A Guest Post

My wife, Barbara, wrote this. It is true, and all of it is her story for which I am thankful on Thanksgiving. Maybe we have more to thankful for than we realize.
 

Grieving the death of a stranger on Thanksgiving Eve

In 1966, I was a 20- year old senior nursing student at Massachusetts General Hospital in Boson. Already able to handle significant responsibilities, I had to work in the Intensive Care Unit on that Thanksgiving Day.  Right after the day shift ended at 3:30 p.m., a classmate and I drove to my sister’s home in Scituate MA. It meant a lot to me that the family was waiting until we got there to have dinner.

That Thanksgiving and all of the ones since have never been the same for me as those wonderful carefree ones preceding it had been.

The evening before, at the Charles Street Red Line MBTA station, I watched a tall man, in a beige raincoat, carrying a brief case, jump in front of the train.

I was waiting for the train, maybe sometime around 5:00 PM. It wasn’t quite dark yet; the weather was mild, cloudy and gloomy.

Some of the details have faded but I remember this stranger walking quickly past me, just inches away and maybe for a quick second making eye contact. I always smiled at people in those days so maybe I did then as well.  He was in such a hurry. Why didn’t I wonder why he was moving at such a fast pace on his way to the far end of the platform, away from the others waiting for the train?

Just a few minutes later, as the train was approaching, he jumped onto the track and the screeching of the brakes pierced the quiet of the twilight.  It happened so fast, I wasn’t sure it was real, but reality struck as workers quickly cordoned off the area and closed the station.

Who was this man? A husband? A father? A businessman? Was he facing spending Thanksgiving alone? Was he having financial or marital problems?  Or was it just a deep depression that holiday festivities seem to make worse for so many people? Could I have smiled harder and maybe distracted him?  If he could have gotten through the holiday weekend, might he have had a change of heart?  Over and over again I’ve asked these questions.  The idea of never knowing anything about this person, who died in an instant right before my eyes, has made it even harder.

Now here I am again, 44 years later, still feeling so sad about the death of a stranger on Thanksgiving eve.  Someone, somewhere loved that man and I just want them to know that I am so sorry for their loss.

This year, I just finally needed to share this story. I never met him or spoke to him but he will always be with me.

A Trip to the Grimsel Pass

Yesterday was a spectacular weather day. Barbara has had school vacation for the last two weeks, so we took off. Originally, we planned to go to Meiringen and go through the Aareschluct, however on the way there, we saw that the high passes were open again. Some days ago, the early fall snows had closed them. Since they had reopened, we decided to go up to the Grimsel Pass and check things out.

On the way, we paused in Lungern because the Wetterhorn was in fine shape for a picture, as was the nice lake.

We went over the Bruenig Pass and started up the Grimsel road at Innertkirchen. There was a fair amount of road construction in the tunnels on the way, but the drive was as spectacular as ever through the village of Guttanen, past the hotel at Hardeck, the Gelmerbahn valley station, and on above the tree line.

Soon, we were at the Grimsel Pass summit. From the parking lot, I was able to see the highest mountain that I ever climbed. The Sidelhorn is 9028 feet above sea level, and it looked a lot harder than it did twelve years ago. Glad not to do that again today.

Most of the shops, etc. at the pass have already closed, but the one hotel/restaurant that was open had a crowd, as it was noon. We decided to look at the Marmot zoo before lunch.

Then, it was time for nourishment for ourselves. Our server told us that after 24 October, the place shuts down until June.

The top picture is the Walliserteller, a plate of air dried meats and cheese served with typical Wallis style bread, pickles, and pearl onions. This was the small size, so the regular would be a multi-person meal. Barbara had a good looking mushroom soup and then had to help me with the dried meat dish. Foods and tastes are always enhanced by high altitude.

A short ride down from the pass, one comes to the Grimsel Hospiz and the actual Grimsel Dam. There has been an extensive renovation of the Hospiz Hotel, and the power company has added a very nice new visitor's center with a wide variety of exhibits.

In 2001, Barbara and I were hiking a wanderweg along the northern side of the lake formed by the dam when she fell and fractured her ankle, requiring a helicopter rescue by the REGA service. The pictures don't show the path from our vantage, but it parallels the lake shore where the mountain river exits the rocks.

While were at Hospiz, we toured the visitor's center, noted the rates at the hotel (very reasonable and open year-round), and watched a working helicopter moving equipment from a project on the dam. Not cheap at about 90 CHF per minute!

This trip can be done without a car using the great Swiss Postal Bus System too.

Then it was time to head for home. Wonderful weather, good lunch, and a chance to see what man and nature can do.

It's Football Time!

The NCAA season is upon us in college football. With ESPN, even in CH I can see about 300 games. Not always my choice but some great teams unknown to me. So far I have watched three games and am in the midst of a fourth.

Early observations:
Arm garters are still a big thing. All I could find out last year was that they were some kind of "fashion statement".  If that's the case, they probably aren't the stupidest thing that ever got that term. I can't help but wonder if there isn't another reason. If the blood return from the lower arms and hands is impeded by these rubber bands (I guess they are rubber), do the fingers swell enough so the hands are bigger to catch the ball or another player?
This season there seems to be a proliferation of intricate and ornate tattoos on many upper arms. Some of these guys look like a character in "The Girl with the Dragon Tattoo". Are these supposed to frighten the opposition?
Has anyone done a survey on how many players have first names that start with a "T"? There is a whole gaggle of them.

Somethings do not change. The quarterbacks still don't even scratch without a signal from a coach. The cocktail waitresses and waiters still carry around drinks to the players. I suppose that is to prevent fights and gossip at the water cooler.

Evidently, college football players don't spit. Maybe they drool a lot, but one cannot see that on TV.

The season has just begun, so there will a lot more to come. I am looking forward to it!

An Old Mistress of Mine

I first met her way back in 1974. We were both much younger and had a bit of a wild streak in us. Little did I know then that our lives would be intertwined for over twenty years. My wife and children knew about her from the very first but rarely interacted with her. This was good because I loved her dearly and would have been heartbroken if I had been made to give her up. A lot of my friends were jealous of our union. My business partner gazed at her and simply said, "She is a real sex machine". She and I both had a penchant for traveling, and we went many places together with great pleasure. It was a rare occasion when we were apart for more than a few hours. Her upkeep was not cheap, but the joy she gave me was well worth more than mere money. Sometimes, I felt as if I had waited my whole life for her to come to me. As she aged, she became like a fine wine; more precious than ever. She watched my children grow up, and even a second wife was tolerated. Her health remained good until the very end. When I had to give up up, she was still a daily delight in my life. I know that she has found another liaison, but I have not seen her in many years. I do keep her picture with me and often look at it with a certain longing in my heart. She has become more and more valuable as the years have passed.

A 911 Porsche Targa. In 1974, she cost 13,500.00 brand new, and in 1994, she fetched 9,800.00 on departure.

Dummie

Dummie was all that I ever heard him called. As a preschooler, I sometimes would see a large black man in our neighborhood. I say large because everyone was large to me, but I used my father as the standard. If someone was taller than my dad, he was large. Anyway, my mother told me that the man was called Dummie because he could not hear and therefore could not speak. That, in itself, was a new revelation to me.

I suspect that Dummie did yard work for some people, but I never saw him except when he was walking in the street by our house. He always had a big grin on his face and would give a wave. Shortly after I began school, Dummie seemed not to be around anymore. One can hope that maybe he went to The Tennessee School for the Deaf, but I doubt it. In this day and time, his life would have been very different.

Gigli Eats a Bit of Crow

Some of you know that I am not much of a Francophile. I don't know why. I have French ancestors, a French name, and I have had some great excursions to Province, Grenoble, Lyon, and Normandy. Regardless of this, I have never had an urge to see Paris. I have often disparaged the city as sidewalks covered with dog poopage, surly people, French snobs, etc.

It was a source of conflict for me when two of my grandchildren wanted to come to Paris on their spring break and requested that Barbara and I meet them for a week in The City of Light. Without a believable way to cop out, I agreed, and off we went. The TGV ride from Basel to Paris was like greased lightening. We had booked a hotel around the corner from what was to be our apartment for a week, so we could meet the USA contingent there the next morning. In past French visits, my severely deficient French had always served me well. It was true in all of Paris, that if one opened a conversation with a bit of their language, they were happy to speak with you in yours, if they could.

I found the service in the stores and restaurants at least comparable with that in any tourist mecca. That was never more evident in the many open markets that Paris has. On more than one occasion, a person waiting with us would also offer their assistance in translating. The same was true on the streets when looking at a map, etc.

I was surprised to hear and see German both written and occasionally spoken in Paris, once occupied by the Nazis. I frequented a small bakery close to the apartment and usually used a French word or gesture to communicate. On one day, I misspoke a few words of German. To my surprise, the young lady clerk spoke back to me in German! She spoke both German and English but was better at English.

We enjoyed the usual tourist spots such as the Eiffel Tower, The Lourve, and other attractions. These would be a shame to miss, but for the most part are best seen once in my opinion. Everyone should do these things, but many such as the tower are best enjoyed from a distance. The Champs Elysees was a favorite for people watching and widow shopping, but since the rents are over 100,000 dollars a month, the prices are a bit high for my tastes. The avenue does make Zurich's Bahnhofstrasse look a bit small time.

Would I go back to Paris? Sure I would if given the same circumstances. One must understand that I was with some of the people who are treasures of my life. If not, then I still might go back, but only after some other things on my list. Another trip to Normandy, another trip to Berlin, more of Austria and Bavaria, and last but not least, Ireland. If I went back to Paris, I likely wouldn't do so much of the tourist thing. I would spend more time in the side streets and by-ways.

Anyway, I hope crow will BBQ well, since I have the grill fired up.

NO NO (Norah)

I got the idea for this blog from a book that I have almost finished. "The Help" by Kathryn Stockett, could almost be a biography of my early years. Some of you know that I was born and grew up in the South (Tennessee). Hitler invaded Poland when I was 6 months old. The Civil War had been over for 75 years, but there were remnants of segregation all over the USA (not limited to the South). Because of that, black people were at the bottom of the job chain. A lot of black women found work as maids. Maids came in two categories, day and full time. Full time meant that they lived on site. Full time maids wore white uniforms, as a rule, at least out in public. A white uniform on a black woman with a white child in tow would get her into a lot of places that she would not ordinarily go.

Exactly when NO NO came to live with us is beyond my memory, but I expect it was while I was still a baby in arms. Our house was separated by about 10 yards from "the little house", a two room affair attached to our single garage. The small house was fitted with gas heat and electricity. It was NO NO's home. During the day, she took care of our house, and mostly she was my nanny. I was her full time charge, but my mother took care of a lot of the household duties. I never recall NO NO cooking or serving meals. She did wash and iron clothes, but I think she had me as her main duty. The rest was secondary.

Why NO NO? It was all I could get out of my mouth in early talking efforts, and it stuck. In effect, I renamed Norah. I know that she had at least a sister, but I recall no history of a marriage or children for NO NO. She had a family name, but I have forgotten this and likely never heard it more than once or twice. She was such a great part of my daily life that I always considered her as family. Unlike some in "The Help", my parents treated her as a valuable member of the household. I have no clue as to her salary, but she had a place to live, which I learned later was a nicer spot than a lot of her friend's. She had at least a Sunday off, and her schedule could be flexible. She worked only nights when my parents were gone. I learned a lot about many things from NO NO. Early on, she taught me about race. The "N" word was not used in our household. She was called by her name, and others were called "colored". I remember being in a car somewhere with my mother and NO NO, and for some reason race came up. NO NO explained me that God made all people but some were different colors. She always preferred to think of her self as a Negro. That was a lot for a 3 or so year old to soak up, but it was the first word that I learned to spell. I knew that her skin was black but she was still NO NO to me.

On occasion, we would travel down into Alabama or to Memphis to see grandparents. NO NO was always with us. I wish that I could know where she slept, bathed, or went to the bathroom at those places. My grandmothers both had maids but not full time. I can only imagine that NO NO stayed with these women. Once, in Memphis, NO NO took me to the municipal swimming pool not far from my grandmother's house. I strolled off and jumped into the deep end of the pool. NO NO began to scream for help, as I sunk. Not being happy with the response from onlookers, she jumped into the pool, white uniform and all, to fish me out. Now, a black woman in Memphis, Tennessee in the 1940s, jumping into a whites only public pool was out of the ordinary. Years later, she would pull up her skirt to show her knees. "See them white scars on my black skin? That is from pulling you out of that water". Regardless, I am here to tell the tale. My first nickname was also a thing from NO NO. While in Alabama at my other grandmother's house, I came out the back door one morning crunching on something. NO NO was already in the yard and thought I had a piece of toast in there. UNTIL, she saw two legs slip through my lips. She fished out a June bug, and for her, I always answered to "June Bug".

As I mentioned, NO NO had at least one sister. The first time that I remember her was in her house which was also some sort of black woman's beauty parlor. For a small child, the view of a black woman having her hair done with a curling iron heated to sizzling over a coal stove was impressive. NO NO's sister had a boy my age named Robert. Sometimes, Robert would come to see her, and we would explore the small world of our back yard and vacant lot. When it came time for Robert and I to go to school, our ways parted. That was the way it was then. I wonder what happened to Robert? In later years, NO NO went to live in retirement with her sister. Even when in college, it was a Christmas time visit yearly that we took NO NO her gift there. Usually, a 10$ bill. Often that would buy her a ton of coal for her winter. One of those years, my mom told me that this year we would not go. NO NO had died. How old? I do not know, but I remember her gray hair. My mother never had across word to or about NO NO.They were partners more than employer-employee.

Random memories: I can remember that it was a joke in our house that NO NO would rock me to sleep even after I was almost tall enough to drag the floor with my feet. I remember NO NO as a snuff user. Did you know that a finger in her mouth with it applied to a bee sting is curative? As in the book, there was a network of maids who cared for children together. I remember my sandpile sweetheart from down the street had a nanny named Jessie. NO NO taught me by listening to speak in "Dialy" (dialect). This stood me well when in the 5th grade, my teacher (whose father had been in the KKK) praised my recitation of an Uncle Remus story in class

There is no doubt in my mind that NO NO loved me, as if I was her own. Our skins were different, but I don't think for a minute that we thought about that. Times change. Sometimes for the best. I do think that I had something that others will never have. Right or wrong, it was good for me, and I think it was good for NO NO.

I loved "The Help". The author's web site is informative also.

Pathology Reports

For the few that will get prostatic cancer, a word on reports.

I think that reports need to be addressed, both biopsy and surgical pathology reports. As a medical student, I was fortunate to spend a 3 month lay-out quarter working in a hospital pathology department. Since it was in the nation's largest privately owned hospital with about 1200 beds, we had plenty to do back in the 60s. I was also lucky to work with four very nice pathologists who were interested in teaching. Other than a dozen autopsies (also very instructive), I spent all my days cutting surgicals. For whatever reason, surgical pathology was not stressed in our general pathology courses, so my mind was a fertile field to plow.

Each day, I was given specimens removed at surgery to describe grossly into a dictaphone, cut sections (I was taught where to cut on a given specimen), and then read with a double microscope the microscopic slides from those that I had cut two days before. The pathologist was on the other side of the double scope to teach me. It was one of the most rewarding periods in my medical education. With this lengthy preamble, I will now try to get to the point.

We saw a lot of prostate specimens, both whole and chips from trans-urethral resections (TUR). I would guess maybe 20-30 specimens per week. Most of these specimens were sent to us because men had prostatism (BPH) and not cancer. In those days, there was no PSA test, and a man with PC usually came to surgery because of a nodule on DRE. The TURs were the majority unless a man with a so-called "median bar" required open prostatectomy, which was treated with complete removal rather than a TUR.

When examined microscopically, often the chips or the sections of the whole prostate would reveal malignant cell structures. These were usually considered as incidental findings and reported to the surgeon. CT scans were unknown, bone scans were so primitive as to be nearly worthless, and the urologist had to watch for new evidence of recurrence. If bone metastasis showed up on x-rays, then an orchiectomy (testicle removal) was done. Biopsies may have been done back then, but I recall seeing none.

OK. Now to the REAL point of this message, When a pathologist looks at sections of prostate tissue with cancer evident, there is not a little sign there down in the tissue that says "Gleason 4+3, 4+4, or some such". This determination is an ESTIMATE, not an absolute, and it is based on cell appearance. Give the same slides to another pathologist and, you may get a different grading, up or down. The same goes with estimates of per cent of the prostate involved. Of course this is a good reason for multiple readings of slides. I suppose one could send slides to a hundred pathologists, and then take the majority opinion as gospel, but that is ridiculous. In our department, it was standard procedure for more than one doc to look at anything questionable. Disputes were judged by the head man. Gleason was yet to set out his system, so the grades were I-IV, with IV being what is now a Gleason 10.

If you are disturbed by your Gleason score or other micro findings remember the doc is looking at a tiny portion of your prostate on biopsy. In a whole specimen, as a rule, the look is not a lot greater (sometimes our guys would tell us to make more slides of other areas to see further cells). Those scores are not written in stone by any means.

The New American Football, Page Two

Some weeks ago, I wrote some observations about how American college football had changed in my perception over the years that I have seen it infrequently. Well, now the season is over. I had a lot of fun watching various teams from all over the USA play season and bowl games. The ESPN-360 was well worth it.

I like ESPN, but I wonder if they realize that their announcers and "color commentators" are often afflicted with the terminal "blathertosis". These guys are constantly yapping about something and not always about football either. I really do not care about which restaurant at which they ate last night. They often digress, and frequently sound like pitchmen for a given player or coach to the NFL. I wonder if they get a commission? Another thing; what is the deal with all these girls(mostly) running around on the sidelines with green bottles like cocktail waitresses? I understand the need for good hydration, but what happened to the table with cups of liquids on it? These players are big boys who ought to be able to get their own drinks. On another note,each broadcast team seems to have at least one female member who is on the sidelines. Now, I am all for equality in the workplace, but if I was a coach in a tight game, I would likely be unkind when one of these babes stuck a microphone in my face to ask an asinine question about how I felt.

I guess the modern locker room looks like a hospital now with x-ray machines, CT scanners, etc. Won't be long before there will an OR in it, so that arthroscopy can be done on shoulders and knees. Sometimes, the coaches look like they are going to stroke out also, so CT scans might be helpful for them.

Just a few last thoughts for this year....