more than other groups.

When my sons were young I gave them one of the most important bits of wisdom I could think of when it came to dealing with possible violence. “Boys, learn to keep your mouths shut.”

That is, don’t provoke angry, potentially dangerous people (particularly other men) and don’t give them reasons to stay angry. It’s all too easy to face off with another man and say, ‘oh, yeah, and what are you gonna do about it?’ Or ‘do you have a problem? Let’s take this outside!’

Things like 💣 that might feel empowering in the moment but in the end, one never knows when 💥 a gun or knife will appear, or when the unarmed individual turns out to be a dangerous person who has no restraint. (Or when all of his friends decide to join in the assault.)

By the way, it doesn’t take a weapon to create life-altering injuries. It’s not like the movies where everyone squares off and has a fair fight. There are no fair fights in the end.

The other thing I would say to a young man now is that it’s always best, when misunderstandings and anger arise, to simply say ‘hey, I’m sorry, I didn’t mean anything,’ or ‘I apologize if I insulted you.’ 🕊️

Along the same lines, road rage incidents can lead to terrible injuries or death. It’s really wise to learn not to honk, make hand gestures, scream or try to speed past others or cut them off. We can never know which person is simply annoyed and which is fleeing from the police; who is using drugs and who is simply late for work. And the potential danger to uninvolved bystanders is a very real threat, as cars crash into other cars or pedestrians.

Another reality of violence, little discussed, is that alcohol is associated with half of all violence (including half of ☠️ murders) worldwide. People who are intoxicated are disinhibited and more prone to violence.

There’s a lot written on this topic, but I’ll close with this. When trouble is brewing, at a party or even on a city street, the best possible path is to find a safe exit and leave the area. Call the police along the way. But staying to watch, and film, the ‘festivities’ is dangerous. Bullets don’t care who is in their path. This is even more true when a man is responsible for the safety of his wife, girlfriend, a date or a child.

I’ve seen people die of violent injuries and it’s always a horrible thing, between the wounds, the blood and the weeping of family members. The less of it we all experience, the better.

PS: For further reading, The Gift of Fear, by Gavin De Becker, is an interesting book on learning to identify dangerous people and behaviors.
https://edwinleap.substack.com/p/avoiding-violence

AGelbert COMMENT: Well said. I believe that almost ALL later regreted negative verbalizations by humans, that trigger more violence instead of calming things down, are caused by Pride overcoming common sense and reason, within both the victim and the perpetrator of physically injurious violence.

C.S. Lewis 🕊️ wrote, and I agree, that

"... it is Pride which has been the chief cause of misery in every nation and every family since the world began. Other vices may sometimes bring people together: you may find good fellowship and jokes and friendliness among drunken people or unchaste people. But Pride always means enmity—it is enmity. And not only enmity between man and man, but enmity to God."

-- Quote from Mere Christianity by C. S. Lewis.

COUNTERPUNCH

MARCH 8, 2024 BY RALPH NADER


Image by Nikolas Gannon.

SNIPPETS:

The extreme right-wing Netanyahu regime has enforced its declared siege of, in its genocidal words, “no food, no water, no electricity, no fuel, no medicine.”

The relentless bombing has destroyed apartment buildings, marketplaces, refugee camps, hospitals, clinics, ambulances, bakeries, schools, mosques, churches, roads, electricity networks, critical water mains – just about everything.

The U.S.-equipped Israeli war machine has even uprooted agricultural fields, including thousands of olive trees on one farm, bulldozed many cemeteries and bombed civilians fleeing on Israeli orders, while obstructing the few trucks carrying humanitarian aid from Egypt.

With virtually no healthcare left, no medications, and infectious diseases spreading especially among infants, children, the infirm and the elderly, can anybody believe that the fatalities have just gone over 30,000? With five thousand babies born every month into the rubble, their mothers wounded and without food, healthcare, medicine and clean water for any of their children, severe skepticism about the Hamas Health Ministry’s official count is warranted. ... ...

In recent days, the situation has become more dire. In the March 2, 2024, Washington Post, reporter, Ishaan Tharoor writes: “The bulk of Gaza’s more than 2 million people face the prospect of famine — a state of affairs that constitutes the fastest decline in a population’s nutrition status ever recorded, according to aid workers. Children are starving 🥵 at the fastest rate  the world has ever known. 😱 ... ...

Just like the entire mass media, many governments, even the independent media and critics of the war would have us accept that between 98% and 99% of Gaza’s entire population has survived – albeit the sick, injured and more Palestinians about to die. This is lethally improbable!

From accounts of people on the ground, videos and photographs of deadly episode after episode, plus the resultant mortalities from blocking or smashing the crucial necessities of life, a more likely estimate, in my appraisal, is that at least 200,000 Palestinians must have perished by now and the toll is accelerating by the hour.

Full article: 🕯️😵
https://www.counterpunch.org/2024/03/08/stop-the-worsening-undercount-of-palestinian-casualties-in-gaza/

👉 Graphics and emojies by AGelbert. 👈


October 30, 2024 By 🕯️🗽 Alon Mizrahi


SNIPPETS:

You see, it becomes very simple once you deconstruct fake complexity, created and constantly fueled by media outlets and political structures that benefit from the status quo, namely all the ills stated above.

In real life, nothing is ever exceptionally morally complex. Contrary to colonial thinking, morality is simple, intuitive, and clear. You do not molest and abuse children (or anyone). You do not harm innocent people. You do not use authority unethically. You do not sit comfortably in public transportation when someone who needs a seat more than you do can’t find a place to sit.

You never act, with people of any group, like they are less human than you or your group. If you do, you deserve to be shunned and punished by the rest of humanity. It is exceedingly simple.

So once you understand what’s going on, and what basic principles of humanity and morality have been breached, all you have to do as a political being, is to make your voice and judgment heard. And the greater the breach of humanity, the louder and more fierce your voice should be, as the outcry needs to match the severity of the crime. It is not complicated at all.

Israel is mass murdering the 🥵 Palestinian and 🥵 Lebanese people because it is a sick, demented, psychopathic society.

The US is helping Israel because it is willing to sacrifice Palestinian children for its deranged quest for 🦍 world domination and because it is occupied by Zionists. Period. It is all as simple as that.

There is no need to argue, no need to engage. We only need to make this truth heard everywhere, all the time, unequivocally, unapologetically, without any regard for acceptable norms and narratives.

Be a fanatic for children and humanity. Yes. If you can’t do that, go to hell. I have nothing to say to you, and there is nothing you have to say to me.

Read more:
https://alonmizrahi.substack.com/p/a-time-of-piercing-absolute-truths